Central nervous system progression in advanced non-small cell lung cancer patients with EGFR mutations in response to first-line treatment with two EGFR-TKIs, gefitinib and erlotinib: a comparative study.

BACKGROUND: Central nervous system (CNS) brain metastasis of advanced non-small cell lung cancer (NSCLC) patients confers a worse quality of life and prognosis. The efficacy comparison of two first-generation epidermal growth factor receptor (EGFR) inhibitors erlotinib or gefitinib as first-line treatment for CNS metastasis NSCLC patients with EGFR-sensitizing mutations is yet to be elucidated. METHODS: A retrospective analysis was done on cerebral metastasis rate after erlotinib or gefitinib as first-line treatment for advanced NSCLC patients with EGFR-sensitizing mutations. Time to neurological progression (nTTP) and median progression-free survival (mPFS) were calculated. RESULTS: The study involved 279 patients (erlotinib group: 108, gefitinib group: 171). After a median follow-up of 22 months, 27 patients (25%) in the erlotinib group and 60 patients (35.1%) in the gefitinib group showed CNS progression. The HR of CNS progression for erlotinib versus gefitinib was 0.695 [95% confidence interval (CI), 0.406-1.190], suggesting a risk reduction of 30.5% although not achieving statistical significance. The 6-, 12- and 18-month cumulative CNS progression rates were 0.9, 3.7 and 12% for erlotinib compared with corresponding rates of 5.8, 9.4 and 17% for gefitinib (P = 0.181). However, for those patients with preexisting brain metastases prior to EGFR-TKI treatment, erlotinib as first line treatment significantly extended the median nTTP in comparison to gefitinib (30 months vs 15.8 months, p = 0.024). CONCLUSIONS: Our data show that nTTP can be effectively extended in preexisting brain metastases patients with EGFR-sensitizing mutations initially treated with erlotinib compared with gefitinib. If confirmed, our results indicate that erlotinib may play an important role in controlling CNS progression from EGFR mutation-positive NSCLC.

The role of monoacylglycerol lipase (MAGL) in the cancer progress.

In recent years, metabolism is talked highly important in cancer research, especially the lipid metabolism. Researchers believe that the de novo fatty acid synthesis plays an important role in tumor development, while many studies illustrated that Endocannabinoids have anti-tumorigenic actions, including anti-proliferation, apoptosis induction, and anti-metastatic effects, MAGL as an important decomposing enzyme of both lipid metabolism and endocannabinoids system, additionally as a part of a gene expression signature contributes to different aspects of tumourigenesis.

[IFN-gamma promotes human monocytes to differentiate to untypical mature DC].

AIM: To explore the morphologic and phenotypic changes of monocytess in response to the stimulation of IFN-gamma, TNF-alpha and IFN-alpha. METHODS: Newly isolated monocytes from human PBMCs were treated with IFN-gamma, TNF-alpha or IFN-alpha. The phenotypic growth of monocytes with or without stimulation was observed by microscope. The surface expression of CD1a, CD14, CD80, CD83, CD86, and HLA-DR on the monocytes was assayed by flow cytometry. RESULTS: After IFN-gamma stimulation, monocytes displayed the shape of fusiform or polygon and were more likely to adhere and cluster to form the distinct structure as "cell islet". IFN-gamma; also induced or up-regulated the surface expression of CD80, CD83, CD86, and HLA-DR on the monocytes and down-regulated the CD14 expression. IFN-gamma even induced the CD1a expression and changed the monocytes phenotype from CD14(+)CD1a(-)CD83(-) to CD14(+)CD1a(+)CD83(+) after stimulated for 5 days. Cytokines TNF-alpha and IFN-alpha; have the different impacts on monocytes from IFN-gamma. CONCLUSION: IFN-gamma have the immunoregulatory function of making monocytes differentiate to untypical mature dendritic cells (DC).

Identification of a new HLA-A*0201-restricted cytotoxic T lymphocyte epitope from CML28.

Identification of cytotoxic T lymphocyte (CTL) epitopes from additional tumor antigens is essential for the development of specific immunotherapy of malignant tumors. CML28, a recently discovered cancer-testis (CT) antigen from chronic myelogenous leukemia, is considered to be a promising target of tumor-specific immunotherapy. Because HLA-A*0201 is one of the most common histocompatibility molecule in Chinese, we aim at identifying CML28 peptides presented by HLA-A*0201. A panel of CML28-derived antigenic peptides was predicted using a computer-based program. Four peptides with highest predicted score were synthesized and tested for their binding affinities to HLA-A*0201 molecule. Then these peptides were assessed for their immunogenicity to elicit specific immune responses mediated by CTLs both in vitro, from PBMCs sourced from four healthy HLA-A*0201(+) donors, and in vivo, in HLA-A*0201 transgenic mice. One of the tested peptides, CML28((173-181)), induced peptide-specific CTLs in vitro as well as in vivo, which could specifically secrete IFN-gamma and lyse major histocompatibility complex (MHC)-matched tumor cell lines endogenously expressing CML28 antigen and CML28((173-181) )pulsed Jurkat-A2/Kb cells, respectively. These results demonstrate that CML28((173-181) )is a naturally processed and presented CTL epitope with HLA-A*0201 motif and has a promising immunogenicity both in vitro and in vivo. As CML28 is expressed in a large variety of histological tumors besides chronic myelogenous leukemia, we propose that the newly identified epitope, CML28((173-181)), would be of potential use in peptide-based, cancer-specific immunotherapy against a broad spectrum of tumors.