Identifying sarcopenia in advanced non-small cell lung cancer patients using skeletal muscle CT radiomics and machine learning.

BACKGROUND: Sarcopenia has been confirmed as a poor prognostic indicator of lung cancer. However, the lack of abdominal computed tomography (CT) hindered the application to assess the status of sarcopenia. The purpose of this study was to assess the ability of chest CT radiomics combined with machine learning classifiers to identify sarcopenia in advanced non-small cell lung cancer (NSCLC) patients. METHODS: This study retrospectively analyzed CT images of 99 patients with NSCLC. Skeletal muscle radiomics were extracted from a single axial slice of the chest CT scan at the 12th thoracic vertebrae level. In total, 854 radiomic and clinical features were obtained from each patient. Feature selection was conducted with FeatureSelector module, optimal key features were fed into the lightGBM classifier for model construction, and Bayesian optimization was adopted to tune hyperparameters. The model's performance was evaluated by specificity, sensitivity, accuracy, precision, F1-score, Matthew's correlation coefficient (MCC), Cohen's kappa coefficient (Kappa), and AUC. RESULTS: A total of 40 patients were found to have sarcopenia. Five optimal features were selected. In the base lightGBM model, the specificity, sensitivity, accuracy, precision, F1-score, AUC, MCC, Kappa of validation set were 0.889, 0.750, 0.833, 0.818, 0.783, 0.819, 0.649, 0.648, respectively. After Bayesian hyperparameter tuning, the optimized lightGBM model achieved better prediction performance, and the corresponding values were 0.944, 0.833, 0.900, 0.909, 0.870, 0.889, 0.791, 0.789, respectively. CONCLUSIONS: Chest CT-based radiomics has the potential to identify sarcopenia in NSCLC patients with the lightGBM classifier, and the optimal lightGBM model via Bayesian hyperparameter tuning demonstrated better performance. KEY POINTS: SIGNIFICANT FINDINGS OF THE STUDY: Our study demonstrates that chest CT-based radiomics combined with lightGBM classifier has the ability to identify sarcopenia in NSCLC patients. WHAT THIS STUDY ADDS: Skeletal muscle radiomics would be a potential biomarker for sarcopenia identity in NSCLC patients.

An evidence-based update on the pharmacological activities and possible molecular targets of Lycium barbarum polysaccharides.

Lycium barbarum berries, also named wolfberry, Fructus lycii, and Goji berries, have been used in the People's Republic of China and other Asian countries for more than 2,000 years as a traditional medicinal herb and food supplement. L. barbarum polysaccharides (LBPs) are the primary active components of L. barbarum berries and have been reported to possess a wide array of pharmacological activities. Herein, we update our knowledge on the main pharmacological activities and possible molecular targets of LBPs. Several clinical studies in healthy subjects show that consumption of wolfberry juice improves general wellbeing and immune functions. LBPs are reported to have antioxidative and antiaging properties in different models. LBPs show antitumor activities against various types of cancer cells and inhibit tumor growth in nude mice through induction of apoptosis and cell cycle arrest. LBPs may potentiate the efficacy of lymphokine activated killer/interleukin-2 combination therapy in cancer patients. LBPs exhibit significant hypoglycemic effects and insulin-sensitizing activity by increasing glucose metabolism and insulin secretion and promoting pancreatic ß-cell proliferation. They protect retinal ganglion cells in experimental models of glaucoma. LBPs protect the liver from injuries due to exposure to toxic chemicals or other insults. They also show potent immunoenhancing activities in vitro and in vivo. Furthermore, LBPs protect against neuronal injury and loss induced by ß-amyloid peptide, glutamate excitotoxicity, ischemic/reperfusion, and other neurotoxic insults. LBPs ameliorate the symptoms of mice with Alzheimer's disease and enhance neurogenesis in the hippocampus and subventricular zone, improving learning and memory abilities. They reduce irradiation- or chemotherapy-induced organ toxicities. LBPs are beneficial to male reproduction by increasing the quality, quantity, and motility of sperm, improving sexual performance, and protecting the testis against toxic insults. Moreover, LBPs exhibit hypolipidemic, cardioprotective, antiviral, and antiinflammatory activities. There is increasing evidence from preclinical and clinical studies supporting the therapeutic and health-promoting effects of LBPs, but further mechanistic and clinical studies are warranted to establish the dose-response relationships and safety profiles of LBPs.

Plumbagin elicits differential proteomic responses mainly involving cell cycle, apoptosis, autophagy, and epithelial-to-mesenchymal transition pathways in human prostate cancer PC-3 and DU145 cells.

Plumbagin (PLB) has exhibited a potent anticancer effect in preclinical studies, but the molecular interactome remains elusive. This study aimed to compare the quantitative proteomic responses to PLB treatment in human prostate cancer PC-3 and DU145 cells using the approach of stable-isotope labeling by amino acids in cell culture (SILAC). The data were finally validated using Western blot assay. First, the bioinformatic analysis predicted that PLB could interact with 78 proteins that were involved in cell proliferation and apoptosis, immunity, and signal transduction. Our quantitative proteomic study using SILAC revealed that there were at least 1,225 and 267 proteins interacting with PLB and there were 341 and 107 signaling pathways and cellular functions potentially regulated by PLB in PC-3 and DU145 cells, respectively. These proteins and pathways played a critical role in the regulation of cell cycle, apoptosis, autophagy, epithelial to mesenchymal transition (EMT), and reactive oxygen species generation. The proteomic study showed substantial differences in response to PLB treatment between PC-3 and DU145 cells. PLB treatment significantly modulated the expression of critical proteins that regulate cell cycle, apoptosis, and EMT signaling pathways in PC-3 cells but not in DU145 cells. Consistently, our Western blotting analysis validated the bioinformatic and proteomic data and confirmed the modulating effects of PLB on important proteins that regulated cell cycle, apoptosis, autophagy, and EMT in PC-3 and DU145 cells. The data from the Western blot assay could not display significant differences between PC-3 and DU145 cells. These findings indicate that PLB elicits different proteomic responses in PC-3 and DU145 cells involving proteins and pathways that regulate cell cycle, apoptosis, autophagy, reactive oxygen species production, and antioxidation/oxidation homeostasis. This is the first systematic study with integrated computational, proteomic, and functional analyses revealing the networks of signaling pathways and differential proteomic responses to PLB treatment in prostate cancer cells. Quantitative proteomic analysis using SILAC represents an efficient and highly sensitive approach to identify the target networks of anticancer drugs like PLB, and the data may be used to discriminate the molecular and clinical subtypes, and to identify new therapeutic targets and biomarkers, for prostate cancer. Further studies are warranted to explore the potential of quantitative proteomic analysis in the identification of new targets and biomarkers for prostate cancer.

Inhibition of mitotic Aurora kinase A by alisertib induces apoptosis and autophagy of human gastric cancer AGS and NCI-N78 cells.

Gastric cancer is one of the most common cancers and responds poorly to current chemotherapy. Alisertib (ALS) is a second-generation, orally bioavailable, highly selective small-molecule inhibitor of the serine/threonine protein kinase Aurora kinase A (AURKA). ALS has been shown to have potent anticancer effects in preclinical and clinical studies, but its role in gastric cancer treatment is unclear. This study aimed to investigate the cancer cell-killing effect of ALS on gastric cancer cell lines AGS and NCI-N78, with a focus on cell proliferation, cell-cycle distribution, apoptosis, and autophagy and the mechanism of action. The results showed that ALS exhibited potent growth-inhibitory, proapoptotic, and proautophagic effects on AGS and NCI-N78 cells. ALS concentration-dependently inhibited cell proliferation and induced cell-cycle arrest at G2/M phase in both cell lines, with a downregulation of cyclin-dependent kinase 1 and cyclin B1 expression but upregulation of p21 Waf1/Cip1, p27 Kip1, and p53 expression. ALS induced mitochondria-mediated apoptosis and autophagy in both AGS and NCI-N78 cells. ALS induced the expression of proapoptotic proteins but inhibited the expression of antiapoptotic proteins, with a significant increase in the release of cytochrome c and the activation of caspase 9 and caspase 3 in both cell lines. ALS induced inhibition of phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) and p38 mitogen-activated protein kinase (MAPK) signaling pathways while activating the 5'-adenosine monophosphate-activated protein kinase (AMPK) signaling pathway as indicated by their altered phosphorylation, contributing to the proautophagic effects of ALS. SB202191 and wortmannin enhanced the autophagy-inducing effect of ALS in AGS and NCI-N78 cells. Notably, ALS treatment significantly decreased the ratio of phosphorylated AURKA over AURKA, which may contribute, at least in part, to the inducing effects of ALS on cell-cycle arrest and autophagy in AGS and NCI-N78 cells. Taken together, these results indicate that ALS exerts a potent inhibitory effect on cell proliferation but inducing effects on cell-cycle arrest, mitochondria-dependent apoptosis, and autophagy with the involvement of PI3K/Akt/mTOR, p38 MAPK, and AURKA-mediated signaling pathways in AGS and NCI-N78 cells.

Bing De Ling, a Chinese herbal formula, inhibits cancer cells growth via p53.

Bing De Ling is a Chinese herbal formula that has been used to treat cancer patients for more than a decade. However, the molecular mechanisms behind its anti-tumor efficacy are still elusive. Here, we show that Bing De Ling inhibits cell proliferation in ovarian cancer epithelial cell lines, OV2008 and C13. It induces G1/S arrest in a p53-dependent manner in that this effect is attenuated in OV2008 cells transfected with dominant-negative p53 plasmid. Moreover, we show that Bing De Ling up-regulates p53 transcriptional activities as well as its downstream target genes, such as p21Cip1, MDM2, and MDMX. In addition, Bing De Ling inhibits MDMX-p53 interaction which may result in stabilization and activation of p53. Collectively, our results suggest that the anti-tumor activity of Bing De Ling may be in part due to activation of p53.

Chinese herbal formula, Bing De Ling, enhances antitumor effects and ameliorates weight loss induced by 5-fluorouracil in the mouse CT26 tumor model.

The use of complementary and alternative medicines-including a variety of herbal therapies-by patients undergoing cancer chemotherapy has been well documented. Despite such widespread use, however, the benefits and potential mechanisms of such herbal medicines remain largely anecdotal. In this study we examined the effects of a Chinese herbal formula, Bing De Ling, when administered as an adjunct to chemotherapeutic agent 5-fluorouracil (5-FU) in the CT26 mouse colon cancer model. 5-FU and Bing De Ling were administered to both nave and CT26 mouse colon cancer-bearing BALB/c mice. Our results indicate that although the herbal formula alone did not result in antitumor effects under experimental conditions, it significantly enhanced 5-FU-induced tumor growth inhibition. Oral administration of Bing De Ling also increased survival rates of both tumor-bearing and tumor-free mice treated with 5-FU. Furthermore, oral administration of Bing De Ling reduced weight loss in tumor-free mice receiving 5-FU when compared to tumor-free mice that received 5-FU alone. Our data further show that 5-FU upregulates serum levels of IL-6, known to contribute to weight loss, in tumor-free mice, and that this increase in IL-6 is significantly less in mice that received Bing De Ling in addition to 5-FU. These data show Bing De Ling both enhances the antitumor responses of 5-FU and ameliorates side effects.