【全球24h抗癌突破】--脑瘤又出新疗法--DNX-2401，延长生存期超过3年！

portant; word-wrap: break-word !important;1、镥177获批治疗胃肠胰腺肿瘤 患者就可以一劳永逸了吗？

portant; word-wrap: break-word !important;根据III期NETTER-1试验结果，2018年1月FDA批准Lutathera（放射性元素镥177）用于治疗生长抑素受体阳性胃肠胰腺肿瘤（GEP-NETs）患者。该试验比较了Lutathera与高剂量奥曲肽LAR治疗1或2个转移性中肠NETs的患者。

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portant; word-wrap: break-word !important;在NETTER-1中，使用30mg奥曲肽治疗的中肠NETs患者随机分配到Lutathera（n = 116）或高剂量奥曲肽（n = 113）组。患者每8周以7.4GBq剂量接受4剂Lutathera联合30 mg奥曲肽。对照组每4周接受60mg奥曲肽LAR。结果，与奥曲肽相比，Lutathera的进展或死亡风险降低了79％。Lutathera组没有达到中位无进展生存期（PFS），高剂量奥曲肽组为8.5个月。

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portant; word-wrap: break-word !important;在Luthathera批准后，医学博士Jonathan R. Strosberg指出，挑战依然存在，仍有进行的研究正在探索更新治疗方案和组合，肿瘤学专家必须意识到有新的治疗方法。

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portant; word-wrap: break-word !important;标准方案：每8周一次200mCi l Lu 177，8个多月进行4个疗程。该药通常与生长抑素类似物联合使用，长效奥曲肽或兰瑞肽，特别是类癌综合征患者。关于在每次治疗之前患者需要停用长效生长抑素类似物的时间有一些争议。过去常推荐延迟6周，但越来越多的证据表明患者不需要中断他们生长抑素类似物治疗，可以安排在下次治疗之前进行。

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portant; word-wrap: break-word !important;除了Lutathera的批准之外，向前迈出的一大步是Gallium-68 dotatate扫描，这是一项生长抑素受体影像学研究，比先前的生长抑素受体影像学研究（即OctreoScan）更为准确和敏感。许多机构已经从OctreoScan转为镓-68点扫描，因为它们可以显示出几毫米的肿瘤。

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portant; word-wrap: break-word !important;2、NSCLC下一个靶向药物靶点是MET 基因检测告诉你能否获益！

portant; word-wrap: break-word !important;虽然检查点封锁免疫治疗在非小细胞肺癌（NSCLC）治疗中已经取得了迅速进展，但研究人员对开发这种恶性肿瘤靶向治疗的兴趣仍然很高，越来越关注MET癌基因。

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portant; word-wrap: break-word !important;MET是一种跨膜受体酪氨酸激酶，其异常活性可影响重要的细胞信号传导途径。该途径可以通过MET蛋白质过表达、其配体过表达、肝细胞生长因子表达增加、MET突变、基因扩增、和选择性剪接或外显子14跳跃来激活。每一过程都已经作为治疗癌症患者的潜在方法。过多年来，这种过多的可能性导致了该领域的很多混淆，不知使用哪种生物标志物来用于MET靶向治疗。

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portant; word-wrap: break-word !important;使用MET蛋白过表达作为生物标记导致几项随机研究失败。例如，Onartuzumab（MetMAb）联合厄洛替尼（Tarceva）的III期METLung试验未能达到主要终点，即在先前治疗的局部晚期或转移性NSCLC患者中添加onartuzumab可改善总体生存（OS）。Onartuzumab是一种结合MET胞外结构域的单克隆抗体，然而厄洛替尼与onartuzumab联用方案的中位OS为6.8个月，而厄洛替尼和安慰剂为9.1个月。与MET免疫治疗相比，选择MET靶向治疗可能是更好的方法。

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portant; word-wrap: break-word !important;使用基因检测来判断是否可以将MET作为靶点。在PROFILE 001研究中，在MET扩增的晚期非小细胞肺癌患者中研究了克唑替尼。虽然克唑替尼适用于ALK或ROS1重排肺癌患者，但酪氨酸激酶抑制剂（TKI）最初是作为MET抑制剂开发的。其他新型MET抑制剂（capmatinib，tepotinib，glesatinib如卡马替尼、替泊替尼和格列他尼）还处于临床前研究阶段，值得注意的是，克唑替尼正在对MET扩增或外显子14跳跃突变的患者中进行探索，作为2个篮试验NCI-MATCH（NCT02465060）和National Lung MATRIX试验（NCT02664935）的一部分。具体详情可以登录全球肿瘤医生网咨询。

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portant; word-wrap: break-word !important;3、脑瘤又出新疗法--DNX-2401，延长生存期超过3年！

portant; word-wrap: break-word !important;研究显示：DNX-2401治疗使得20％的复发性恶性胶质瘤患者存活超过3年。

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portant; word-wrap: break-word !important;DNX-2401是一种溶瘤腺病毒，选择性杀伤肿瘤，增强感染性和复制能力。为了评估安全性和有效性并确定病毒剂量逐渐增加的生物学效应，研究者招募了37例复发性恶性胶质瘤患者。在剂量递增研究中，患者被纳入仅治疗组A（n = 25）或治疗-切除治疗组B（n = 12）。

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portant; word-wrap: break-word !important;A组接受立体定向活检以证实复发，随后通过活检针将指定剂量的DNX-2401瘤内注射入造影增强肿瘤中。在B组中，通过植入导管立体定向活组织检查和瘤内注射DNX-2401，2周后通过整体肿瘤切除的开颅术，然后在切除腔壁的几个位置施用第二次DNX-2401。

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portant; word-wrap: break-word !important;A组25例患者中有5例（20％）存活3年以上，其中3例患者完全缓解（CR，定义为增强肿瘤大小减少95％）和2例患者病情稳定。所有3例达到CR的患者均无进展期3年。B组中2例（17％）存活2年。在总体人群中，中位生存时间为13.0个月。

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portant; word-wrap: break-word !important;在这项剂量递增研究中，DNX-2401是一种新型的肿瘤选择性腺病毒，安全且能够强力复制病毒并杀死复发恶性胶质瘤细胞，DNX-2401治疗可延长无进展间期和长期存活。A组中近四分之三的患者（72％）有肿瘤缩小。无论剂量如何，中位总生存期为9.5个月。

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portant; word-wrap: break-word !important;DNX-2401可以诱导直接溶瘤作用，获得抗肿瘤免疫应答，由于DND-2401由于RGD基序使得感染性增强而高度有效，并且由于它能够增强抗原呈递，我们推测这些效应导致免疫细胞浸润和抗肿瘤活性。

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portant; word-wrap: break-word !important;4、益生菌预防皮肤癌这事你听说过吗？

portant; word-wrap: break-word !important;科学剥离皮肤微生物群以揭示其保护特性。在2月28日发表在科学进展上的一项研究中，加利福尼亚大学圣地亚哥分校医学院的研究人员报告了一些细菌在皮肤上潜在的新作用：预防癌症。

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portant; word-wrap: break-word !important;Richard Gallo博士说：我们发现了一种表皮葡萄球菌，常见于健康的人类皮肤上，发挥选择性抑制某些癌细胞生长的能力，这种独特的皮肤细菌产生的化学物质可杀死几种类型的癌细胞，但对正常细胞没有毒性。

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portant; word-wrap: break-word !important;研究发现表皮葡萄球菌菌株产生化合物6-N-羟基氨基嘌呤（6-HAP）。携带表皮葡萄球菌但皮肤上不产生6-HAP的小鼠暴露于致癌紫外线（UV）后会患皮肤癌，但携带能产生6-HAP的表皮葡萄球菌菌株的小鼠不会患癌。

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portant; word-wrap: break-word !important;6-HAP是一种能损害DNA合成的分子，可阻止肿瘤细胞扩散，具有抑制UV诱导的皮肤癌发展的潜力。在两周内每48小时接受一次6-HAP静脉注射的小鼠没有明显的毒性作用，但当移植黑色素瘤细胞时，其肿瘤大小比对照组抑制50％以上。

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portant; word-wrap: break-word !important;越来越多的证据表明，皮肤微生物组是人体健康的重要组成部分，事实上，我们以前曾报道说，我们皮肤上的一些细菌会产生抗菌肽，抵御诸如金黄色葡萄球菌等病原菌。表皮葡萄球菌似乎也增加了一层防止某些形式癌症形成的保护作用。

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portant; word-wrap: break-word !important;但是，需要进一步的研究来了解6-HAP是如何产生的，如果它可以用于预防癌症，或者6-HAP的损失会增加癌症风险，这可能作为黑色素瘤治疗的一个研究方向。

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portant; word-wrap: break-word !important;5、又一癌症治疗新机制问世 小鼠模型肺癌治疗大获成功！

portant; word-wrap: break-word !important;通过减弱特定RNA分子的活性，瑞典Sahlgrenska学院的研究人员已经无进展生存了40-50％的小鼠肺部肿瘤。其结果代表了这个广泛研究项目的冰山一角，其中633种新型生物标志物已被确定用于治疗14种癌症。

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portant; word-wrap: break-word !important;研究小组研究了肿瘤发育如何受长非编码RNA分子的影响。这些分子由先前分类为垃圾DNA的基因组部分产生，但已被证明具有细胞分裂的功能。共研究了16种不同的癌症类型，其中包括6,419个实体肿瘤和701个正常组织样本，这些样本被用作对照。该研究的目的是寻找长的非编码RNA分子，其在遗传物质被复制的细胞分裂阶段是活跃的。

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portant; word-wrap: break-word !important;研究人员利用内部开发的技术和现代RNA测序技术，确定了570种非编码RNA分子，这些分子根据癌症的类型表达也不同，还有用于预测和治疗14种类型的癌症633种新的独立生物标志物。预计这一结果对世界许多地区的癌症研究人员都很重要。

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portant; word-wrap: break-word !important;给携带人肺癌组织的小鼠模型注射阻断相关长非编码RNA分子功能的物质（锁核酸修饰的反义寡核苷酸，LNA-ASO）。每周两次注射反义寡核苷酸并在15天内，肿瘤的大小减少了近一半。这种长非编码RNA分子参与了癌细胞分裂。通过针对这些特定分子，可以减少了癌症的生长，同时还可以被用来预测疾病。我们需要进行更多的研究，以确定是否有潜力开展患者的临床试验，以RNA为基础的癌症治疗将有很好的未来。

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portant; word-wrap: break-word !important;6、研究报告|中度宫颈癌前病变可能不需要治疗！

portant; word-wrap: break-word !important;对于中度宫颈病变-宫颈表面的异常细胞（通常称为宫颈上皮内瘤变2级或CIN2），常规监测（主动监测）而非立即治疗被认可。研究结果应该有助于女性与医生做出更明智的选择。

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portant; word-wrap: break-word !important;CIN根据癌前病变严重程度分为1级、2级或3级，但CIN不是宫颈癌。它有可能进展为癌症，但也可能恢复正常（退化）或保持不变。目前CIN2的诊断是治疗的切入点。但一些研究表明，CIN2病变通常不需要治疗即可完全消退，应该积极监测，特别是年轻女性，因为治疗可能对未来怀孕有害。

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portant; word-wrap: break-word !important;这项研究分析了36项研究的结果，涉及3,160名确诊为CIN2的女性，这些女性接受了积极监测至少三个月。两年后，50%病变自发消退，32%持续存在，仅有18%进展至CIN3或更严重。在30岁以下的女性中，退化率更高（60%），23%维持，11%进展。

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portant; word-wrap: break-word !important;大多数CIN2病变，尤其是年龄小于30岁的女性，会自发退化，因此积极监测而不是立即干预是合理的，尤其是那些可能坚持监测的年轻女性。退化的机会是50-60%，即使患癌风险很小（这项研究中为0.5%）但仍有可能。监视只是延迟治疗，有些人还是不接受。还要考虑其他因素包括治疗效果，定期就诊的不便以及妊娠并发症的可能性。

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portant; word-wrap: break-word !important;CIN2的退化率令人放心，但必须以有意义的方式呈现CIN2的退化率，并提供有关监测和治疗效果的明确信息，这样女性可以做出充分知情的选择。

portant; word-wrap: break-word !important;参考资料：

portant; word-wrap: break-word !important;http://www.onclive.com/web-exclusives/strosberg-discusses-lutathera-approval-remaining-challenges-in-nets?p=1

portant; word-wrap: break-word !important;http://www.onclive.com/publications/oncology-live/2018/vol-19-no-5/interest-builds-in-targeting-met-mutations-in-nonsmall-cell-lung-cancer

portant; word-wrap: break-word !important;http://www.onclive.com/web-exclusives/dnx2401-demonstrates-dramatic-survival-benefit-in-glioma

portant; word-wrap: break-word !important;https://medicalxpress.com/news/2018-02-beneficial-skin-bacteria-cancer.html

portant; word-wrap: break-word !important;https://medicalxpress.com/news/2018-02-rna-based-therapy-lung-cancer-mouse.html

portant; word-wrap: break-word !important;https://www.drugs.com/news/moderate-precancerous-cervical-lesions-may-not-need-study-68840.html

portant; word-wrap: break-word !important;以上抗癌技术及新药，均可通过全球肿瘤医生网咨询及评估，详情登录医学部（）

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