Mcleodnapier7055
To retrospectively assess data on immune checkpoint inhibitors(ICIs)in an actual clinical setting, examine the factors that contribute to response and survival using real-world data, and compare the effectiveness of the 3 types of ICIs for patients with non-small cell lung cancer(NSCLC).
A retrospective analysis of 127 patients with NSCLC treated with ICIs at our hospital was conducted.
Nivolumab(56 patients)showed a 3-year survival rate of 21.6% and a disease control rate of 57.1%. These results are consistent with the clinical trials of Nivolumab. Pembrolizumab(36 patients) showed a 2-year survival rate of 60.3%, a response rate of 50.0%, and a disease control rate of 63.9%. Atezolizumab(35 patients)displayed a particularly low response rate with a 1-year survival rate of 58.4%, response rate of 8.6%, and disease control rate of 25.7%. The treatment results for recurrence after surgery for lung cancer were comparable to those for unresectable lung cancer.
Anti-PD-1 antibody displayed better therapeutic results than anti-PD-L1 antibody. The efficacy of ICI administration for postoperative recurrent lung cancer was also shown in this study.
Anti-PD-1 antibody displayed better therapeutic results than anti-PD-L1 antibody. The efficacy of ICI administration for postoperative recurrent lung cancer was also shown in this study.The integration of standard oncology and palliative care has become common around the world. Since the proposal of this approach by ASCO in the late 1990s, and studies by Temel, et al on EBM using RCT in 2010, and by Kaasa, et al at the Lancet Oncology Commission in 2018, it seems that most of the world agrees. Today, there are increasing expectations that comprehensive cancer care should be carried out by a multidisciplinary team. However, this has been challenging due to significant ideological differences between cancer treatment based on natural science and palliative care, which is mainly based on social science. From this, the idea of"palliative oncology"developed, which is built on the premise that palliative care should exist as a science derived from symptomatic treatment. Therefore, clinical oncologists should provide palliative care to enable better integration in cancer care.Current adoptive T cell therapies conducted in an autologous setting are costly, time consuming, and depend on the quality of the patient's T cells. To address these issues, we developed a strategy in which T cells are regenerated from induced pluripotent stem cells (iPSCs) that were originally derived from T cells, and succeeded in regenerating cytotoxic T lymphocytes (CTLs) specific for the WT1 antigen, which exhibited therapeutic efficacy in a xenograft model of leukemia. We recently have extended our strategy to solid tumors. To make our method more generally applicable, we developed an allogeneic approach by transducing HLA-haplotype homozygous iPSCs with WT1-specific TCR α/β genes that had been tested clinically. The regenerated CTLs antigen-specifically suppressed tumor growth in a patient-derived xenograft model of renal cell carcinoma, demonstrating the feasibility of our strategy against solid tumors.NKT cells are innate lymphocytes that express an invariant T cell receptor. Since activated NKT cells exert strong anti-tumor responses, NKT cells have been intensively studied for the purpose of their application to cancer immunotherapeutic approaches. Although human peripheral blood contained a very low fraction of NKT cells, and decreased number of NKT cells was also demonstrated in cancer-bearing patients, peripheral blood NKT cells can be activated by ligand-pulsed antigen presenting cells, and can produce a large amount of interferon-γ upon activation. The clinical trials of adoptive transfer of autologous NKT cells were already performed in patients with non-small cell lung cancer, and with head and neck cancer at Chiba University to show its effectiveness and limitation. Meanwhile, RIKEN reported NKT cell regeneration using iPS cell technology in mice, and subsequently established a protocol for regenerating NKT cells from human peripheral blood NKT cells using iPS cell technology. It was confirmed that the iPS cell-derived NKT cells (iPS-NKT) have sufficient expansion c apacity and potent direct and indirect cytotoxic activity in the humanized mice models, which suggests their therapeutic competence. We are currently planning an investigator-initiated clinical trial of allogeneic iPS-NKT cell therapy for head and neck cancer.Seminal studies by Dr. Shinya Yamanaka revealed that reprogramming technology was able to convert differentiated somatic cells to self-renewing and pluripotent stem cells. Although reprogramming process does not require changes in the genome information, cellular reprogramming elicits dynamic changes of epigenetic regulation. Therefore, reprogramming technology is a powerful tool for the modifying epigenetic regulation. Previous studies have reported that epigenetic regulation plays a critical role on both the development and maintenance of cancer cells. Taking advantage of reprogramming technology, previous studies have actively modified the epigenome of cancer cells and revealed the importance of the coordinated interactions between genetic abnormalities and epigenetic regulation in cancer cells. In this review, we describe advances and challenges in the use of reprogramming technology for studying cancer biology.We have developed cell sheet-based regenerative medicine, in which cell sheets are fabricated with temperature-responsive culture surfaces. We succeeded in clinical translation and large animal model experiments of cell sheet-based regenerative medicine to treat various complications of cancer therapy including esophageal stricture after esophageal early cancer endoscopic submucosal dissection(ESD)and lung air leaks. We would like to continue development of cell sheet-based regenerative medicine to treat frail, sarcopenia, and cancer cachexia after surgery, chemotherapy, and radio therapy by supplying stem cells and paracrine effects.With the development and diversification of medical care, the importance of precision medicine, which selects a suitable treatment for the individual patient from a huge number of options, is increasing. It is often difficult to explain multifactorial diseases such as cancer and chronic inflammatory diseases by a single hypothesis. In such case, a data-driven approach is essential to construct individualized models based on comprehensive observation of the target disease. The data-driven approach utilizes artificial intelligence to extract, predict, and classify patterns of data, considering different types of variables and complex dependencies between variables. In this paper, we introduce the basic idea, typical methods, and application examples of artificial intelligence and its core technology, machine learning. Tacrolimus FKBP inhibitor We would like to discuss a new framework of medical research toward the next generation medicine, while reviewing how machine learning is used in precise prediction and data-driven redefinition of diseases.