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Exciting progress in targeted therapy innovation for unresectable stage III EGFR-mutated NSCLC: the phase III LAURA study 针对无法切除的 III 期表皮生长因子受体突变 NSCLC 的靶向疗法创新取得令人振奋的进展:III 期 LAURA 研究。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-10-10 DOI: 10.1002/cac2.12611
Ziyan Tong, Ning Zhu, Hong Shen, Ying Yuan
{"title":"Exciting progress in targeted therapy innovation for unresectable stage III EGFR-mutated NSCLC: the phase III LAURA study","authors":"Ziyan Tong, Ning Zhu, Hong Shen, Ying Yuan","doi":"10.1002/cac2.12611","DOIUrl":"10.1002/cac2.12611","url":null,"abstract":"<p>Based on the PACIFIC trial (NCT02125461), the standard treatment for unresectable stage III non-small cell lung cancer (NSCLC) is chemoradiotherapy (CRT) followed by durvalumab consolidation [<span>1</span>]. However, a subsequent post-hoc analysis revealed no advantage of durvalumab in terms of progression-free survival (PFS) for patients with epidermal growth factor receptor (<i>EGFR</i>) mutations (hazard ratio [HR] = 0.91) [<span>2</span>]. This indicates that “PACIFIC” treatment does not meet the clinical needs of unresectable stage III <i>EGFR</i>-mutated NSCLC patients, who have short PFS and are prone to new metastases.</p><p>The results of the LAURA study (NCT03521154) were recently published in <i>The New England Journal of Medicine</i> [<span>3</span>]. This was a double-blind, randomized, placebo-controlled phase III study that enrolled 216 patients from 145 centers who were diagnosed with unresectable stage III <i>EGFR</i>-mutated NSCLC without disease progression after CRT. They were randomized in a 2:1 ratio to consolidation therapy with osimertinib or placebo until disease progression or death. The primary endpoint was PFS, whereas the secondary endpoints included overall survival (OS), central nervous system PFS, objective response rate (ORR), and safety.</p><p>The LAURA study revealed that osimertinib significantly prolonged the median PFS compared with placebo (39.1 months vs. 5.6 months, HR = 0.16, <i>P</i> < 0.001), with substantial PFS benefits across all subgroups. Moreover, the osimertinib group demonstrated remarkable reductions in new metastases compared to placebo, particularly in the brain (8% vs. 29%) and lung (6% vs. 29%).</p><p>The safety of osimertinib has been closely scrutinized by clinicians and patients. Although there was a higher rate of adverse events (AEs) over grade 3 in the osimertinib group (35% vs. 12%), these events were largely predictable, and there were no new safety concerns. Furthermore, the rate of radiation pneumonitis, which is often the most concerning AE, did not differ significantly between the osimertinib and placebo groups (48% vs. 38%). Overall, the safety was within the expected manageable range.</p><p>For <i>EGFR</i>-mutated NSCLC, previous studies have demonstrated the favorable efficacy of EGFR-tyrosine kinase inhibitors (EGFR-TKIs) (Table 1) [<span>4-7</span>]. Osimertinib has been approved as a first-line treatment for stage IV NSCLC and an adjuvant treatment for resectable stage I-III NSCLC. However, for unresectable stage III NSCLC, it remains an unmet clinical need. Recently, an international multicenter real-world study involved 136 patients with unresectable stage III <i>EGFR</i>-mutated NSCLC who received CRT followed by treatment with osimertinib, durvalumab, or observation [<span>8</span>]. Results revealed that osimertinib outperformed durvalumab and observation in real-world median PFS (not reached [NR] vs. 12.7 months vs. 9.7 months), supporting the successful launc","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 12","pages":"1381-1384"},"PeriodicalIF":20.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Deciphering protective genomic factors of tumor development in pediatric Down syndrome via deep learning approach to whole genome and RNA sequencing 通过对全基因组和 RNA 测序的深度学习方法,破译小儿唐氏综合征肿瘤发生的保护性基因组因素。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-10-10 DOI: 10.1002/cac2.12612
Yichuan Liu, Hui-Qi Qu, Xiao Chang, Frank D Mentch, Haijun Qiu, Kenny Nguyen, Kayleigh Ostberg, Tiancheng Wang, Joseph Glessner, Hakon Hakonarson
{"title":"Deciphering protective genomic factors of tumor development in pediatric Down syndrome via deep learning approach to whole genome and RNA sequencing","authors":"Yichuan Liu, Hui-Qi Qu, Xiao Chang, Frank D Mentch, Haijun Qiu, Kenny Nguyen, Kayleigh Ostberg, Tiancheng Wang, Joseph Glessner, Hakon Hakonarson","doi":"10.1002/cac2.12612","DOIUrl":"10.1002/cac2.12612","url":null,"abstract":"<p>Childhood solid tumors represent a significant public health challenge worldwide, with approximately 15,000 new cases annually in the United States and an estimated 300,000 globally. Down syndrome (DS), a genetic disorder characterized by an extra full or partial copy of chromosome 21, results in distinctive developmental and physical features. Notably, individuals with DS exhibit a remarkable resilience against solid tumors compared to the general population, with an overall standardized incidence ratio (SIR) of 0.45, despite their increased susceptibility to hematologic malignancies [<span>1</span>]. This paradoxical observation has spurred extensive research aimed at uncovering the biological underpinnings of this natural resistance to solid cancers. Current theories suggest that the overexpression of specific genes on chromosome 21 may confer protective benefits (e.g. <i>RCAN1</i> contributes to antiangiogenic effects), and alterations in immune system function may enhance apoptosis and DNA repair pathways in individuals with trisomy 21 DS [<span>2</span>]. The well-established epigenetic effects of trisomy 21, which influence the entire genome, are another potential contributor to the reduced risk of solid tumors [<span>3</span>]. Nonetheless, these hypotheses face significant challenges, such as the potential oversimplification of complex genetic interactions and the lack of comprehensive genome-wide analyses. This study seeks to critically evaluate the correlations between genomic variants and cancer clinical phenotypes in patients with DS, and proposes directions for future research into the genetic and molecular mechanisms that confer cancer resistance in DS, potentially transforming our understanding and treatment of pediatric cancers.</p><p>We conducted an innovative unbiased data-driven analysis in 2,452 whole-genome sequencing (WGS) samples with both DS individuals (<i>n</i> = 635) and pediatric oncology cases (<i>n</i> = 280) within the Gabriella Miller Kids First program project (https://kidsfirstdrc.org/) housed at the Children's Hospital of Philadelphia (Supplementary Figure S1). Additionally, 284 RNA sequencing samples from human peripheral blood mononuclear cells (PBMCs), a subset of WGS samples, were also analyzed, offering unprecedented insights into the complex interplay of genetic and immunological factors influencing cancer resistance.</p><p>The importance of each variant was calculated using deep learning algorithms, and their corresponding weights to DS cancer were generated based on linear algebra models as described in the Supplementary Materials and Methods. There were 2,523 unique cancer protective variants identified based on deep learning algorithms combined with linear algebra models in exonic, intronic, non-coding RNA and 5’untranslated region (5’UTR) regions. The prevalence for cancer protective variants in the DS cancer group (89.2%) is significantly higher compared to non-DS cancer individuals (58.1%) (<i>P","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 11","pages":"1374-1378"},"PeriodicalIF":20.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12612","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142458708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Genomic imprinting biomarkers for cervical cancer risk stratification 用于宫颈癌风险分层的基因组印记生物标志物。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-10-10 DOI: 10.1002/cac2.12617
Xue Xiao, Wei Wang, Peng Bai, Ying Chen, Zhengwen Qin, Tong Cheng, Xing Li, John P. Pineda, Panying Shi, Xiaonan Wang, Jianhong Wang, Lian Xu, Xuemei Gao, Huixian Zheng, Lulu Yang, Wenyi Lin, Wenbin Huang, Rulong Shen, Changjun Yue, Huixiong Xu, Felipe Batalini, Yang Liu, Ning Zhou, Yaoyao Zhang, Hanmin Liu
{"title":"Genomic imprinting biomarkers for cervical cancer risk stratification","authors":"Xue Xiao, Wei Wang, Peng Bai, Ying Chen, Zhengwen Qin, Tong Cheng, Xing Li, John P. Pineda, Panying Shi, Xiaonan Wang, Jianhong Wang, Lian Xu, Xuemei Gao, Huixian Zheng, Lulu Yang, Wenyi Lin, Wenbin Huang, Rulong Shen, Changjun Yue, Huixiong Xu, Felipe Batalini, Yang Liu, Ning Zhou, Yaoyao Zhang, Hanmin Liu","doi":"10.1002/cac2.12617","DOIUrl":"10.1002/cac2.12617","url":null,"abstract":"<p>Cervical cancer remains a significant global public health issue due to its high incidence and mortality. Current clinical guidelines recommend screening for high-risk human papillomavirus (hrHPV)-DNA alongside a Thinprep cytologic test (TCT) before further medical evaluation [<span>1</span>]. The hrHPV-DNA test detects 14 high-risk HPV genotypes including the predominant hrHPV16/18, which can cause cervical abnormalities that may progress to cancer if untreated. TCT is paired with the hrHPV-DNA test to pathologically classify cervical specimens into categories based on increasing malignancy risks. Despite the high sensitivities, both tests have high false positive rates which lead to unnecessary colposcopy while HPV is cleared naturally in most women without progressing into lesions. To reduce overdiagnosis and overtreatment, several DNA methylation detections [<span>2, 3</span>] have been developed for triaging the malignancy risk of hrHPV-positive cervical lesions, but have yet to become clinically available. Here, we proposed an epigenetic biomarker panel based on imprinting alterations as a high-performance triage method to improve cervical cancer risk assessment accuracy in hrHPV-positive women.</p><p>Loss of imprinting (LOI), an early molecular event in carcinogenesis, is an epigenetic phenomenon when a normally silenced allele of the imprinted gene is activated and expressed [<span>4</span>]. Using the quantitative chromogenic imprinted gene in-situ hybridization (QCIGISH) to visualize and quantify imprinted genes’ transcription sites in the nuclei, early epigenetic changes through LOI have been shown as effective biomarkers for detecting multiple malignancies [<span>5</span>]. In the present study, we first screened imprinted gene candidates using resected cervical tissue samples and subsequently developed a cancer risk stratification method based on cytological specimens diagnosed by colposcopy and biopsy (Supplementary Figure S1). The diagnostic model was blindly validated in prospectively collected cytological samples by comparing the QCIGISH results with colposcopy biopsy pathology. Full study protocols are detailed in the Supplementary file.</p><p>To identify the most efficient biomarker panel for differentiating malignancy in cervical lesions, we evaluated four candidate imprinted genes based on prior research evidence and targeted literature review of female cancers: guanine nucleotide-binding protein, alpha-stimulating complex locus (<i>GNAS</i>) related to thyroid cancer, osteosarcoma, and skin cancer [<span>6</span>], small nuclear ribonucleoprotein polypeptide N (<i>SNRPN</i>) associated with seminoma, yolk sac tumor, and acute myeloid leukemia [<span>7</span>], histocompatibility minor 13 (<i>HM13</i>) linked to breast cancer [<span>8</span>], and small nuclear ribonucleoprotein 13 (<i>SNU13</i>) involved with lung cancer [<span>9</span>]. QCIGISH was applied to 79 formalin-fixed paraffin-embedded samples comprised of 30 b","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 12","pages":"1385-1390"},"PeriodicalIF":20.1,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11666962/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142399494","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Yap methylation-induced FGL1 expression suppresses anti-tumor immunity and promotes tumor progression in KRAS-driven lung adenocarcinoma Yap甲基化诱导的FGL1表达抑制了KRAS驱动的肺腺癌中的抗肿瘤免疫并促进了肿瘤进展。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-09-28 DOI: 10.1002/cac2.12609
Ji Jiang, Pengfei Ye, Ningning Sun, Weihua Zhu, Mei Yang, Manman Yu, Jingjing Yu, Hui Zhang, Zijie Gao, Ningjie Zhang, Shijie Guo, Yuru Ji, Siqi Li, Cuncun Zhang, Sainan Miao, Mengqi Chai, Wenmin Liu, Yue An, Jian Hong, Wei Wei, Shihao Zhang, Huan Qiu
{"title":"Yap methylation-induced FGL1 expression suppresses anti-tumor immunity and promotes tumor progression in KRAS-driven lung adenocarcinoma","authors":"Ji Jiang,&nbsp;Pengfei Ye,&nbsp;Ningning Sun,&nbsp;Weihua Zhu,&nbsp;Mei Yang,&nbsp;Manman Yu,&nbsp;Jingjing Yu,&nbsp;Hui Zhang,&nbsp;Zijie Gao,&nbsp;Ningjie Zhang,&nbsp;Shijie Guo,&nbsp;Yuru Ji,&nbsp;Siqi Li,&nbsp;Cuncun Zhang,&nbsp;Sainan Miao,&nbsp;Mengqi Chai,&nbsp;Wenmin Liu,&nbsp;Yue An,&nbsp;Jian Hong,&nbsp;Wei Wei,&nbsp;Shihao Zhang,&nbsp;Huan Qiu","doi":"10.1002/cac2.12609","DOIUrl":"10.1002/cac2.12609","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Despite significant strides in lung cancer immunotherapy, the response rates for Kirsten rat sarcoma viral oncogene homolog (<i>KRAS</i>)-driven lung adenocarcinoma (LUAD) patients remain limited. Fibrinogen-like protein 1 (FGL1) is a newly identified immune checkpoint target, and the study of related resistance mechanisms is crucial for improving the treatment outcomes of LUAD patients. This study aimed to elucidate the potential mechanism by which FGL1 regulates the tumor microenvironment in <i>KRAS</i>-mutated cancer.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>The expression levels of FGL1 and SET1 histone methyltransferase (SET1A) in lung cancer were assessed using public databases and clinical samples. Lentiviruses were constructed for transduction to overexpress or silence FGL1 in lung cancer cells and mouse models. The effects of FGL1 and Yes-associated protein (Yap) on the immunoreactivity of cytotoxic T cells in tumor tissues were evaluated using immunofluorescence staining and flow cytometry. Chromatin immunoprecipitation and dual luciferase reporter assays were used to study the SET1A-directed transcriptional program.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Upregulation of FGL1 expression in <i>KRAS</i>-mutated cancer was inversely correlated with the infiltration of CD8<sup>+</sup> T cells. Mechanistically, <i>KRAS</i> activated extracellular signal-regulated kinase 1/2 (ERK1/2), which subsequently phosphorylated SET1A and increased its stability and nuclear localization. SET1A-mediated methylation of Yap led to Yap sequestration in the nucleus, thereby promoting Yap-induced transcription of FGL1 and immune evasion in <i>KRAS</i>-driven LUAD. Notably, dual blockade of programmed cell death-1 (PD-1) and FGL1 further increased the therapeutic efficacy of anti-PD-1 immunotherapy in LUAD patients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>FGL1 could be used as a diagnostic biomarker of <i>KRAS</i>-mutated lung cancer, and targeting the Yap-FGL1 axis could increase the efficacy of anti-PD-1 immunotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 11","pages":"1350-1373"},"PeriodicalIF":20.1,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12609","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142342201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Single-cell transcriptomic atlas reveals immune and metabolism perturbation of depression in the pathogenesis of breast cancer 单细胞转录组图谱揭示了乳腺癌发病机制中免疫和代谢对抑郁症的干扰
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-09-19 DOI: 10.1002/cac2.12603
Lingling Wu, Junwei Liu, Yimeng Geng, Jianwen Fang, Xingle Gao, Jianbo Lai, Minya Yao, Shaojia Lu, Weiwei Yin, Peifen Fu, Wei Chen, Shaohua Hu
{"title":"Single-cell transcriptomic atlas reveals immune and metabolism perturbation of depression in the pathogenesis of breast cancer","authors":"Lingling Wu,&nbsp;Junwei Liu,&nbsp;Yimeng Geng,&nbsp;Jianwen Fang,&nbsp;Xingle Gao,&nbsp;Jianbo Lai,&nbsp;Minya Yao,&nbsp;Shaojia Lu,&nbsp;Weiwei Yin,&nbsp;Peifen Fu,&nbsp;Wei Chen,&nbsp;Shaohua Hu","doi":"10.1002/cac2.12603","DOIUrl":"10.1002/cac2.12603","url":null,"abstract":"&lt;p&gt;Epidemiological evidence indicates that major depressive disorder (MDD) may predispose the development and prognosis of breast cancer (BC) in females [&lt;span&gt;1&lt;/span&gt;]. However, the mechanisms linking these phenotypes are not fully understood. Chronic stress, a hallmark of depression, has been underscored to affect anti-tumor immunity, tumor metabolic reprogramming, hormone synthesis in BC [&lt;span&gt;2, 3&lt;/span&gt;], and increase tumor metastasis [&lt;span&gt;4&lt;/span&gt;], but there is a lack of detailed cellular-level characterization of how MDD history affects the tumorigenesis of BC. This study explored the single-cell atlas of multiple tissues from BC patients with and without a history of MDD for characterizing the potential molecular alternations in their tumorigenesis (Figure 1A).&lt;/p&gt;&lt;p&gt;Paired primary tumor tissues (&lt;i&gt;n&lt;/i&gt; = 10), adjacent normal tissues (&lt;i&gt;n&lt;/i&gt; = 7), and peripheral blood samples (&lt;i&gt;n&lt;/i&gt; = 10) were collected from a cohort of 10 BC patients, 5 of whom had a history of MDD (Supplementary Table S1). All BC patients had estrogen receptor (ER)-positive tumors and were further predicted as Luminal A (&lt;i&gt;n&lt;/i&gt; = 9) and B subtypes (&lt;i&gt;n&lt;/i&gt; = 1) (Supplementary Table S2). Further details on patient recruitment, sample handling, and single-cell data analysis are provided in Supplementary Methods. In total, we obtained 224,557 single cells and further annotated them into major cell subsets based on lineage markers and copy number variations [&lt;span&gt;5&lt;/span&gt;] (Figure 1B, Supplementary Figure S1A-B). Aneuploid cells in primary tumor tissues were obtained (Supplementary Table S3) to characterize their phenotypic differences in BC patients with MDD history (BC-MDD) or not (BC-Ctrl). The Uniform Manifold Approximation and Projection (UMAP) of unintegrated aneuploid cells revealed intrinsic differences across individual patients (Supplementary Figure S1C). Downstream functional profiling analysis identified distinct immune response pathways in BC-MDD and BC-Ctrl groups and enrichment of the oxidative phosphorylation (OXPHOS) pathway in BC-Ctrl tumors (Supplementary Figure S1D-E). Cellular Gene Set Variation Analysis (GSVA) [&lt;span&gt;6&lt;/span&gt;] confirmed the distinct metabolic phenotypes between BC-MDD and BC-Ctrl groups (Figure 1C). Additionally, utilizing predefined gene module (GM) signatures of BC tumor cells [&lt;span&gt;7&lt;/span&gt;], we observed specific restraint of GM4 and GM6 in BC-MDD (Supplementary Figure S1F-G). GM6 encompasses various antigen presentation genes, aligning with the observed downregulation of major histocompatibility complex class I (MHC-I) class genes in BC-MDD tumor cells (Supplementary Figure S1H).&lt;/p&gt;&lt;p&gt;Upon re-clustering 12,371 normal epithelial cells within primary breast tumor and adjacent normal tissues from the 10 patients, we identified 9 cell clusters, including luminal hormone-responsive (LumHR), luminal secretory (LumSec), and myoepithelial cells [&lt;span&gt;8&lt;/span&gt;] (Supplementary Figure S2A-B). Distribution analysis suggested","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 11","pages":"1311-1315"},"PeriodicalIF":20.1,"publicationDate":"2024-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12603","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Local TSH/TSHR signaling promotes CD8+ T cell exhaustion and immune evasion in colorectal carcinoma 局部 TSH/TSHR 信号促进结直肠癌 CD8+ T 细胞衰竭和免疫逃避
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-09-16 DOI: 10.1002/cac2.12605
Sisi Zeng, Huiling Hu, Zhiyang Li, Qi Hu, Rong Shen, Mingzhou Li, Yunshi Liang, Zuokang Mao, Yandong Zhang, Wanqi Zhan, Qin Zhu, Feifei Wang, Jianbiao Xiao, Bohan Xu, Guanglong Liu, Yanan Wang, Bingsong Li, Shaowan Xu, Zhaowen Zhang, Ceng Zhang, Zhizhang Wang, Li Liang
{"title":"Local TSH/TSHR signaling promotes CD8+ T cell exhaustion and immune evasion in colorectal carcinoma","authors":"Sisi Zeng,&nbsp;Huiling Hu,&nbsp;Zhiyang Li,&nbsp;Qi Hu,&nbsp;Rong Shen,&nbsp;Mingzhou Li,&nbsp;Yunshi Liang,&nbsp;Zuokang Mao,&nbsp;Yandong Zhang,&nbsp;Wanqi Zhan,&nbsp;Qin Zhu,&nbsp;Feifei Wang,&nbsp;Jianbiao Xiao,&nbsp;Bohan Xu,&nbsp;Guanglong Liu,&nbsp;Yanan Wang,&nbsp;Bingsong Li,&nbsp;Shaowan Xu,&nbsp;Zhaowen Zhang,&nbsp;Ceng Zhang,&nbsp;Zhizhang Wang,&nbsp;Li Liang","doi":"10.1002/cac2.12605","DOIUrl":"10.1002/cac2.12605","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Dysfunction of CD8<sup>+</sup> T cells in the tumor microenvironment (TME) contributes to tumor immune escape and immunotherapy tolerance. The effects of hormones such as leptin, steroid hormones, and glucocorticoids on T cell function have been reported previously. However, the mechanism underlying thyroid-stimulating hormone (TSH)/thyroid-stimulating hormone receptor (TSHR) signaling in CD8<sup>+</sup> T cell exhaustion and tumor immune evasion remain poorly understood. This study was aimed at investigating the effects of TSH/TSHR signaling on the function of CD8<sup>+</sup> T cells and immune evasion in colorectal cancer (CRC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>TSHR expression levels in CD8<sup>+</sup> T cells were assessed with immunofluorescence and flow cytometry. Functional investigations involved manipulation of TSHR expression in cellular and mouse models to study its role in CD8<sup>+</sup> T cells. Mechanistic insights were mainly gained through RNA-sequencing, Western blotting, chromatin immunoprecipitation and luciferase activity assay. Immunofluorescence, flow cytometry and Western blotting were used to investigate the source of TSH and TSHR in CRC tissues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>TSHR was highly expressed in cancer cells and CD8<sup>+</sup> T cells in CRC tissues. TSH/TSHR signaling was identified as the intrinsic pathway promoting CD8<sup>+</sup> T cell exhaustion. Conditional deletion of TSHR in CD8<sup>+</sup> tumor-infiltrating lymphocytes (TILs) improved effector differentiation and suppressed the expression of immune checkpoint receptors such as programmed cell death 1 (PD-1) and hepatitis A virus cellular receptor 2 (HAVCR2 or TIM3) through the protein kinase A (PKA)/cAMP-response element binding protein (CREB) signaling pathway. CRC cells secreted TSHR via exosomes to increase the TSHR level in CD8<sup>+</sup> T cells, resulting in immunosuppression in the TME. Myeloid-derived suppressor cells (MDSCs) was the main source of TSH within the TME. Low expression of TSHR in CRC was a predictor of immunotherapy response.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The present findings highlighted the role of endogenous TSH/TSHR signaling in CD8<sup>+</sup> T cell exhaustion and immune evasion in CRC. TSHR may be suitable as a predictive and therapeutic biomarker in CRC immunotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 11","pages":"1287-1310"},"PeriodicalIF":20.1,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12605","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142269897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Perioperative toripalimab plus neoadjuvant chemotherapy might improve outcomes in resectable esophageal cancer: an interim analysis of a phase III randomized clinical trial 围手术期托利帕利单抗加新辅助化疗可改善可切除食管癌的预后:一项III期随机临床试验的中期分析。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-09-02 DOI: 10.1002/cac2.12604
Yan Zheng, Guanghui Liang, Dongfeng Yuan, Xianben Liu, Yufeng Ba, Zimin Qin, Sining Shen, Zhenxuan Li, Haibo Sun, Baoxing Liu, Quanli Gao, Peng Li, Zongfei Wang, Shilei Liu, Jianping Zhu, Haoran Wang, Haibo Ma, Zhenzhen Liu, Fei Zhao, Jun Zhang, He Zhang, Daoyuan Wu, Jinrong Qu, Jie Ma, Peng Zhang, Wenjie Ma, Ming Yan, Yongkui Yu, Qing Li, Jiangong Zhang, Wenqun Xing
{"title":"Perioperative toripalimab plus neoadjuvant chemotherapy might improve outcomes in resectable esophageal cancer: an interim analysis of a phase III randomized clinical trial","authors":"Yan Zheng,&nbsp;Guanghui Liang,&nbsp;Dongfeng Yuan,&nbsp;Xianben Liu,&nbsp;Yufeng Ba,&nbsp;Zimin Qin,&nbsp;Sining Shen,&nbsp;Zhenxuan Li,&nbsp;Haibo Sun,&nbsp;Baoxing Liu,&nbsp;Quanli Gao,&nbsp;Peng Li,&nbsp;Zongfei Wang,&nbsp;Shilei Liu,&nbsp;Jianping Zhu,&nbsp;Haoran Wang,&nbsp;Haibo Ma,&nbsp;Zhenzhen Liu,&nbsp;Fei Zhao,&nbsp;Jun Zhang,&nbsp;He Zhang,&nbsp;Daoyuan Wu,&nbsp;Jinrong Qu,&nbsp;Jie Ma,&nbsp;Peng Zhang,&nbsp;Wenjie Ma,&nbsp;Ming Yan,&nbsp;Yongkui Yu,&nbsp;Qing Li,&nbsp;Jiangong Zhang,&nbsp;Wenqun Xing","doi":"10.1002/cac2.12604","DOIUrl":"10.1002/cac2.12604","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>In the era of immunotherapy, neoadjuvant immunochemotherapy (NAIC) for the treatment of locally advanced esophageal squamous cell carcinoma (ESCC) is used clinically but lacks of high-level clinical evidence. This study aimed to compare the safety and long-term efficacy of NAIC followed by minimally invasive esophagectomy (MIE) with those of neoadjuvant chemotherapy (NAC) followed by MIE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A prospective, single-center, open-label, randomized phase III clinical trial was conducted at Henan Cancer Hospital, Zhengzhou, China. Patients were randomly assigned to receive either neoadjuvant toripalimab (240 mg) plus paclitaxel (175 mg/m<sup>2</sup>) + cisplatin (75 mg/m<sup>2</sup>) (toripalimab group) or paclitaxel + cisplatin alone (chemotherapy group) every 3 weeks for 2 cycles. After surgery, the toripalimab group received toripalimab (240 mg every 3 weeks for up to 6 months). The primary endpoint was event-free survival (EFS). The pathological complete response (pCR) and overall survival (OS) were key secondary endpoints. Adverse events (AEs) and quality of life were also assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Between May 15, 2020 and August 13, 2021, 252 ESCC patients ranging from T1N1-3M0 to T2-3N0-3M0 were enrolled for interim analysis, with 127 in the toripalimab group and 125 in the chemotherapy group. The 1-year EFS rate was 77.9% in the toripalimab group compared to 64.3% in the chemotherapy group (hazard ratio [HR] = 0.62; 95% confidence interval [CI] = 0.39 to 1.00; <i>P</i> = 0.05). The 1-year OS rates were 94.1% and 83.0% in the toripalimab and chemotherapy groups, respectively (HR = 0.48; 95% CI = 0.24 to 0.97; <i>P =</i> 0.037). The patients in the toripalimab group had a higher pCR rate (18.6% vs. 4.6%; <i>P</i> = 0.001). The rates of postoperative Clavien-Dindo grade IIIb or higher morbidity were 9.8% in the toripalimab group and 6.8% in the chemotherapy group, with no significant difference observed (<i>P</i> = 0.460). The rates of grade 3 or 4 treatment-related AEs did not differ between the two groups (12.5% versus 12.4%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The interim results of this ongoing trial showed that in resectable ESCC, the addition of perioperative toripalimab to NAC is safe, may improve OS and might change the standard treatment in the future.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 10","pages":"1214-1227"},"PeriodicalIF":20.1,"publicationDate":"2024-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12604","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142104685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Unraveling the routes to distant metastases in colorectal cancer: Tumor deposits and lymph node metastases as the gateway 揭示结直肠癌远处转移的途径:以肿瘤沉积和淋巴结转移为入口。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-08-25 DOI: 10.1002/cac2.12598
Nelleke Pietronella Maria Brouwer, Ayse Selcen Oguz Erdogan, Shannon van Vliet, Natasja Rutgers, Nikki Knijn, Gesina van Lijnschoten, Jessica Juliana Tan, Johannes Hendrik Willem de Wilt, Niek Hugen, Gina Brown, Femke Simmer, Iris Dionne Nagtegaal
{"title":"Unraveling the routes to distant metastases in colorectal cancer: Tumor deposits and lymph node metastases as the gateway","authors":"Nelleke Pietronella Maria Brouwer,&nbsp;Ayse Selcen Oguz Erdogan,&nbsp;Shannon van Vliet,&nbsp;Natasja Rutgers,&nbsp;Nikki Knijn,&nbsp;Gesina van Lijnschoten,&nbsp;Jessica Juliana Tan,&nbsp;Johannes Hendrik Willem de Wilt,&nbsp;Niek Hugen,&nbsp;Gina Brown,&nbsp;Femke Simmer,&nbsp;Iris Dionne Nagtegaal","doi":"10.1002/cac2.12598","DOIUrl":"10.1002/cac2.12598","url":null,"abstract":"&lt;p&gt;Currently, lymph node metastases (LNM) are seen as the gateway to distant metastases in CRC and play a crucial role in the Tumor Node Metastasis (TNM) staging system [&lt;span&gt;1, 2&lt;/span&gt;]. Tumor deposits (TD) have been identified as another histological feature with a strong prognostic impact but are currently only deemed clinically relevant in the absence of LNM [&lt;span&gt;2, 3&lt;/span&gt;]. TD are clusters of tumor cells in the fat surrounding the bowel and are often associated with nerves, vessels and lymphatic tissue, giving the cancer cells access to multiple routes of spread [&lt;span&gt;4&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;To study whether TD could indeed form an alternative gateway to distant metastases, we have used polyG-based phylogenetics on formalin-fixed paraffin-embedded (FFPE) tissue to investigate the role of histologically defined TD and LNM in CRC evolution and distant metastatic spread to the liver and peritoneum.&lt;/p&gt;&lt;p&gt;We collected data from patients who were diagnosed with colorectal liver or peritoneal metastases between January 2015 and January 2022 and not previously treated with chemotherapy. DNA was isolated from the TD and LNM (Figure 1A), normal tissue (which was sampled at the edge of the resection specimen) and distant metastases. Three distinct tissue parts of the primary tumor were sampled to account for intra-tumor heterogeneity (Figure 1B), yielding a total of 480 samples (Supplementary Table S1). Polymerase chain reaction (PCR) was used to genotype up to 24 polyG regions for every sample (Supplementary Table S2). Sequentially, phylogenetic trees were constructed based on the peak distribution of all PCR results from the polyG regions using an analysis pipeline previously developed by Naxerova et al. in R software (version 4.3.1) [&lt;span&gt;5&lt;/span&gt;]. Phylogenetic trees are graphical representations of the evolutionary relationship between biological entities, in this case, the different tissue samples. After quality control of PCR results (i.e., poor quality DNA), impurity (i.e., contamination of samples with non-tumorous cells, Supplementary Figure S1), and branching confidence (i.e., values &lt; 50% were deemed unreliable), 47 CRC patients with a total of 43 individual liver metastases and 30 individual peritoneal metastases were included in the final results (Supplementary Table S3-S5). The distribution of origins (TD, LNM, primary tumor or a mix of these) was compared between the group of liver and the group of peritoneal metastases using Fisher's exact test. Potential confounding clinicopathological factors were analyzed using the Kruskal-Wallis of Fisher's exact test. &lt;i&gt;P&lt;/i&gt; values &lt; 0.05 were considered significant. Full descriptions of the materials and methods are provided in the Supplementary Materials.&lt;/p&gt;&lt;p&gt;Phylogenetic analysis showed that the primary tumor, TD, and LNM could be possible origins of liver metastases. An exemplary phylogenetic tree is shown in Figure 1C, where different subclones gave rise to different LNMs, and sev","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 10","pages":"1209-1213"},"PeriodicalIF":20.1,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12598","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142055045","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial 针对局部晚期胸腔食管鳞状细胞癌的不同放射剂量和不同照射野的同期化放疗:一项随机、多中心、III 期临床试验。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-08-19 DOI: 10.1002/cac2.12601
Jian Zhang, Minghao Li, Kaixian Zhang, Anping Zheng, Guang Li, Wei Huang, Shaoshui Chen, Xiangming Chen, Xiaomin Li, Yanxing Sheng, Xinchen Sun, Liping Liu, Xiaowei Liu, Jie Li, Jun Wang, Hong Ge, Shucheng Ye, Qingsong Pang, Xianwen Zhang, Shengbin Dai, Richard Yu, Wendong Gu, Mingming Dai, Gaowa Siqin, Yunwei Han, Xiaolin Ge, Xin Yuan, Yongjing Yang, Haiwen Zhu, Juan Pu, Lihua Dong, Xiangdong Sun, Jundong Zhou, Weidong Mao, Fei Gao, Haiqun Lin, Heyi Gong, Tao Zhou, Zhenjiang Li, Hongsheng Li, Zhongtang Wang, Baosheng Li
{"title":"Concurrent chemoradiotherapyof different radiation doses and different irradiation fields for locally advanced thoracic esophageal squamous cell carcinoma: A randomized, multicenter, phase III clinical trial","authors":"Jian Zhang,&nbsp;Minghao Li,&nbsp;Kaixian Zhang,&nbsp;Anping Zheng,&nbsp;Guang Li,&nbsp;Wei Huang,&nbsp;Shaoshui Chen,&nbsp;Xiangming Chen,&nbsp;Xiaomin Li,&nbsp;Yanxing Sheng,&nbsp;Xinchen Sun,&nbsp;Liping Liu,&nbsp;Xiaowei Liu,&nbsp;Jie Li,&nbsp;Jun Wang,&nbsp;Hong Ge,&nbsp;Shucheng Ye,&nbsp;Qingsong Pang,&nbsp;Xianwen Zhang,&nbsp;Shengbin Dai,&nbsp;Richard Yu,&nbsp;Wendong Gu,&nbsp;Mingming Dai,&nbsp;Gaowa Siqin,&nbsp;Yunwei Han,&nbsp;Xiaolin Ge,&nbsp;Xin Yuan,&nbsp;Yongjing Yang,&nbsp;Haiwen Zhu,&nbsp;Juan Pu,&nbsp;Lihua Dong,&nbsp;Xiangdong Sun,&nbsp;Jundong Zhou,&nbsp;Weidong Mao,&nbsp;Fei Gao,&nbsp;Haiqun Lin,&nbsp;Heyi Gong,&nbsp;Tao Zhou,&nbsp;Zhenjiang Li,&nbsp;Hongsheng Li,&nbsp;Zhongtang Wang,&nbsp;Baosheng Li","doi":"10.1002/cac2.12601","DOIUrl":"10.1002/cac2.12601","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Concurrent chemoradiotherapy (CCRT) is the standard treatment for locally advanced esophageal squamous cell carcinoma (ESCC). However, the optimal radiotherapy regimen, particularly in terms of total dose and planned range of irradiation field, remains unclear. This phase III clinical trial aimed to compare the survival benefits between different radiation doses and different target fields.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This trial compared two aspects of radiation treatment, total dose and field, using a two-by-two factorial design. The high-dose (HD) group received 59.4 Gy radiation, and the standard-dose (SD) group received 50.4 Gy. The involved field irradiation (IFI) group and elective nodal irradiation (ENI) group adopted different irradiation ranges. The participants were assigned to one of the four groups (HD+ENI, HD+IFI, SD+ENI and SD+IFI). The primary endpoint was overall survival (OS), and the secondary endpoints included progression-free survival (PFS). The synergy indexwas used to measure the interaction effect between dose and field.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The interaction analysis did not reveal significant synergistic effects between the dose and irradiation field. In comparison to the target field, patients in IFI or ENI showed similar OS (hazard ratio [HR] = 0.99, 95% CI: 0.80-1.23, <i>p</i> = 0.930) and PFS (HR = 1.02, 95% CI: 0.82–1.25). The HD treatment did not show significantly prolonged OS compared with SD (HR = 0.90, 95% CI: 0.72–1.11, <i>p</i> = 0.318), but it suggested improved PFS (25.2 months to 18.0 months). Among the four groups, the HD+IFI group presented the best survival, while the SD+IFI group had the worst prognosis. No significant difference in the occurrence of severe adverse events was found in dose or field comparisons.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>IFI demonstrated similar treatment efficacy to ENI in CCRT of ESCC. The HD demonstrated improved PFS, but did not significantly improve OS. The dose escalation based on IFI (HD+IFI) showed better therapeutic efficacy than the current recommendation (SD+ENI) and is worth further validation.</p>\u0000 </section>\u0000 </div>","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 10","pages":"1173-1188"},"PeriodicalIF":20.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12601","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
FGFR3 alterations in bladder cancer: Sensitivity and resistance to targeted therapies 膀胱癌中的 FGFR3 改变:靶向疗法的敏感性和耐药性。
IF 20.1 1区 医学
Cancer Communications Pub Date : 2024-08-19 DOI: 10.1002/cac2.12602
Maxim Noeraparast, Katarina Krajina, Renate Pichler, Dora Niedersüß-Beke, Shahrokh F Shariat, Viktor Grünwald, Sascha Ahyai, Martin Pichler
{"title":"FGFR3 alterations in bladder cancer: Sensitivity and resistance to targeted therapies","authors":"Maxim Noeraparast,&nbsp;Katarina Krajina,&nbsp;Renate Pichler,&nbsp;Dora Niedersüß-Beke,&nbsp;Shahrokh F Shariat,&nbsp;Viktor Grünwald,&nbsp;Sascha Ahyai,&nbsp;Martin Pichler","doi":"10.1002/cac2.12602","DOIUrl":"10.1002/cac2.12602","url":null,"abstract":"<p>In this review, we revisit the pivotal role of fibroblast growth factor receptor 3 (FGFR3) in bladder cancer (BLCA), underscoring its prevalence in both non-muscle-invasive and muscle-invasive forms of the disease. FGFR3 mutations in up to half of BLCAs play a well-established role in tumorigenesis, shaping distinct tumor initiation patterns and impacting the tumor microenvironment (TME). Emphasizing the importance of considering epithelial-mesenchymal transition profile and TME status, we revisit their relevance in predicting responses to immune checkpoint inhibitors in FGFR3-mutated BLCAs. This writing highlights the initially promising yet transient efficacy of the FGFR inhibitor Erdafitinib on FGFR3-mutated BLCA, stressing the pressing need to unravel resistance mechanisms and identify co-targets for future combinatorial studies. A thorough analysis of recent preclinical and clinical evidence reveals resistance mechanisms, including secondary mutations, epigenetic alterations in pathway effectors, phenotypic heterogeneity, and population-specific variations within FGFR3 mutational status. Lastly, we discuss the potential of combinatorial treatments and concepts like synthetic lethality for discovering more effective targeted therapies against FGFR3-mutated BLCA.</p>","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"44 10","pages":"1189-1208"},"PeriodicalIF":20.1,"publicationDate":"2024-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.12602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142003691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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