Immune checkpoint inhibitors (ICIs) combined with anti-angiogenic agents manifest improved survival in advanced hepatocellular carcinoma (HCC), but responses remain heterogeneous. Although high PIVKA-II expression correlates with advanced disease stage, early recurrence, shorter survival, and may predict resistance to anti-PD-1 plus lenvatinib therapy, the tumor microenvironment (TME) and resistance mechanisms in HCC with high PIVKA-II expression remain unclear. Clinical data from 156 resected HCC patients and 104 patients treated with anti-PD-1 plus lenvatinib are analyzed to correlate PIVKA-II expression with clinical features and outcomes. Single-cell RNA sequencing (scRNA-seq) is performed on tumors from 15 untreated and 7 treated patients. Mechanistic findings are validated in vitro and in vivo. High PIVKA-II expression is associated with advanced disease stage, increased microvascular invasion (MVI), early recurrence, and poor response to therapy. ScRNA-seq revealed an immunosuppressive TME enriched with regulatory T cells (Tregs), exhausted CD8⁺ T cells, and SPP1⁺ tumor-associated macrophages (TAMs). Mechanistically, tumors with high PIVKA-II expression upregulated NQO1, which stabilized p65 by inhibiting ubiquitination, activating the NF-κB/CXCL12 axis, and recruiting Tregs. This pathway mediated therapeutic resistance. Plerixafor, a CXCL12 inhibitor, disrupted this axis and significantly enhanced anti-tumor efficacy when combined with anti-PD-1 plus lenvatinib in vivo. PIVKA-II is a potentially effective biomarker for predicting resistance to anti-PD-1 plus lenvatinib therapy. Its high expression denotes an immunosuppressive TME. Targeting the NQO1/CXCL12/Tregs axis with Plerixafor may restore sensitivity and improve outcomes.

Extensive-stage small cell lung cancer (ES-SCLC) is characterized by a high risk of malignancy and a poor prognosis. This trial aimed to evaluate the efficacy and safety of envafolimab plus chemotherapy as a first-line treatment for ES-SCLC. This prospective, single-arm, phase II trial was conducted at the Fifth Medical Center of Chinese PLA General Hospital. Eligible patients with histologically or cytologically confirmed ES-SCLC were consecutively enrolled. Patients were given four cycles of carboplatin (area under the curve of 5–6 mg/mL/min, day 1 of each cycle) and etoposide (80–100 mg/m2 of body-surface area, on day 1–3 of each cycle) with envafolimab (300 mg, Q3W, day 3 post-chemotherapy of each cycle), followed by envafolimab maintenance until disease progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS). Between October 2021 and November 2022, a total of 32 patients were enrolled in this trial. A total of 32 patients were included in the safety analysis, and 31 patients were included in the efficacy analysis. As of the data cutoff (September 15, 2024), the median follow-up was 27.7 months (IQR, 22.6–NA). The objective response rate (ORR) was 87.1

BACKGROUND:Gastric cancer (GC) is still imposing a severe threat to human health. An increasing number of studies have found that neural activity plays an important role in the tumor microenvironment. However, the clinical implications of nerve-related genes (NRGs) remain largely unexplored. METHODS:Matched GC and adjacent normal tissue from 8 patients were collected for single-cell RNA sequencing (scRNA-seq) analysis. Gene expression and patient information were downloaded from TCGA and GEO databases. A total of 441 NRGs were collected from the KEGG database, and LASSO regression analysis was used to construct the nerve-related risk score (NRRS). The survival, immune microenvironment, and mutation analyses were then carried out. Finally, scRNA-seq analysis was used to analyze the distribution of NRGs in GC patients. RESULTS:We enrolled 441 NRGs and analyzed the association between NRGs expression and overall survival (OS). Finally, 8 NRGs highly associated with OS were identified to construct the NRRS model. Patients with low NRRS had significantly longer OS compared with high NRRS patients. We then analyzed the distribution of gene mutation landscape, enrichment annotation and immune infiltration in different NRRS subtypes. It was found that high NRRS patients displayed a significantly higher infiltration abundance of immune cell subtypes and immune checkpoint molecules. In addition, scRNA-seq was used to analyze the distribution of NRGs in 8 GC patients. We obtained 55, 052 cells in the scRNA-seq data, and the NRRS signature was significantly higher in GC tissues. EPHB3 and LPAR2 were highly expressed in epithelial cells, while NRP1, GNAI1, and SEMA6A were highly expressed in endothelial cells. CONCLUSIONS:Taken together, NRRS could serve as a stable and powerful model for survival prediction, and can help to identify GC patients who may benefit from chemotherapy and immunotherapy.

Despite the crucial involvement of the EGFR pathway in hepatocellular carcinoma (HCC), the clinical efficacy of EGFR antibodies in HCC remains uncertain. While existing evidence suggests that immune dysfunction and tumor microenvironment alterations may contribute to treatment resistance, the precise markers underlying this phenomenon in HCC warrant further investigation. In this study, we employed patient-derived xenograft (PDX) models generated from 14 HCC patients enrolled in the REHOPE301 cohort to evaluate the sensitivity to nimotuzumab, a humanized anti-EGFR monoclonal antibody. Whole-exome sequencing (WES) and single-cell RNA sequencing (scRNA) were performed on tumor tissues and tumor-infiltrating lymphocytes (TILs) to elucidate the association between TIL characteristics and EGFR antibody response. In addition, immunofluorescence (IF) staining and flow cytometry were used to validate the findings from scRNA. A predictive risk score and nomogram were subsequently developed using LASSO regression analysis. The prognostic performance of this model was evaluated using 2 external datasets (ICGC-JP and GSE141202) through receiver operator characteristic (ROC) curves and calibration curves analyses. Nimotuzumab demonstrated a 50

Purpose To determine the characteristic changes of peripheral blood T cells and identify potential biomarkers that associated with the clinical efficacy of combined immunotherapy and anti-angiogenic therapy in patients with advanced squamous non-small cell lung cancer (NSCLC). Methods We performed a comprehensive immunological assessment of peripheral blood mononuclear cell samples from advanced squamous NSCLC patients before and after combination of immunotherapy (Camrelizumab) and anti-angiogenic therapy (Apatinib) using spectral flow cytometry. Correlations between these immunological features and clinical efficacy were analyzed. Results Our findings revealed that, following two treatment cycles, the concentration of type 1 T helper (Th1) cells in the peripheral circulation was significantly higher in the responder group than in the non-responder group, correlating with a statistically significant improvement in survival outcomes. Post-treatment, CD137 expression within Th1 cells in the responders, whereas TIM-3 expression was significantly reduced. In the validation cohort, elevated CD4+ CXCR3+ CD137+ cells in the peripheral blood were associated with a positive clinical reaction to the treatment and extended survival. Conclusions Our findings suggest that peripheral blood circulating CD4+ CXCR3+ CD137+ cells serve as biomarkers of response to combined immunotherapy and anti-angiogenic therapy in patients with advanced squamous NSCLC, providing potential guidance for improving clinical outcomes.

BACKGROUND:Immunotherapy combinations have revolutionised the therapeutic landscape of advanced hepatocellular carcinoma (HCC), but not all yield a significant overall survival benefit, underscoring the need for novel effective agents. Anlotinib plus penpulimab has demonstrated encouraging activity and safety in a phase 2 study. In this phase 3 trial, we aimed to assess whether the combination of anlotinib plus penpulimab improved survival versus sorafenib in patients with unresectable HCC. METHODS:APOLLO was a multicentre, open-label, parallel-controlled, randomised, phase 3 trial conducted at 79 centres in China. Patients aged 18-75 years with unresectable HCC, no previous systemic therapy, and an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 were randomly assigned (2:1) to anlotinib (10 mg orally once daily on days 1-14) plus penpulimab (200 mg intravenously on day 1), or sorafenib (400 mg orally twice daily) every 3 weeks. Randomisation was done centrally using block randomisation with a fixed block size of 3 and stratified by the presence of macrovascular invasion or extrahepatic metastasis, α-fetoprotein concentration, and ECOG performance status. Sex (male or female) and ethnicity (Chinese or other) were self-reported. The co-primary endpoints were progression-free survival assessed by masked independent review committee and overall survival in the intention-to-treat population. Safety was assessed in all participants who received at least one dose of the study drug and had at least one recorded safety assessment. Final progression-free survival and second interim overall survival analyses are presented. This trial is registered at ClinicalTrials.gov, NCT04344158, and follow-up is ongoing. FINDINGS:From Aug 11, 2020, to June 20, 2023, 940 patients were screened for inclusion in the trial, 291 were excluded, and 649 were randomly assigned to an intervention (433 were assigned to the anlotinib plus penpulimab group and 216 were assigned to the sorafenib group. 551 (85%) of the 649 patients were male and 98 (15%) were female. All patients were Chinese with a median age of 57 years (IQR 50-65). For the final analysis of progression-free survival (June 5, 2023), 636 patients (424 patients in the anlotinib plus penpulimab group vs 212 patients in the sorafenib group) comprised the intention-to-treat population. For the second interim analysis of overall survival (Jan 29, 2024), 649 patients (433 vs 216) comprised the intention-to-treat population. Median follow-up was 6·2 months (IQR 5·5-7·5) for the anlotinib plus penpulimab group and 4·2 months (2·9-7·1) for the sorafenib group for final progression-free survival analysis, and 15·3 months (14·3-17·3) for the anlotinib plus penpulimab group and 14·5 months (11·5-17·0) for the sorafenib group for the second interim overall survival analysis. Median progression-free survival was significantly extended with anlotinib plus penpulimab versus sorafenib (6·9 months [95% CI 5·8-8·0] vs 2·8 months [2·7-4·1]; hazard ratio [HR] 0·52 [95% CI 0·41-0·66]; p<0·0001). Median overall survival was significantly prolonged with anlotinib plus penpulimab compared with sorafenib (16·5 months [95% CI 14·7-19·0] vs 13·2 months [9·7-16·9]; HR 0·69 [95% CI 0·55-0·87]; p=0·0014). The most common grade 3 or worse treatment-related adverse events were hypertension (75 [17%] patients in the anlotinib plus penpulimab group vs 22 [10%] in the sorafenib group) and decrease in platelet count (39 [9%] vs 13 [6%]). Treatment-related serious adverse events occurred in 90 (21%) and 19 (9%) patients in the respective groups; treatment-related deaths occurred in one (<1%) patient in the anlotinib plus penpulimab group (upper gastrointestinal haemorrhage) and two (1%) patients in the sorafenib group (hepatic failure and death of unknown cause). INTERPRETATION:Anlotinib plus penpulimab significantly improved progression-free survival and overall survival versus sorafenib in unresectable HCC and might be a new first-line option. These findings require verification in other regions of the world. FUNDING:Chia Tai Tianqing Pharmaceutical Group.

We aimed to investigate the genomic and immune microenvironmental characteristics and their prognostic value in limited-stage small cell lung cancer (SCLC). Whole exome sequencing and multiplex immunofluorescence analysis were conducted on 38 patients diagnosed with limited-stage SCLC. The two most frequently mutated cancer-related genes observed were RB1 (73.68%) and TP53 (63.16%). However, none of the cancer-related genes, including RB1 and TP53, were associated with prognosis. Furthermore, genomic factors such as tumor mutation burden, copy number instability, and mutant-allele tumor heterogeneity were unrelated to prognosis. Approximately 52.63% (20/38) of cases exhibited PD-L1 expression (combined positive score > 1). The average percentage of CD8-positive tumor-infiltrating lymphocytes (TILs) was 3.27%, with a range spanning from 0.04 to 18.96%. Survival analyses showed that PD-L1 positivity, a high proportion of CD8-positive TILs, and wild-type PI3K pathway were significantly associated with better survival. A predictive prognostic model was further developed based on these three biomarkers, resulting in more accurate stratification of patients according to disease-free survival (DFS, hazard ratio (HR) = 2.020, P < 0.001) and overall survival (OS, HR = 2.344, P < 0.001). Moreover, PD-L1 negative patients who did not undergo adjuvant chemotherapy exhibited significantly improved OS (P = 0.029) and a favorable trend in DFS (P = 0.053) compared to those who underwent adjuvant chemotherapy. In conclusion, this study analyzed the genomic and immune microenvironment characteristics of limited-stage SCLC and constructed a prognostic model based on PD-L1 expression, CD8-positive TILs, and PI3K pathway mutation, which may potentially contribute to the clinical management of limited-stage SCLC. Clinical trial number: Not applicable.

Neurofibromatosis type 2 (NF2) is a genetic disorder caused by mutations in the NF2 tumor suppressor gene. This disease causes the growth of multiple schwannomas and meningiomas. There are currently no Food and Drug Administration-approved treatments for these malignancies. Due to their continuous development, these tumors cause a high rate of morbidity and mortality. The aim of the present study was to observe the short-term efficacy of brigatinib in treating NF2. Patients diagnosed with NF2 at The First Medical Center of Chinese PLA General Hospital (Beijing, China) between June 2021 and April 2024 were retrospectively enrolled and treated with 90 mg oral brigatinib once daily, with changes in the size of meningiomas and vestibular schwannomas, as well as hearing, emotional state and pain, measured before and after treatment. Adverse reactions to medication administration were also seen and documented. Changes in markers before and after therapy were investigated using repeated-measures ANOVA. Patients were stratified into two age groups (<18 and ≥18 years), with disease progression evaluated by longitudinal changes in meningioma maximal diameter on magnetic resonance imaging. The log-rank test was used to determine the difference in time between drug delivery and illness development. A total of 12 patients were enrolled. After 12 months of oral brigatinib therapy, the meningioma volume significantly decreased (P<0.05) at both the 6 and 12th month. There was a significant difference in time to illness development between individuals aged <18 and ≥18 years (P=0.049). The symptom checklist-90 and visual analogue scale scores were considerably reduced at 6 and 12 months (P<0.05). However, no significant improvement was seen in acoustic neuroma volume or the mean hearing threshold (both P>0.05). In conclusion, brigatinib may relieve meningiomas and pain and improve emotional well-being in patients with NF2.

8090 Background: Extensive-stage small cell lung cancer (ES-SCLC) is related to high malignancy and the poor prognosis. At present, immunotherapy combined with chemotherapy resulted in favorable therapeutic efficacy, and had been established as the standard treatment regimen for first-line treatment of ES-SCLC. However, some patients may still experience intolerable AEs over the course of treatment, such as immune-related pneumonitis and enteritis. Additionally, currently marketed ICIs were administered by continuous intravenous infusion, which is inconvenient for patients. This trial aimed to evaluate the efficacy and safety of envafolimab, which is a subcutaneously administered fusion protein of humanized anti-PD-L1 monodomain antibody, plus chemotherapy as a first-line treatment for ES-SCLC. Methods: This prospective, single-arm, phase II trial was conducted at the Fifth Medical Center of Chinese PLA General Hospital. Eligible patients with histologically or cytologically confirmed ES-SCLC were consecutively enrolled. Patients were given four cycles of carboplatin (5-6 mg/mL/min, day 1 of each cycle) and etoposide (80-100 mg/m², days 1-3 of each cycle) with envafolimab (300 mg, Q3W, day 3 post-chemotherapy of each cycle), followed by envafolimab maintenance until disease progression or intolerable toxicity. The primary endpoint was progression-free survival (PFS), and the secondary endpoint included objective response rate (ORR), disease control rate (DCR), and safety. Results: Between October 2021 and November 2022, a total of 32 patients were enrolled in this study. 32 patients were included for safety analysis, and 31 patients were included for efficacy analysis. As of the data cutoff (September 15, 2024), the median follow-up was 27.7 months. The ORR was 87.1% (95% CI, 70.2-96.4%), and the DCR was 100% (95% CI, 88.8-100%). The median DoR was 5.47 months (95% CI, 3.43-10 months). The median PFS was 6.43 months (95% CI, 4.83-7.67 months), and median OS was 20 months (95% CI, 14.7-NA). Treatment-related adverse events (TRAEs) of any grade were reported in 59.4% of patients, with grade ≥ 3 TRAEs in 15.6% patients. No treatment-related deaths occurred. Conclusions: First-line envafolimab in combination with carboplatin and etoposide yielded favorable clinical efficacy with a manageable safety profile for patients with ES⁃SCLC, representing a promising treatment modality. Clinical trial information: ChiCTR2100044981 .

Gastric cancer (GC) is among the most lethal human malignancies with limited treatment options. Cell-cell interactions within the tumor microenvironment (TME) can promote tumor growth, yet their therapeutic value has not been fully explored. Here, bulk RNA-seq, single-cell RNA sequencing (scRNA-seq), and spatial transcriptomics (ST) were integrated to analyze the heterogeneity of GC microenvironment. Tumor-specific GREM1+ fibroblasts and SPP1+ macrophages were significantly enriched in GC tissues and were involved in immunosuppression, inflammation regulation, and tumor progression. We then indicated that GREM1+ fibroblasts and SPP1+ macrophages were positively correlated in 12 independent GC datasets and validated their close localization by multiplex immunohistochemistry staining and spatial transcriptomics. Patients with both high GREM1+ fibroblasts and SPP1+ macrophages exhibited significantly shorter OS and showed enrichment of tumor-associated pathways. Our results demonstrated the complex interactions between GREM1+ fibroblasts and SPP1+ macrophages, which may serve as a potential therapeutic target for future treatment of GC.

This study was the first to report the prognostic value of PD-1, PD-L1, CTLA-4, TGF-β1, HIF-1α, IL-2 and IL-6 in peripheral blood on PFS and OS of SCLC.Few studies had reported the correlation between immune-related factors and SCLC survival in SCLC studies, while no studies had reported more than 7 immune-related factors at the same time.We investigated the changes of IL-2, IL-6, TGF-β1, HIF-1α, PD-1, PD-L1 and CTLA-4 in the course of chemotherapy compared with healthy controls, the relationships between each factor and clinical characteristics, the relationships among the 7 factors, and the relationships between the 7 factors and survival，prognosis.There were statistical differences in 7 cytokines between SCLC patients and healthy controls before and during treatment

BackgroundPenpulimab is a novel programmed death (PD)-1 inhibitor. This study aimed to establish the efficacy and safety of first line penpulimab plus chemotherapy for advanced squamous non-small-cell lung cancer.MethodsThis multicentre, randomised, double-blind, placebo-controlled, phase 3 clinical trial enrolled patients with locally advanced or metastatic squamous non-small-cell lung cancer from 74 hospitals in China. Eligible participants were aged 18–75 years, had histologically or cytologically confirmed locally advanced (stage IIIb or IIIc) or metastatic (stage IV) squamous non-small-cell lung cancer, were ineligible to complete surgical resection and concurrent or sequential chemoradiotherapy, had an Eastern Cooperative Oncology Group (ECOG) performance status of 0–1, did not have previous systemic chemotherapy for locally advanced or metastatic non-small-cell lung cancer, and had one or more measurable lesions according to RECIST (version 1.1). Participants were randomly assigned (1:1) to receive intravenous penpulimab 200 mg or placebo (excipient of penpulimab injection), plus paclitaxel 175 mg/m2 and carboplatin AUC of 5 intravenously on day 1 every 3 weeks for four cycles, followed by penpulimab or placebo as maintenance therapy. Stratification was done according to the PD-L1 tumour proportion score (<1% vs 1–49% vs ≥50%) and sex (male vs female). The participants, investigators, and other research staff were masked to group assignment. The primary outcome was progression-free survival assessed by the masked Independent Radiology Review Committee in the intention-to-treat population and patients with a PD-L1 tumour proportion score of 1% or more (PD-L1-positive subgroup). The primary analysis was based on the intention-to-treat analysis set (ie, all randomly assigned participants) and the PD-L1-positive subgroup. The safety analysis included all participants who received at least one dose of study drug after enrolment. This trial was registered with ClinicalTrials.gov (NCT03866993).FindingsBetween Dec 20, 2018, and Oct 10, 2020, 485 patients were screened, and 350 participants were randomly assigned (175 in the penpulimab group and 175 in the placebo group). Of 350 participants, 324 (93%) were male and 26 (7%) were female, and 347 (99%) were of Han ethnicity. In the final analysis (June 1, 2022; median follow-up, 24·7 months [IQR 0–41·4]), the penpulimab group showed an improved progression-free survival compared with the placebo group, both in the intention-to-treat population (median 7·6 months, 95% CI 6·8–-9·6 vs 4·2 months, 95% CI 4·2–4·3; HR 0·43, 95% CI 0·33–0·56; p<0·0001) and in the PD-L1-positive subgroup (8·1 months, 5·7–9·7 vs 4·2 months, 4·1–4·3; HR 0·37, 0·27–0·52, p<0·0001). Grade 3 or worse treatment-emergent adverse events occurred in 120 (69%) 173 patients in the penpulimab group and 119 (68%) of 175 in the placebo group.InterpretationPenpulimab plus chemotherapy significantly improved progression-free survival in patients with advanced squamous non-small-cell lung cancer compared with chemotherapy alone. The treatment was safe and tolerable. Penpulimab combined with paclitaxel and carboplatin is a new option for first-line treatment in patients with this advanced disease.FundingThe National Natural Science Foundation of China, Shanghai Municipal Health Commission, Chia Tai Tianqing Pharmaceutical, Akeso.

Background: Microvascular invasion (MVI) is associated with an unfavorable prognosis and early recurrence of hepatocellular carcinoma (HCC), which is the crucial pathological hallmark of immunotherapy. While microvascular invasion (MVI) in hepatocellular carcinoma (HCC) currently lacks a detailed single-cell analysis of the tumor microenvironment (TME), it holds significant promise for immunotherapy using immune checkpoint inhibitors (ICI). Methods: We performed single-cell RNA sequencing (scRNA-seq) on 3 MVI positive (MVIP) and 14 MVI-negative (MVIN) tumor tissues, as well as their paired adjacent non-tumoral tissues. Results: We identified SPP1+ macrophages and CD4+ proliferative T cells as intertumoral populations critical for the formation of cold tumors and immunosuppressive environments in MVI-positive patients and verified their prognostic value in correlation with MVIP HCC patients. Additionally, we identified SPP1+ dominated interactions between SPP1+ macrophages and the immunosuppressive T population as contributors to MVI destruction and tumorigenesis. Conclusions: We provide a comprehensive single-cell atlas of HCC patients with MVI, shedding light on the immunosuppressive ecosystem and upregulated signaling associated with MVI. These findings demonstrate that intercellular mechanisms drive MVI and provide a potential immunotherapeutic target for HCC patients with HCC and underlying MVI.

Chimeric antigen receptor (CAR) T cells have demonstrated outstanding therapeutic success in hematological malignancies. Yet, their efficacy against solid tumors remains constrained due to inadequate infiltration of cytotoxic T and CAR-T cells in the tumor microenvironment (TME), a factor correlated with poor prognosis in patients with solid tumors. To overcome this limitation, we engineered CAR-T cells to secrete CXCL10 and IL15 (10 x 15 CAR-T), which sustain T cell viability and enhance their recruitment, thereby amplifying the long-term cytotoxic capacity of CAR-T cells in vitro. In a xenograft model employing NUGC4-T21 cells, mice receiving 10 x 15 CAR-T cells showed superior tumor reduction and extended survival rates compared to those treated with second-generation CAR-T cells. Histopathological evaluations indicated a pronounced increase in cytotoxic T cell accumulation in the TME post 10 x 15 CAR-T cell treatment. Therefore, the synergistic secretion of CXCL10 and IL15 in these CAR-T cells enhances T cell recruitment and adaptability within tumor tissues, improving tumor control. This approach may offer a promising strategy for advancing CAR-T therapies in the treatment of solid tumors.

Purpose:This study aims to investigate the process of small cell lung cancer (SCLC) patients from achieving optimal efficacy to experiencing disease progression until death. It examines the predictive value of the treatment response on progression free survival (PFS) and overall survival (OS) of SCLC patients.Patients and Methods:We conducted a retrospective analysis on 136 SCLC patients diagnosed from 1992 to 2018. Important prognostic factors were identified to construct nomogram models. The predictive performance of the models was evaluated using the receiver operating characteristic curves and calibration curves. Survival differences between groups were compared using Kaplan-Meier survival curves. Subsequently, an independent cohort consisting of 106 SCLC patients diagnosed from 2014 to 2021 was used for validation.Results:We constructed two nomograms to predict first-line PFS (PFS1) and OS of SCLC. The area under the receiver operating characteristic curves for the PFS1 nomogram predicting PFS at 3-, 6-, and 12-months were 0.919 (95% CI: 0.867-0.970), 0.908 (95% CI: 0.860-0.956) and 0.878 (95% CI: 0.798-0.958), and for the OS nomogram predicting OS at 6-, 12-, and 24-months were 0.814 (95% CI: 0.736-0.892), 0.819 (95% CI: 0.749-0.889) and 0.809 (95% CI: 0.678-0.941), indicating those two models with a high discriminative ability. The calibration curves demonstrated the models had a high degree of consistency between predicted and observed values. According to the risk scores, patients were divided into high-risk and low-risk groups, showing a significant difference in survival rate. And these findings were validated in another independent validation cohort.Conclusion:Based on the patients' treatment response after standardized treatment, we developed and validated two nomogram models to predict PFS1 and OS of SCLC. The models demonstrated good accuracy, reliability and clinical applicability by validating in an independent cohort.

Objective:CD8+ T cells are the key effector cells in the anti-tumor immune response. The mechanism underlying the infiltration of CD8+ T cells in esophageal squamous cell carcinoma (ESCC) has not been clearly elucidated. Methods:Fresh ESCC tissues were collected and grouped according to the infiltration density of CD8+ T cells. After the transcriptome sequencing on these samples and the combined analyses with The Cancer Genome Atlas (TCGA) ESCC data, a secreted protein DEFB1 was selected to explore its potential role in the infiltration of CD8+ T cells. Bioinformatics analyses, histological verification and in vitro experiments were then performed. Results:DEFB1 was highly expressed in ESCC, and the high expression of DEFB1 was an independent risk factor for overall survival. Since the up-regulation or down-regulation of DEFB1 did not affect the proliferation, migration and apoptosis of ESCC cells, we speculated that the oncogenic effect of DEFB1 was achieved by regulating microenvironmental characteristics. Bioinformatics analyses suggested that DEFB1 might play a major role in the inflammatory response and anti-tumor immune response, and correlate to the infiltration of immature dendritic cell (imDC) in ESCC. Histological analyses further confirmed that there were less CD8+ T cells infiltrated, less CD83+ mature DC (mDC) infiltrated and more CD1a+ imDC infiltrated in those ESCC samples with high expression of DEFB1. After the treatment with recombinant DEFB1 protein, the maturation of DC was hindered significantly, followed by the impairment of the killing effects of T cells in both 2D and 3D culture in vitro. Conclusions:Tumor-derived DEFB1 can inhibit the maturation of DC and weaken the function of CD8+ T cells, accounting for the immune tolerance in ESCC. The role of DEFB1 in ESCC deserves further exploration.

Tumor-infiltrating immune cells (TICs) play a central role in the tumor microenvironment, which can reflect the host anti-tumor immune response. However, few studies have explored TICs in predicting the prognosis of lung adenocarcinoma (LUAD). In our study, we enrolled 2470 LUAD patients from TCGA and GEO databases, and the normalized enrichment scores for 65 immune cell types were quantified for each patient. An immune-related risk score (IRRS) was built on the basis of 17 selected TICs using LASSO regression analysis, and the results showed that high-risk patients were correlated with shorter survival time for the LUAD cohorts. Correlation analyses between IRRS and clinical characteristics were also evaluated to validate the clinical use of IRRS. In addition, we analyzed the differences in the distribution of immune cell infiltration and immunoregulatory gene expression, which may facilitate individual immunotherapy. Based on the above result, we conclude that IRRS can act as a powerful predictor for risk stratification and prognosis prediction, and may facilitate the decision-making process for LUAD patients.

Up to half of hepatocellular carcinoma (HCC) cases are diagnosed at an advanced stage, for which effective treatment options are lacking, resulting in a poor prognosis. Over the past few years, the combination of immune checkpoint inhibitors and anti-angiogenic targeted therapy has proven highly efficacious in treating advanced HCC, significantly extending patients' survival and providing a potential for sequential curative surgery. After sequential curative hepatectomy or liver transplantation following conversion therapy, patients can receive long-term survival benefits. In order to improve the long-term survival rate of the overall population with liver cancer and achieve the goal of a 15% increase in the overall 5-year survival rate outlined in the Healthy China 2030 blueprint, the Professional Committee for Prevention and Control of Hepatobiliary and Pancreatic Diseases of Chinese Preventive Medicine Association, Chinese Society of Liver Cancer, and the Liver Study Group of Surgery Committee of Beijing Medical Association organized in-depth discussions among relevant domestic experts in the field. These discussions focused on the latest progress since the release of the Chinese expert consensus on conversion therapy of immune checkpoint inhibitors combined antiangiogenic targeted drugs for advanced hepatocellular carcinoma (2021 Edition) and resulted in a new consensus on the modifications and supplements to related key points. This consensus aims to further guide clinical practice, standardize medical care, and promote the development of the discipline.

BackgroundIonizing radiation (IR), including radiotherapy, can exert lasting harm on living organisms. While liposaccharide (LPS) offers resistance to radiation damage, it also induces toxic responses. Thankfully, an LPS analogue called N-formylmethionine-leucyl-phenylalanine (fMLP) holds the potential to mitigate this toxicity, offering hope for radiation protection.MethodsSurvival of C57BL/6 mice exposed to IR after administration with fMLP/LPS/WR-2721 or saline was recorded. Cell viability and apoptosis assay of bone marrow (BMC), spleen and small intestinal epithelial (HIECs) cells were tested by Cell Counting Kit-8 (CCK-8) and flow cytometry assay. Tissue damage was evaluated by Hematoxilin and Eosin (H&E), Ki-67, and TUNEL staining. RNA sequencing was performed to reveal potential mechanisms of fMLP-mediated radiation protection. Flow cytometry and western blot were performed to verify the radiation protection mechanism of fMLP on the cell cycle.ResultsThe survival rates of C57BL/6 mice exposed to ionizing radiation after administering fMLP increased. fMLP demonstrated low toxicity in vitro and in vivo, maintaining cell viability and mitigating radiation-induced apoptosis. Moreover, it protected against tissue damage in the hematopoietic and intestinal system. RNA sequencing shed light on fMLP's potential mechanism, suggesting its role in modulating innate immunity and cell cycling. This was evidenced by its ability to reverse radiation-induced G2/M phase arrests in HIECs.ConclusionfMLP serves as a promising radioprotective agent, preserving cells and radiosensitive tissues from IR. Through its influence on the cell cycle, particularly reversing radiation-induced arrest in G2/M phases, fMLP offers protection against IR's detrimental effects.