The inhibition of cyclin-dependent kinases(CDKs)is considered a promising strategy for cancer treatment due to their role in cell cycle regulation.However,CDK inhibitors with no selectivity among CDK families have not...The inhibition of cyclin-dependent kinases(CDKs)is considered a promising strategy for cancer treatment due to their role in cell cycle regulation.However,CDK inhibitors with no selectivity among CDK families have not been approved.A CDK inhibitor with high selectivity for CDK4/6 exhibited significant treatment effects on breast cancer and has become a heavy bomb on the market.Subsequently,resistance gradually decreased the efficacy of selective CDK4/6 inhibitors in breast cancer treatment.In this review,we first introduce the development of selective CDK4/6 inhibitors and then explain the role of CDK2 activation in inducing resistance to CDK4/6 inhibitors.Moreover,we focused on the development of CDK2/4/6 inhibitors and selective CDK2 inhibitors,which will aid in the discovery of novel CDK inhibitors targeting the cell cycle in the future.展开更多
目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安...目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、美国国立指南数据库、美国国立综合癌症网络、加拿大医学会临床实践指南网、苏格兰校际指南网、国际指南协作网、英国国家卫生与临床优化研究所、新西兰指南协作组网站、加拿大安大护理学会、Pub Med、Web of Science、Cochrane Library、Embase、中国期刊全文数据库、万方学术期刊全文数据库、医脉通等,检索时限为建库起至2023年12月31日。由2~4名研究者进行文献筛选、质量评价、证据提取及整合。结果最终纳入17篇文献,其中包含1篇临床决策、1篇指南、2篇专家共识、4篇meta分析、1篇随机对照试验、2篇系统评价、6篇原始研究。从用药前评估、用药观察、皮肤护理、胃肠道反应管理、多学科协作管理、心理干预6个方面总结出17条证据。结论本研究总结了CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,可为临床护理实践提供参考,护理人员可结合患者的临床症状与实际需求,实施规范化、个体化的护理干预。展开更多
Laboratory research and pharmacoepidemiology provide support for metformin as a potential antitumor agent.However,the lack of a clear understanding of the indications of metformin limits its efficacy.Here,we performed...Laboratory research and pharmacoepidemiology provide support for metformin as a potential antitumor agent.However,the lack of a clear understanding of the indications of metformin limits its efficacy.Here,we performed a genome-wide CRISPR knockout negative screen to identify potential targets that might synergize with metformin.Next-generation sequencing of pooled genomic DNAs isolated from surviving cells after 18 days of metformin treatment(T18)compared to those of the untreated cells at day 0(T0)yielded candidate genes.Knockdown of a group of cyclin-dependent kinases(CDKs),including CDK1,CDK4,and CDK6,confirmed the results of the screen.Combination treatment of the CDKs inhibitor abemaciclib with metformin profoundly inhibited tumor viability in vitro and in vivo.Although cell cycle parameters were not further altered under the combination treatment,investigation of the metabolome revealed significant changes in cell metabolism,especially with regard to fatty acid oxidation,the tricarboxylic acid cycle and aspartate metabolism.Such changes appeared to be mediated through inhibition of the mTOR pathway.Collectively,our study suggests that the combination of CDKs inhibitor with metformin could be recognized as a potential therapy in future clinical applications.展开更多
Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance pati...Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.展开更多
The cyclin-dependent kinase inhibitor p21( waf1/cip1/sdi1) is an important negative regulator in control of cell cycle. Its functions of inhibiting cancer cell growth and its effects on expression of Gl phase cyclins ...The cyclin-dependent kinase inhibitor p21( waf1/cip1/sdi1) is an important negative regulator in control of cell cycle. Its functions of inhibiting cancer cell growth and its effects on expression of Gl phase cyclins and related CDKs are a worthy topic for study. The plasmid expressing p2l with high level was transformed to human breast cancer cells, and the expression of p2l in cells was enhanced, then the cell growth rate, anchorage-independent growth and tu-morigenecity were tested, at the same time the expression levels of cyclinD1, CDK4,展开更多
基金supported by the National Key R&D Program of China(No.2023YFC2706303)the National Natural Science Foundation of China(Nos.82373738 and 82304293)Natural Science Foundation of Jiangsu Province(Nos.SBK2024090146 and BK20221040).
文摘The inhibition of cyclin-dependent kinases(CDKs)is considered a promising strategy for cancer treatment due to their role in cell cycle regulation.However,CDK inhibitors with no selectivity among CDK families have not been approved.A CDK inhibitor with high selectivity for CDK4/6 exhibited significant treatment effects on breast cancer and has become a heavy bomb on the market.Subsequently,resistance gradually decreased the efficacy of selective CDK4/6 inhibitors in breast cancer treatment.In this review,we first introduce the development of selective CDK4/6 inhibitors and then explain the role of CDK2 activation in inducing resistance to CDK4/6 inhibitors.Moreover,we focused on the development of CDK2/4/6 inhibitors and selective CDK2 inhibitors,which will aid in the discovery of novel CDK inhibitors targeting the cell cycle in the future.
文摘目的总结CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,为临床实践提供循证依据。方法采用PIPOST问题开发工具构建循证问题,按照“6S”证据金字塔模型,遵循自上而下的原则,系统检索BMJ Best Practice、Up To Date、澳大利亚乔安娜布里格斯研究所循证卫生保健数据库、美国国立指南数据库、美国国立综合癌症网络、加拿大医学会临床实践指南网、苏格兰校际指南网、国际指南协作网、英国国家卫生与临床优化研究所、新西兰指南协作组网站、加拿大安大护理学会、Pub Med、Web of Science、Cochrane Library、Embase、中国期刊全文数据库、万方学术期刊全文数据库、医脉通等,检索时限为建库起至2023年12月31日。由2~4名研究者进行文献筛选、质量评价、证据提取及整合。结果最终纳入17篇文献,其中包含1篇临床决策、1篇指南、2篇专家共识、4篇meta分析、1篇随机对照试验、2篇系统评价、6篇原始研究。从用药前评估、用药观察、皮肤护理、胃肠道反应管理、多学科协作管理、心理干预6个方面总结出17条证据。结论本研究总结了CDK4/6抑制剂治疗乳腺癌所致不良反应的相关护理证据,可为临床护理实践提供参考,护理人员可结合患者的临床症状与实际需求,实施规范化、个体化的护理干预。
基金supported by the National Natural Science Foundation Fund(81472559,81772490)the National Key R&D Program of China(2020YFC2002705,2018YFC0115204)the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)(Grants 2016-I2M-1-001,2017-I2M-3-004,and 2019-I2M-1-003).
文摘Laboratory research and pharmacoepidemiology provide support for metformin as a potential antitumor agent.However,the lack of a clear understanding of the indications of metformin limits its efficacy.Here,we performed a genome-wide CRISPR knockout negative screen to identify potential targets that might synergize with metformin.Next-generation sequencing of pooled genomic DNAs isolated from surviving cells after 18 days of metformin treatment(T18)compared to those of the untreated cells at day 0(T0)yielded candidate genes.Knockdown of a group of cyclin-dependent kinases(CDKs),including CDK1,CDK4,and CDK6,confirmed the results of the screen.Combination treatment of the CDKs inhibitor abemaciclib with metformin profoundly inhibited tumor viability in vitro and in vivo.Although cell cycle parameters were not further altered under the combination treatment,investigation of the metabolome revealed significant changes in cell metabolism,especially with regard to fatty acid oxidation,the tricarboxylic acid cycle and aspartate metabolism.Such changes appeared to be mediated through inhibition of the mTOR pathway.Collectively,our study suggests that the combination of CDKs inhibitor with metformin could be recognized as a potential therapy in future clinical applications.
文摘Background:Cyclin-dependent kinase 4/6(CDK4/6)inhibitors have transformed the management of hormone receptor–positive/HER2–negative(HR+/HER2–)advanced breast cancer,yet evidence for elderly or poor-performance patients remains limited.This study examined real-world outcomes of palbociclib plus endocrine therapy in Asian patients,with additional subgroup analyses by age and performance status.Methods:We retrospectively analyzed 46 consecutive Asian patients with recurrent or de novo HR+/HER2−breast cancer treated with first-line palbociclib plus ET between April 2021 and March 2025.The primary endpoint was progression-free survival(PFS).Secondary endpoints included overall response rate(ORR),disease control rate(DCR),and safety.Subgroup analyses were performed by age(<70 vs.≥70 years)and performance status(PS;0–1 vs.2–3).Results:The median PFS was 26.6 months(range,1.4–69.5).Stratified by age,median PFS was 26.9 months in patients<70 years and 26.2 months in those≥70 years(p=0.760).By PS,PFS was 26.9 months for PS 0–1 and 17.8 months for PS 2–3(p=0.099).ORR was 60.9%and DCR 93.5%;notably,all PS 2–3 patients achieved disease control.Hematologic toxicities were common,with neutropenia(80.4%)and leukopenia(86.7%)predominating,but grade≥3 anemia was rare(2.2%).Elderly patients experienced anemia more frequently,while overall toxicity remained manageable.Dose reductions occurred in 47.8%without loss of efficacy.Conclusions:In routine Japanese practice,palbociclib plus ET provided prolonged PFS and high disease control consistent with pivotal trials and international real-world evidence.Importantly,elderly patients tolerated treatment well,and selected PS 2–3 patients also derived clinical benefit.These findings indicate that neither age nor PS alone should preclude the use of palbociclib in carefully monitored real-world patients.
文摘The cyclin-dependent kinase inhibitor p21( waf1/cip1/sdi1) is an important negative regulator in control of cell cycle. Its functions of inhibiting cancer cell growth and its effects on expression of Gl phase cyclins and related CDKs are a worthy topic for study. The plasmid expressing p2l with high level was transformed to human breast cancer cells, and the expression of p2l in cells was enhanced, then the cell growth rate, anchorage-independent growth and tu-morigenecity were tested, at the same time the expression levels of cyclinD1, CDK4,
