Immune checkpoint inhibitor (ICI) has become one of the important therapeutic strategies for the patients with advanced non-small cell lung cancer (NSCLC). The latest clinical studies have shown that immunotherapy can bring more survival benefits to patients with early lung cancer and operable patients with locally advanced lung cancer. However, the strategies of neoadjuvant immunotherapy, the timing of operation, the evaluation system of curative effect, predictive markers and other problems still need to be explored in the clinical practice of large samples. This paper reviews the progress of neoadjuvant immunotherapy in NSCLC.

Objective:To determine the derivative chromosome 9 by the method of detecting the ASS gene,and to explore the relationship between the deletion of derivative chromosome 9 and the efficacy and prognosis of the chronic myeloid leukemia (CML)patients. Methods:The materials of 34 CML patients with positive BCR-ABL fusion gene whose ASS genes were detected were retrospectively analyzed. All patients were treated with Extra-signal (ES)probe to detect the derivative chromosome 9.All patients were divided into two groups according to whether they carried the derivative chromosome 9.The blastic phase or the accelerated phase rates in two groups were compared by using Fisher exact probability. Results:All patients were detected by FISH (BCR-ABL ES probe),and all the BCR-ABL fusion signals were positive.6 of 34 patients were found the deletion of ASS gene, among them 1 case blonged to chronic phase,and 5 cases developed into blastic phase or accelerated phase. In the patients without ASS gene deletion,there were 22 cases in chronic phase,and 6 cases in plastic phase or accelerate phase,there was significant difference of blastic phase rate/accelated phase rate between them (P<0.05).A total of 26 patients were treated with tyrosine kinase inhibitors (TKI).5 of 26 patients belonged to the ASS gene deletion group,1 of 5 patients treated with TKI got molecular remission,4 of 5 patients developed into blastic phase or accelerated phase.21 of 26 patients belonged to the group without ASS gene deletion,and among them,19 cases got molecular remission,2 cases developed into plastic phase or accelerated phase after treatment of TKI,there was significant difference between them (P < 0.05 ). 6 patients were treated with traditional chemotherapy (hydroxyurea,interferon);1 of 6 patients belonged to the ASS gene deletion group,finally developed into the blastic phase or accelerated phase;5 of 6 patients belonged to the group without ASS gene deletion,2 cases got the hematological remission,and 3 patients developed into blastic phase or accelerated phase after treatment,and there was no significant difference of blastic phase rate/ accelerated phase rate between them (P > 0.05 ). Conclusion:The CML patients with derivative chromosome 9 (ASS gene deletion)prone to get disease progression, and have a higher proportion in the blastic phase or accelerated phase patients.Derivative chromosome 9 is related to the bad treatment efficacy of TKI and the poor prognosis of CML.

乳腺癌是中国女性最常见的恶性肿瘤，传统治疗方法存在一定副作用，而免疫治疗为攻克乳腺癌提供了新途径，尤以 晚期乳腺癌及三阴性乳腺癌（triple-negative breast cancer, TNBC）患者的PD-1/PD-L1抑制剂治疗最具发展前景。随着乳腺癌免疫 治疗相关临床试验的开展， 以HER2/nue疫苗、MUC-1疫苗等为代表的肿瘤疫苗已观察到可以改善患者的无病生存期（DFS）和总 生存期（OS）。曲妥珠单抗、帕妥珠单抗、T-DM1、MM-111等单克隆抗体也显示出较好疗效，CIK、TIL、CAR-T等过继性细胞治疗 具有较强的肿瘤杀伤能力且安全性良好，而抗PD-1/PD-L1抗体、 抗CTLA-4抗体、 抗LAG-3抗体等免疫负调控抑制剂能够抑制肿 瘤逃逸，为乳腺癌的治疗提供了新策略，这些突破性的成果推动了乳腺癌治疗实现“个体化”的进程。

In recent years, immune checkpoint inhibitors have been continuously researched and developed, and gradually expanded in clinical practice, rapidly changing the treatment mode of lung cancer. At present, a number of immunotherapeutic drugs are also actively developed in China and gradually applied to clinical research, indicating that China has entered a new era of immunotherapy. However, with the continuous expansion of clinical research and the continuous accumulation of experimental data, it also brings us many new challenges and new thinking. This article mainly analyzes the development status and challenges of immunotherapy for lung cancer in the aspects of breakthroughs in treatment modes, special populations excluded from clinical immunotherapy trials, response evaluation, treatment-related adverse events and predictive biomarkers.

Objective To study the cytogenetic features of acute myeloid leukemia (AML) and analyze the association with cytogenetic features and early responses after induction therapy.Methods The karyotypes of 395 patients who had been newly diagnosed with AML were analyzed.These patients were divided into three groups (low-risk,intermediate-risk and high-risk),according to the AML NCCN guidelines.The incidence of different karyotypes in these three groups and the complete remission (CR) rate after the first cycle of induction therapy were analyzed.Results The incidence rates of karyotypes in high-risk,intermediate-risk and low-risk groups were 50.56 ％ (180/356),39.89 ％ (142/356),9.55 ％ (34/356),respectively.All patients with t(15;17) who completed induction therapy reached CR.There was significant difference in the CR rates of t(8;21) groups with or without additional karyotypes [92.00 ％(23/25) vs 50.00 ％(11/22)] (x2 =10.317,P =0.001).There was no significant difference in the CR rates between normal and-Y karyotype group [61.90 ％ (39/63) vs 58.82 ％ (10/17)] (x2 =0.054,P =0.817).Complex cytogenetics ascribed to the low-risk group,of which monosomal karyotype was common,nine of ten patients with monosomal karyotype were associated with an inferior CR rate.Conclusion The cytogenetic features of AML are different from previous reports by other centers.The cytogenetic features of AML patients not only influence the long-term survival,but also the CR rates of induction therapy.

Objective To evaluate the efficacy and safety of bortezomib-based chemotherapy and MPT regimen in the MM patients who were newly diagnosed or relapsed/refractory. Methods Twenty-seven MM patients were treated with bortezomib-based chemotherapy, median cycles:3 (range 1-5 cycles). Other 30patients received MPT chemotherapy. EBMT and WHO criteria were used to evaluate the therapeutic effects and the adverse effects, respectively. Results Bortezomib group: 21 patients (77.8 %) showed effects after the first cycle chemotherapy and 24 patients (88.8 %) showed effects after the whole therapy. In wich, 15 patients(94.0 %) and 9 patients (82.0 %) were newly diagnosed and relapsed/refractory, respectively. MPT group: 15patients (50.0 %) showed effects after the whole therapy. In wich, 12 patients (44.0 %) were newly diagnosed.And the other 3 were relapsed/refractory patients. The ORR in Bortezomib group was better than MPT group (P ＜0.05). The incidence of peripheral neuropathy, herpes and Ⅲ - Ⅳ grade thrombocytopenia in the bortezomib group was 10 patients (37.0 %), 7patients (26.0 %), 10 patients (37.0 %) respectively,and they were more common than MPT group, but the incidence of Ⅲ-Ⅳgrade anemia was 21 patients (70.0 %) and more comumom in the MPT group. The theraputic efficacy of bortezomib for renal insufficiency and normal renal function patients was similar, and no significant increase in all kinds of adverse effects. In MPT group,there were 4 patients with renal insufficiency, the serum level of creatinine in the 3 patients returned to normal after 5 cycles therapy. Conclusion Bortezomib-based chemotherapy is more effective than MPT regimen in the treatment of MM. The newly diagnosed, relapsed/ refractory and with renal insufficiency patients all can benefit from it. The adverse effects are mild and with better tolerance.

Objective To explore the clinical characteristics and prognosis of acute myeloid leukemia (AML) patients with CCAAT/enhancer binding protein α (CEBPA) mutations.Methods 208 patients with de novo AML were retrospectively analyzed with regard to frequency of CEBPA mutations,clinical characteristics,therapeutic response and long-term outcome.Results CEBPA mutations were detected in 37 patients (17.8 ％),with 29 cases of double mutations and 8 cases of single mutation.In 117 cases of patients with normal karyotype,28 cases (23.9 ％) were detected with CEBPA mutations.As compared with no CEBPA mutation,the following characteristics were observed in patients with CEBPA double mutations.Presented with younger age at diagnosis,82.8 ％ (24/29) of the patients were M1 and M2.Presented with higher peripheral white blood cell count,higher hemoglob in and low platelet count.And increases of CD7,CD34 and HLA-DR expression.Compared with those without mutation,patients with biCEBPA mutations had better overall survival (OS) (2-years OS:100 ％ vs 75.1％,P =0.045).Conclusion BiCEBPA mutation is one of the favorable prognosis indicators.

With the advent of the times of immunotherapy and the emergence of a variety of unconventional response patterns such as delayed response and pseudo-progressive disease,a variety of immune-related efficacy evaluation criteria such as immune-related response criteria,immune-related response evaluation criteria in solid tumor and immune response evaluation criteria in solid tumor have been proposed successively.The evaluation principles and judgment results of these criteria are distinctly different from the traditional response evaluation criteria.In particular,the newly proposed immune response evaluation criteria in solid tumor introduces two new concepts of unconfirmed progressive disease and confirmed progressive disease and provides a new response evaluation model for solid tumors,which is expected to provide solutions to some of the most urgent clinical problems under the times of cancer immunotherapy.

Following the development of antineoplastic modalities and improvement in the prognosis of patients with cancer, the oc-currence of cardiotoxicity induced by chemotherapeutic drugs is increasing. Traditional chemotherapeutic drugs, mainly anthracyclines cause varying degrees of direct or indirect damage to the heart, which may even occur several years after the end of treatment. This is-sue is becoming more complicated with the emergence of some new antineoplastic drugs. Treatment options for patients with cancer are limited, and these also have an important effect on patient survival and prognosis. Cardio-oncology is a emerging discipline that in-volves understanding the pathophysiology of cardiotoxicity induced by chemotherapeutic drugs, evaluation of the risks, early detec-tion and systematic management, and optimal drug therapy to reduce the occurrence of cardiotoxicity and to improve the prognosis of patients.

Lynch综合征（Lynch syndrome，LS）是一种常染色体显性遗传病，是由于几种DNA错配修复（mismatch repair，MMR） 基因（MLH1、MSH2、MSH6、PMS2）中的一种出现种系突变，或由于EPCAM基因缺失导致MSH2表达丢失引起。LS是遗传性结 直肠癌（colorectal cancer，CRC）最常见的原因，其特征为患CRC和子宫内膜癌（endometrial cancer，EC）的风险显著增加，且存在 发生其他几种恶性肿瘤的风险。对于LS 的诊断，目前几种临床病理学标准（如阿姆斯特丹标准等）已被用于识别存在Lynch综合 征风险的个体。然而，这些标准的敏感性及特异性有限，仍有赖于临床医生对LS的警惕并关注其家族史。伴有MMR基因变异 的LS相关肿瘤通常具有微卫星高度不稳定的特征，由于移码突变新抗原的存在，可以激发强大而持久的免疫反应和肿瘤浸润淋 巴细胞浸润，所以对于LS患者，免疫检查点抑制剂将会是一种很有前景的治疗方法。由于LS是一种基因遗传病， 与DNA错配修 复缺陷具有独特关系，对其的充分理解对相关肿瘤的诊断、预防和治疗具有重要的临床意义。