1.Pharmacotherapy plan for metastatic hormone-sensitive prostate cancer:a network meta-analysis
Haichi SONG ; Zongwei TANG ; Wanyi CHEN
China Pharmacy 2024;35(1):84-89
OBJECTIVE To determine the optimal therapeutic plan for metastatic hormone-sensitive prostate cancer (mHSPC), and to provide reference for clinical decision-making. METHODS Retrieved from Medline, Embase, BIOSIS preview, the Cochrane Library and ClinicalTrials. gov systematically, randomized controlled trials about mHSPC therapy, with overall survival (OS) and radiographic progression-free survival (rPFS) as efficacy outcomes and the incidence of serious adverse events (SAEs) as safety outcome, were collected during the inception-Mar. 2022. Two researchers independently screened the literature, extracted data, and evaluated the risk of bias for the included study before conducting a Bayesian network meta-analysis. RESULTS Eight studies with 9 437 patients were finally included. The effectiveness and safety of 7 therapy plans were compared [abiraterone acetate, apalutamide, darolutamide+docetaxel, docetaxel, enzalutamide, standard non-steroidal antiandrogen (SNA) in addition to ADT, and ADT alone]. In terms of efficacy index, the most beneficial regimen (except for ADT+SNA) for OS was ADT+darolutamide+docetaxel (HR=0.54, 95%CI of 0.44-0.66), followed by ADT+abiraterone acetate (HR=0.64,95%CI of 0.57- 0.71), apalutamide (HR=0.65, 95%CI of 0.53-0.79), enzalutamide (HR=0.66, 95%CI of 0.53-0.82); the least beneficial regimen for OS was ADT+docetaxel (HR=0.79, 95%CI of 0.71-0.88). The most beneficial regimen (except for ADT+SNA) for rPFS was ADT+enzalutamide (HR=0.39, 95%CI of 0.30-0.50), followed by ADT+apalutamide (HR=0.48, 95%CI of 0.39- 0.60), abiraterone acetate (HR=0.57, 95%CI of 0.51-0.64), docetaxel (HR=0.62, 95%CI of 0.56-0.69). The results of the tumor- loading subgroup analysis were the same. In terms of safety, ADT+darolutamide+docetaxel (OR=25.86, 95%CI of 14.08-51.33), and ADT+docetaxel (OR=23.35, 95%CI of 13.26-44.81) were associated with markedly increased SAEs; the incidence of SAEs caused by ADT+abiraterone acetate (OR=1.42,95%CI of 1.10-1.82) was slightly increased, and those of other therapy plans had no significant difference. CONCLUSIONS Compared with ADT alone, ADT+ darolutamide+docetaxel may provide the most significant OS benefit, but the incidence of SAEs is increased greatly; compared with ADT+docetaxel, ADT+abiraterone acetate, apalutamide or enzalutamide provide more OS benefits. ADT+enzalutamide provide optimal rPFS benefits with no increased SAEs.
2.Platelet-rich plasma and hydrogel for spinal cord injury
Wenqi ZHAO ; Haichi YU ; Yiru SONG ; Tianyang YUAN ; Qinyi LIU
Chinese Journal of Tissue Engineering Research 2025;29(10):2189-2200
BACKGROUND:A large number of articles have reported the effect and mechanism of platelet-rich plasma and hydrogel in the treatment of spinal cord injury,but few articles have summarized their treatment strategies for spinal cord injury. OBJECTIVE:To summarize the pathological process of spinal cord injury and the strategies of repairing spinal cord injury with platelet-rich plasma and hydrogel alone and in combination. METHODS:PubMed and CNKI databases were searched for articles published from inception to March 2024 by computer.The Chinese search terms were"spinal cord injury,platelet-rich plasma,hydrogel."The English search terms were"spinal cord injury,spinal cord,platelet-rich plasma,hydrogel,angiogenesis,neuralgia,combination therapy."Articles were screened according to inclusion and exclusion criteria,and 128 articles were finally included for review and analysis. RESULTS AND CONCLUSION:(1)The classification of platelet-rich plasma is complex and diverse,and the effects of platelet-rich plasma in the repair treatment of spinal cord injury are various,but they all show certain positive effects,that is,they can promote axon regeneration,stimulate angiogenesis,and treat neuropathic pain and so on.(2)The effect of platelet-rich plasma is mainly due to the growth factors contained in platelet-rich plasma.(3)There are many types of hydrogels,which mainly play the role of filling,simulating extracellular matrix,carrying drugs and biological products,and carrying cells as scaffolds in the repair treatment of spinal cord injury.(4)Compared with single therapy,combination therapy of platelet-rich plasma and hydrogel can promote nerve regeneration and spinal cord function recovery more effectively.