Targeted therapy combined with chemotherapy has achieved great success in palliative treatment for metastatic colorectal cancer.Recent studies gave more emphasis on new fields,such as maintenance treatment,adjuvant treatment and the prognostic & predictive biomarker.These advances have been gradually changing the treatment strategies for colorectal cancer.The latest advances on the targeted therapy for colorectal cancer from the 2010 Annual Meeting of American Society of Clinical Oncology are reviewed below.

Pirh2 (p53-induced protein with a Ring-H2 domain),one of the ubiquitin-protein E3 ligases,can promote p53 degradation via ubiquitin-proteasome pathway,and repress the biological functions of p53.Researchers have found that the Pirh2 is overexpressed in many cancers,which suggests Pirh2 is probably correlated with tumorigenesis and cancer development,and it may become a promising cancer therapeutic target.

Many studies have proven that arsenic trioxide (As2 O3 )as a single agent is not effective against hepatocellular carcinoma (HCC).Many scholars believe that chemotherapy drug resistance of HCC to As2 O3 is the most important reason.The underlying drug resistance mechanism of HCC cells to As2 O3 remains unclear.Studies show that potential mechanism may be tightly associated with As2 O3 pharmacokinetics and properties of HCC tissues and complex molecular biology.

MicroRNAs (miRNAs)can influence the proliferation,apoptosis,invasion and metastasis of esophageal squamous cell carcinoma (ESCC)cells by signal transduction,epithelial-mesenchymal transi-tion,angiogenesis and other regulating mechanisms.Specific serum miRNAs can serve as novel diagnostic and prognostic biomarkers of ESCC.Recent studies have indicated that miRNAs can improve the radiation sensitivi-ty and even reverse multi-drug resistance of ESCC,holding great clinical value.

Infiltrated immune cells and cytokines in the tumor microenvironment may play different functions that appear tightly related to clinical outcomes.Radiotherapy mainly kills tumor cells through radiobio-logical effect,meanwhile it can indirectly change tumor immunologic microenvironment,and has a local or dis-tant anti-tumor immunological effect cooperatively.Animal experiments and clinical trials of radiotherapy com-bined with immunotherapy display well applied prospects,but the mode of radiotherapy in combined treatment needs further research.

Patients with malignant tumor are easy to be complicated with venous thrombosis,which is the second leading cause of death for patients with malignant tumor.The mechanism of tumor thrombus forma-tion is related to tumor type,treatment,metastasis,heredity and tumor itself.Evaluating the risk of venous thrombosis in patients with cancer and providing targeted preventive anticoagulation measures for high-risk patients have important significances for improving the quality of life and prolonging the survival period of pa-tients with cancer.

Immunotherapy has become an important therapy for solid tumors,which is in addition to surgery,radiotherapy,chemotherapy and targeted therapy.However immune treatment mechanism is different from those previous treatment.The effect of immunotherapies is on the immune system and not directly on the tumor.The kinetics of immunotherapy is characterized by a cellular immune response followed by potential changes in tumor burden and survival period.They are not captured by the traditional World Health Organiza-tion (WHO)or the Response Evaluation Criteria in Solid Tumors (RECIST).New immune-related response criteria are defined which more comprehensively capture all response patters and gradually applied in clinical practice.

Objective To systematically review the efficacy and safety of postoperative radiotherapy and postoperative chemotherapy for patients with endometrial cancer,which may give support for clinical proper selection.Methods The randomized controlled trials (RCTs)comparing postoperative radiotherapy with post-operative chemotherapy for patients with endometrial cancer were searched in EMBase,PubMed,Cochrane Library,Chinese Biomedical Literature Data,China National Knowledge Infrastructure,and VIP database from the inception to August 201 5.Two reviewers independently assessed the quality of included studies and extrac-ted data.We analyzed the statistic data using RevMan 5.1 software.Results Three RCTs concluding 1 1 21 patients were included.Meta analysis showed that there were no significant differences between the two groups in five-year survival rate (RR =0.94,95%CI:0.80-1 .1 0,Z =0.77,P =0.440),five-year progression-free survival rate (RR =0.98,95%CI:0.90-1 .07,Z =0.52,P =0.61 0)and recurrence rate (RR =1 .06, 95%CI:0.91 -1 .24,Z =0.75,P =0.450),but there were significant differences between the two groups in grade 3-4 thrombocytopenia (RR =0.1 3,95%CI:0.07-0.27,Z =5.62,P <0.000 01 )and grade 3-4 neu-tropenia (RR =0.01 ,95%CI:0.00-0.03,Z =8.27,P <0.000 01 ).Subgroup analysis showed that there were significant differences between the two groups in five-year survival rate (RR =0.79,95%CI:0.68-0.91 , Z =3.1 5,P =0.002)and five-year progression-free survival rate (RR =0.82,95%CI:0.69-0.97,Z =2.31 ,P =0.020)for patients with Ⅲ-Ⅳ stage endometrial cancer.Conclusion Current evidence indicates that compared with postoperative radiotherapy,postoperative chemotherapy may improve the survival rate for pa-tients with advanced stage endometrial cancer.The long-term curative effects still need to be confirmed by RCTs with high quality and large sample.

Objective To observe the clinical efficacy and adverse reactions of compound mylabris capsules combined with concurrent chemoradiotherapy for patients with locally advanced cervical cancer. Methods From September 201 3 to September 201 4,we collected 80 patients with stage ⅡB-ⅣA cervical cancer who were admitted to Cancer Center of Affiliated People′s Hospital of Hubei University of Medicine. They were divided into the observation group (n =40)and control group (n =40)according to random number table.Patients of observation group were treated with compound mylabris capsules combined with chemo-radiotherapy,and patients of the control group were treated with the concurrent chemoradiotherapy alone.TP scheme of paclitaxel plus cisplatin was used in chemotherapy.Intensity-modulated radiation therapy (IMRT) and intracavitary brachytherapy was used in radiotherapy.The effective rates,Karnofsky Performance Status (KPS)scores,and recent adverse reactions in the two groups were compared.Results The short-time effec-tive rates in the observation group and control group were 97.5% and 95.0% respectively,with no significant difference (χ2 =0.346,P =0.556).The grade Ⅲ-Ⅳ adverse reactions in the observation group and control group included leucopenia (80.0% vs.95.0%),lower hemoglobin (22.5% vs.45.0%),thrombocytopenia (60.0% vs.82.5%),radioactive urocystitis (5.0% vs.30.0%),radioactive proctitis (1 0.0% vs. 30.0%),with significant differences (χ2 =4.1 1 4,P =0.043;χ2 =4.528,P =0.033;χ2 =4.943,P =0.026;χ2 =8.658,P =0.003;χ2 =5.000,P =0.025).The KPS score in the observation group was higher than that in the control group (90 vs.70),with significant difference (Z =4.523,P =0.000).Conclusion The clinical efficacy of compound mylabris capsules combined with concurrent chemoradiotherapy and chemoradio-therapy alone for patients with locally advanced cervical cancer are similar.Compound mylabris capsules can re-duce the rates of adverse reactions such as leucopenia,lower hemoglobin,thrombocytopenia,radioactive urocysti-tis and radioactive proctitis,and can improve KPS score,which plays a role of reliving toxicity.

Objective To investigate the effects of dendritic cells (DCs)loading alpha-Galactosylce-ramide (α-GalCer)combined with tumor specific cytotoxic T lymphocytes (CTLs)on the growth of transplanted Heps hepatoma in mice.Methods We induced the augmentation of the DC cells and T lymphocyte derived from the mice bone marrow,and enabled them to be specific CTLs.DC cells loaded α-GalCer in vitro.First we established a Heps liver cancer xenograft model,then divided the model mice into 4 groups by random number table method (n =9):control group (intravenous injection with physiological saline),CTL group,DC loadingα-Galcer group and DC loading α-Galcer combined with CTLs group.After 2 weeks of intervention,we extrac-ted the tumor tissue,weighed the tumor and calculated the inhibition rate of tumor.The expressions of Bax/Bcl-2 cells in groups of transplanted tumor tissues were detected using immunohistochemistry and Western blotting. Results The average tumor weight of CTL group,DC loading α-GalCer group and combined treatment group were (1 .07 ±0.1 5)g,(1 .1 1 ±0.1 7)g,(0.79 ±0.1 4)g,respectively.All of them were lower than that of control group (1 .69 ±0.23)g,with significant differences (t =1 4.1 76,P =0.023;t =1 2.351 ,P =0.034;t =1 8.672,P =0.000).The average tumor weight of combined treatment group was lower than those of the CTL group and DC loading α-GalCer group,with significant differences (t =1 5.236,P =0.01 2;t =1 1 .1 76, P =0.037).Compared to the CTL group (36.69%)and DC loading α-GalCer group (34.32%),the com-bined treatment group had a higher tumor inhibition rate (53.25%;P =0.034,P =0.021 ).Immunohisto-chemical assay showed that the numbers of Bax-positive cells in CTL group,DC loading α-GalCer group and combined treatment group were 35.83 ±0.75,33.67 ±0.82,41 .1 7 ±1 .1 7 respectively,and compared with the control group (21 .67 ±2.1 6),the differences were statistically significant (t =-1 3.789,P =0.002;t =-1 5.1 1 6,P =0.001 ;t =-1 7.452,P =0.000).The numbers of Bax-positive cells in combined treatment group were different with CTL group and DC loading α-GalCer group (t =-7.730,P =0.009;t =-5.872, P =0.01 1 ).The numbers of Bcl-2-positive cells in CTL group,DC loading α-GalCer group and combined treatment group were 30.83 ±0.75,31 .67 ±1 .03,25.00 ±0.89,and compared with the control group (38.67 ±1 .21 ),the differences were statistically significant (t =9.234,P =0.007;t =1 1 .738,P =0.003;t =20.608,P =0.000).The numbers of Bcl-2-positive cells in combined treatment group were different with CTL group and DC loading α-GalCer group (t =1 1 .952,P =0.003;t =1 2.223,P =0.002).Western blot-ting test results showed that the expression levels of Bax in CTL group,DC loading α-GalCer group and com-bined treatment group were 0.46 ±0.01 ,0.42 ±0.03,0.55 ±0.01 ,and compared with the control group (0.31 ±0.02),the differences were statistically significant (t =1 .035,P =0.032;t =1 .1 24,P =0.027;t =1 .425,P =0.01 0).The expression level of Bax in combined treatment group was different with CTL group and DC loading α-GalCer group (t =1 .305,P =0.01 3;t =1 .421 ,P =0.01 0).The positive expressions of Bcl-2 in CTL group,DC loading α-GalCer group and combined treatment group were 0.34 ±0.03,0.33 ± 0.02,0.24 ±0.01 ,and compared with the control group (0.46 ±0.01 ),the differences were statistically sig-nificant (t =-1 .1 23,P =0.025;t =-1 .061 ,P =0.031 ;t =1 .278,P =0.01 4);the positive expression level of Bcl-2 in combined treatment group was different with CTL group and DC loading α-GalCer group (t =1 .1 60,P =0.021 ;t =1 .21 9,P =0.01 5).Conclusion It has synergistic killing effect on transplanted Heps hepatoma in mice using DC loading α-GalCer combined with the tumor specific CTL.