Malignant pleural effusion(MPE)is a common complication in patients with advanced malignant tumors,which not only significantly reduces their quality of life but also shortens their survival duration.Despite the widespread use of traditional treatment methods such as thoracentesis and pleurodesis,their efficacy is limited accompanied by high recurrence rates.Therefore,exploring novel therapeutic strategies becomes particularly urgent.In recent years,immunotherapy has attracted extensive attention for its potential in cancer treatment.This article systematically reviews the roles of CD4+T cell subsets,including regulatory T cells(Treg),T helper cell(Th)17,Th9,and Th22 cells,within the immunosuppressive microenvironment of MPE.These cell subsets are involved in the formation of the immunosuppressive state of MPE through various mechanisms and play key roles in the occurrence and development of the disease.In addition,the article discusses in detail the role of immune checkpoint molecules,such as programmed death protein 1(PD-1),PD-1 ligand(PD-L1),and cytotoxic T-lymphocyte-associated protein 4(CTLA-4),in the immune evasion of MPE.The abnormal expressions of these molecules provide opportunity for tumor cells to evade immune system surveillance.At the same time,this article also summarizes the application prospects of novel immunotherapy strategies,such as adoptive cell therapy(ACT)and chimeric antigen receptor T cell(CAR-T)therapy,in the treatment of MPE.These innovative therapies offer possibilities for improving the prognosis of MPE patients through activating and enhancing the anti-tumor immune response.

Objective To compare the adverse reactions and efficacy of dose-dense biweekly EC-T regimen with three-weekly TEC regimen in adjuvant chemotherapy for high risk breast cancer patients. Methods Fifty-one patients with high-risk breast cancer were divided into two groups according to random number table method. 27 cases in EC-T group: epirubicin 90 mg/m2, d1, cyclophosphamide 600 mg/m2, d1, every 2 weeks for 4 cycles followed by paclitaxel 175 mg/m2, d1, every 2 weeks for 4 cycles; 24 cases in TEC group: docetaxel 75 mg/m2, d1, epirubicin 75 mg/m2, d1, and cyclophosphamide 500 mg/m2, d1, every 3 weeks. All the patients in both groups received prophylactic granulocyte-colony stimulating factor 5 μg/(kg·d) from d3 of chemotherapy according to treatment protocol. The adverse reactions, disease-free survival (DFS) and overall survival (OS) were compared between the two groups using χ2 test. Results After a median follow-up of 31 months, the median DFS in the two groups were 28 months and 26 months, the 2-year DFS rates were 85.2 % and 79.2 %, and the 2-year OS rates were 100.0 % and 95.8 %. The EC-T group had higher median DFS, 2-year DFS and 2-year OS than the TEC group, but the differences were not statistically significant (all P> 0.05). The EC-T group had lower incidence of grade 3-4 leukopenia and neutropenia, grade 2-3 diarrhea than the TEC group, and no febrile neutropenia was observed in the EC-T group, the differences were statistically significant (all P< 0.05).However, the incidence of neurotoxicity, myodynia and arthrodynia were significantly higher in the EC-T group than those in the TEC group, the differences were statistically significant (both P< 0.05). Other adverse reactions, including anemia, nausea and vomiting, alopecia, liver dysfunction, and cardiac toxicity were similar between the two groups (all P > 0.05). Conclusion EC-T dose-dense biweekly regimen is well tolerated in adjuvant chemotherapy for high risk breast cancer patients with a trend to improve the DFS and OS when compared with the TEC regimen.

Objective To observe the efficacy and safety of albumin-bound paclitaxel on the patients with advanced malignance in more than the third-lines (including the third-lines).Methods 34 patients with advanced malignance diagnosed by pathological evidence accepted more than the third-lines (including the third-lines) chemotherapy containing albumin-bound paclitaxel after failure of chemotherapy.The efficacy and safety were observed.Results Totally 110 cycles chemotherapy were completed,with a mean of 3.24 cycles in each of the 34 patients.No CR patients,12 cases of PR,9 cases of SD and 13 cases of PD were found.The response rate (RR) was 35.29 ％ (12/34) and the disease control rate (DCR) was 61.76 ％ (21/34).The main toxicity was hematologic toxicity,including neutropenia in 26 cases (76.47 ％),anemia in 14 cases (41.18 ％) and thrombocytopenia in 3 cases (8.82 ％).Other common adverse reactions included alopecia in 27 patients (79.41％) and muscle and joint pain in 15 cases (44.18 ％).Conclusions The albumin-bound paclitaxel is effective and tolerable in patients with advanced malignance in more than the third-lines (include the thirdlines) chemotherapy.