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      Targeting folate receptor β positive tumor-associated macrophages in lung cancer with a folate-modified liposomal complex

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          Abstract

          Tumor-associated macrophages (TAMs) facilitate cancer progression by promoting tumor invasion, angiogenesis, metastasis, inflammatory responses, and immunosuppression. Folate receptor β (FRβ) is overexpressed in TAMs. However, the clinical significance of FRβ-positive macrophages in lung cancer remains poorly understood. In this study, we verified that FRβ overexpression in lung cancer TAMs was associated with poor prognosis. We utilized a folate-modified lipoplex comprising a folate-modified liposome (F-PLP) delivering a BIM-S plasmid to target both lung cancer cells and FRβ-positive macrophages in the tumor microenvironment. Transfection of LL/2 cells and MH-S cells with F-PLP/pBIM induced cell apoptosis. Injection of F-PLP/pBIM into LL/2 and A549 lung cancer models significantly depleted FRβ-positive macrophages and reduced tumor growth. Treatment of tumor-bearing mice with F-PLP/pBIM significantly inhibited tumor growth in vivo by inducing tumor cell and macrophage apoptosis, reducing tumor proliferation, and inhibiting tumor angiogenesis. In addition, a preliminary safety evaluation demonstrated a good safety profile of F-PLP/pBIM as a gene therapy administered intravenously. This work describes a novel application of lipoplexes in lung cancer targeted therapy that influences the tumor microenvironment by targeting TAMs.

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          The International Epidemiology of Lung Cancer: geographical distribution and secular trends.

          This review presents the latest available international data for lung cancer incidence, mortality and survival, emphasizing the established causal relationship between smoking and lung cancer. In 2002, it was estimated that 1.35 million people throughout the world were diagnosed with lung cancer, and 1.18 million died of lung cancer-more than for any other type of cancer. There are some key differences in the epidemiology of lung cancer between more developed and less developed countries. In more developed countries, incidence and mortality rates are generally declining among males and are starting to plateau for females, reflecting previous trends in smoking prevalence. In contrast, there are some populations in less developed countries where increasing lung cancer rates are predicted to continue, due to endemic use of tobacco. A higher proportion of lung cancer cases are attributable to nonsmoking causes within less developed countries, particularly among women. Worldwide, the majority of lung cancer patients are diagnosed after the disease has progressed to a more advanced stage. Despite advances in chemotherapy, prognosis for lung cancer patients remains poor, with 5-year relative survival less than 14% among males and less than 18% among females in most countries. Given the increasing incidence of lung cancer in less developed countries and the current lack of effective treatment for advanced lung cancers, these results highlight the need for ongoing global tobacco reform to reduce the international burden of lung cancer.
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            BH3-Only proteins-essential initiators of apoptotic cell death.

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              Folate-targeted therapeutic and imaging agents for cancer.

              Cancer therapies that exploit targeting ligands to deliver attached cytotoxic drugs selectively to malignant cells are currently receiving significant attention. While antibody-targeted drugs have been the first to enter the clinic, recent studies demonstrate that the vitamin folic acid can also be used to deliver attached imaging and therapeutic agents selectively to malignant cells in both animal tumor models and human cancer patients. Thus, folate conjugates bind to folate receptors that are overexpressed on approximately 40% of human cancers and mediate internalization of their attached drugs by receptor-mediated endocytosis. With the use of proper linkers, folate-targeted drugs can be released inside their target cells where they can perform their desired cytotoxic functions. Based on this strategy, six folate-targeted drugs are currently in human clinical trials.
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                Author and article information

                Contributors
                xiaweiwei@scu.edu.cn
                Journal
                Signal Transduct Target Ther
                Signal Transduct Target Ther
                Signal Transduction and Targeted Therapy
                Nature Publishing Group UK (London )
                2095-9907
                2059-3635
                22 January 2020
                22 January 2020
                2020
                : 5
                : 6
                Affiliations
                [1 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Laboratory of Aging Research and Cancer Drug Target, State Key Laboratory of Biotherapy and Cancer Center, National Clinical Research Center for Geriatrics, West China Hospital, , Sichuan University, ; Chengdu, 610041 Sichuan PR China
                [2 ]ISNI 0000 0004 0369 4060, GRID grid.54549.39, Department of Oncology, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, School of Medicine, , University of Electronic Science and Technology of China, ; Chengdu, 610041 Sichuan PR China
                [3 ]ISNI 0000 0001 0807 1581, GRID grid.13291.38, Department of Gynecology and Obstetrics, Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, West China Second Hospital, , Sichuan University, ; Chengdu, 610041 Sichuan PR China
                [4 ]ISNI 0000 0004 1936 8163, GRID grid.266862.e, Department of Biomedical Sciences, School of Medicine and Health Sciences, , University of North Dakota, ; Grand Forks, ND 58202 USA
                Author information
                http://orcid.org/0000-0002-1271-5375
                Article
                115
                10.1038/s41392-020-0115-0
                6976681
                32296011
                b5bea973-b5b7-434b-b47b-8ad86471746a
                © The Author(s) 2020

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 26 November 2019
                : 10 December 2019
                : 31 December 2019
                Funding
                Funded by: the Natural Science Foundation of China (No. 81602492) and the National Key Research and Development Program of China (No. 2016YFA0201402)
                Categories
                Article
                Custom metadata
                © The Author(s) 2020

                lung cancer,prognostic markers
                lung cancer, prognostic markers

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