基因治疗ASCO-ZHOU.pptVIP

* Response rates by Response Evaluation Criteria in Solid Tumors * * State Key Laboratory of Cancer Biology Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an, P.R.China Xin-min Zhou rAd-P53 gene therapy for advanced hepatocellular carcinoma tumor type Cases（10,000） Rank Deaths （10,000） Rank lung cancer 135.0 1 118.0 1 breast cancer 115.0 2 41.1 5 colorectal cancer 100.0 3 52.9 4 stomach cancer 93.4 4 70.0 2 prostate cancer 67.9 5 22.1 6 liver cancer 62.6 6 59.8 3 Parkin DM, et al. CA Cancer J Clin 2005;55:74-108 HCC is the sixth most common cancer worldwide and the third most common cause of death from cancer China is the most prevalent region of HCC Global Cancer Statistics, 2002. CA Cancer J Clin 2005;55:74-108 There were 626,162 new cases of HCC worldwide in 2002 China accouts for 55％ of all cases Male-to-female ratios are around 3 Distribution of HCC patient according to BCLC staging in China Data from Chinese HCC status survey initiated by Chinese Anti-cancer Association stage A stage B stage C stage D 53.9 27.1 15.3 2.6 BCLC staging and treatment strategy Stage 0PST 0, Child-Pugh A Portal pressure/bilirubin RFA = radiofrequency ablation;PEI = percutaneous ethanol injection. HCC Stage A–COkuda 1–2, PST 0–2, Child-Pugh A–B Stage DPST 2,Child-Pugh C Very early stage (0)Single 2 cmcarcinoma in situ Early stage (A)1–3 nodules 3 cm,PS 0 Intermediate stage (B)Multinodular,PS 0 Advanced stage (C)Portal invasion, N1, M1, PS 1–2 End stage (D) Single 3 nodules ≤3 cm Increased Associated diseases Normal No Yes Resection Liver transplantation PEI/RFA Chemoembolization Sorafenib Curative treatments Palliative treatments Symptomatictreatment Bruix J, et al. Hepatology 2011; 53(3):1020-1022. TP53 gene, widely regarded as the genome guardian of cells, plays a key role in cell cycle control, apoptosis, and inhibition of tumor cell proliferation. Mutations in the TP53 gene are a feature of 50% of all rep