Publications by authors named "Yulu Zhao"

4 Publications

  • Page 1 of 1

Clinical Effects of Stereotactic Body Radiation Therapy Targeting the Primary Tumor of Liver-Only Oligometastatic Pancreatic Cancer.

Front Oncol 2021 27;11:659987. Epub 2021 May 27.

Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Nanjing Medical University, Nanjing, China.

Aim: To investigate the efficacy and safety of stereotactic body radiotherapy (SBRT) targeting the primary tumor for liver-only oligometastatic pancreatic cancer.

Methods: We compared the efficacy and safety of SBRT plus chemotherapy with chemotherapy alone in patients with liver-only oligometastatic pancreatic cancer. The populations were balanced by propensity score-weighted and propensity score-matched analyses based on baseline variables. The primary outcome was overall survival (OS). The secondary outcomes included progression free survival (PFS), local progression, metastatic progression and symptomatic local control.

Results: This is a retrospective study of 89 pancreatic cancer patients with liver-only oligometastasis. Overall, 34 (38.2%) and 55 (61.8%) patients received SBRT plus chemotherapy and chemotherapy alone, respectively. After propensity score matching, 1-year OS rate was 34.0% (95%CI, 17.8-65.1%) in the SBRT plus chemotherapy group and 16.5% (95%CI, 5.9-46.1%) in chemotherapy alone group (P=0.115). The 6-month PFS rate was 29.4% (95%CI, 15.4-56.1) in SBRT plus chemotherapy and 20.6% (95%CI, 8.8-48.6) in chemotherapy alone group (P=0.468), respectively. Further subgroup analysis indicated that the addition of SBRT improved OS in patients with primary tumor located in the head of pancreas (stratified HR, 0.28; 95% CI, 0.09 to 0.90) or good performance status (stratified HR, 0.24; 95% CI, 0.07 to 0.86). In terms of disease control, SBRT delayed local progression of pancreas (P=0.008), but not distant metastatic progression (P=0.56). Besides, SBRT offered significant abdominal/back pain relief (P=0.016) with acceptable toxicities.

Conclusions: The addition of SBRT to chemotherapy in patients with liver-only oligometastatic pancreatic cancer improves the OS of those with primary tumor located in the head of pancreas or good performance status. In addition, it is a safe and effective method for local progression control and local symptomatic palliation in patients with metastatic pancreatic cancer.
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http://dx.doi.org/10.3389/fonc.2021.659987DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8190391PMC
May 2021

CRISPR screen in cancer: status quo and future perspectives.

Am J Cancer Res 2021 15;11(4):1031-1050. Epub 2021 Apr 15.

Department of Medical Oncology, Jinling Hospital, The First School of Clinical Medicine, Southern Medical University Nanjing 210002, China.

Clustered regularly interspaced short palindromic repeats (CRISPR) system offers a powerful platform for genome manipulation, including protein-coding genes, noncoding RNAs and regulatory elements. The development of CRISPR screen enables high-throughput interrogation of gene functions in diverse tumor biologies, such as tumor growth, metastasis, synthetic lethal interactions, therapeutic resistance and immunotherapy response, which are mostly performed or in transplant models. Recently, direct CRISPR screens have been developed to identify drivers of tumorigenesis in native microenvironment. Key parameters of CRISPR screen are constantly being optimized to achieve higher targeting efficiency and lower off-target effect. Here, we review the recent advances of CRISPR screen in cancer studies both and , with a particular focus on identifying cancer immunotherapy targets, and propose optimizing strategies and future perspectives for CRISPR screen.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8085856PMC
April 2021

Efficient sparse estimation on interval-censored data with approximated L0 norm: Application to child mortality.

Authors:
Yan Chen Yulu Zhao

PLoS One 2021 9;16(4):e0249359. Epub 2021 Apr 9.

School of Statistics and Management, Shanghai University of Finance and Economics, Shanghai, China.

A novel penalty for the proportional hazards model under the interval-censored failure time data structure is discussed, with which the subject of variable selection is rarely studied. The penalty comes from an idea to approximate some information criterion, e.g., the BIC or AIC, and the core process is to smooth the ℓ0 norm. Compared with usual regularization methods, the proposed approach is free of heavily time-consuming hyperparameter tuning. The efficiency is further improved by fitting the model and selecting variables in one step. To achieve this, sieve likelihood is introduced, which simultaneously estimates the coefficients and baseline cumulative hazards function. Furthermore, it is shown that the three desired properties for penalties, i.e., continuity, sparsity, and unbiasedness, are all guaranteed. Numerical results show that the proposed sparse estimation method is of great accuracy and efficiency. Finally, the method is used on data of Nigerian children and the key factors that have effects on child mortality are found.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0249359PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8034720PMC
April 2021

Outcomes of Stereotactic Body Radiotherapy for Metastatic Colorectal Cancer With Oligometastases, Oligoprogression, or Local Control of Dominant Tumors.

Front Oncol 2020 29;10:595781. Epub 2021 Jan 29.

Department of Medical Oncology, Jinling Hospital, Nanjing Clinical School of Nanjing Medical University, Nanjing, China.

Aim: To evaluate the clinical outcomes of metastatic colorectal cancer (mCRC) patients with oligometastases, oligoprogression, or local control of dominant tumors after stereotactic body radiotherapy (SBRT) and establish a nomogram model to predict the prognosis for these patients.

Methods And Materials: A cohort of 94 patients with 162 mCRC metastases was treated with SBRT at a single institution. Treatment indications were oligometastases, oligoprogression, and local control of dominant tumors. End points of this study were the outcome in terms of progression-free survival (PFS), overall survival (OS), local progression (LP), and cumulative incidence of starting or changing systemic therapy (SCST). In addition, univariate and multivariable analyses to assess variable associations were performed. The predictive accuracy and discriminative ability of the nomogram were determined by concordance index (C-index) and calibration curve.

Results: Median PFS were 12.6 months, 6.8 months, and 3.7 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. 0-1 performance status, < 10 ug/L pre-SBRT CEA, and ≤ 2 metastases were significant predictors of higher PFS on multivariate analysis. Median OS were 40.0 months, 26.1 months, and 6.5 months for oligometastases, oligoprogression, and local control of dominant tumors, respectively. In the multivariate analysis of the cohort, the independent factors for survival were indication, performance status, pre-SBRT CEA, and PTV, all of which were selected into the nomogram. The calibration curve for probability of survival showed the good agreement between prediction by nomogram and actual observation. The C-index of the nomogram for predicting survival was 0.848.

Conclusions: SBRT for metastases derived from colorectal cancer offered favorable survival and symptom palliation without significant complications. The proposed nomogram could provide individual prediction of OS for patients with mCRC after SBRT.
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http://dx.doi.org/10.3389/fonc.2020.595781DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878536PMC
January 2021