Comment

Bevacizumab in cervical cancer: a step forward for survival

Targeted delivery of adequate glucose oxidase (GOX) into tumor cells by covalent organic frameworks (COFs) remains a great challenge due to their insolubility and easy aggregation. Herein, an effective strategy to synthesize nanosized donor–acceptor (D-A) structured COFs with tunable sizes, long-time water-dispersibility and special selectivity was developed. Designed D-A structure provided pathways and channels for effective charge carriers transport, and this endowed COFs with excellent photothermal property to greatly enhance starvation therapy efficiency. Large surface area and porosity in the cross-linked crystal allowed high GOX loading capacity, and further surface modification with biomolecules made it possess colloid-like water stability and targeted selectivity. All these good properties guaranteed much better in vivo and in vitro tumor ablation than single therapy, and outstanding anti-migration results were also achieved. Detailed cell apoptosis study indicated the combined therapy effectively produced reactive oxygen species, and apoptosis was induced by endogenous mitochondrial apoptosis pathway and Caspase-3 activation process, finally making cancer cells more sensitive to inadequate energy supply and high temperature. This work developed a new strategy to synthesize D-A structured photothermal COFs with good dispersibility and greatly enhance starvation therapy without any additional use of chemical drugs.

The Indonesian government has provided free HPV vaccines for female students in years 5–6 in Jakarta since 2016. We examined parents’ beliefs, attitudes and intentions to allow their daughters to receive the HPV vaccine, as well as the uptake of the vaccine. This cross-sectional study was conducted between September and November 2019 in Jakarta. We invited 680 parents or guardians of year 6 female students from 33 primary schools who were offered the free HPV vaccine to complete a questionnaire; 484 (71%) responded. Analysis was done in two groups: the ‘Decided’ Group (those parents who allowed or denied for their daughter to receive the HPV vaccination), and the ‘Undecided’ Group (those parents who did not recall being approached about the HPV vaccine or forgot their response). In the ‘Decided’ group, 295 (83.6%) parents allowed their daughters to receive the vaccination, while 58 (16.4%) parents refused it. In the ‘Undecided’ group, 49 (70%) parents reported a strong intention to allow their daughters to receive the vaccination; 21 (30%) had weak intention. Attitude, subjective norms and perceived behavioural control were shown to be significant predictors of HPV vaccine uptake when multilevel multivariate logistic regression analysis was undertaken. On the contrary, no independent variable was seen as a significant predictor for parents’ intentions to vaccinate their daughter against HPV. No sociodemographic characteristic was significantly associated with parents’ decisions or intentions regarding HPV vaccine for their daughters. Further qualitative research is needed to explore parents’ knowledge and reasons behind their decision-making processes.

Tumor-infiltrating immune cells (TICs) are highly relevant to tumor development and are promising prognostic biomarkers. However, the precise assessment of TICs is limited by the deficiencies of traditional measurements, such as the lack of phenotypic markers. Here, we analyzed the composition of TICs in cervical cancer based on RNA expression data with a metagene approach called CIBERSORT and evaluated the prognostic value of TICs. The immune infiltration profiles functioned as intrinsic features to distinguish cervical cancer from normal tissue. According to the Cox regression analysis, higher levels of activated memory CD4⁺ T cells were independently associated with favorable overall survival (OS) (hazard ratio [HR] = 0.71, 95% confidence interval [CI]: 0.57–0.89; p = 0.003), whereas a higher fraction of activated mast cells was independently associated with adverse outcomes (HR = 1.53, 95% CI: 1.23–1.91; p < 0.001). Furthermore, a novel prognostic model named aTMNs (activated memory CD4⁺ T cells, activated mast cells and activated natural killer [NK] cells) was constructed to predict OS in cervical cancer with high accuracy (area under the curve [AUC] = 0.723, concordance index [C-index] = 0.738): risk score = −0.34508 × (proportion of activated memory CD4⁺ T cells) + 0.426841 × (proportion of activated mast cells) + 0.272202 × (proportion of activated NK cells). The aTMNs model outperformed the immunomodulator model (AUC = 0.673, C-index = 0.693). Overall, TICs are important prognostic determinants in cervical cancer and may be a useful resource for the development of effective immunotherapy.