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The proposed hypothesis for this mechanism is that cells with inactive p53 have a defective G1/S checkpoint and therefore can be sensitized to inhibition of the G2/M checkpoint in combination with DNA-damaging agents [ 23].
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The aberrant mitosis can be caused either by premature or inappropriate entry into mitosis or a failure of related checkpoints in combination with cellular damage.
PD-1 and PD-L1 are differentially expressed in oncogene-addicted NSCLC supporting further investigation of specific checkpoint inhibitors in combination with targeted therapies.
It might also be prudent to revisit cancer vaccines to see if their effectiveness improves when used in combination with checkpoint inhibitors.
While the ability to progress through mitosis even when Topo IIα is inhibited may be a general feature of malignancy, it may be due to the presence of Metnase alone, or Metnase in combination with checkpoint inactivation.
These can also be used in combination with checkpoint inhibitors.
Sipuleucel T is a therapeutic vaccine, and CTLA-4 (T cell checkpoint) blockade is being explored in combination with vaccination.
p53 is also implicated in the checkpoint of cell-cycle progression in combination with DNA repair and/or induction of apoptosis.
This pattern suggests that, similarly to the situation in poor-prognosis ccRCC tumors, high inflammation hampers the activity of cytotoxic cells in mesenchymal CRC tumors, and thus anti-inflammatory or anti-angiogenic treatments could be used in combination with checkpoint inhibitors to simultaneously dampen inflammatory signals and restore cytotoxic T-cell function in this subgroup.
Silencing inhibitory molecules, such as Fas, or targeting prostate tumors with CAR T cells in combination with checkpoint blockade antibodies, such as anti-CTLA4, anti-PD-1, and/or anti-PD-L1, may lead to synergistic effects and strengthen the immune response mounted by the CAR T cells.
Clinical trials of CAR T cells in combination with immune checkpoint blockade antibodies are ongoing.
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