SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma

Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO...

Ausführliche Beschreibung

Gespeichert in:
Bibliographische Detailangaben
Veröffentlicht in:The Journal of pathology 2023-04, Vol.259 (4), p.428-440
Hauptverfasser: Lee, Yi‐Mei, Chen, Yu‐Hsin, Ou, Da‐Liang, Hsu, Chia‐Lang, Liu, Jia‐Hua, Ko, Jenq‐Yuh, Hu, Mickey C‐T, Tan, Ching‐Ting
Format: Artikel
Sprache:eng
Schlagworte:
Online-Zugang:Volltext
Tags: Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
container_end_page 440
container_issue 4
container_start_page 428
container_title The Journal of pathology
container_volume 259
creator Lee, Yi‐Mei
Chen, Yu‐Hsin
Ou, Da‐Liang
Hsu, Chia‐Lang
Liu, Jia‐Hua
Ko, Jenq‐Yuh
Hu, Mickey C‐T
Tan, Ching‐Ting
description Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO3a, can suppress programmed cell death ligand‐1 (PD‐L1) expression in breast and ovarian tumor models. We analyzed the SN‐38‐mediated activation of natural killer cells in vitro and explored the efficacy of SN‐38 in combination with anti‐PD‐1 for treatment in vivo. In vitro, SN‐38 enhanced the expression of FoxO3a and reduced the expression of c‐Myc and PD‐L1 dose‐dependently in tumor cells. Low‐dose SN‐38 increased interferon‐γ secretion by NK cells and promoted NK cell‐mediated cytotoxicity in tumor cells. In vivo studies revealed that at non‐cytotoxic drug concentrations, SN‐38 significantly enhanced anti‐PD‐1 activity in suppressing murine tumor growth. We found increased NK cell and CD8+ T‐cell infiltration in post‐treatment tumors. RNA‐seq analysis indicated that SN‐38 increased the enrichment of immune cells and biological function genes related to the immune responses. SN‐38 is a potentially beneficial adjunct to checkpoint inhibitor therapy in HNSCC. Further studies exploring its mechanism of action and possible applications are necessary. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
doi_str_mv 10.1002/path.6055
format Article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2765778101</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2784240750</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3885-f63ccd03c3e981978b6170029c74485a8f0edbdc986298ba35116987e4a94e8f3</originalsourceid><addsrcrecordid>eNp1kcFOFTEUhhuCgSu64AVMEzaaMNBOp512SVDEhCiJuJ6c6ZzJLc50Lm1Hc1fyCDwjT2KvF1mYuGmT9uuX__Qn5JCzE85YebqCtDxRTModsuDMqMJoo3bJIt-Vhah4vU9exnjLGDNGyj2yL5TKp0ouyK-vnx_vH4Q-puAp2OR-IB0xQTsNLiGdeuqC81NCC_6Yol-CtxgznFx-d_0-L5ymgJBG9Ili3zsLdk2dp0uELoMd9Wi_03g3wzjNkVocBmoh2Kwd4RV50cMQ8fXTfkC-XXy4Ob8srr58_HR-dlVYobUseiWs7ZiwAo3mptat4nUez9i6qrQE3TPs2s4arUqjWxCSc2V0jRWYCnUvDsjbrXcVprsZY2pGFzdRwGNO1ZT5N-pac8YzevQPejvNwed0mdJVWbFasky921I2TDEG7JtVcCOEdcNZs2ml2bTSbFrJ7Jsn49yO2D2Tf2vIwOkW-OkGXP_f1Fyf3Vz-Uf4GVHeYtw</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2784240750</pqid></control><display><type>article</type><title>SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Lee, Yi‐Mei ; Chen, Yu‐Hsin ; Ou, Da‐Liang ; Hsu, Chia‐Lang ; Liu, Jia‐Hua ; Ko, Jenq‐Yuh ; Hu, Mickey C‐T ; Tan, Ching‐Ting</creator><creatorcontrib>Lee, Yi‐Mei ; Chen, Yu‐Hsin ; Ou, Da‐Liang ; Hsu, Chia‐Lang ; Liu, Jia‐Hua ; Ko, Jenq‐Yuh ; Hu, Mickey C‐T ; Tan, Ching‐Ting</creatorcontrib><description>Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO3a, can suppress programmed cell death ligand‐1 (PD‐L1) expression in breast and ovarian tumor models. We analyzed the SN‐38‐mediated activation of natural killer cells in vitro and explored the efficacy of SN‐38 in combination with anti‐PD‐1 for treatment in vivo. In vitro, SN‐38 enhanced the expression of FoxO3a and reduced the expression of c‐Myc and PD‐L1 dose‐dependently in tumor cells. Low‐dose SN‐38 increased interferon‐γ secretion by NK cells and promoted NK cell‐mediated cytotoxicity in tumor cells. In vivo studies revealed that at non‐cytotoxic drug concentrations, SN‐38 significantly enhanced anti‐PD‐1 activity in suppressing murine tumor growth. We found increased NK cell and CD8+ T‐cell infiltration in post‐treatment tumors. RNA‐seq analysis indicated that SN‐38 increased the enrichment of immune cells and biological function genes related to the immune responses. SN‐38 is a potentially beneficial adjunct to checkpoint inhibitor therapy in HNSCC. Further studies exploring its mechanism of action and possible applications are necessary. © 2023 The Authors. The Journal of Pathology published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</description><identifier>ISSN: 0022-3417</identifier><identifier>EISSN: 1096-9896</identifier><identifier>DOI: 10.1002/path.6055</identifier><identifier>PMID: 36641765</identifier><language>eng</language><publisher>Chichester, UK: John Wiley &amp; Sons, Ltd</publisher><subject>Animals ; Apoptosis ; B7-H1 Antigen ; CD8 antigen ; Cell activation ; Cell death ; Cytotoxicity ; FOXO3 protein ; FoxO3a ; Head &amp; neck cancer ; Head and neck carcinoma ; Head and Neck Neoplasms - drug therapy ; Head and Neck Neoplasms - genetics ; head and neck squamous cell carcinoma ; Humans ; immune checkpoint inhibitor ; Immune checkpoint inhibitors ; Immune response ; Irinotecan ; Irinotecan - pharmacology ; Metastases ; Mice ; Myc protein ; Natural killer cells ; NK cells ; Ovarian cancer ; PD-L1 protein ; PD‐1 ; PD‐L1 ; Squamous cell carcinoma ; Squamous Cell Carcinoma of Head and Neck - drug therapy ; Treatment Outcome ; Tumor cells</subject><ispartof>The Journal of pathology, 2023-04, Vol.259 (4), p.428-440</ispartof><rights>2023 The Authors. published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</rights><rights>2023 The Authors. The Journal of Pathology published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</rights><rights>2023. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3885-f63ccd03c3e981978b6170029c74485a8f0edbdc986298ba35116987e4a94e8f3</citedby><cites>FETCH-LOGICAL-c3885-f63ccd03c3e981978b6170029c74485a8f0edbdc986298ba35116987e4a94e8f3</cites><orcidid>0000-0001-8317-2235 ; 0000-0002-7447-8045 ; 0000-0002-7794-585X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fpath.6055$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fpath.6055$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36641765$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Yi‐Mei</creatorcontrib><creatorcontrib>Chen, Yu‐Hsin</creatorcontrib><creatorcontrib>Ou, Da‐Liang</creatorcontrib><creatorcontrib>Hsu, Chia‐Lang</creatorcontrib><creatorcontrib>Liu, Jia‐Hua</creatorcontrib><creatorcontrib>Ko, Jenq‐Yuh</creatorcontrib><creatorcontrib>Hu, Mickey C‐T</creatorcontrib><creatorcontrib>Tan, Ching‐Ting</creatorcontrib><title>SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma</title><title>The Journal of pathology</title><addtitle>J Pathol</addtitle><description>Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO3a, can suppress programmed cell death ligand‐1 (PD‐L1) expression in breast and ovarian tumor models. We analyzed the SN‐38‐mediated activation of natural killer cells in vitro and explored the efficacy of SN‐38 in combination with anti‐PD‐1 for treatment in vivo. In vitro, SN‐38 enhanced the expression of FoxO3a and reduced the expression of c‐Myc and PD‐L1 dose‐dependently in tumor cells. Low‐dose SN‐38 increased interferon‐γ secretion by NK cells and promoted NK cell‐mediated cytotoxicity in tumor cells. In vivo studies revealed that at non‐cytotoxic drug concentrations, SN‐38 significantly enhanced anti‐PD‐1 activity in suppressing murine tumor growth. We found increased NK cell and CD8+ T‐cell infiltration in post‐treatment tumors. RNA‐seq analysis indicated that SN‐38 increased the enrichment of immune cells and biological function genes related to the immune responses. SN‐38 is a potentially beneficial adjunct to checkpoint inhibitor therapy in HNSCC. Further studies exploring its mechanism of action and possible applications are necessary. © 2023 The Authors. The Journal of Pathology published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</description><subject>Animals</subject><subject>Apoptosis</subject><subject>B7-H1 Antigen</subject><subject>CD8 antigen</subject><subject>Cell activation</subject><subject>Cell death</subject><subject>Cytotoxicity</subject><subject>FOXO3 protein</subject><subject>FoxO3a</subject><subject>Head &amp; neck cancer</subject><subject>Head and neck carcinoma</subject><subject>Head and Neck Neoplasms - drug therapy</subject><subject>Head and Neck Neoplasms - genetics</subject><subject>head and neck squamous cell carcinoma</subject><subject>Humans</subject><subject>immune checkpoint inhibitor</subject><subject>Immune checkpoint inhibitors</subject><subject>Immune response</subject><subject>Irinotecan</subject><subject>Irinotecan - pharmacology</subject><subject>Metastases</subject><subject>Mice</subject><subject>Myc protein</subject><subject>Natural killer cells</subject><subject>NK cells</subject><subject>Ovarian cancer</subject><subject>PD-L1 protein</subject><subject>PD‐1</subject><subject>PD‐L1</subject><subject>Squamous cell carcinoma</subject><subject>Squamous Cell Carcinoma of Head and Neck - drug therapy</subject><subject>Treatment Outcome</subject><subject>Tumor cells</subject><issn>0022-3417</issn><issn>1096-9896</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kcFOFTEUhhuCgSu64AVMEzaaMNBOp512SVDEhCiJuJ6c6ZzJLc50Lm1Hc1fyCDwjT2KvF1mYuGmT9uuX__Qn5JCzE85YebqCtDxRTModsuDMqMJoo3bJIt-Vhah4vU9exnjLGDNGyj2yL5TKp0ouyK-vnx_vH4Q-puAp2OR-IB0xQTsNLiGdeuqC81NCC_6Yol-CtxgznFx-d_0-L5ymgJBG9Ili3zsLdk2dp0uELoMd9Wi_03g3wzjNkVocBmoh2Kwd4RV50cMQ8fXTfkC-XXy4Ob8srr58_HR-dlVYobUseiWs7ZiwAo3mptat4nUez9i6qrQE3TPs2s4arUqjWxCSc2V0jRWYCnUvDsjbrXcVprsZY2pGFzdRwGNO1ZT5N-pac8YzevQPejvNwed0mdJVWbFasky921I2TDEG7JtVcCOEdcNZs2ml2bTSbFrJ7Jsn49yO2D2Tf2vIwOkW-OkGXP_f1Fyf3Vz-Uf4GVHeYtw</recordid><startdate>202304</startdate><enddate>202304</enddate><creator>Lee, Yi‐Mei</creator><creator>Chen, Yu‐Hsin</creator><creator>Ou, Da‐Liang</creator><creator>Hsu, Chia‐Lang</creator><creator>Liu, Jia‐Hua</creator><creator>Ko, Jenq‐Yuh</creator><creator>Hu, Mickey C‐T</creator><creator>Tan, Ching‐Ting</creator><general>John Wiley &amp; Sons, Ltd</general><general>Wiley Subscription Services, Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7T5</scope><scope>7TK</scope><scope>7TM</scope><scope>7TO</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8317-2235</orcidid><orcidid>https://orcid.org/0000-0002-7447-8045</orcidid><orcidid>https://orcid.org/0000-0002-7794-585X</orcidid></search><sort><creationdate>202304</creationdate><title>SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma</title><author>Lee, Yi‐Mei ; Chen, Yu‐Hsin ; Ou, Da‐Liang ; Hsu, Chia‐Lang ; Liu, Jia‐Hua ; Ko, Jenq‐Yuh ; Hu, Mickey C‐T ; Tan, Ching‐Ting</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3885-f63ccd03c3e981978b6170029c74485a8f0edbdc986298ba35116987e4a94e8f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Animals</topic><topic>Apoptosis</topic><topic>B7-H1 Antigen</topic><topic>CD8 antigen</topic><topic>Cell activation</topic><topic>Cell death</topic><topic>Cytotoxicity</topic><topic>FOXO3 protein</topic><topic>FoxO3a</topic><topic>Head &amp; neck cancer</topic><topic>Head and neck carcinoma</topic><topic>Head and Neck Neoplasms - drug therapy</topic><topic>Head and Neck Neoplasms - genetics</topic><topic>head and neck squamous cell carcinoma</topic><topic>Humans</topic><topic>immune checkpoint inhibitor</topic><topic>Immune checkpoint inhibitors</topic><topic>Immune response</topic><topic>Irinotecan</topic><topic>Irinotecan - pharmacology</topic><topic>Metastases</topic><topic>Mice</topic><topic>Myc protein</topic><topic>Natural killer cells</topic><topic>NK cells</topic><topic>Ovarian cancer</topic><topic>PD-L1 protein</topic><topic>PD‐1</topic><topic>PD‐L1</topic><topic>Squamous cell carcinoma</topic><topic>Squamous Cell Carcinoma of Head and Neck - drug therapy</topic><topic>Treatment Outcome</topic><topic>Tumor cells</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Yi‐Mei</creatorcontrib><creatorcontrib>Chen, Yu‐Hsin</creatorcontrib><creatorcontrib>Ou, Da‐Liang</creatorcontrib><creatorcontrib>Hsu, Chia‐Lang</creatorcontrib><creatorcontrib>Liu, Jia‐Hua</creatorcontrib><creatorcontrib>Ko, Jenq‐Yuh</creatorcontrib><creatorcontrib>Hu, Mickey C‐T</creatorcontrib><creatorcontrib>Tan, Ching‐Ting</creatorcontrib><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium &amp; Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of pathology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Yi‐Mei</au><au>Chen, Yu‐Hsin</au><au>Ou, Da‐Liang</au><au>Hsu, Chia‐Lang</au><au>Liu, Jia‐Hua</au><au>Ko, Jenq‐Yuh</au><au>Hu, Mickey C‐T</au><au>Tan, Ching‐Ting</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma</atitle><jtitle>The Journal of pathology</jtitle><addtitle>J Pathol</addtitle><date>2023-04</date><risdate>2023</risdate><volume>259</volume><issue>4</issue><spage>428</spage><epage>440</epage><pages>428-440</pages><issn>0022-3417</issn><eissn>1096-9896</eissn><abstract>Anti‐programmed cell death 1 (anti‐PD‐1) therapy shows definite but modest activity in patients with advanced/metastatic head and neck squamous cell carcinoma (HNSCC). Preliminary evidence suggests that SN‐38, an activated form of irinotecan that increases expression of the transcription factor FoxO3a, can suppress programmed cell death ligand‐1 (PD‐L1) expression in breast and ovarian tumor models. We analyzed the SN‐38‐mediated activation of natural killer cells in vitro and explored the efficacy of SN‐38 in combination with anti‐PD‐1 for treatment in vivo. In vitro, SN‐38 enhanced the expression of FoxO3a and reduced the expression of c‐Myc and PD‐L1 dose‐dependently in tumor cells. Low‐dose SN‐38 increased interferon‐γ secretion by NK cells and promoted NK cell‐mediated cytotoxicity in tumor cells. In vivo studies revealed that at non‐cytotoxic drug concentrations, SN‐38 significantly enhanced anti‐PD‐1 activity in suppressing murine tumor growth. We found increased NK cell and CD8+ T‐cell infiltration in post‐treatment tumors. RNA‐seq analysis indicated that SN‐38 increased the enrichment of immune cells and biological function genes related to the immune responses. SN‐38 is a potentially beneficial adjunct to checkpoint inhibitor therapy in HNSCC. Further studies exploring its mechanism of action and possible applications are necessary. © 2023 The Authors. The Journal of Pathology published by John Wiley &amp; Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.</abstract><cop>Chichester, UK</cop><pub>John Wiley &amp; Sons, Ltd</pub><pmid>36641765</pmid><doi>10.1002/path.6055</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0001-8317-2235</orcidid><orcidid>https://orcid.org/0000-0002-7447-8045</orcidid><orcidid>https://orcid.org/0000-0002-7794-585X</orcidid><oa>free_for_read</oa></addata></record>
fulltext fulltext
identifier ISSN: 0022-3417
ispartof The Journal of pathology, 2023-04, Vol.259 (4), p.428-440
issn 0022-3417
1096-9896
language eng
recordid cdi_proquest_miscellaneous_2765778101
source MEDLINE; Wiley Online Library Journals Frontfile Complete
subjects Animals
Apoptosis
B7-H1 Antigen
CD8 antigen
Cell activation
Cell death
Cytotoxicity
FOXO3 protein
FoxO3a
Head & neck cancer
Head and neck carcinoma
Head and Neck Neoplasms - drug therapy
Head and Neck Neoplasms - genetics
head and neck squamous cell carcinoma
Humans
immune checkpoint inhibitor
Immune checkpoint inhibitors
Immune response
Irinotecan
Irinotecan - pharmacology
Metastases
Mice
Myc protein
Natural killer cells
NK cells
Ovarian cancer
PD-L1 protein
PD‐1
PD‐L1
Squamous cell carcinoma
Squamous Cell Carcinoma of Head and Neck - drug therapy
Treatment Outcome
Tumor cells
title SN‐38, an active metabolite of irinotecan, enhances anti‐PD‐1 treatment efficacy in head and neck squamous cell carcinoma
url https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-15T12%3A46%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=SN%E2%80%9038,%20an%20active%20metabolite%20of%20irinotecan,%20enhances%20anti%E2%80%90PD%E2%80%901%20treatment%20efficacy%20in%20head%20and%20neck%20squamous%20cell%20carcinoma&rft.jtitle=The%20Journal%20of%20pathology&rft.au=Lee,%20Yi%E2%80%90Mei&rft.date=2023-04&rft.volume=259&rft.issue=4&rft.spage=428&rft.epage=440&rft.pages=428-440&rft.issn=0022-3417&rft.eissn=1096-9896&rft_id=info:doi/10.1002/path.6055&rft_dat=%3Cproquest_cross%3E2784240750%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2784240750&rft_id=info:pmid/36641765&rfr_iscdi=true