Volume & Issue: Articles in Press
Research - Scientific -

Examining the expression changes of BAX, Caspase 9, Caspase-3, miR-34a in pancreatic cancer cells of PANC-1 cell line treated with silver nanoparticles synthesized by wormwood plant (Artemisia absinthium)

Articles in Press, Accepted Manuscript, Available Online from 21 March 2026

https://doi.org/10.61882/jct.2026.2076231.2117

Seyyed Morteza Mortazavi, Khadije Nejad Shahrokhabadi, javad baharara, Maryam Lotfi

Abstract Introduction: Concerns about fossil energy costs, environmental deterioration, and energy security has created strong motivation for the research and development of routes to provide sustainable and renewable fuels. In recent years, the use of biomass to produce highly valued chemicals has attracted widespread attention. Lignocellulosic biomass, as a promising renewable resource for biofuel production, has distinct advantages in terms of economic and environmental benefits. The conversion of renewable raw materials to hydrocarbon fuels is an attractive alternative to fossil fuels from economic and environmental perspectives. The production process of lignocellulosic biomass mainly consists of biomass accumulation, biomass decomposition, simple sugars, and conversion of sugars to biofuel. One of the crucial steps for the economic success of lignocellulosic biofuels depends on the inhibition of competitive metabolism in microorganisms to achieve high productivity. To date, there has been a growing focus on the use of S. cerevisiae and E. coli as cell lines. These two cellular factories have well known advantages. They are genetically transmissible and several tools are available for genetic manipulation. In order to produce xylonate, the engineered xylose is first converted by a dehydrogenase into the intermediate xylonolactone, which is then slowly converted to xylonate in a nonenzymatic reaction.
Aim: The organic compound D-1,2,4-Butanetriol (BT) is a valuable chemical with wide-ranging applications in various fields such as pharmaceuticals, paper, polymer materials, and military applications. However, the chemical synthesis routes for BT have many drawbacks. By genetically modifying microorganisms, the metabolic pathway for producing many substances, including BT, can be engineered. When D-xylose is supplied to the bacterium, it is first converted into an intermediate compound called xylonolactone. This compound slowly converts into xylonate through a non-enzymatic reaction. To produce xylonate, the engineered bacteria receive xylose, which is initially converted by a dehydrogenase reaction catalysed by the xylose dehydrogenase enzyme into an intermediate compound, xylonolactone. Xylonolactone is slowly converted to xylonate in a nonenzymatic reaction. Xylonate is a five-carbon organic acid. Over the past few years, xylonate has increasingly been considered as an important chemical due to its potential as an important chemical component. Xylonate has many applications in the food, chemical, and pharmaceutical industries. Specifically, xylonate can act as a precursor for the synthesis of D-1,2,4-Butanetriol and as a concrete water reducing agent. E. coli was chosen as the target strain for genetic and metabolic engineering due to its fast growth in inexpensive culture media, the presence of two enzymes for BT synthesis, and product formation in less than 24 hours of fermentation. This study aimed to clone and express xylose dehydrogenase from Caulobacter vibrioides in E.coli.
Materials and Methods: At first, to access the bacterial gene sequence, the genome of the target bacterium was extracted. Then, to create a strain expressing the enzymes xylose dehydrogenase and xylonolactonase, the genes for these proteins were amplified from Caulobacter vibrioides CB1 and transferred into E. coli. For this purpose, the target genes were amplified using specifically designed primers via the Polymerase Chain Reaction (PCR) method and initially cloned into a pTZ57cloning vector and then subcloned into pET 26b expression vector. At the final step, the expression of the enzyme was assessed by SDS-PAGE, and the other confirmation was the reduction of NAD+ to NADH, which was used as an activity indicator of the enzyme, as investigated by a change in NADH absorbance at 340 nm.
Results: Confirmatory tests were performed to ensure the presence of the gene in the vectors (using restriction enzymes and colony PCR for gene amplification). The expression and activity of the enzyme were analyzed. The recombinant protein's presence was confirmed by SDS-PAGE for the xylose dehydrogenase gene, with a molecular weight of 52.2 kDa. The estimated expression level of the recombinant protein was approximately 25%.
Conclusion: The objective of this research was solely to establish the metabolic pathway for xylonate production in E. coli by surface expression of enzymes in this pathway (xylose dehydrogenase). The results obtained in this study confirm that half of the pathway is active at the cell surface, but further experiments are required to determine the precise production levels and complete the pathway.

Review Articles -

Studying the molecular and physiological mechanisms of glycine betaine accumulation in order to improve tolerance to abiotic stresses in plants

Articles in Press, Accepted Manuscript, Available Online from 13 May 2026

https://doi.org/10.61882/jct.2026.2081953.2123

Lavin Babaei, Reza Darvishzadeh

Abstract Introduction: Global climate change has significantly increased the frequency and intensity of abiotic stresses, thereby limiting plant growth, development, and overall yield by damaging physiological systems. In response to environmental stressors, plants have evolved various adaptive mechanisms, including the accumulation of compatible solutes such as glycine betaine (GB), which plays a pivotal role in protecting cellular functions under adverse conditions. Also known simply as betaine, this compound is a methylated glycine derivative recognized across plant species for its ability to mitigate the deleterious effects of stressful environments. Its zwitterionic structure; comprising a positively charged trimethylammonium group and a negatively charged carboxyl group, confers high solubility and chemical stability to the molecule.
Owing to its excellent biocompatibility, favorable carbon-to-nitrogen ratio, and high-concentration accumulation, glycine betaine can enhance plant tolerance against a wide spectrum of abiotic stresses. Specifically, GB contributes to photosynthetic recovery and the alleviation of oxidative stress by reducing the accumulation and facilitating the detoxification of reactive oxygen species (ROS). Furthermore, it plays a crucial role in stabilizing membranes and macromolecules, while protecting key components of the photosynthetic apparatus, such as the Rubisco enzyme, Photosystem II (PSII), quaternary enzymes, and complex protein structures. Notably, glycine betaine can accumulate at high concentrations within plant cells without interfering with normal metabolic processes, thereby significantly increasing resilience to various osmotic stresses, extreme temperatures (heat and cold), and oxidative damage. The biosynthesis of glycine betaine occurs through distinct metabolic pathways, including the choline oxidation pathway (prevalent in plants and mammals), the direct glycine methylation pathway (specific to certain bacteria and halophytes), the choline dehydrogenase pathway, and the serine metabolism pathway. Such diversity underscores the vital importance of this osmolyte in mediating responses to environmental stresses. Recently, biotechnological interventions, such as Agrobacterium-mediated transformation, have successfully enhanced stress tolerance in susceptible species by overexpressing key genes, most notably codA, BADH, GSMT, and SDMT. Given the functional diversity of genes involved in the glycine betaine biosynthetic pathway, extensive efforts have been made to develop transgenic plants capable of effective accumulation of this metabolite; however, serious challenges such as unstable and weak transgene expression remain as key obstacles in this path. Factors including promoter type, genomic integration site, and epigenetic factors can influence the final performance. Furthermore, the overexpression of enzymes in the glycine betaine biosynthetic pathway may potentially impair growth by disrupting metabolic stability. Therefore, future research should focus on decoding the molecular networks regulating the biosynthesis, signaling, and transport of glycine betaine, particularly its crosstalk with phytohormones, transcription factors, and the identification of stress-inducible promoters. Additionally, optimizing transformation protocols and synchronizing glycine betaine gene expression with the overall plant metabolism are essential.
Aims: This review examines the biosynthesis, physiological functions, and molecular regulation of glycine betaine (GB). It highlights genetic engineering techniques to boost GB production, offering sustainable strategies for enhancing crop tolerance to environmental stresses.
Conclusion: In-planta biosynthesis of glycine betaine (GB) offers a more sustainable alternative to exogenous application, aligning closely with the principles of green agriculture. By integrating GB synthesis pathways, genetically engineered crops can autonomously boost metabolite production and bolster stress resilience, thereby eliminating the logistical costs of external treatments. Furthermore, a more profound investigation into these biosynthetic pathways will facilitate the identification and cloning of novel target genes, ultimately maximizing GB accumulation and enhancing environmental tolerance.

Review Articles -

Bladder cancer treatment with vaccines

Articles in Press, Accepted Manuscript, Available Online from 09 June 2026

https://doi.org/10.61882/jct.2026.2064491.2097

Fatemeh Rezaei, Maedeh Tamimi, mohammad javad dehghan esmatabadi, Ali Asghar Deldar

Abstract Bladder cancer is one of the most common malignancies of the urinary tract and ‎originates from the bladder epithelium. Despite advances in surgery, chemotherapy, ‎radiation, and immunotherapy, bladder cancer remains a major clinical challenge ‎because of its high recurrence rate, risk of progression, and the need for long-term ‎surveillance and repeated interventions. In recent years, vaccine-based immunotherapy ‎has gained increasing attention as a promising strategy for improving antitumor ‎immune responses, reducing relapse, and enhancing therapeutic outcomes across ‎different disease stages.‎
Bacillus Calmette–Guérin (BCG) is the first and most established vaccine used in ‎bladder cancer treatment and remains the standard intravesical adjuvant ‎immunotherapy for non muscle invasive bladder cancer (NMIBC). Its antitumor ‎activity is largely mediated by immunomodulatory effects within the bladder ‎microenvironment, including activation of innate immune cells, induction of ‎pro inflammatory cytokines, and subsequent priming of adaptive immune responses ‎that support cytotoxic T cell–mediated tumor control. However, a substantial ‎proportion of patients experience intolerance, inadequate response, recurrence, or ‎resistance, underscoring the need for next generation vaccine strategies with improved ‎specificity and durability.‎
Accordingly, several emerging vaccine platforms have been investigated. Cell based ‎vaccines, particularly dendritic cell (DC) vaccines, aim to exploit the antigen presenting ‎function of DCs to enhance tumor specific T cell activation using tumor lysates, ‎defined tumor associated antigens, or engineered immunostimulatory constructs. In ‎parallel, monoclonal antibody–based approaches that target tumor associated antigens ‎have been explored as immunotherapeutic tools that may complement vaccine-‎induced immunity. Peptide vaccines provide a more defined strategy by stimulating ‎antigen specific responses against selected epitopes, and their performance may be ‎strengthened through the use of appropriate adjuvants, optimized epitope selection, ‎and improved delivery systems. More recently, mRNA vaccines have attracted ‎considerable interest because they enable rapid and flexible design, can encode one or ‎multiple tumor antigens, and may induce robust cellular immunity. These platforms ‎also offer opportunities for personalization based on patient specific antigenic profiles ‎and may be manufactured in a scalable manner.‎
Combination therapy is an important direction in this field. Pairing vaccine approaches ‎with immune checkpoint inhibitors (e.g., PD 1/PD L1 blockade) may enhance ‎therapeutic efficacy by reversing tumor mediated immune suppression and improving ‎the magnitude and durability of antitumor responses. In addition, integrating vaccines ‎with conventional modalities such as chemotherapy or radiotherapy may further ‎augment immunogenicity through increased antigen release, activation of danger ‎signaling pathways, and immune priming, thereby potentially converting ‎immunologically “cold” tumors into more responsive disease states.‎
This review summarizes major vaccine strategies investigated for bladder cancer, ‎including BCG, cell based vaccines, peptide vaccines, and mRNA vaccines, and ‎discusses their proposed mechanisms, advantages, and current limitations. Despite ‎encouraging progress, key challenges remain, including tumor heterogeneity, antigen ‎loss, immune evasion, optimization of delivery and dosing schedules, manufacturing ‎complexity, and cost. Future research should focus on refining antigen discovery and ‎vaccine design, identifying predictive biomarkers for patient selection and response ‎monitoring, optimizing combination regimens to maximize synergy, and conducting ‎larger, well designed clinical studies to support clinical translation. Overall, vaccine-‎based immunotherapy represents a rapidly evolving and promising avenue that may ‎contribute to more effective, durable, and individualized treatment of bladder cancer ‎for patients across disease stages.‎

Research - Scientific -

REVIEW SPERM DNA BREAKAGE ININDIVIDUALS WITH OLIGOASTHENOSPERMIA AND ITS EFFECT ON ICSI AND EMBRYO FORMATION IN THE INFERTILITY VENTER ROUYESH KARAJ

Articles in Press, Accepted Manuscript, Available Online from 10 June 2026

https://doi.org/10.61882/jct.2026.2080079.2122

Golriz Lak, farinaz behfarjam

Abstract Introduction: About half of the causes of infertility are related to men. The sperm of infertile men often have different functional and structural defects. Among these defects is sperm DNA damage, which can be caused by DNA fragmentation, improper chromatin packaging, and epigenetic defects. All men have some degree of damage to sperm DNA, but when the percentage of this damage increases significantly, it causes pregnancy disruption, miscarriage, and failure in assisted reproductive methods. Studies have shown that 15% of couples are unable to have children despite trying to conceive and are considered infertile, with half of these cases of infertility being due to male factors. The majority of male infertility is due to abnormal sperm. Therefore, these individuals are candidates for assisted reproductive techniques such as IVF and ICSI and may have tried these treatments repeatedly and failed. One of the most important factors in the success of in vitro fertilization is the health of sperm DNA. Various studies show that the lower the quality of sperm, the more problems sperm DNA health faces.
Aims: Therefore, the purpose of conducting research to identify sperm DNA damage and study its effect on the success rate of assisted reproductive methods, including microinjection, in infertile couples is essential, with the aim of improving sperm quality before starting the treatment cycle and imposing excessive costs on couples.

Materials and methods: The present study was experimental and appropriate laboratory equipment, materials, and solutions were used in the research process. In this experiment, semen samples were collected from 60 infertile couples (30 of which were considered positive control samples) who had referred to the Royesh Infertility Treatment Center in Karaj for ICSI treatment. Oligoasthenospermia samples and positive control samples were selected and separated. Anti-Mullerian hormone (AMH) of women candidates for ICSI, which is present in the patient's serum and measured through a blood test, was examined, and those with AMH equal to 2 and above were selected. Then, sperm washing was performed for intracytoplasmic injection. Sperm injection into the egg is usually done 2-3 hours after ovulation. In the next step, sperm DNA breakage was assessed. Failure assessment was performed immediately after sample receipt. The collected data was analyzed using SPSS software, which provides a summary of the methods and techniques used.
Results: The average embryo quality in the normal sperm group was 93.35%, while this index was only as high as 75.74% in the DNA-damaged sperm group. Also, the average sperm velocity in the normal sperm group was 36.2%, while this index in the DNA-damaged sperm group showed a small value of 5.53%. Also, The average percentage of non-motile sperm, sperm with DNA breakage was 82.17%, and in the normal sperm group, the average was 41.93%. In addition, in the DNA breakage sperm group, the average percentage of sperm with rotational movement was 17%, sperm with slow progressive movement was 5.4%, and sperm with fast progressive movement was 0.1%, while in the normal sperm group, the desired indicators showed averages of 0.87%, 25.13%, and 11.07%, respectively. The results of the study also showed that sperm with DNA breakage has a significant impact on reducing embryo quality. And sperm DNA damage can severely and significantly reduce sperm velocity and count. And finally, sperm DNA breakage has a significant impact on sperm shape.
Discussion: The results obtained indicate that DNA breakage is more common in oligoasthenospermic individuals than in healthy individuals, and this breakage significantly affects embryo quality.
Conclusion: Since in assisted reproductive methods, damage to sperm DNA may cause treatment failure, it is recommended to check the sperm DNA fragmentation rate (SDFA) before choosing the appropriate treatment method. And in many cases, if there is damage to sperm DNA, appropriate treatment can improve sperm quality. SDFA testing is a reliable method for assessing sperm DNA health, which greatly contributes to the clinical diagnosis and treatment of male infertility and is of great value in the success of treatment methods.

Research - Scientific -

Comparison of the Effects of Papaverine and Tamoxifen on the Expression of CDK4, miR-146a, and miR-22 in DU145 Prostate Cancer Cells line

Articles in Press, Accepted Manuscript, Available Online from 23 June 2026

https://doi.org/10.61882/jct.2026.2087561.2132

Hamid Reza Momeni, Tahereh Etemadi, Arkan Al Masoodi, Zahra Azizi

Abstract Introduction: Prostate cancer is one of the most prevalent malignancies among men worldwide and represents a major cause of cancer related morbidity and mortality. Despite advances in screening and therapeutic approaches, resistance to standard treatments, including androgen‑deprivation therapy, remains a major clinical challenge in prostate cancer. As a result, identifying novel compounds that can suppress proliferation or modulate key molecular regulators of the cell cycle is of considerable interest. Papaverine is an isoquinoline alkaloid derived from the opium poppy, widely known for its long‑standing clinical use as a smooth‑muscle relaxant and vasodilator. In recent years, it has gained attention for its potential anticancer effects, including its influence on mitochondrial function, cellular energy metabolism, and the modulation of signaling pathways involved in cell cycle regulation. However, the specific effects of papaverine on prostate cancer cells have not yet been clearly elucidated. Tamoxifen, a selective estrogen receptor modulator widely used in breast cancer therapy, has also demonstrated off target antiproliferative effects in various tumor models.
Aims: The present study aimed to evaluate the effects of papaverine and tamoxifen on the viability and molecular regulatory profile of DU145 prostate cancer cells line. Specifically, the study investigated the cytotoxic potential of these compounds on different concentrations and incubation times, and their ability to alter the expression of CDK4 gene, a key mediator of G1 to S phase progression, along with two microRNAs, miR-146a and miR-22, known to influence cell cycle control and tumorigenic pathways. By integrating cellular and molecular findings, the study sought to clarify whether these compounds could serve as potential modulators of prostate cancer cell growth.
Materials and Methods: DU145 human prostate cancer cell line were cultured under standard conditions and treated with different concentrations of papaverine and tamoxifen. Cell viability was assessed for 24, 48, and 72 hours using the MTT assay (3 [4,5 dimethylimidazole-2-yl] 2,5 diphenyl tetrazolium bromide). Dose–response curves were generated to calculate IC50 values for each compound at the specified time points. To investigate molecular changes, total RNA was extracted from the treated and the control cells, and the expression levels of CDK4 gene, miR-146a, and miR-22 were quantified using Real Time PCR with appropriate internal controls. Relative expression changes were determined using the 2-ΔΔCt method. The data were analyzed using SPSS software. Results were presented as Mean ± SD, and significance level of p ≤ 0.05 was considered statistically significant.
Results: Treatment of DU145 prostate cancer cell line with various concentrations of papaverine and tamoxifen resulted in a significant reduction in cell viability in a concentration and time dependent manner, as measured by the MTT assay for 24, 48, and 72 hours. IC50 values were successfully determined for both compounds across the different time points.
Molecular analysis using Real Time PCR showed that treatment with either papaverine or tamoxifen led to a marked downregulation of CDK4 expression compared with untreated controls. In contrast, both compounds induced a significant up‑regulation of miR‑146a and miR‑22 levels.
Discussion: The observed decrease in viability suggests that papaverine and tamoxifen exert notable antiproliferative effects on DU145 prostate cancer cells. The downregulation of CDK4 gene provides a mechanistic link to cell cycle arrest, as CDK4 is a central regulator of G1‑to‑S phase progression. Such suppression is in line with reduced cellular proliferation and supports the therapeutic potential of these compounds.
The increased expression of miR‑146a and miR‑22 further highlights the involvement of tumor suppressive microRNAs in mediating these effects. Both miRNAs have been implicated in regulating pathways associated with proliferation, apoptosis, and oncogenic signaling. Their upregulation may contribute to the inhibition of cell growth through negative modulation of critical oncogenic targets.
These results align with prior evidence demonstrating tamoxifen’s antiproliferative effects but also importantly emphasize that the molecular and cellular impacts of papaverine in prostate cancer remain poorly understood. The current findings provide initial insight into papaverine’s interaction with cell cycle regulatory genes and microRNAs, suggesting a potential role in prostate cancer growth inhibition. Considering the adverse effect profile associated with tamoxifen, papaverine may therefore represent a more favorable candidate for further investigation, particularly as a potential alternative with a potentially safer therapeutic window.

Research - Scientific -

Engineering of CNC-based hydrogel nanoparticles with controlled concentrations to enhance the selectivity and efficacy of cisplatin in AGS cells

Articles in Press, Accepted Manuscript, Available Online from 01 July 2026

https://doi.org/10.61882/jct.2026.2088522.2135

Payam Madazadeh, hashem yaghoubi

Abstract Introduction
Cancer remains one of the leading causes of mortality worldwide, and gastric cancer is among the most aggressive malignancies because of its high incidence, late diagnosis, and poor prognosis. Conventional treatments such as surgery, radiotherapy, and chemotherapy are often associated with systemic toxicity, severe side effects, and drug resistance. Cisplatin (CDP), a widely used chemotherapeutic drug for gastric cancer, induces apoptosis through DNA damage; however, its clinical use is limited by toxicity and resistance. Nanotechnology has enabled the development of smart nanocarriers that improve drug stability, bioavailability, and targeted delivery. Cellulose nanocrystals (CNCs) are attractive drug carriers because of their biodegradability, mechanical strength, and controlled-release properties. In addition, bovine serum albumin (BSA), polyvinyl alcohol (PVA), polyethylene glycol (PEG), and hyaluronic acid (HA) improve biocompatibility and targeting efficiency through interactions with CD44 receptors overexpressed on gastric cancer cells.
Aims
This study aimed to design and evaluate a smart nanocarrier system composed of CNCs, BSA, PVA, PEG, and HA for targeted cisplatin delivery to AGS gastric cancer cells. The study investigated physicochemical properties, pH-responsive drug release, cytotoxicity, selectivity toward cancer cells, and apoptosis induction to determine the therapeutic potential of the synthesized nanocapsules.
Materials and Methods
Cellulose nanocrystals were extracted from raw cellulose using sulfuric acid hydrolysis (64%), followed by ultrasonication, centrifugation, and dialysis. Cisplatin was loaded onto CNCs at different concentrations, and drug-loading efficiency was measured spectrophotometrically at 370 nm. Multifunctional BSA-PVA-CNC-CDP nanoparticles coated with PEG-hyaluronic acid were synthesized through sequential coating and hydrogel formation processes. First, CNC-CDP complexes were coated with bovine serum albumin and stabilized in a PVA hydrogel matrix. The nanoparticle surface was then functionalized with NH2-PEG-HA using EDC/NHS coupling chemistry to enhance targeting ability and biological stability. The synthesized nanoparticles were characterized using XRD, TGA, and DLS analyses to evaluate crystalline structure, thermal stability, particle size, and zeta potential. Drug release behavior was investigated at pH 7.4 and pH 5.8 to simulate physiological and tumor microenvironments. Cytotoxicity and biocompatibility were assessed in AGS gastric cancer cells and normal GES-1 cells using the MTT assay. The selectivity index (SI) was calculated to evaluate preferential toxicity toward cancer cells. In addition, apoptosis induction was analyzed using Annexin V/PI staining and flow cytometry. Statistical analysis was performed using one-way ANOVA followed by Duncan’s multiple range test.
Results
XRD analysis demonstrated that all synthesized nanoparticles and nanocapsules exhibited predominantly amorphous structures, confirming successful incorporation of CNC-CDP complexes into the BSA-PVA matrix. TGA results showed that increasing CNC concentration from 50 to 200 mg significantly improved the thermal stability of CNC-CDP nanoparticles. Furthermore, BPC(100 mg)CP-HA nanocapsules displayed greater structural stability and lower thermal degradation compared with drug-free nanocapsules. DLS analysis indicated that increasing CNC concentration increased particle size from 322 to 363 nm while reducing zeta potential from +13.05 to +2.14 mV. Surface coating with BSA, PVA, PEG, and HA further increased particle size to 476 nm, confirming the formation of multilayered nanocapsules. Drug release studies demonstrated significantly higher cisplatin release under acidic conditions (pH 5.8) compared with physiological conditions (pH 7.4). In contrast, increasing CNC concentration reduced the release rate because of the formation of denser polymeric networks.
Biological evaluations showed that drug-free nanocapsules exhibited negligible toxicity against both AGS and GES-1 cells, confirming favorable biocompatibility. In contrast, cisplatin-loaded nanocapsules significantly reduced AGS cell viability. Among all formulations, BPC(50 mg)CP-HA demonstrated the strongest anticancer activity, with an IC50 value of 224.75 µg.mL⁻¹ and the highest selectivity index (SI=1.75). Flow cytometry analysis further revealed that this formulation induced the highest levels of apoptosis in AGS cells, whereas free cisplatin predominantly caused necrotic cell death.
Conclusion
The BPCCP-HA smart nanocapsules developed in this study represent a promising strategy for targeted gastric cancer therapy. The nanocarrier system improved physicochemical stability, enabled pH-responsive controlled release of cisplatin, enhanced selective toxicity toward AGS cancer cells, and promoted apoptosis-mediated cell death while maintaining low toxicity toward healthy cells. These findings suggest that the designed nanocarrier system may effectively overcome major therapeutic limitations associated with conventional cisplatin treatment.