Neoadjuvant endocrine therapy: A potential strategy for ER-positive breast cancer

A potential strategy for patients with estrogen receptor(ER)-positive breast cancer is necessary to replace neoadjuvant chemotherapy which has limited benefit.Neoadjuvant endocrine therapy(NAE)has been indicated to be a favorable alternate approach to downstage large or locally advanced breast cancer in ER-positive,human epidermal growth factor receptor 2(HER2)-negative(ER+/HER2-)patients,especially postmenopausal women.Previous studies have demonstrated the efficacy of various endocrine agents in NAE.Aromatase inhibitors(AIs)have proven superiority over tamoxifen as a suitable choice to optimize treatment efficacy.Fulvestrant was recently reported as an effective agent,similar to AIs.Furthermore,the addition of targeted agents exerts synergistic antiproliferative effects with endocrine agents and rapidly improves response rates in both endocrine sensitive and resistant tumors.The neoadjuvant platform provides a unique opportunity to define the appropriate strategy and address the mechanisms of endocrine resistance.In addition,the predictive value of biomarkers and genomic assays in NAE is under investigation to evaluate individual effects and validate biomarker-based strategies.In this review,we discuss the most relevant evidence on the potential of NAE for ER+breast cancer.The current understanding also offers new insights into the identification of the optimal settings and valuable predictive tools of NAE to guide clinical treatment decisions and achieve beneficial therapeutic effects.

The sirtuin family in health and disease

Sirtuins(SIRTs)are nicotine adenine dinucleotide(+)-dependent histone deacetylases regulating critical signaling pathways in prokaryotes and eukaryotes,and are involved in numerous biological processes.Currently,seven mammalian homologs of yeast Sir2 named SIRT1 to SIRT7 have been identified.Increasing evidence has suggested the vital roles of seven members of the SIRT family in health and disease conditions.Notably,this protein family plays a variety of important roles in cellular biology such as inflammation,metabolism,oxidative stress,and apoptosis,etc.,thus,it is considered a potential therapeutic target for different kinds of pathologies including cancer,cardiovascular disease,respiratory disease,and other conditions.Moreover,identification of SIRT modulators and exploring the functions of these different modulators have prompted increased efforts to discover new small molecules,which can modify SIRT activity.Furthermore,several randomized controlled trials have indicated that different interventions might affect the expression of SIRT protein in human samples,and supplementation of SIRT modulators might have diverse impact on physiological function in different participants.In this review,we introduce the history and structure of the SIRT protein family,discuss the molecular mechanisms and biological functions of seven members of the SIRT protein family,elaborate on the regulatory roles of SIRTs in human disease,summarize SIRT inhibitors and activators,and review related clinical studies.

Surveillance on schistosomiasis in five provincial-level administrative divisions of the People's Republic of China in the post-elimination era

Background:The People's Republic of China(P.R.China)has made significant progress on schistosomiasis control.Among the 12 provincial-level administrative divisions(PLADs)with schistosomiasis endemic in P.R.China,Guangdong,Shanghai,Fujian,Guangxi and Zhejiang PLADs(following as five PLADs)had successively eliminated schistosomiasis during 1985-1995.However,consolidation of the schistosomiasis elimination in these five PLADs remains challenging.In the current study,we sought to understand the epidemic situation in these post-elimination areas and their surveillance capabilities on schistosomiasis.Methods:Annual data reflecting the interventions and surveillance on human beings,cattle and snails based on county level from 2005 to 2016 were collected through the national schistosomiasis reporting system and the data were analyzed to understand the epidemic status of schistosomiasis in the five PLADs.A standardized score sheet was designed to assess the surveillance capacity for schistosomiasis of selected disease control agencies in five PLADs and ten counties.Assessment on surveillance capacity including schistosomiasis diagnostic skills,identification of snails'living and infection status and knowledge about schistosomiasis and its control were made.Descriptive analysis was used to analyze the epidemic status and evaluation results on surveillance capacities.Results:The assessments showed that no local cases in humans and cattle or infected snail were found in these five PLADs since 2005.However,from 2005 to 2016,a total of 221 imported cases were detected in Zhejiang,Shanghai and Fujian,and 11.98 hm^2 of new snail habitats were found in Zhejiang,Shanghai and Guangxi.In addition,snail infestation reoccurred in 247.55 hm^2 of former snail habitats since 2011.For the surveillance capacity assessment,the accuracy rate of IHA and MHT were 100 and 89.3%,respectively.All participants could judge the living status of snails accurately and 98.1%on the infection status of snails.The accuracy rate of the questionnaire survey was 98.0%.Conclusions:Elimination of schistosomiasis was consolidated successfully in five PLADs of P.R.China due to effective and strong post-elimination surveillance.Comprehensive consolidation strategies should be focused on the elimination of residual snails and the prevention of imported infection sources to consolidate the achievements of schistosomiasis control.