Individualized treatment of breast cancer with chronic renal failure: A case report and review of literature

BACKGROUND Studies have shown that patients with chronic renal failure(CRF)are more likely to suffer from breast cancer and other malignant tumors.To our knowledge,CRF can reduce drug excretion,thereby increase drug exposure and lead to increased toxicity,which will limit drug treatment and lead to tumor progression.Currently,there are few successful reports on the combination of docetaxel,trastuzumab,and pertuzumab(THP)as a neoadjuvant treatment regimen for breast cancer patients with CRF.CASE SUMMARY We report a breast cancer(cT2N2M0,Her-2+/HR-)patient with CRF.It was a clinical stage IIIA tumor on the left breast.The patient had suffered from uremia for 2 years,and her heart function was normal.Based on the pathological type,molecular type,and clinical stage of breast cancer,and the patient’s renal function,the clinician analyzed the pharmacological and pharmacokinetic characteristics of the antitumor drugs after consulting the relevant literature,and prescribed the neoadjuvant regimen of THP(docetaxel 80 mg/m²,trastuzumab 8 mg/kg for the first dose,and 6 mg/kg for the maintenance dose with pertuzumab 840 mg for the first dose and 420 mg for the maintenance dose),once every 3 wk,for a total of 6 courses.The neoadjuvant treatment had a good effect,and the patient then underwent surgery which was uneventful.CONCLUSION CRF is not a contraindication for systemic treatment and surgery of breast cancer.The THP regimen without dose adjustment may be a safe and effective neoadjuvant treatment for HER-2 positive breast cancer patients with CRF.

Follicular carcinoma of the thyroid with a single metastatic lesion in the lumbar spine:A case report

BACKGROUND The bone is the second most common site of thyroid cancer metastasis,after the lung.Treatment options for bone metastasis of thyroid cancer include surgery,radioiodine therapy(RAIT),external radiation therapy,thyroid-stimulating hormone(TSH)inhibition,bisphosphonates,and small-molecule targeted therapies.In most cases,thyroid carcinoma is found in the thyroid tissue;reports of follicular thyroid carcinoma with a single metastasis to the lumbar spine are rare.CASE SUMMARY We report a case of bone metastasis as the only clinical manifestation of thyroid cancer.The patient was a 67-year-old woman with lumbar pain for 7 years and aggravation with intermittent claudication who had previously undergone partial thyroidectomy of a benign thyroid lesion.No abnormal nodules were found in the bilateral thyroid glands.However,imaging studies were consistent with a spinal tumor,and the lesion was diagnosed as a metastatic follicular carcinoma of thyroid origin.We adopted a multidisciplinary collaboration and comprehensive treatment approach.The patient underwent lumbar spine surgery,total resection of the thyroid,postoperative TSH suppression therapy,and RAIT.There were no complications associated with the operation,and the patient had good postoperative recovery.She has experienced no recurrence.CONCLUSION Follicular thyroid carcinoma is associated with early hematogenous metastasis,and the bone is a typical site of metastasis.Single bone metastasis is not a contraindication to medical procedures,and providing the appropriate therapy can result in better outcomes and quality of life for these patients.

Fas-670 A/G polymorphism predicts prognosis of hepatocellular carcinoma after curative resection in Chinese Han population

Background:Apoptosis,also called programmed cell death,is a genetically controlled process against hyperproliferation and malignancy.The Fas-Fas ligand(FasL)system is considered a major pathway for apoptosis in cells and tissues.Thus,this study aimed to investigate whether single nucleotide polymor-phisms(SNPs)in Fas and FasL gene may have effects on the recurrence and survival of patients with hepatocellular carcinoma(HCC)after curative hepatectomy.Methods:We investigated the relationship between Fas rs1800682,rs2234767 and FasL rs763110 poly-morphisms and recurrence-free survival(RFS)as well as overall survival(OS)in 117 Chinese Han patients with HCC who underwent hepatectomy.Results:In Kaplan-Meier survival analysis,only Fas rs1800682(-670 A/G)was associated with RFS and OS.Compared with AA genotype,the AG/GG genotype was significantly associated with better RFS(P=0.008)and OS(P=0.020).Moreover,multivariate Cox regression analysis showed that Fas rs1800682 remained as a significant independent predictor of RFS for HCC patients with hepatectomy[AG/GG vs.AA:adjusted hazard ratio=0.464,95%confidence interval:0.275-0.782,P=0.004],but was not an independent predictor of OS(P=0.395).Conclusions:This study demonstrated that Fas-670 G allele may play a protective role in the recurrence and survival of HCC patients with hepatectomy.Furthermore,Fas rs1800682 polymorphism might be a promising biomarker for HCC patients after hepatectomy.

Nomogram for predicting overall survival in Chinese triple-negative breast cancer patients after surgery

BACKGROUND There are few nomograms for the prognosis of Chinese patients with triplenegative breast cancer(TNBC).AIM To construct and validate a nomogram for overall survival(OS)of Chinese TNBC patients after surgery.METHODS This study used the data of SEER*stat 8.3.5 and selected Chinese patients with TNBC operated on between 2010 and 2015.Univariate and multivariate Cox proportional hazard regression models were used.The identified variables were integrated to form a predictive nomogram and risk stratification model;it was assessed with C-indexes and calibration curves.RESULTS The median and maximal OS of the 336 patients was 39 and 83 mo,respectively.The multivariate analysis showed that age(P=0.043),marital status(P=0.040),tumor localization(P=0.030),grade(P=0.035),T classification(P=0.012),and N classification(P=0.002)were independent prognostic factors.The six variables were combined to construct a 1-,3-and 5-year OS nomogram.The C-indexes of the nomogram to predict OS were 0.766 and compared to the seventh edition staging system,which was higher(0.766 vs 0.707,P<0.001).In order to categorize patients into different prognostic groups,a risk stratification model was created.There was a significant difference between the Kaplan–Meier curves of the entire cohort and each disease stage according to the nomogram.CONCLUSION The nomogram provided prognostic superiority over the traditional tumor,node and metastasis system.It could help clinicians make individual OS or risk predictions for Chinese TNBC patients after surgery.

Computational prediction of cleavage using proteasomal in vitro digestion and MHC I ligand data

Proteasomes are responsible for the production of the majority of cytotoxic T lymphocyte(CTL) epitopes.Hence,it is important to identify correctly which peptides will be generated by proteasomes from an unknown protein.However,the pool of proteasome cleavage data used in the prediction algorithms,whether from major histocompatibility complex(MHC) I ligand or in vitro digestion data,is not identical to in vivo proteasomal digestion products.Therefore,the accuracy and reliability of these models still need to be improved.In this paper,three types of proteasomal cleavage data,constitutive proteasome(cCP),immunoproteasome(iCP) in vitro cleavage,and MHC I ligand data,were used for training cleave-site predictive methods based on the kernel-function stabilized matrix method(KSMM).The predictive accuracies of the KSMM+pair coefficients were 75.0%,72.3%,and 83.1% for cCP,iCP,and MHC I ligand data,respectively,which were comparable to the results from support vector machine(SVM).The three proteasomal cleavage methods were combined in turn with MHC I-peptide binding predictions to model MHC I-peptide processing and the presentation pathway.These integrations markedly improved MHC I peptide identification,increasing area under the receiver operator characteristics(ROC) curve(AUC) values from 0.82 to 0.91.The results suggested that both MHC I ligand and proteasomal in vitro degradation data can give an exact simulation of in vivo processed digestion.The information extracted from cCP and iCP in vitro cleavage data demonstrated that both cCP and iCP are selective in their usage of peptide bonds for cleavage.

A K self-adaptive SDN controller placement for wide area networks

As a novel architecture,software-defined networking(SDN) is viewed as the key technology of future networking.The core idea of SDN is to decouple the control plane and the data plane,enabling centralized,flexible,and programmable network control.Although local area networks like data center networks have benefited from SDN,it is still a problem to deploy SDN in wide area networks(WANs) or large-scale networks.Existing works show that multiple controllers are required in WANs with each covering one small SDN domain.However,the problems of SDN domain partition and controller placement should be further addressed.Therefore,we propose the spectral clustering based partition and placement algorithms,by which we can partition a large network into several small SDN domains efficiently and effectively.In our algorithms,the matrix perturbation theory and eigengap are used to discover the stability of SDN domains and decide the optimal number of SDN domains automatically.To evaluate our algorithms,we develop a new experimental framework with the Internet2 topology and other available WAN topologies.The results show the effectiveness of our algorithm for the SDN domain partition and controller placement problems.