Epirubicin,Cisplatin,5-FU combination chemotherapy in sorafenib-refractory metastatic hepatocellular carcinoma

AIM:To evaluate the clinical efficacy and safety of epirubicin,cisplatin,and 5-FU combination chemotherapy for the sorafenib-refractory metastatic hepatocellular carcinoma(HCC).METHODS:From April 2009 to June 2012,31 patients who were diagnosed with metastatic and progressive HCC after sorafenib treatment were retrospectively reviewed.Patients were treated with the combination of epirubicin(50 mg/m2Ⅳ;day 1),cisplatin(60 mg/m2Ⅳ;day 1),and 5-FU(1000 mg/m2Ⅳ;day 1-3)[Epirubicin,cisplatin,5-FU combination(ECF)],repeated every 4 wk.RESULTS:The overall response rate was 12.9%.Patients who responded to ECF chemotherapy showed a longer overall survival(OS)and time to progression(TTP)relative to those in the non-responder group(OS:20.4 mo vs 4.9 mo,P<0.001,TTP:9.4 mo vs 2.2 mo,P<0.001).Patients with a stable primary liver mass also exhibited a longer OS and TTP relative to those with progressive disease(OS:13.4 mo vs 5.3 mo,P=0.003;TTP:9.4 mo vs 2.3 mo,P=0.003).The most common hematologic toxicity was thrombocytopenia(87.2%),and the incidence of grade 3-4 neutropenia was 53.9%.Age older than 60,a stable primary mass,and a good response to chemotherapy were prognostic factors for OS and TTP.CONCLUSION:This combination cytotoxic chemotherapy can serve as another treatment option after sorafenib failure for the subset of patients with advanced metastatic HCC.

Docetaxel, cisplatin, and 5-fluorouracil compared with epirubicin,cisplatin, and 5-fluorouracil regimen for advanced gastric cancer:A systematic review and meta-analysis

BACKGROUND As the first-line regimens for the treatment of advanced gastric cancer, both docetaxel, cisplatin, and 5-fluorouracil(DCF) and epirubicin, cisplatin, and 5-fluorouracil(ECF) regimens are commonly used in clinical practice, but there is still controversy about which is better.AIM To compare the efficacy and safety of DCF and ECF regimens by conducting this meta-analysis.METHODS Computer searches in PubMed, EMBASE, Ovid MEDLINE, Science Direct, Web of Science, The Cochrane Library and Scopus were performed to find the clinical studies of all comparisons between DCF and ECF regimens. We used progression-free survival(PFS), overall survival(OS), objective response rate(ORR), disease control rate(DCR), and adverse effects(AEs) as endpoints for analysis.RESULTS Our meta-analysis included seven qualified studies involving a total of 598 patients. The pooled hazard ratios between the DCF and ECF groups were comparable in PFS(95%CI: 0.58-1.46, P = 0.73), OS(95%CI: 0.65-1.10, P = 0.21),and total AEs(95%CI: 0.93-1.29, P = 0.30). The DCF group was significantly better than the ECF group in terms of ORR(95%CI: 1.13-1.75, P = 0.002) and DCR(95%CI: 1.03-1.41, P = 0.02). However, the incidence rate of grade 3-4 AEs was also greater in the DCF group than in the ECF group(95%CI: 1.16-1.88, P = 0.002),especially for neutropenia and febrile neutropenia.CONCLUSION With better ORR and DCR values, the DCF regimen seems to be more suitable for advanced gastric cancer than the ECF regimen. However, the higher rate of AEs in the DCF group still needs to be noticed.

Unfavorable Pathological Complete Response Rate of Neoadjuvant Chemotherapy Epirubicin plus Taxanes for Locally Advanced Triple-negative Breast Cancer

Anthracycline-Taxane chemotherapy is widely used in neoadjuvant treatment for breast cancers. However, there is limited data reported in patients with triple negative breast cancer （TNBC）. Here, we evaluated the pathologic responses and survival of neoadjuvant epirubicin and taxanes chemotherapy in patients with locally advanced TNBC to provide some useful information for clinical practice. A total of 43 patients with locally advanced TNBC were enrolled in this study. Patients were administered with epirubicin 75 mg/m^2 plus paclitaxel 175 mg/m^2 or docetaxel 75 mg/m^2 every 3 weeks for at least 2 cycles. The primary endpoint was pathologic complete response （pCR）, which was defined as no residual invasive cancer, or only carcinoma in situ in both the excised breast and axillary lymph node, while relapse-free survival （RFS） and overall survival （OS） were secondary endpoints. Thirty-nine （90.7%） patients were at clinical stages II B-IIIC. Thirty-seven （86%） completed 4-6 cycles of preop- erative chemotherapy, and objective response rate （ORR） was 81.4% （35/43）. Forty-two patients un- derwent radical surgery subsequently. The pCR rate was 14.3% （6/42）. The most common adverse events in neoadjuvant chemotherapy were nausea/vomiting （88.4%, 38/43） and neutropenia （88.4%）. After a median follow-up period of 34.0 months, 3-year RFS and OS rate was 53.6% and 80.1%, respectively. All events of recurrence and death occurred in non-pCR patients, in whom the 3-year RFS and OS rates were 44.3% and 76.6%, respectively. This study suggest that neoadjuvant chemotherapy with epirubicin plus taxanes has a relatively low pCR rate and high early recurrence risk in locally ad- vanced TNBC, which indicates the necessity for more efficacious treatment. Further study is needed to validate these results.

The effect of monosialylganglioside mix modifying the PEGylated liposomal epirubicin on the accelerated blood clearance phenomenon

PEGylated liposomes are potential candidates to improve the pharmacokinetic characteristics of encapsulated drugs, to extend their circulation half-life and facilitate their passive accumulation at tumour sites. However, PEG-modified liposomes can induce accelerated blood clearance(ABC) upon repeated administration, and the extent of ABC phenomenon on the cytotoxic drugs-containing PEGylated liposomes is related to the dose of the cytotoxic drugs.In this study, EPI served as a model cytotoxic drug, a hydrophilic surfactant molecule,monosialylganglioside(GM1) was chosen and modified on the liposomes together with PEG.It was shown that upon mixed modification, when GM1 contents reached 10% or 15% mol,the ABC phenomenon of the PEGylated liposomal EPI significantly reduced. We also found that GM1 played an important role in abrogating the ABC phenomenon in both the induction phase and the effectuation phase. The results suggested that GM1 incorporation unfortunately did not avoid occurrence of ABC phenomenon completely, but GM1 modification on PEGylated liposomes may provide a significant improvement in clinical practice of PEGylated liposomes. Further study must be necessary.

DJ-1 Alters Epirubicin-induced Apoptosis via Modulating Epirubicin-activated Autophagy in Human Gastric Cancer Cells

Epirubicin,which is a conventional chemotherapeutic drug for gastric cancer,has innate and adaptive chemoresistance.Recent studies revealed that epirubicin could induce autophagy as a defensive mechanism in drug resistance of mammary carcinoma.Another study implied that D J-1 may be a chemoresistance-related gene.But the association between D J-1 and drug resistance of epirubicin in gastric cancer is still ambiguous.In the present report,we explored whether and how D J-1 conduced to epirubicin-induced apoptosis in gastric cancer.Epirubicin dose-dependently increased the expression of DJ-1 and induced autophagy.Knockdown of DJ-1 notably enhanced epirubicin-induced cell apoptosis,whereas overexpression of DJ-1 attenuated epirubicin-induced cell apoptosis.Further studies revealed that down-regulation of DJ-1 modulated epirubicin-activated autophagy which augmented epirubicin-induced apoptosis.In conclusion,our results validated that DJ-1 reduced epirubicin-induced apoptosis in gastric cancer cells via modulating epirubicin-activated autophagy.

Evaluation of Epirubicin-induced Cardiotoxicity by Two-dimensional Strain Echocardiography in Breast Cancer Patients

The value of two-dimensional strain echocardiography for assessing left ventricular regional systolic function in breast cancer patients who were treated with epirubicin was evaluated. A total of 116 breast cancer patients were divided into 3 groups： Thirty-eight patients in group A were given epirubicin （Epi） of 120-340 mg/m^2, 42 patients in group B received epimbicin of≥ 360 mg/m^2, and 36 patients after surging without chemotherapy served as the control group C. High frame rate two-dimensional images were recorded from apical long-axis view, four-chamber view, two-chamber view of left ventricle. Peak systolic strain of left ventricular subendocardial myocardium was measured using two-dimensional strain software. The conventional echocardiographic parameters were also obtained. Conventional echocardiography showed there was no significant changes in conventional echocardiographic parameters among the three groups （P〉0.05）. Two-dimensional strain echocardiography revealed that the peak systolic strain of left ventricular subendocardial myocardium in group A was reduced in some segments as compared with the controls （P〈0.05）. The peak systolic strain of left ventricular subendocardial myocardium in group B was reduced significantly as com- pared with group C （P〈0.05）, but that was reduced in group B just in some of the segments as compared with group A （P〈0.05）. It was concluded that two-dimensional strain echocardiography could early and sensitively display the effects of epirubicin-induced cardiotoxicity on the systolic function of left ventricular subendocardial myocardium, and early monitor the epirubicin-induced cardiotoxicity.

Quality of Life of Patients with Metastatic Breast Cancer Treated with Epirubicin and Docetaxel

This phase II study assessed the clinical response and short-term quality of life of patients receiving first-line chemotherapy with epirubicin-docetaxel combination for metastatic breast cancer. Thirty-one breast cancer patients were treated with epirubicin (75 mg/m2 for 15 minutes) followed one hour later by a one-hour infusion of docetaxel (75 mg/m2) q3w. EORTC QLQ-C30 and EORTC QLQ-BR23 forms were filled in at baseline, and at the second and eighth cycle of chemotherapy. The combination of epirubicin and docetaxel provided a high degree of clinical benefit. Clinical response was observed in 17 patients (55%), including five (16%) complete responses and 12 (39%) partial responses. Of responding and stable patients 23 (74%) maintained the same status for at least six months (clinical benefit). The mean survival time was 40.8 months. During the treatment the emotional functioning improved and the concerns about the future were relieved. Some aspects of quality of life were impaired, with slightly decreased physical and cognitive functioning, distress related to body image and hair loss, and adverse effects of chemotherapy. Overall, the global quality of life was maintained.

Epirubicin治疗曾化疗与未化疗晚期乳腺癌的疗效对比

Epirubicin单药治疗晚期乳腺癌,按照用过化疗与未用过化疗的病人分为两组。两组病人均按每次剂量递增的方法,50mg/M^2,60mg/M^2,70mg/M^2～80mg/M^2静脉注射,每3周1次。结果,未曾化疗的病人达PR的4/9例(44.4％),MR3/9(33.3％),NC2/9(22％)。曾用化疗的病人达CR1/11例(9％),MR2/11例(18％),NC1例,PD7例。Epi-Dx的心肌毒性与骨髓毒性较低,无1例发生急性充血性心力衰竭。本实验表明未曾化疗的病人比曾经化疗的病人疗效较高。

Epirubicin-[Anti-HER2/neu] Synthesized with an Epirubicin-(C13-imino)-EMCS Analog: Anti-Neoplastic Activity against Chemotherapeutic-Resistant SKBr-3 Mammary Carcinoma in Combination with Organic Selenium

Purpose: Discover the anti-neoplastic efficacy of epirubicin-(C13-imino)-[anti-HER2/neu] against chemotherapeutic- resistant SKBr-3 mammary carcinoma and delineate the capacity of selenium to enhance it’s cytotoxic anti-neoplastic potency. Methods: In molar excess, EMCH was combined with epirubicin to create a covalent epirubicin-(C13-imino)-EMCH-maleimide intermediate with sulfhydryl-reactive properties. Monoclonal immunoglobulin selective for HER2/neu was then thiolated with 2-iminothiolane at the terminal ε-amine group of lysine residues. The sulfhydryl-reactive epirubicin-(C13-imino)-EMCH intermediate was then combined with thiolated anti-HER2/neu monoclonal immunoglobulin. Western-blot analysis was utilized to characterize the molecular weight profiles while binding of epirubicin-(C13-imino)-[anti-HER2/neu] to membrane receptors was determined by cell-ELISA utilizing populations of SKBr-3 mammary carcinoma that highly over-expresses HER2/neu complexes. Anti-neoplastic potency of epirubicin-(C13-imino)-[anti-HER2/ neu] between the epirubicin-equivalent concentrations of 10–12 M and 10–7 M was determined by vitality staining analysis with and without the presence of selenium (5 μM). Results: Epiribucin-(C13-imino)-[anti-HER2/neu] between epirubicin-equivalent concentrations of 10–8 M to 10–7 M consistently evoked higher anti-neoplastic potency than “free” non- conjugated epirubicin which corresponded with previous investigations utilizing epirubicin-(C3-amide)-[anti-HER2/neu] and epirubicin-(C3-amide)-[anti-EGFR]. Selenium at 5 mM consistently enhanced the cytotoxic anti-neoplastic potency of epirubicin-(C13-imino)-[anti-HER2/neu] at epirubicin equivalent concentrations (10–12 to 10–7 M). Conclusions: Epirubicin-(C13-imino)-[anti-HER2/neu] is more potent than epirubicin against chemotherapeutic-resistant SKBr-3 mammary carcinoma and selenium enhances epirubicin-(C13-imino)-[anti-HER2/neu] potency. The methodology applied for synthesizing epirubicin-(C13-imino)-[anti-HER2/neu] is relatively time convenient and has low instrumentation requirements.

Epirubicin-gold nanoparticles suppress hepatocellular carcinoma xenograft growth in nude mice

We sought to investigate the effects of epirubicin-nanogold compounds （EPI-AuNP） on hepatocellular carcinoma xenograft growth in nude mice. EPI-AuNP was prepared and hepatoma xenograft model was established in nude mice. The mice were then randomly divided into four groups： the control group with injection of saline, the AuNP treatment group, the EPI treatment group and the EPI-AuNP treatment group. After two weeks, the hepatoma weight and volume of the xenografts were assessed. Our transmission electron microscopy revealed that epirubicin- gold nanoparticles caused significantly more structural changes of hepatocellular carcinoma cells HepG2. The tumor weight in the Epi-AuNP treatment group （0.80 ± 0.11 g） was significantly lower than that of the control group （2.48±0.15 g）, the AuNP treatment group （1.67±0.17 g）, and the EPI treatment group （1.39±0.10 g） （P〈0.01）. Furthermore, the tumor volume of mice in the EPI-AuNP treatment group （0.27 ± 0.06 cm3） was significantly smal- ler than that of the control group （2.23 ± 0.34 cm3）, the AuNP treatment group （1.21 ± 0.25 cm3） and the EPI treat- ment group （0.81 ± 0.11 cm3） （P〈0.01）. In conclusion, epirubicin-nanogold compounds （EPI-AuNP） have significant inhibitory effects on the growth of hepatocellular carcinoma cells in vivo.

Randomized Trial Comparing Cyclophosphamide, Methotrexate, and 5-Fluorouracil (CMF) Regimen with Rotational CMFEV Regimen (E=Epirubicin, V=Vincristine) as Adjuvant Chemotherapy in Moderate Risk Operable Breast Carcinoma

Objectives: The CMFEV (cyclophosphamide, methotrexate, 5-fluorouracil, epirubicin, vincristine) regimen is an innovative schedule, designed by our Group, aimed at administering five partially or totally no cross-resistant cytotoxic agents in breast carcinoma. It was randomly compared to CMF (cyclophosphamide, methotrexate, 5-fluorouracil) as primary treatment in operable disease and demonstrated a short-term significant increase in clinical complete response rate and a long-term significant locoregional relapse-free survival in premenopausal patients. So, it seemed worth comparing this regimen with CMF as adjuvant chemotherapy in moderate risk operable breast carcinoma. Methods: Four hundred and eighty-nine patients with stage I or II moderate risk breast carcinoma were randomized to receive CMF or CMFEV regimen for 6 cycles after surgery. Main end points were overall survival (OS), invasive disease-free survival (IDFS) and recurrence-free interval (RFI), as estimated by Kaplan-Meier analyses and log-rank tests. Results: At a median observation time of 7.3 years (range 5.4 months-10.3 years), no significant differences in OS and IDFS were observed between the two arms. Deaths from breast carcinoma were more frequent with CMF (58.5%) than with CMFEV regimen (41.7%) as well as recurrences from breast carcinoma (58.8% with CMF and 41.2% with CMFEV). These differences were not statistically significant. Conclusion: CMFEV appears more effective than CMF in preventing recurrences from primary disease in patients with moderate risk stage I-II breast carcinoma. The lack of statistical significance of the observed differences was probably due to the limited number of patients enrolled which rendered the study underpowdered.

Effect of the tea polyphenol combined with epirubicin on the apoptosis, autophagy and invasive growth of bladder cancer cells

Objective: To study the effect of the tea polyphenol combined with epirubicin on the apoptosis, autophagy and invasive growth of bladder cancer cells. Methods: T24 bladder cancer cell lines were cultured and divided into three groups, TP+EPI group were treated with 100 μmol/L tea polyphenol combined with 5 μmol/L epirubicin, EPI group were treated with 5 μmol/L epirubicin and control group were treated with drug-free RPMI medium. The mRNA expression of apoptosis, autophagy and invasion genes was measured after 24 h of treatment. Results: DAB2IP, PTEN, LC3 and Beclin1 mRNA expression in TP+EPI group and EPI group were significantly higher than those in control group while Rce1, YAP, DEK, p62, KPNA2, GRP78, Fra-1, SPOCK1 and CX43 mRNA expression were significantly lower than those in control group;DAB2IP, PTEN and p62 mRNA expression in TP+EPI group were significantly higher than those in EPI group while Rce1, YAP, DEK, LC3, Beclin1, KPNA2, GRP78, Fra-1, SPOCK1 and CX43 mRNA expression were significantly lower than those in EPI group. Conclusion:Tea polyphenol combined with epirubicin can promote the apoptosis and inhibit the autophagy and invasion of bladder cancer cells.

表柔比星、紫杉醇化疗辅助胃癌根治术患者血清HSP90α、CYFR211水平变化及预后影响因素分析

目的分析表柔比星联合紫杉醇化疗的胃癌根治术患者血清HSP90α、CYFR211水平及预后影响因素。方法选择胃癌根治术的患者96例,均采用表柔比星联合紫杉醇经动脉介入化疗。比较治疗前、治疗6周后、治疗12周后患者血清HSP90α、CYFR211水平。对患者随访2年,统计患者无进展生存时间(PFS)和总生存时间(OS),根据实体肿瘤WHO客观评价标准对患者预后进行评估,分为预后不良组和预后良好组,并通过单因素分析和多因素logistic回归分析影响胃癌根治术患者预后的危险因素。结果治疗6周后,2组患者血清HSP90α、CYFR211水平较治疗前低(P<0.05),治疗12周后,2组患者血清HSP90α、CYFR211水平较治疗前及治疗6周后低(P<0.05)。患者6个月、1年、2年无进展生存率分别为58.3%、30.2%、20.2%,6个月、1年、2年总生存率分别为81.2%、63.5%、32.6%,中位PFS和OS分别为10个月、16个月。单因素分析显示:胃癌根治术患者的预后与性别、体质指数、手术出血量、手术方式、术后是否出现严重不良反应、胃癌发生部位无关(P>0.05),而与年龄、肿瘤直径、手术时间、胃切除范围、TNM分期、肿瘤分化程度有关(P<0.05);多因素分析显示,年龄、肿瘤直径、胃切除范围、手术时间、TNM分期、肿瘤分化程度是影响胃癌根治术患者预后不良的独立危险因素(P<0.05)。结论表柔比星联合紫杉醇经动脉介入化疗治疗胃癌根治术患者,可以降低血清HSP90α、CYFR211水平,疗效尚可。年龄、肿瘤直径、胃切除范围、手术时间、TNM分期、肿瘤分化程度是胃癌根治术患者预后的独立影响因素。

中西医结合治疗三阴性乳腺癌1例

三阴性乳腺癌(TNBC)是指病理学免疫组化检测为雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体2(HER2)三者均无表达的乳腺癌类型,其具有恶性程度高、易转移、侵袭性强、预后差的特点。在临床上TNBC对靶向治疗、免疫治疗、内分泌治疗敏感度低,因此化学治疗为其主要治疗手段。中医药能缓解化疗毒副作用,减少化疗骨髓抑制及胃肠道不适反应发生。本研究报道1例静脉化疗与口服中医药结合治疗TNBC,目前患者带瘤生存10月余,预计生存时间5年以上,总生存期预计70个月。

表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者的效果

目的:观察表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者的效果。方法:选取2021年1月至2023年1月该院收治的122例原发性肝癌患者进行前瞻性研究,按照随机数字表法将其分为研究组与对照组各61例。对照组采用奥沙利铂联合氟尿嘧啶经导管动脉栓塞化疗,研究组在对照组的基础上联用注射用盐酸表柔比星进行经导管动脉栓塞化疗,比较两组客观缓解率(ORR)、血清肿瘤标志物[脊椎蛋白2(SPON2)、癌胚抗原]水平、血清肝功能指标[丙氨酸氨基转移酶(ALT)、总胆红素、白蛋白]水平、卡氏功能状态评分和不良反应发生率。结果:研究组ORR为86.89%,明显高于对照组的72.13%,差异有统计学意义(P<0.05);治疗8周后,研究组血清白蛋白水平和卡氏功能状态评分均高于对照组,血清癌胚抗原、SPON2、总胆红素和ALT水平低于对照组,差异均有统计学意义(P<0.05);两组恶心呕吐、脱发、白细胞降低等不良反应发生率比较,差异均无统计学意义(P>0.05)。结论:表柔比星联合奥沙利铂和氟尿嘧啶经导管动脉栓塞化疗用于原发性肝癌患者可提高ORR、卡氏功能状态评分和血清白蛋白水平,降低血清癌胚抗原、SPON2、总胆红素和ALT水平,效果优于单纯奥沙利铂联合氟尿嘧啶经导管动脉栓塞化疗。

术前血清FOXO1、FABP4水平与非肌层浸润性膀胱癌患者经尿道膀胱肿瘤切除术后灌注治疗疗效的相关性分析

目的:探讨术前血清叉头框蛋白O1(Fork head box protein O1,FoxO1)和脂肪酸转运蛋白4(fatty acid-binding protein 4,FABP4)与非肌层浸润性膀胱癌(Non-muscle invasive bladder cancer,NMIBC)患者灌注治疗疗效的关系。方法:选取2021年1月至2022年10月期间本院收治的68例NMIBC患者作为研究对象。所有患者进行经尿道膀胱肿瘤切除术(Transurethral resection of bladder tumor,TURBT)治疗,患者术后给予表柔比星膀胱灌注。随访12 m,根据最终的病理结果,将患者分为复发组和未复发组。检测对比两组术前血清FOXO1水平和FABP4水平。分析术前血清FABP4水平与TURBT术后膀胱灌注疗效的相关性及诊断价值。结果:68例患者TURBT术后给予表柔比星膀胱灌注,复发率22.1%。复发组术前血清FOXO1水平与未复发组无明显差异(P>0.05);复发组术前血清FABP4水平显著高于未复发组(P<0.05)。以术前血清FABP4水平预测TURBT术后给予表柔比星膀胱灌注治疗后复发的AUC=0.7052。结论:术前血清高FABP4水平提示TURBT术后给予表柔比星膀胱灌注治疗易复发,其用来预测表柔比星膀胱灌注治疗效果有较高价值。

含脂质体阿霉素AC-T方案在乳腺癌辅助化疗中安全性临床分析

目的 观察含脂质体阿霉素AC-T方案相较EC-T方案辅助化疗治疗乳腺癌的临床用药安全性。方法 回顾性分析102例乳腺癌术后辅助化疗患者临床资料,含脂质体阿霉素组48例给予AC-T方案治疗,表柔比星组54例给予EC-T方案治疗,化疗后评估化疗不良反应及临床用药安全性。结果 含脂质体阿霉素组在化疗后骨髓抑制、肝功损伤及心脏毒性等不良反应方面优于表柔比星组,差异有统计学意义(P<0.05);含脂质体阿霉素组在手足综合征方面发生率及严重程度明显较表柔比星组严重,差异有统计学意义(P<0.05)。而两组在胃肠道反应、过敏反应、脱发、周围神经炎等方面差异无统计学意义(P>0.05)。结论 含脂质体阿霉素AC-T方案治疗乳腺癌较传统EC-T方案在骨髓抑制、肝功损伤及心脏毒性方面不良反应轻,临床用药安全性高,而在手足综合征方面不良反应重,应引起临床重视。

表柔比星、环磷酰胺联合白蛋白紫杉醇在乳腺癌患者中的应用效果

目的:探究表柔比星、环磷酰胺联合白蛋白紫杉醇在乳腺癌患者中的应用效果。方法:选择2021年6月—2022年9月福建医科大学肿瘤临床医学院收治的80例乳腺癌患者作为研究对象,根据随机数表法将患者分为对照组40例和观察组40例。对照组采用表柔比星、环磷酰胺联合多西他赛进行治疗,观察组采用表柔比星、环磷酰胺联合白蛋白紫杉醇进行治疗。比较两组治疗效果、各类毒副反应发生情况、治疗前后趋化因子相关指标[趋化因子配体5(CCL5)、趋化因子配体18(CCL18)及趋化因子配体20(CCL20)]及血管内皮生长因子(VEGF)亚型(VEGF-A、VEGF-B及VEGF-C)。结果:观察组治疗总有效率高于对照组,差异有统计学意义(P<0.05)。两组各类毒副反应发生率比较,差异无统计学意义(P>0.05)。两组治疗前趋化因子相关指标及VEGF亚型比较,差异无统计学意义(P>0.05);观察组治疗2个周期、4个周期趋化因子相关指标及VEGF亚型均低于对照组,差异有统计学意义(P<0.05)。结论:表柔比星、环磷酰胺联合白蛋白紫杉醇在乳腺癌患者中的应用效果较好,安全性值得肯定,且可显著改善趋化因子相关指标及其对血管生成的影响。

奥沙利铂联合表柔比星介入治疗原发性肝癌的临床疗效分析

目的深入研究奥沙利铂+表柔比星介入治疗原发性肝癌的临床效果。方法回顾性分析2020年3月—2021年3月在吉林省肿瘤医院接受治疗的76例原发性肝癌患者的临床资料,根据治疗方法分为两组,各38例。研究组采用奥沙利铂+表柔比星治疗、参照组采用奥沙利铂+吉西他滨治疗。比较两组患者的临床疗效。结果治疗前,两组的肿瘤标志物比较,差异无统计学意义(P>0.05);治疗后,研究组的甲胎蛋白、缺氧诱导因子-1α、高尔基体蛋白低于参照组,差异有统计学意义(P<0.05)。治疗前,两组肝功能指标比较,差异无统计学意义(P>0.05);治疗后,研究组肝功能指标优于对照组,差异有统计学意义(P<0.05)。研究组的并发症发生率低于参照组,差异有统计学意义(P<0.05)。研究组的治疗总有效率(97.37%)高于参照组(65.79%),差异有统计学意义(χ^(2)=12.608,P<0.001)。结论给予患者奥沙利铂+表柔比星介入治疗,在控制肝癌疾病进展的同时,还能改善其肿瘤标志物等指标,不易引发一系列不良反应,安全性较高。

Changes of protein expression during tumorosphere formation of small cell lung cancer circulating tumor cells

Small cell lung cancer(SCLC)is frequently disseminated and has a dismal prognosis with survival times of approximately two years.This cancer responds well to initial chemotherapy but recurs within a short time as a globally chemoresistant tumor.Circulating tumor cells(CTCs)are held responsible for metastasis,the extremely high numbers of these cells in advanced SCLC allowed us to establish several permanent CTC cell lines.These CTCs are distinguished by the spontaneous formation of large spheroids,termed tumorospheres,in regular tissue culture.These contain quiescent and hypoxic cells in their interior and are associated with high chemoresistance compared to single cell cultures.Nine CTC lines were compared for their expression of 84 proteins associated with cancer either as single cells or in the form of tumorospheres in Western blot arrays.With the exception of the UHGc5 line,all other CTC lines express EpCAM and lack a complete EpCAM-negative,vimentin-positive epithelial-mesenchymal transition(EMT)phenotype.Upon formation of tumorospheres the expression of EpCAM,that mediates cell-cell adhesion is markedly upregulated.Proteins such as E-Cadherin,p27 KIP1,Progranulin,BXclx,Galectin-3,and Survivin showed variable changes for the distinct CTC cell lines.In conclusion,EpCAM presents the most critical marker for individual SCLC CTCs and the assembly of highly chemoresistant tumorospheres.