AIM: To investigate the correlation between uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene polymorphisms and irinotecan-associated side effects and parameters of drug efficacy in patients with metastat...AIM: To investigate the correlation between uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene polymorphisms and irinotecan-associated side effects and parameters of drug efficacy in patients with metastatic colorectal cancer (mCRC) receiving a low-dose weekly irinotecan chemotherapeutic regimen. METHODS: Genotypes were retrospectively evaluated by gene scan analysis on the ABI 310 sequencer of the TATAA box in the promoter region of the UGT1A1 gene in blood samples from 105 patients who had received 1st line irinotecan-based chemotherapy for mCRC. RESULTS: The distribution of the genotypes was as follows: wild type genotype (WT) (6/6 ) 39.0%, heterozygous genotype (6/7) 49.5%, and homozygous genotype (7/7) 9.5%. The overall response rate (OR) was similar between patients carrying the (6/7, 7/7) or the WT genotype (6/6) (44.3% vs 43.2%, P = 0.75). Neither time to progression [(TTP) 8.1 vs 8.2 mo, P = 0.97] nor overall survival [(OS) 21.2 vs 18.9 mo, P = 0.73] differed significantly in patients who carried the(6/6) when compared to the (6/7, 7/7) genotype. No significant differences in toxicity were observed: Grade 3 and 4 delayed diarrhoea [(6/7, 7/7) vs (6/6); 13.0% vs 6.2%, P =0.08], treatment delays [(6/7, 7/7) vs (6/6); 25.1% vs 19.3%, P = 0.24] or dose reductions [(6/7, 7/7) vs (6/6); 21.5% vs 27.2%, P = 0.07].CONCLUSION: This analysis demonstrates the non-significant influence of the UGT1A1 gene polymorphism on efficacy and rate of irinotecan-associated toxicity in mCRC patients receiving low-dose irinotecan based chemotherapy.展开更多
AIM: To evaluate whether contrast enhanced ultra- sound (CEUS) might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colore...AIM: To evaluate whether contrast enhanced ultra- sound (CEUS) might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS: Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment (CEUS date 1) and before the second (CEUS date 2) and fourth (CEU5 date 3) cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak (l-I-P) and RISE RATE]were correlated with radiological response.RESULTS: For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant (P 〈 0.001) correlation in TTP between metastases of responders (9.08 s) and non-responders (14.76 s) ar- chived on CEUS date 1. By calculating a standardized quotient (metastases divided by normal liver tissue) we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly (P 〈 0.01) dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION: CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.展开更多
We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year...We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.展开更多
Objective: The aim of this study was to evaluate the safety and efficiency of combination of trastuzumab and chemotherapy as first line regimen in Her-2 overexpressing metastatic breast cancer (MBC) patients. The p...Objective: The aim of this study was to evaluate the safety and efficiency of combination of trastuzumab and chemotherapy as first line regimen in Her-2 overexpressing metastatic breast cancer (MBC) patients. The primary endpoint was overall response rate (ORR) and the second endpoint was clinical benefit rate (CBR) and toxcities. Methods: Estrogen recep- tor (ER) (-), progesterone receptor (PR) (-), Her-2 (+++) patients were included in the study. 126 eligible patients were divided into 2 groups, 51 of them were assigned to the Herceptin group (H group) and 75 of them were assigned to the Control group (C group). They were treated by commonly used chemotherapy regimens with or without trastuzumab. Results: Response rate (RR) of the H group and the C group were 51.0% and 24.0% separately, and the difference were statistically significant (P 〈 0.05). CBR of the two groups were 76.4% (H group) and 64.0% (C group), had significant difference (P 〈 0.05). Complete response rate (CRR) of the two groups were 21.5% and 6.6%, there were no significant difference between the two groups (P = 0.055). Grade 3-4 cardiac toxicity were recorded in 9 patients with trastuzumab plus chemotherapy (17.6%) and 4 patients with chemotherapy (5.4%), with no statistical significance (P = 0.054). In the subgroup of antharcycline-containing regimens, Grade 1-4 cardiac toxicity occurred in 9 patients in the trasutuzumab combining with antharcycline-containing regimens arm [herceptin plus anthracyciine contained chemotherapy (H + ACCT arm; 40.9%, g/22)], and 4 patients in the antharcycline- containing chemotherapy arm (ACCT arm; 12.5%, 4/32). There was statistical significant difference between the two arms (P 〈 0.05). Grade 3--4 cardiac toxicity, the occurance rates were 18.1% (4/22) in H + ACCT arm and 6.3% (2/32) in ACCT arm, and there was no significant statistical difference (P = 0.352). Grade 3-4 granulocytopenia in the H group and C group were 27.5% (14/51) and 26.7% (20/75), with no significant difference (P = 0.922). Conclusion: The efficiency of trastuzumab combining with chemotherapy using as first line regimen in Her-2 overexpressing MBC patients were exact. However, the long-term cardiac toxicity can be hidden troubles of trastuzumab using.展开更多
文摘AIM: To investigate the correlation between uridine diphosphate glucuronosyl transferase 1A1 (UGT1A1) gene polymorphisms and irinotecan-associated side effects and parameters of drug efficacy in patients with metastatic colorectal cancer (mCRC) receiving a low-dose weekly irinotecan chemotherapeutic regimen. METHODS: Genotypes were retrospectively evaluated by gene scan analysis on the ABI 310 sequencer of the TATAA box in the promoter region of the UGT1A1 gene in blood samples from 105 patients who had received 1st line irinotecan-based chemotherapy for mCRC. RESULTS: The distribution of the genotypes was as follows: wild type genotype (WT) (6/6 ) 39.0%, heterozygous genotype (6/7) 49.5%, and homozygous genotype (7/7) 9.5%. The overall response rate (OR) was similar between patients carrying the (6/7, 7/7) or the WT genotype (6/6) (44.3% vs 43.2%, P = 0.75). Neither time to progression [(TTP) 8.1 vs 8.2 mo, P = 0.97] nor overall survival [(OS) 21.2 vs 18.9 mo, P = 0.73] differed significantly in patients who carried the(6/6) when compared to the (6/7, 7/7) genotype. No significant differences in toxicity were observed: Grade 3 and 4 delayed diarrhoea [(6/7, 7/7) vs (6/6); 13.0% vs 6.2%, P =0.08], treatment delays [(6/7, 7/7) vs (6/6); 25.1% vs 19.3%, P = 0.24] or dose reductions [(6/7, 7/7) vs (6/6); 21.5% vs 27.2%, P = 0.07].CONCLUSION: This analysis demonstrates the non-significant influence of the UGT1A1 gene polymorphism on efficacy and rate of irinotecan-associated toxicity in mCRC patients receiving low-dose irinotecan based chemotherapy.
文摘AIM: To evaluate whether contrast enhanced ultra- sound (CEUS) might also be used for response predic- tion and early response evaluation in patients receiving bevacizumab based chemotherapy for metastasized colorectal cancer.METHODS: Thirty consecutive patients with non prima- ry resectable liver metastases from colorectal cancer underwent CEUS before treatment (CEUS date 1) and before the second (CEUS date 2) and fourth (CEU5 date 3) cycle of bevacizumab based chemotherapy. Three parameters [PEAK, Time to peak (l-I-P) and RISE RATE]were correlated with radiological response.RESULTS: For neoadjuvant purpose a reduction of tu- mour mass was required to assume clinical response. Based on these response criteria there was a significant (P 〈 0.001) correlation in TTP between metastases of responders (9.08 s) and non-responders (14.76 s) ar- chived on CEUS date 1. By calculating a standardized quotient (metastases divided by normal liver tissue) we were able to define a cut off, predicting response with a sensitivity of 92.3 % and a specificity of 100 %. To reflect a palliative intention only those patients with progressive disease were classified as non-responders. In this stetting -FI-P was also significantly (P 〈 0.01) dif- ferent between responders and non-responders. In con- trast, Peak and Rise rate did not show any significant difference between responder and non-responder. CONCLUSION: CEUS might serve as a surrogate mark- er to predict treatment response in patients with me- tastasized colorectal cancer who receive antiangiogenic therapy.
文摘We report the successful treatment of multiple lung metastases after hepatic resection for hepatocellular carcinoma (HCC) with combined docetaxel, cisplatin (CDDP), and enteric-coated tegafur/uracil (UFT-E). A 68-year-old man was diagnosed with multiple lung metastases of HCC 7 mo after partial hepatectomy for HCC. Oral UFT-E was given daily and docetaxel and CDDP were given intra-arterially (administered just before the bronchial arteries) every 2 wk via a subcutaneous injection port. One month after starting chemotherapy, levels of tumor marker, protein induced by vitamin K absence(PIVKA--), decreased rapidly,and after a further month, chest X-ray and computed tomography revealed the complete disappearance of multiple liver metastases. Two years after the combined chemotherapy, HCC recurred in the liver and was treated but no pulmonary recurrence occurred. In the absence of a standardized highly effective therapy, this combined chemotherapy with docetaxel, CDDP and UFT-E may be an attractive option for multiple lung metastases of HCC.
基金Supported by grants from the Sub-topics of Major Drug Discovery Platform in the Twelfth-Five Year Research Program of China(No.2012ZX09303016-002)Liaoning Province Science & Technology Development Funds(No.2012225019)
文摘Objective: The aim of this study was to evaluate the safety and efficiency of combination of trastuzumab and chemotherapy as first line regimen in Her-2 overexpressing metastatic breast cancer (MBC) patients. The primary endpoint was overall response rate (ORR) and the second endpoint was clinical benefit rate (CBR) and toxcities. Methods: Estrogen recep- tor (ER) (-), progesterone receptor (PR) (-), Her-2 (+++) patients were included in the study. 126 eligible patients were divided into 2 groups, 51 of them were assigned to the Herceptin group (H group) and 75 of them were assigned to the Control group (C group). They were treated by commonly used chemotherapy regimens with or without trastuzumab. Results: Response rate (RR) of the H group and the C group were 51.0% and 24.0% separately, and the difference were statistically significant (P 〈 0.05). CBR of the two groups were 76.4% (H group) and 64.0% (C group), had significant difference (P 〈 0.05). Complete response rate (CRR) of the two groups were 21.5% and 6.6%, there were no significant difference between the two groups (P = 0.055). Grade 3-4 cardiac toxicity were recorded in 9 patients with trastuzumab plus chemotherapy (17.6%) and 4 patients with chemotherapy (5.4%), with no statistical significance (P = 0.054). In the subgroup of antharcycline-containing regimens, Grade 1-4 cardiac toxicity occurred in 9 patients in the trasutuzumab combining with antharcycline-containing regimens arm [herceptin plus anthracyciine contained chemotherapy (H + ACCT arm; 40.9%, g/22)], and 4 patients in the antharcycline- containing chemotherapy arm (ACCT arm; 12.5%, 4/32). There was statistical significant difference between the two arms (P 〈 0.05). Grade 3--4 cardiac toxicity, the occurance rates were 18.1% (4/22) in H + ACCT arm and 6.3% (2/32) in ACCT arm, and there was no significant statistical difference (P = 0.352). Grade 3-4 granulocytopenia in the H group and C group were 27.5% (14/51) and 26.7% (20/75), with no significant difference (P = 0.922). Conclusion: The efficiency of trastuzumab combining with chemotherapy using as first line regimen in Her-2 overexpressing MBC patients were exact. However, the long-term cardiac toxicity can be hidden troubles of trastuzumab using.