This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vin- blastine, and dacarbazine （ABVD） with the dose-dense ABVD regimen （ABVD-21） in terms of effi- cacy and toxicity. Patients who h...This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vin- blastine, and dacarbazine （ABVD） with the dose-dense ABVD regimen （ABVD-21） in terms of effi- cacy and toxicity. Patients who had early-stage unfavorable or advanced Hodgkin＇s lymphoma （HL） according to German Hodgkin Study Group criteria from March 1999 to February 2011 were ana- lyzed for treatment response, long-term survival and hematological toxicity. There were 85 patients in the ABVD-21 group and 118 patients in the ABVD group respectively. The complete remission rates aider completion of treatment were 92.9% and 90.7% for ABVD-21 and ABVD, respectively. During a median follow-up period of 62 months, no significant difference was found in projected 10-year progression-free survival （PFS） and overall survival （OS） rates （84.7% and 94.1% respectively for ABVD-21; 81.4% and 91.5% for ABVD）. Subgroup analyses showed that ABVD-21 was signifi- cantly better than ABVD for patients with IPS〉3 in terms of PFS and OS rates. Grade 3 to 4 leuko- penia （51.8% vs. 28.8%, P=0.001） and neutropenia （57.6% vs. 39.0%, P=0.009） were more common with ABVD-21. We were led to conclude that dose-dense ABVD did not result in better tumor con- trol and overall survival than did ABVD for early-stage unfavorable HL. However, patients at high risk, for example, with IPS〉3, may benefit from dose-dense ABVD.展开更多
Dose-dense chemotherapy is the preferred first-line therapy for triple-negative breast cancer(TNBC),a highly aggressive disease with a poor prognosis.This treatment uses the same drug doses as conventional chemotherap...Dose-dense chemotherapy is the preferred first-line therapy for triple-negative breast cancer(TNBC),a highly aggressive disease with a poor prognosis.This treatment uses the same drug doses as conventional chemotherapy but with shorter dosing intervals,allowing for promising clinical outcomes with intensive treatment.However,the frequent systemic administration used for this treatment results in systemic toxicity and low patient compliance,limiting therapeutic efficacy and clinical benefit.Here,we report local dose-dense chemotherapy to treat TNBC by implanting 3D printed devices with timeprogrammed pulsatile release profiles.The implantable device can control the time between drug releases based on its internal microstructure design,which can be used to control dose density.The device is made of biodegradable materials for clinical convenience and designed for minimally invasive implantation via a trocar.Dose density variation of local chemotherapy using programmable release enhances anti-cancer effects in vitro and in vivo.Under the same dose density conditions,device-based chemotherapy shows a higher anticancer effect and less toxic response than intratumoral injection.We demonstrate local chemotherapy utilizing the implantable device that simulates the drug dose,number of releases,and treatment duration of the dose-dense AC(doxorubicin and cyclophosphamide)regimen preferred for TNBC treatment.Dose density modulation inhibits tumor growth,metastasis,and the expression of drug resistance-related proteins,including p-glycoprotein and breast cancer resistance protein.To the best of our knowledge,local dose-dense chemotherapy has not been reported,and our strategy can be expected to be utilized as a novel alternative to conventional therapies and improve anti-cancer efficiency.展开更多
Objective:The objective of this open-label,randomized study was to compare dose-dense paclitaxel plus carboplatin(PCdd)with dose-dense epirubicin and cyclophosphamide followed by paclitaxel(ECdd-P)as an adjuvant chemo...Objective:The objective of this open-label,randomized study was to compare dose-dense paclitaxel plus carboplatin(PCdd)with dose-dense epirubicin and cyclophosphamide followed by paclitaxel(ECdd-P)as an adjuvant chemotherapy for early triple-negative breast cancer(TNBC).Methods:We included Chinese patients with high recurrence risk TNBC who underwent primary breast cancer surgery.They were randomly assigned to receive PCdd[paclitaxel 150 mg/m2 on d 1 and carboplatin,the area under the curve,(AUC)=3 on d 2]or ECdd-P(epirubicin 80 mg/m2 divided in 2 d and cyclophosphamide 600 mg/m2 on d 1 for 4 cycles followed by paclitaxel 175 mg/m2 on d 1 for 4 cycles)every 2 weeks with granulocyte colony-stimulating factor(G-CSF)support.The primary endpoint was 3-year disease-free survival(DFS);the secondary endpoints were overall survival(OS)and safety.Results:The intent-to-treat population included 143 patients(70 in the PCdd arm and 73 in the ECdd-P arm).Compared with the ECdd-P arm,the PCdd arm had significantly higher 3-year DFS[93.9%vs.79.1%;hazard ratio(HR)=0.310;95%confidence interval(95%CI),0.137-0.704;log-rank,P=0.005]and OS(98.5%vs.92.9%;HR=0.142;95%CI,0.060-0.825;log-rank,P=0.028).Worse neutropenia(grade 3/4)was found in the ECdd-P than the PCdd arm(47.9%V5.21.4%,P=0.001).Conclusions:PCdd was superior to ECdd-P as an adjuvant chemotherapy for early TNBC with respect to improving the 3-year DFS and OS.PCdd also yielded lower hematological toxicity.Thus,PCdd might be a preferred regimen for early TNBC patients with a high recurrence risk.展开更多
Chemotherapy with continuous infusion of 5-fluorouracil and cisplatin in a monthly schedule is one of the most common regimens in the treatment of advanced gastric cancer. In this study, we evaluated the efficacy and ...Chemotherapy with continuous infusion of 5-fluorouracil and cisplatin in a monthly schedule is one of the most common regimens in the treatment of advanced gastric cancer. In this study, we evaluated the efficacy and safety of a dosedense administration of this regimen in this patient population. Sixty-six consecutive patients with previously untreated histologically confirmed unresectable or metastatic gastric adenocarcinoma were treated with a 2-hour infusion of cisplatin 100 mg/m2 followed by continuous infusion of 5-fluorouracil 1000 mg/m2/day for 5 days, every 21 days. The most common grade ≥3 toxicities were fatigue (42%), nausea/vomiting (30%) and leucopenia (12%). Four patients (6%) died from treatment-related toxicity. The response rate was 35%, the median progression-free survival was 4.3 months and the median survival was 5.9 months. In light of these results, the dose-dense approach seems to offer little, if any, benefit compared with the standard regimens.展开更多
1文献来源
Viviani S, Zinzani PL, Rambaldi A, et al. ABVD versus BEACOPP for Hodgkin＇s lymphoma when high-dose salvage is planned [J]. N Engl J Med, 2011,365（3） ：203-212.
1文献来源
Federico M, Luminari S, Iannitto E, et al.ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin＇s lymphoma： Results from the HD2000 Gruppo Italiano per l...1文献来源
Federico M, Luminari S, Iannitto E, et al.ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin＇s lymphoma： Results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial [J]. J Clin Oncol, 2009,27（5）：805-811.展开更多
BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin ...BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin infiltration,reporting a wide range of clinical presentations that frequently include ulcers;plaques,nodules and papules have also been noticed.CASE SUMMARY We report the case of a 56-year-old man who presented fever,multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions.After an initial diagnostic workup for a suspected active infectious disease,a lymph node biopsy was performed,which showed a neoplastic invasion from a mixed cellularity classical HL.The same histological pattern was described in a cutaneous biopsy of the chest lesions.The other staging procedures performed revealed an advanced disease,with unfavourable clinical prognostic features.The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin,bleomycin,vinblastine,dacarbazine),a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.CONCLUSION Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.展开更多
BACKGROUND The outcomes of Hodgkin's lymphoma(HL)in Mexico have not been widely reported.Simplified and affordable treatments have been adopted in middleincome countries.AIM The aim was to evaluate long-used thera...BACKGROUND The outcomes of Hodgkin's lymphoma(HL)in Mexico have not been widely reported.Simplified and affordable treatments have been adopted in middleincome countries.AIM The aim was to evaluate long-used therapies for HL in Mexico in a long-term basis.METHODS In a 34-year time period,88 patients with HL were treated at a single institution in Mexico.Patients were treated with adriamycin bleomycin vinblastine and dacarbazine(ABVD)or mechlorethamine,vincristine,procarbazine,and prednisone(MOPP).Relapsed or refractory patients were given ifosfamide,carboplatin,and etoposide(ICE)followed by autologous or allogeneic stem cell transplants.RESULTS Thirty-seven women and 51 men were included;the median age was 29 years.Patients were followed for a mean of 128 mo.The 310-mo overall survival(OS)was 83%for patients treated with MOPP and 88%for those treated with ABVD.The OS of patients who received autologous stem cell transplantation was 76%(330 mo)vs 93%(402 mo)in those who did not.CONCLUSION HL may be less aggressive in Mexican population than in Caucasians.Combined chemotherapy renders acceptable results,regardless of clinical stage.展开更多
文摘This retrospective analysis compared standard regimen of doxorubicin, bleomycin, vin- blastine, and dacarbazine （ABVD） with the dose-dense ABVD regimen （ABVD-21） in terms of effi- cacy and toxicity. Patients who had early-stage unfavorable or advanced Hodgkin＇s lymphoma （HL） according to German Hodgkin Study Group criteria from March 1999 to February 2011 were ana- lyzed for treatment response, long-term survival and hematological toxicity. There were 85 patients in the ABVD-21 group and 118 patients in the ABVD group respectively. The complete remission rates aider completion of treatment were 92.9% and 90.7% for ABVD-21 and ABVD, respectively. During a median follow-up period of 62 months, no significant difference was found in projected 10-year progression-free survival （PFS） and overall survival （OS） rates （84.7% and 94.1% respectively for ABVD-21; 81.4% and 91.5% for ABVD）. Subgroup analyses showed that ABVD-21 was signifi- cantly better than ABVD for patients with IPS〉3 in terms of PFS and OS rates. Grade 3 to 4 leuko- penia （51.8% vs. 28.8%, P=0.001） and neutropenia （57.6% vs. 39.0%, P=0.009） were more common with ABVD-21. We were led to conclude that dose-dense ABVD did not result in better tumor con- trol and overall survival than did ABVD for early-stage unfavorable HL. However, patients at high risk, for example, with IPS〉3, may benefit from dose-dense ABVD.
基金supported by the National Research Foundation of Korea(NRF)grant funded by the Ministry of Science and ICT(MSIT)(No.2021R1A2C2012808)Technology Innovation Program(Alchemist Project)(No.20012378)funded by the Ministry of Trade,Industry&Energy(MOTIE),South Korea.
文摘Dose-dense chemotherapy is the preferred first-line therapy for triple-negative breast cancer(TNBC),a highly aggressive disease with a poor prognosis.This treatment uses the same drug doses as conventional chemotherapy but with shorter dosing intervals,allowing for promising clinical outcomes with intensive treatment.However,the frequent systemic administration used for this treatment results in systemic toxicity and low patient compliance,limiting therapeutic efficacy and clinical benefit.Here,we report local dose-dense chemotherapy to treat TNBC by implanting 3D printed devices with timeprogrammed pulsatile release profiles.The implantable device can control the time between drug releases based on its internal microstructure design,which can be used to control dose density.The device is made of biodegradable materials for clinical convenience and designed for minimally invasive implantation via a trocar.Dose density variation of local chemotherapy using programmable release enhances anti-cancer effects in vitro and in vivo.Under the same dose density conditions,device-based chemotherapy shows a higher anticancer effect and less toxic response than intratumoral injection.We demonstrate local chemotherapy utilizing the implantable device that simulates the drug dose,number of releases,and treatment duration of the dose-dense AC(doxorubicin and cyclophosphamide)regimen preferred for TNBC treatment.Dose density modulation inhibits tumor growth,metastasis,and the expression of drug resistance-related proteins,including p-glycoprotein and breast cancer resistance protein.To the best of our knowledge,local dose-dense chemotherapy has not been reported,and our strategy can be expected to be utilized as a novel alternative to conventional therapies and improve anti-cancer efficiency.
基金This work was supported by National Key Research and Development Program of China(No.2O18YFC13121O1)Chinese Academy of Medical Science Initiative for Innovative Medicine(No.CAMS-2016-I2M-1-010).
文摘Objective:The objective of this open-label,randomized study was to compare dose-dense paclitaxel plus carboplatin(PCdd)with dose-dense epirubicin and cyclophosphamide followed by paclitaxel(ECdd-P)as an adjuvant chemotherapy for early triple-negative breast cancer(TNBC).Methods:We included Chinese patients with high recurrence risk TNBC who underwent primary breast cancer surgery.They were randomly assigned to receive PCdd[paclitaxel 150 mg/m2 on d 1 and carboplatin,the area under the curve,(AUC)=3 on d 2]or ECdd-P(epirubicin 80 mg/m2 divided in 2 d and cyclophosphamide 600 mg/m2 on d 1 for 4 cycles followed by paclitaxel 175 mg/m2 on d 1 for 4 cycles)every 2 weeks with granulocyte colony-stimulating factor(G-CSF)support.The primary endpoint was 3-year disease-free survival(DFS);the secondary endpoints were overall survival(OS)and safety.Results:The intent-to-treat population included 143 patients(70 in the PCdd arm and 73 in the ECdd-P arm).Compared with the ECdd-P arm,the PCdd arm had significantly higher 3-year DFS[93.9%vs.79.1%;hazard ratio(HR)=0.310;95%confidence interval(95%CI),0.137-0.704;log-rank,P=0.005]and OS(98.5%vs.92.9%;HR=0.142;95%CI,0.060-0.825;log-rank,P=0.028).Worse neutropenia(grade 3/4)was found in the ECdd-P than the PCdd arm(47.9%V5.21.4%,P=0.001).Conclusions:PCdd was superior to ECdd-P as an adjuvant chemotherapy for early TNBC with respect to improving the 3-year DFS and OS.PCdd also yielded lower hematological toxicity.Thus,PCdd might be a preferred regimen for early TNBC patients with a high recurrence risk.
文摘Chemotherapy with continuous infusion of 5-fluorouracil and cisplatin in a monthly schedule is one of the most common regimens in the treatment of advanced gastric cancer. In this study, we evaluated the efficacy and safety of a dosedense administration of this regimen in this patient population. Sixty-six consecutive patients with previously untreated histologically confirmed unresectable or metastatic gastric adenocarcinoma were treated with a 2-hour infusion of cisplatin 100 mg/m2 followed by continuous infusion of 5-fluorouracil 1000 mg/m2/day for 5 days, every 21 days. The most common grade ≥3 toxicities were fatigue (42%), nausea/vomiting (30%) and leucopenia (12%). Four patients (6%) died from treatment-related toxicity. The response rate was 35%, the median progression-free survival was 4.3 months and the median survival was 5.9 months. In light of these results, the dose-dense approach seems to offer little, if any, benefit compared with the standard regimens.
文摘1文献来源
Viviani S, Zinzani PL, Rambaldi A, et al. ABVD versus BEACOPP for Hodgkin＇s lymphoma when high-dose salvage is planned [J]. N Engl J Med, 2011,365（3） ：203-212.
文摘1文献来源
Federico M, Luminari S, Iannitto E, et al.ABVD compared with BEACOPP compared with CEC for the initial treatment of patients with advanced Hodgkin＇s lymphoma： Results from the HD2000 Gruppo Italiano per lo Studio dei Linfomi Trial [J]. J Clin Oncol, 2009,27（5）：805-811.
文摘BACKGROUND Cutaneous involvement in Hodgkin lymphoma (HL) is a rare finding.Few cases have been reported in literature,most describing paraneoplastic manifestations.Only very few papers have described primary HL skin infiltration,reporting a wide range of clinical presentations that frequently include ulcers;plaques,nodules and papules have also been noticed.CASE SUMMARY We report the case of a 56-year-old man who presented fever,multiple adenomegalies of neck and axilla and thick serpiginous skin lesions involving bilateral pectoral regions.After an initial diagnostic workup for a suspected active infectious disease,a lymph node biopsy was performed,which showed a neoplastic invasion from a mixed cellularity classical HL.The same histological pattern was described in a cutaneous biopsy of the chest lesions.The other staging procedures performed revealed an advanced disease,with unfavourable clinical prognostic features.The patient was prescribed 6 cycles of ABVD chemotherapy scheme (doxorubicin,bleomycin,vinblastine,dacarbazine),a regiment that requires demonstration of metabolic response achievement at the interim PET/CT scan to confirm continuation or to change therapeutic strategy.CONCLUSION Skin involvement in HL is a rare finding and may represent a challenging clinical presentation due to extremely various types of lesions observed.
文摘BACKGROUND The outcomes of Hodgkin's lymphoma(HL)in Mexico have not been widely reported.Simplified and affordable treatments have been adopted in middleincome countries.AIM The aim was to evaluate long-used therapies for HL in Mexico in a long-term basis.METHODS In a 34-year time period,88 patients with HL were treated at a single institution in Mexico.Patients were treated with adriamycin bleomycin vinblastine and dacarbazine(ABVD)or mechlorethamine,vincristine,procarbazine,and prednisone(MOPP).Relapsed or refractory patients were given ifosfamide,carboplatin,and etoposide(ICE)followed by autologous or allogeneic stem cell transplants.RESULTS Thirty-seven women and 51 men were included;the median age was 29 years.Patients were followed for a mean of 128 mo.The 310-mo overall survival(OS)was 83%for patients treated with MOPP and 88%for those treated with ABVD.The OS of patients who received autologous stem cell transplantation was 76%(330 mo)vs 93%(402 mo)in those who did not.CONCLUSION HL may be less aggressive in Mexican population than in Caucasians.Combined chemotherapy renders acceptable results,regardless of clinical stage.
