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Hepatocellular carcinoma (HCC) has a high recurrence rate after surgical resection. There is little chance for patients with recurrent HCC to receive surgery again, and the main therapy is systemic treatment. However, the efficacy of traditional systemic treatments such as targeted therapy and chemotherapy is limited and the prognosis of patients with advanced HCC is poor. The authors reported a HCC patient who relapsed after surgical resection achieved partial remission with first-line treatment of atelizumab and bevacizumab, according to the latest report of Imbrave150 study. The patient has maintained partial response for more than 1 year, with mild adverse reactions and good efficacy.
ABSTRACT
PURPOSE: Rituximab with cyclophosphamide, doxorubicin, vincristine, and prednisone administered every 3 weeks (R-CHOP-21) is the standard care for diffuse large B-cell lymphoma (DLBCL). It is unknown whether the dose-dense R-CHOP (R-CHOP-14) could improve the outcome of the disease in Asian population. MATERIALS AND METHODS: Newly diagnosed DLBCL patients were centrally, randomly assigned (1:1) to receive R-CHOP-14 or R-CHOP-21. R-CHOP-14 was administered every 2 weeks, and R-CHOP-21 was administered every 3 weeks. Primary end point was disease-free survival (DFS). Secondary end points included overall survival (OS), progression-free survival (PFS), response rate and toxicities. RESULTS: Seven hundred and two patients were randomly assigned to receive R-CHOP-14 (n=349) or R-CHOP-21 (n=353). With a median follow-up of 45.6 months, the two groups did not differ significantly in 3-year DFS (79.6% for R-CHOP-14 vs. 83.2% for R-CHOP-21, p=0.311), 3-year OS (77.5% for R-CHOP-14 vs. 77.6% for R-CHOP-21, p=0.903), or 3-year PFS (63.2% for R-CHOP-14 vs. 66.1% for R-CHOP-21, p=0.447). Patients with an International Prognostic Index (IPI) score ≥ 2 had a poorer prognosis compared to those with an IPI score < 2. Grade 3/4 hematologic and non-hematologic toxicities were manageable and similar between R-CHOP-14 and R-CHOP-21. CONCLUSION: R-CHOP-14 did not improve the outcome of DLBCL compared to R-CHOP-21 in Asian population. With manageable and similar toxicities, both of the two regimens were suitable for Asian DLBCL patients. For high-risk patients with IPI ≥ 2, new combination regimens based on R-CHOP deserve further investigation to improve efficacy.
Subject(s)
Humans , Asian People , B-Lymphocytes , Cyclophosphamide , Disease-Free Survival , Doxorubicin , Follow-Up Studies , Lymphoma, B-Cell , Prednisone , Prognosis , Rituximab , VincristineABSTRACT
OBJECTIVE: To identify long-term outcomes and safety of transplantation of autologous peripheral blood stem cells (PBSC) for treating dilated cardiomyopathy.METHODS: A total of 38 cases with dilated cardiomyopathy received treatment at the Department of Cardiology, Guangdong General Hospital of Chinese People's Armed Police Forces, were selected, including 26 males and 12 females, aged 42-72 years, mean aged 56 years. Based on given standard therapy, 38 patients divided randomly into the transplantation group (n=20) and the control group (n=18). Patients in the transplantation group were received recombinant human granulocyte colony-stimulating factor (rhG-CSF) 300 ug/d once per day for 5 days to mobilize stem cells. At day 6, PBSC were collected with blood-cells separator and were transplanted through intracoroary way. The routine medication was performed in the control group. Blood routine test, hepatic function, renal function, glucose, triglyeride (TG), cholesterol, low density cholesterol (C-LDL), high density cholest- erol (C-HDL), uric acid (UA), creatine kinase (CK), isoenzyme of creatine kinase (CK-MB) and high sensitive C-reactive protein (hsCRP) were measured before and at months 6 and 12 after transplantation. All patients also received ultrasonic echocardiography, ECG Holter monitor and six-minute-walk test before and at 12 and 24 months after the procedure. Survival rate and incidence rate of heart incidents were compared. The study end-point was death from any cause. RESULTS: All patients received a 12-24 month follow-up with mean (18±6) months. One patient in the transplantation group received mitral valve replacement. One patient of the transplantation group and 2 of the control group died due to refractory heart failure. The blood routine test and biochemical indicators of the transplantation group had no significant differences among 6 months and 12 months after transplantation compared with control and pre-transplantation (P > 0.05). Six-minute-walking distance in the transplantation group significantly increased at 12 months after transplantation than pre-transplantation level, which was also higher than that of control patients (P < 0.05). The left ventricular ejection fraction (LVEF) was increased (P < 0.01). The left ventricular diastolic diameter (LVDd) decreased significantly in the transplantation group (P < 0.01). In the control group, improvement in LVEF and LVDd were observed, but there was no significant difference (P > 0.05). After 24 months of follow-up, the above-mentioned indexes had not improved in the transplantation group without significant differences. No malignant arrhythmias and severe side effects could be observed around transplantation and during 24 months follow-up. Survival was similar between the two groups during 24 months follow. CONCLUSION: Transplantation of mobilized autologous PBSC might be a safe and effective method for the treatment of dilated cardiomyopathy, which may improve the ventricular systolic function in a short-term, however, the long-term effects still uncertain.
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Objective To investigate the mechanisms of oridonin inducing apoptosis on acute leukeamia NB4 cells and its mechanism. Methods NB4 cells in culture medium in vitro were given with different concentrations (8, 16, 24, and 32 μmol/L) of oridonin. The inhibitory rate of the cells was measured by MTT assay, cell apoptotic rate was detected by flow cytometry (FCM), morphology of apoptosis was observed by Hoechst 33258 fluorescence staining, DNA fragmentation was assayed by agarose gel electrophoresis, caspase-3 expression was detected by Western blotting, and caspase-3 activity was assayed with colorimetric assay kit before and after apoptosis occurred. Results Oridonin (over 16 μmol/L) could inhibit the growth of NB4 cells and cause apoptosis significantly, the suppression was both in a timeand dose-dependent manner. Marked changes of apoptosis including condensation of chromatin and nuclear fragmentation were observed very clearly by Hoechst 33258 fluorescence staining and a characteristic "ladder" of DNA fragments was elicited by agarose gel electrophoresis; Western blot analysis revealed that caspase-3 was activated by the loss of caspase-3 proenzyme (32 kDa) and the appearance of its 20 kDa subunit, and that along with the apoptotic process caspase-3 activity was increased concurrently. Conclusion Oridonin can induce apoptosis in NB4 cells via activation of caspase-3. These results will provide laboratory evidence for the clinical treatment of acute leukemia with oridonin.