ABSTRACT
Human epidermal growth factor receptor 2 （HER2）-positive breast cancer is aggressive and prone to metastasis，and the applications of HER2 agents have improved the prognosis of patients with HER2-positive breast cancer. Among the marketed HER2 agents，macromolecular monoclonal antibodies that target the extracellular domain Ⅳ of HER2 were the cornerstone drugs of HER2-positive breast cancer，including trastuzumab，inetetamab，and margetuximab. Trastuzumab is available for the full-line treatment of breast cancer with sufficient proof of evidence-based medicine，sufficient practical experience and controllable safety. Inetetamab and trastuzumab have similar efficacy and controllable safety in HER2-positive metastatic breast cancer and neoadjuvant/ adjuvant therapy. Margetuximab focuses on patients carrying the CD16A-158F allele，and is an option of posterior line treatment for advanced breast cancer. It is necessary to select the most suitable drugs clinically according to the specific condition of the patient.
ABSTRACT
Objective@#To investigate the clinicopathological characteristic and risk factors for recurrence in different subtypes of mucinous breast cancer(MBC).@*Methods@#Clinical data of 97 MBC patients at Zhejiang Cancer Hospital from August 2005 to November 2012 were retrospectively analyzed. All of patients were divided into 3 subtypes according to the mucinous components in the tumors, named as partial mixed MBC with less than 50% of mucinous components, main mixed MBC where the mucinous component accounted for 50% to 90%, and pure MBC with more than 90% of mucinous components. In this study, 43, 16 and 38 patients were included in partial mixed MBC, main mixed MBC, and pure MBC, respectively. Follow-up was collected by out-patient, in-patient system and phone call. The relationship between different subtypes and clinicopathological significance were analyzed by χ2 test. Kaplan-Meier curve combined with Log-rank test was used to evaluate the risk factors of relapse free survival(RFS) at 3- and 5-year. Cox proportional hazard regression model was used for multivariate analysis.@*Results@#The median follow-up time was 65 months (range 24-125). Of the 97 patients, 14 patients were relapse or metastasis at the end point. The 3- and 5-year RFS were 90.7% and 85.7%, respectively. Tumor size, number of involved lymph nodes (LN), axillary LN metastasis, TNM stages and p53 mutant status were all related with subtypes of MBC(all of P<0.05). There was no correlation between subtypes of MBC and the other parameters, including age at surgery, estrogen receptor (ER) status, progesterone receptor (PR) status, human epidermal growth factor receptor-2 (HER-2) overexpression, menstruation status, and the relapse of disease(all of P>0.05). Univariate analysis showed menstruation status and TNM stages were associated with the relapse of breast cancer(P<0.05). The patients with menopause and stage Ⅲ-Ⅳ showed significantly shorter RFS time(both of P<0.05). Multivariate Cox proportional hazard regression analysis revealed that tumor size, PR status and postoperative radiotherapy were the independent prognostic factors for the relapse of MBC.@*Conclusions@#Tumor size, status of axillary LN metastasis, TNM stages, and p53 mutation status are differ among different subtypes of MBC. The tumor size (>30 mm), PR status and postoperative radiotherapy are the independent risk factors for recurrence, whereas the proportion of the mucinous component is not associated with relapse in MBC patients.
ABSTRACT
0.05,X 2 =0.45),and the focus stability ratio were42.5%and32.4%respectively.Compared with the FOLFOX4group,the hospitalization course in capecitabine group is significantly shorter(8.5days vs25.3days,P=0.000)and the total medical cost was significantly lower(5941.7RMB vs13304.6RMB,P=0.001).The cost structure analysis showed that the direct and indirect medical costs of the FOLFOX4group increased more significantly(P=0.001)and the incidence for adverse effects of this group was lower than that of the capecitabine group.CONCLUSION:From the perspective of pharmacoeconomic evaluation,capecitabine is better than FOLFOX4in treating the digestive malignant tumor.