ABSTRACT
CONTEXT: Introduction of trastuzumab, a recombinant monoclonal antibody against the extracellular domain of HER‑2, is a cornerstone in the treatment of HER‑2+ breast carcinoma. However, many cancers that have an initial response to trastuzumab will progress some time later. After progression on trastuzumab‑based first‑line treatment, there are several options. Although TDM‑1 (Trastuzumab emtansine) has prolonged progression‑free survival (PFS) and overall survival in patients previously treated with trastuzumab and taxane, it is still not available in Turkey. Patients may be switched to lapatinib (an oral tyrosine kinase inhibitor targeting both HER‑1 and HER‑2), or they may re‑challenge with trastuzumab. There is no clear definition of the patients who should be switched to lapatinib. AIM: In this study, we investigated the factors predicting the efficacy of lapatinib. SUBJECTS AND METHODS: Totally, 94 patients treated with lapatinib for metastatic breast carcinoma was included in our study. Retrospective data including pathology, treatments and treatment results, metastatic sites, and laboratory tests were collected. RESULTS: Progression‑free survival was 9.1 months. Histologic subtypes other than invasive ductal carcinoma and liver metastasis were inversely related with PFS. Overall survival was 22.1 months, and patients with histologic subtypes other than invasive ductal carcinoma and who progress with brain metastasis had a worse prognosis. CONCLUSION: Clinicians should give attention to histologic subtype and metastatic sites when choosing patients for lapatinib treatment.
ABSTRACT
OBJECTIVE: Children operated on for tracheo-oesophageal malformation (TOM) often suffer from postoperative respiratory system difficulties. There is little current literature about this subject. This study aimed to investigate the causes of these problems in rats with experimental TOM by evaluating the lung alveolar histology. SUBJECTS AND METHODS: Twenty Wistar albino rats were used for the experiment. Twelve rats with a sperm positive vaginal smear received 1.75 mg/kg intraperitoneal adriamycin on days six to nine of gestation. A sham group was infused with saline instead of adriamycin. A control group was not subjected to any additional procedure. Their fetuses were dissected under surgical microscope. After examining the trachea and oesophagus, the lungs were dissected and fixed in 10% formalin. The groups were compared with respect to alveolar flat cell (Type-1), capillary density and air space percentage in the samples obtained under light microscopy. Statistical evaluation was performed through Mann-Whitney-U tests and Pearson Chi-squared tests. RESULTS: Type-1 cell ratio and air space percentage were the highest for the control and sham groups. However, the group that received adriamycin and developed TOM had the lowest values. There were no statistically significant differences between the groups with respect to capillary density. CONCLUSION: In rats with experimentally produced TOM, the pulmonary parenchyma showed delayed maturation. This could be the cause of the frequently seen respiratory system pathologies in children suffering from TOM. Further studies should be done to elucidate this.
OBJETIVO: Los niños operados por malformaciones tráqueo-esofágicas (MTE) sufren a menudo de dificultades postoperatorias en el sistema respiratorio. En el presente, existe poca literatura sobre este problema. Este estudio va encaminado a investigar las causas de estos problemas en ratas con MTE experimentales, mediante la evaluación de la histología alveolar del pulmón. SUJETOS Y MÉTODOS: Veinte ratas albinas Wistar fueron usadas en el experimento. Doce ratas con frotis vaginal positivo de esperma recibieron 1.75 mg/kg de adriamicina intraperitoneal en los días seis al nueve de gestación. A un grupo de simulación (sham group) se le dio una solución salina en lugar de adriamicina. El grupo de control no fue sometido a ningún procedimiento adicional. Sus fetos fueron disecados bajo microscopio quirúrgico. Luego de examinar la tráquea y el esófago, los pulmones fueron disecados y puestos en formaldehído al 10%. Recurriendo a la microscopía lumínica, los grupos fueron comparados con respecto a células alveolares planas (tipo 1), densidad capilar y porcentaje de espacio de aire en las muestras obtenidas. La evaluación estadística se realizó mediante tests U de Mann-Whitney y tests de Chi-cuadrado Pearson. RESULTADOS: La proporción de células de tipo 1 y el porcentaje de espacio de aire, fueron los más altos para los grupos de simulación y control. Sin embargo, el grupo que recibió adriamicina y desarrolló MTE, tuvo los valores más bajos. Con respecto a la densidad capilar, no hubo diferencias estadísticamente significativas entre los grupos. CONCLUSIÓN: En ratas con malformación MTE producida experimentalmente, el parénquima pulmonar mostró retardo en su maduración. Esto podría ser la causa de las patologías del sistema respiratorio observadas con frecuencia en niños que padecen de MTE. Se requieren estudios ulteriores a fin de dilucidar esta cuestión.