Two-weekly docetaxel in treatment of advanced breast cancer: A preliminary study

@#Objective: Three-weekly docetaxel causes a high rate of febrile neutropenia, especially in the Asian population. Two-weekly docetaxel has been shown to reduce rate of febrile neutropenia in castrate-resistant prostate cancer patients. We conducted a preliminary study to investigate the safety of two-weekly docetaxel in advanced breast cancer patients. Methods: We recruited 10 patients with advanced breast cancer with ECOG (Eastern Cooperative Oncology Group) performance status score of zero to two, who needed chemotherapy in the first or second-line setting to receive two-weekly docetaxel for 8 cycles. The primary endpoint was safety and secondary endpoints were response rate and progression free survival. Results: The most reported adverse events were haematological (anaemia 100% and neutropenia 90%). The febrile neutropenia rate was 10%. The overall response rate was 20%. The median progression free survival was 5.0 months. Conclusion: Two-weekly docetaxel may be a reasonable alternative treatment regimen for patients with advanced breast cancer in the first or second-line setting. This regimen is yet to be compared with standard 3-weekly schedule in a phase 3 randomised clinical trial.

Taxane diterpenoids from the leaves and stems of Taxus wallichiana var. mairei / 中国药科大学学报

@#The chemical constituents of the CHCl3 extracts from the leaves and stems of Taxus wallichiana var. mairei were investigated. Twelve taxane diterpenoids were isolated and identified by spectroscopic analysis as 2-deacetoxytaxinine E (1),2-deacetoxytaxinine J (2),7-deacetoxytaxinine J (3),taxinine J (4),7,2′-didesacetoxyaustrospicatine (5),N-methyltaxol C (6),2-deacetoxydecinnamoyl taxinine J (7),taxol (8),7-epi-taxol (9),7-epi-10- deacetoxytaxol (10),cephalomannine (11),7-epi-cephalomannine (12). Compounds 1 and 3 were isolated from the leaves and stems of Taxus wallichiana var. mairei for the first time.

Uso do PET-SCAN como preditor de eficácia para controle locoregional e sobrevida em carcinoma de cabeça e pescoço / Use of PET-SCAN as a predictor of efficacy for locoregional control and survival in head and neck carcinoma

Introdução: A avaliação da resposta à quimioterapia de indução (QI) com regimes triplos, incluindo taxane, cisplatina e 5 fluorouracil (TPF) em carcinoma de células escamosas de cabeça e pescoço localmente avançado (CECCPLA) é geralmente realizada após 2 ciclos de quimioterapia usando critérios morfológicos. Preocupações em relação ao perfil de toxicidade do TPF sugerem um benefício potencial de uma abordagem de avaliação de resposta precoce. Objetivo: o objetivo deste estudo é avaliar a utilidade de se avaliar precocemente a resposta tumoral por método funcional e morfológico com uso do PET-SCAN em pacientes portadores de CECCPLA tratados com QI seguido de radioteapia após o primeiro ciclo de QI. Métodos: Pacientes com CECCPLA que se submeteram ao QI com TPF foram avaliados prospectivamente. Os procedimentos de estadiamento incluíram imagem locorregional e de tórax, exame endoscópico e PET-SCAN. Pacientes foram avaliados para resposta tumoral após o segundo ciclo da QI e ao término do tratamento, conforme conduta estabelecida para a prática clínica. No dia 14 do primeiro ciclo, um segundo PET- SCAN foi realizado e os médicos e pacientes foram cegados para os seus resultados. Todos os pacientes assinaram consentimento para participação do estudo. Resultados: Entre fevereiro de 2010 e julho de 2013, 49 pacientes portadores de CECCPLA estádio III / IVA-B CECCPLA foram recrutados. Após um seguimento mediano de 44,3 meses, pacientes cujos achados de PET-SCAN não registraram aumento no Stardard Uptake Value (SUV) máximo dos linfonodos regionais apresentaram melhor sobrevida livre de recidiva (HR = 0,18; IC95% 0,056-0,585; p = 0,004) e sobrevida global (HR = 0,14, IC 95% 0,040-0,498; p = 0,002) e foram considerados respondedores. Neste subgrupo, os pacientes que atingiram pelo menos 45% de redução no SUV máximo do tumor primário apresentaram melhor sobrevida livre de progressão tumoral (HR = 0,23, IC 95% 0,062-0,854; p = 0,028) e sobrevida global (HR = 0,11, IC 95% 0,013 -0,96; p = 0,046). Conclusão: Estes resultados sugerem um potencial papel da avaliação da resposta tumoral precoce com PET-SCAN em pacientes com CECCPLA submetidos a QI. Aumento no SUV máximo do linfonodo regional e diminuição insuficiente na captação do tumor primário predizem pior evolução clínica (AU)

Introduction: Evaluation of induction chemotherapy (IC) response with triplet taxane, cisplatin and 5 fluorouracil containing regimen (TPF) in locally advanced head and neck squamous cell carcinoma (LASCCHN) is usually performed after 2 cycles of chemotherapy using morphological criteria. Concerns regarding the TPF toxicity profile suggest a potential benefit of an early tumor response assessment approach. Objective: The objective of this study is to evaluate the usefulness of early evaluation of tumor response by functional and morphological method using PET-SCAN patients with LASCCHN treated with IC followed by radiotherapy after the first IC cycle. Methods: Patients with LASCCHN who underwent IC with TPF were prospectively evaluated. Staging procedures included standard primary neck tumor and chest imaging, endoscopic examination and PET-SCAN. Patients were evaluated for tumor response after the second cycle of IC and at the end of treatment, according to established practice guidelines. On day 14 of the first cycle, a second PET-SCAN was performed and physicians and patients were blinded to their exam findings. Results: Between February 2010 and July 2013, 49 patients staged AJCC III / IVA-B LASCCHN were recruited. After a median follow-up of 44.3 months, patients with no increase in the regional maximum lymph node SUV had better relapse-free survival (HR = 0.18, 95% CI 0.056-0.585, p = 0.004) and overall survival (HR = 0.14, 95% CI 0.040-0.498, p = 0.002) and were considered responders. Among cases considered responders, patients who achieved at least 45% reduction of SUV in the primary tumor presented improvement in progression-free (HR = 0.23, 95% CI 0.062-0.854, p = 0.028) and overall survival (HR = 0.11, 95% CI 0.013 -0.96, p = 0.046). All patients provided informed consent for study participation. Conclusion: These results suggest an important role of the evaluation of the early response with PET-SCAN in patients with LASCCHN undergoing IC. Increase in the regional SUV maximum and insufficient decrease in primary tumor uptake predict worse clinical outcome (AU)

Clinical efficacy and safety of paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer / 中国基层医药

Objective@#To compare the treatment effect and adverse reaction of oxaliplatin and tiggio and paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer.@*Methods@#From January 2015 to April 2018, 60 patients with advanced gastric cancer were selected from Department of Oncology of the First Affiliated Hospital of Anhui Medical University.The patients were randomly divided into two groups according to the principle of simple randomization, with 30 cases in each group.The control group was treated with oxaliplatin + tiggio.The observation group was given paclitaxel (or docetaxel) combined with oxaliplatin (or cisplatin) and fluorouracil.The incidence of adverse reactions(hematotoxicity and non-hematologic toxicity), the efficacy(CR, PR, SD, PD) of the two groups were compared.@*Results@#The RR level of the observation group was 66.7%, which was significantly higher than 40.0% of the control group (χ2=4.286, P<0.05). There were no statistically significant differences between the two groups in incidence of adverse reactions such as thrombocytopenia, impaired liver function, anemia, oral mucositis, nausea and vomiting and neurotoxicity(all P>0.05).@*Conclusion@#Treatment of advanced gastric cancer with FLOT or DCF can improve efficacy without increasing side effects.

Clinical efficacy and safety of paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer / 中国基层医药

Objective To compare the treatment effect and adverse reaction of oxaliplatin and tiggio and paclitaxel or docetaxel combined with oxaliplatin or cisplatin and fluorouracil or tiggio in the treatment of advanced gastric cancer.Methods From January 2015 to April 2018, 60 patients with advanced gastric cancer were selected from Department of Oncology of the First Affiliated Hospital of Anhui Medical University.The patients were randomly divided into two groups according to the principle of simple randomization,with 30 cases in each group.The control group was treated with oxaliplatin + tiggio.The observation group was given paclitaxel (or docetaxel) combined with oxaliplatin (or cisplatin) and fluorouracil.The incidence of adverse reactions(hematotoxicity and non-hematologic toxicity),the efficacy(CR,PR,SD,PD) of the two groups were compared.Results The RR level of the observation group was 66.7% ,which was significantly higher than 40.0% of the control group (χ2 =4.286,P<0.05).There were no statistically significant differences between the two groups in incidence of adverse reactions such as thrombo-cytopenia,impaired liver function, anemia, oral mucositis, nausea and vomiting and neurotoxicity ( all P >0.05). Conclusion Treatment of advanced gastric cancer with FLOT or DCF can improve efficacy without increasing side effects.

Comparison of Breast Conserving Surgery Followed by Radiation Therapy with Mastectomy Alone for Pathologic N1 Breast Cancer Patients in the Era of Anthracycline Plus Taxane-Based Chemotherapy: A Multicenter Retrospective Study (KROG 1418) / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: We compared the oncologic outcomes of breast-conserving surgery plus radiation therapy (BCS+RT) and modified radical mastectomy (MRM) under anthracycline plus taxane-based (AT) regimens and investigated the role of adjuvant radiation therapy (RT) in patients with pathologic N1 (pN1) breast cancer treated by mastectomy. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 2,011 patients with pN1 breast cancer who underwent BCS+RT or MRM alone at 12 institutions between January 2006 and December 2010. Two-to-one propensity score matching was performed for balances in variables between the groups. RESULTS: The median follow-up duration for the total cohort was 69 months (range, 1 to 114 months). After propensity score matching, 1,074 patients (676 in the BCS+RT group and 398 in the MRM-alone group) were analyzed finally. The overall survival, disease-free survival, locoregional failure-free survival, and regional failure-free survival (RFFS) curves of the BCS+RT group vs. MRM-alone group were not significantly different. The subgroup analysis revealed that in the group with both lymphovascular invasion (LVI) and histologic grade (HG) III, the BCS+RT showed significantly superior RFFS (p=0.008). Lymphedema (p=0.007) and radiation pneumonitis (p=0.031) occurred more frequently in the BCS+RT group than in the MRM-alone group, significantly. CONCLUSION: There are no differences in oncologic outcomes between BCS+RT and MRM-alone groups under the AT chemotherapy regimens for pN1 breast cancer. However, BCS+RT group showed superior RFFS to MRM-alone group in the patients with LVI and HG III. Adjuvant RT might be considerable for pN1 breast cancer patients with LVI and HG III.

Impact of taxanes on androgen receptor signaling / 亚洲男科学杂志(英文版)

The development and progression of metastatic castration-resistant prostate cancer is the major challenge in the treatment of advanced prostate cancer. The androgen receptor signaling pathway remains active in metastatic castration-resistant prostate cancer. Docetaxel and cabazitaxel are the first- and second-line chemotherapy, respectively, for patients with metastatic castration-resistant prostate cancer. These two taxanes, in general, function by (i) inhibiting mitosis and inducing apoptosis and (ii) preventing microtubule-dependent cargo trafficking. In prostate cancer, taxanes have been reported to inhibit the nuclear translocation and activity of the androgen receptor. However, whether this is attainable or not clinically remains controversial. In this review, we will provide a comprehensive view of the effects of taxanes on androgen receptor signaling in prostate cancer.

Survival benefit of patients with early-stage ovarian carcinoma treated with paclitaxel chemotherapeutic regimens / 부인종양

OBJECTIVE: Adjuvant chemotherapy was introduced in patients with early-stage ovarian cancer (OC). The benefit of standard chemotherapeutic regimens including taxane has not been established. METHODS: Patients with early-stage OC from the National Health Insurance Research database of Taiwan who received platinum plus cyclophosphamide (CP) or platinum plus paclitaxel (PT) for 3–6 cycles were recruited, and the disease-free survival (DFS) and overall survival (OS) were determined. RESULTS: A total of 1,510 early-stage OC patients, including 841 who received CP regimen and 699 who received PT regimen, were included. The 2 groups had a similar estimated probability of 5-year DFS (PT vs. CP, 79.0% vs. 77.6%; p=0.410) and OS (84.6% vs. 84.3%; p=0.691). Patients >50 years of age who received the CP regimen had a lower 5-year DFS than the patients ≤50 years of age who received the CP (p50 years of age who received the CP regimen had a worse 5-year OS compared with the other 3 groups (p=0.019) (p=0.179 for patients >50 years of age in the PT group; p=0.002 for patients ≤50 years of age in the CP group; and p=0.061 for patients ≤50 years of age in the PT group). Patients with the CP or PT regimen for 3–5 cycles had a similar 5-year DFS and OS compared to 6 cycles (p>0.050). CONCLUSION: Chemotherapeutic regimens with taxane could be recommended for early-stage OC patients >50 years of age.

Chemical constituents from twig and leaves of Taxus media / 中草药

Objective: To study the chemical constituents from the petroleum ether and ethyl acetate extract of the twig and leaves of Taxus media. Methods: Several column chromatography including silica gel, Sephadex LH-20 gel, ODS and so on were applied in isolation and purification. The structures were elucidated on the basis of physicochemical properties and spectral data. Results: Eight taxane diterpenoids, five flavonoids, three phenolic acids, and two other compounds were isolated and determined as taxinine-11,12-oxide (1), 2-deacetoxytaxuspine C (2), 2-deacetoxytaxinine E (3), 7,9-deacetyltaxinine B (4), taxagifin (5), 9-deacetyltaxinine A (6), 9-deacetyltaxinine (7), 10-desacetylbaccatin III (8), kaempferol (9), aromadendrin (10), apigenin (11), sciadopitysin (12), ginkgetin (13), 4-hydroxy-benzaldehyde (14), p-hydroxybenzoic acid (15), pyrocatechol (16), β-sitosterol (17), and eicosan-10-ol (18), respectively. Conclusion: Compounds 1-4, 6, 7, 10, 14-16 are firstly isolated from the plant of T. media, and compound 18 is obtained from the Taxaceae for the first time.

Taxane resistance in castration-resistant prostate cancer: mechanisms and therapeutic strategies

Despite its good initial response and significant survival benefit in patients with castration-resistant prostate cancer (CRPC), taxane therapy inevitably encounters drug resistance in all patients. Deep understandings of taxane resistant mechanisms can significantly facilitate the development of new therapeutic strategies to overcome taxane resistance and improve CRPC patient survival. Multiple pathways of resistance have been identified as potentially crucial areas of intervention. First, taxane resistant tumor cells typically have mutated microtubule binding sites, varying tubulin isotype expression, and upregulation of efflux transporters. These mechanisms contribute to reducing binding affinity and availability of taxanes. Second, taxane resistant tumors have increased stem cell like characteristics, indicating higher potential for further mutation in response to therapy. Third, the androgen receptor pathway is instrumental in the proliferation of CRPC and multiple hypotheses leading to this pathway reactivation have been reported. The connection of this pathway to the AKT pathway has received significant attention due to the upregulation of phosphorylated AKT in CRPC. This review highlights recent advances in elucidating taxane resistant mechanisms and summarizes potential therapeutic strategies for improved treatment of CRPC.

Effect of neoadjuvant chemotherapy combined with anthracycline and taxane in early or locally advanced breast cancer and its effects on ER,PR and Her-2 / 中国生化药物杂志

Objective To research the effect of neoadjuvant chemotherapy with anthracycline and taxane in early or locally advanced breast cancer and its effects on ER, PR and Her-2.Methods 120 cases of early or locally advanced breast cancer patients were selected as the research objects, according to the order of admission, the patients were divided into the observation group and the control group.The control group were given conventional chemotherapy with EC regimen (epirubicin +cyclophosphamide), while the observation group were treated with anthracyclines and taxanes.The clinical efficacy and the expression of ER, PR and Her-2 receptor in the two groups after treatment were compared.Results The total effective rate of the observation group was 73.33%, which was higher than that of the control group (53.33%) (P<0.05).After treatment, the positive expression level (0~+++) of ER receptor in the observation group were 20.00%, 15.00%, 35.00%, 30.00%, respectively, the positive expression level(0~+++) of PR receptor were 26.67%, 20.00%, 23.33% and 30.00%, respectively, were significantly better than those of the control group ( ER:31.67%, 21.67%, 28.33%, 18.33%, PR:40.00%, 25.00%, 20.00%, 15.00%) (P<0.05).But there was no significant difference between the two groups in the expression of Her-2 receptor (25.00%, 11.67%, 30.00%, 33.33% and 31.67%, 21.67%, 16.67%, 30.00%, respectively).The incidence of adverse reactions in the observation group and the control group were 6.67% and 21.67%, respectively, and there was significant difference between the two groups ( P<0.05 ) .Conclusion In the treatment of early or late stage breast cancer , anthracycline combined with taxane neoadjuvant chemotherapy has a significant effect, which can effectively improve the expression of ER and PR receptors.In addition to improve the effect of clinical treatment, and reduce the incidence of adverse reactions in a certain extent,so it can be used as a new adjuvant chemotherapy in the clinical application of the best option.

Postmastectomy Radiotherapy in Patients with pT1-2N1 Breast Cancer Treated with Taxane-Based Chemotherapy: A Retrospective Multicenter Analysis (KROG 1418) / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to evaluate the impact of postmastectomy radiotherapy (PMRT) on loco-regional recurrence-free survival (LRRFS), disease-free survival (DFS), and overall survival (OS) in pT1-2N1 patients treated with taxane-based chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed the medical data of pathological N1 patients who were treated with modified radical mastectomy and adjuvant taxane-based chemotherapy in 12 hospitals between January 2006 and December 2010. RESULTS: We identified 714 consecutive patients. The median follow-up duration was 69 months (range, 1 to 114 months) and the 5-year LRRFS, DFS, and OS rates were 97%, 94%, and 98%, respectively, in patients who received PMRT (PMRT [+]). The corresponding figures were 96%, 90%, and 96%, respectively, in patients who did not receive PMRT (PMRT [–]). PMRT had no significant impact on survival. Upon multivariable analysis, only the histological grade (HG) was statistically significant as a prognostic factor for LRRFS and DFS. In a subgroup analysis of HG 3 patients, PMRT (+) showed better DFS (p=0.081). CONCLUSION: PMRT had no significant impact on LRRFS, DFS, or OS in pT1-2N1 patients treated with taxane-based chemotherapy. PMRT showed a marginal benefit for DFS in HG 3 patients. Randomized studies are needed to confirm the benefit of PMRT in high risk patients, such as those with HG 3.

Prognostic Impact of Elective Supraclavicular Nodal Irradiation for Patients with N1 Breast Cancer after Lumpectomy and Anthracycline Plus Taxane-Based Chemotherapy (KROG 1418): A Multicenter Case-Controlled Study / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: This study was conducted to evaluate the impact of supraclavicular lymph node radiotherapy (SCNRT) on N1 breast cancer patients receiving post-lumpectomy whole-breast irradiation (WBI) and anthracycline plus taxane-based (AT) chemotherapy. MATERIALS AND METHODS: We performed a case-control analysis to compare the outcomes of WBI and WBI plus SCNRT (WBI+SCNRT). Among 1,147 patients with N1 breast cancer who received post-lumpectomy radiotherapy and AT-based chemotherapy in 12 hospitals, 542 were selected after propensity score matching. Patterns of failure, disease-free survival (DFS), distant metastasis-free survival (DMFS), and treatment-related toxicity were compared between groups. RESULTS: A total of 41 patients (7.6%) were found to have recurrence. Supraclavicular lymph node (SCN) failure was detected in three patients, two in WBI and one in WBI+SCNRT. All SCN failures were found simultaneously with distant metastasis. There was no significant difference in patterns of failure or survival between groups. The 5-year DFS and DMFS for patients with WBI and WBI+SCNRT were 94.4% versus 92.6% (p=0.50) and 95.1% versus 94.5% (p=0.99), respectively. The rates of lymphedema and radiation pneumonitis were significantly higher in the WBI+SCNRT than in the WBI. CONCLUSION: We did not find a benefit of SCNRT for N1 breast cancer patients receiving AT-based chemotherapy.

Leptin, insulin and body composition changes during adjuvant taxane based chemotherapy in patients with breast cancer, preliminary study.

BACKGROUND: The objectives of the present study were to compare the effect of adjuvant chemotherapy for breast cancer on serum insulin levels, serum leptin levels, and body composition in early stage breast cancer patients. MATERIALS AND METHODS: 17 breast cancer patients underwent 6 cycles of docetaxel (75 mg), epirubicine (100 mg) and cyclophosphamide (500 mg) (TEC). Anthropometrical and foot‑to‑foot body fat analyzer BIA, serum glucose, insulin, lipids, HOMA‑IR and leptin were compared pre‑ and post‑treatment. RESULTS: There was no statistically significant weight gain after treatment; however, there was an overall trend toward weight gain (69.7 ± 9.8 kg vs 71.03 ± 9.8; P = 0.05). From baseline to the end of the study, percentage of body fat and body fat mass showed an upward trend at the end of chemotherapy (1%; 2 kg P > 0.05). Pre and post‑treatment period, leptin was strongly correlated with insulin and HOMA‑IR (Spearman’s pre-T; r = 0.74; P <0.001, r = 0.66; P = 0.004 post-T; r = 0.549; P =0.022, r = 0.51; P =0.036, respectively). Insulin levels were significantly increased in the post‑treatment period (P < 0.05). On correlation analysis, post‑T insulin levels were correlated with leptin, weight, fat‑mass and fat percentage (Spearman’s r = 0.549; P =.022, r = 0.567; P = 0.018, r = 0.498, P = 0.042, r = 0.502; P = 0.040, respectively). DISCUSSION: High insulin and leptin levels, important factors that were previously shown to be related to breast cancer outcome, and insulin resistance may be increased in taxane based chemotherapy regimen. These data may have broad implications for diet and lifestyle strategies for the prevention and treatment of cancers.

Tissue culture and analysis on taxane diterpenoids in callus of Taxus chinensis var. mairei / 中草药

Objective: To investigate some factors which could influence the tissue culture of callus from Taxus chinensis var. mairei such as the culturing callus time, callus induction rate, callus development rate, growth rate, and browning degree. Then, the five taxane diterpenoids including paclitaxel in callus were studied and compared. Methods: The factors which influence the T. chinensis var. mairei callus induction and growth rate were studied by single factor analysis and orthogonal test design. The five taxane diterpenoids including paclitaxel in callus from different sources were determined by HPLC analysis. The weighted score for each of the above factors mentioned would be taken account to optimise the tissue culture conditions. Results: Among the explants, the stems intacted leaves would exhibit the best ability of dedifferentiation to form callus. The enrichment dark culture was conducive to paclitaxel and other five kinds of terpene constituents. The most optimum culture medium of the callus induction was B5 + 2, 4-D 3.0 mg/L + 6-BA 1.0 mg/L + NAA 1.0 mg/L + KT 0.5 mg/L. Conclusion: The callus culture conditions for T. chinensis var. mairei have indicated greater association with different types of the explantation, nutrient medium, and light illumination. The five kinds of enrichment taxane paclitaxel diterpenoids would be significantly affected by the type and concentration of the plant growth regulators. This study has shown some references value for T. chinensis var. mairei tissue culture and for the screening of high-yielding cell lines.

Relationship of BRCA1 andβ-tubulinⅢmRNA expression with efficacy of taxanes for advanced esophageal carcinoma / 中国肿瘤临床

Objective:To investigate the relationship of the mRNA expression of BRCA1 andβ-tubulinⅢwith docetaxel-resistance in esophageal cancer. Methods:The genes BRCA1 andβ-tubulinⅢwere determined at the mRNA level using RT-qPCR in 36 esophageal carcinoma specimens. Results:The mRNA expression of BRCA1 andβ-tubulinⅢwas determined in the 36 tumor samples using RT-qPCR. The median BRCA1 mRNA expression level in relation to that ofβ-actin was 6.27. The medianβ-tubulinⅢmRNA expression level in relation to that ofβ-actin was 4.44. The patients were divided into two groups using these cutoff values. The BRCA1 mRNA expression level was not correlated with the sensitivity of esophageal cancer patients to docetaxel (P=0.733). The response rate of the tumors with highβ-tubulinⅢexpression was (38.9%), which is significantly lower than in patients with lowβ-tubulinⅢexpression (83.3%) (P=0.015). Conclusion:Theβ-tubulinⅢexpression levels in the tumor tissues were probably an important biomarker for the efficacy of docetaxel chemotherapy in esophageal cancer patients. Our study may provide new insights into taxane chemotherapy for advanced esophageal cancer patients.

MAD2 Expression in Ovarian Carcinoma: Different Expression Patterns and Levels among Various Types of Ovarian Carcinoma and Its Prognostic Significance in High-Grade Serous Carcinoma

BACKGROUND: Mitotic arrest deficiency protein 2 (MAD2) is a key component of spindle assembly checkpoint function, which mediates cell apoptosis through microtubule kinetics. Aberrant expression of MAD2 is believed to be associated with the development of chromosome instability. MAD2 also has a signihicant role in cellular drug resistance to taxane chemotherapeutic agents. METHODS: Expression of MAD2 and p53 was investigated using immunohistochemistry in 85 cases of ovarian carcinomas. Clinicopathological data including progression-free survival were analyzed. RESULTS: A significant (p=.035) association was observed between the grade of serous carcinoma and the expression level of MAD2. While low-grade serous carcinoma showed a low-level expression of MAD2, high-grade serous carcinoma showed a high-level expression of MAD2. We also determined that low-level expression of MAD2 was associated with reduced progression-free survival (PFS) (p=.016) in high-grade serous carcinoma. CONCLUSIONS: MAD2 expression in ovarian carcinoma is related to the grade of serous carcinoma and PFS of high-grade serous carcinoma. Expression level of MAD2 detected by immunohistochemistry may serve as an indicator in predicting the response of microtubule-interfering chemotherapeutic agents.

Symptom and Interference of Activities of Daily Living of Chemotherapy-Induced Peripheral Neuropathy in Patients Receiving Taxanes and Platinums

PURPOSE: The purpose of this study was to identify the symptoms and interference of activities of daily living (ADL) of chemotherapy induced peripheral neuropathy (CIPN) in patients receiving taxane and platinums. METHODS: 141 cancer patients were recruited in the cross-sectional survey design. The instruments used in the study was the Chemotherapy-induced Peripheral Neuropathy Assessment Tool (CIPNAT) developed by Tofthagen and colleagues. RESULTS: The patients experienced the symptom and interference of ADL of CIPN moderately. The most common symptom was nerve pain (70.2%) and the patients with high cumulative doses showed a significant of tingling sensation in the feet. Symptom severity increased substantially with cumulative dose of chemotherapeutic agents. CONCLUSION: The results of this study suggest that chemotherapy-induced peripheral neuropathy increase due to repeated chemotherapy and nursing intervention is necessary to reduce symptom severity and interference of ADL of CIPN.

Complete biologic response to taxane based chemotherapy confirmed by 18FFDG PET/CT and surgery in a cancer of unknown primary site / 부인종양

Cancers of an unknown primary site are heterogenous with respect to their clinical and pathologic features. They are generally very aggressive, but specific favorable subsets have a better prognosis. For these favorable subsets, taxane based chemotherapy is very effective for a subset of woman with papillary serous peritoneal adenocarcinoma. A 52 year-old woman underwent [18F]-FDG PET/CT for routine health screening. On PET/CT, multiple hypermetabolic lymph nodes were detected in the paraaortic spaces, and there were no other hypermetabolic abnormalities. The patient was diagnosed with an unknown primary cancer that probably originated from the ovary or peritoneum, according to clinical studies and biopsy results. This was not a typical case of a favorable subset of cancer of an unknown primary site, but the tumor showed complete biologic response to taxane based chemotherapy as revealed by PET/CT, and necrotic tumor cells were confirmed by surgery.

Prognostic Factors of Second and Third Line Chemotherapy Using 5-FU with Platinum, Irinotecan, and Taxane for Advanced Gastric Cancer / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The aims of this study are to find out whether the sequence of chemotherapeutic regimens including second- and third-line taxane and irinotecan influences the survival of patients with unresectable gastric carcinoma and to identify clinical characteristics of patients with improved response. MATERIALS AND METHODS: Fifty gastric carcinoma patients who were treated by third-line sequential chemotherapy between November 2004 and July 2010 were enrolled in this study. Their overall survival (OS) and time to progression (TTP) were set up as primary and secondary end points. For the sequence of chemotherapy regimen, two arms were used. Arm A was defined as 5-fluorouracil (5-FU)+cisplatin (FP) or folinic acid, 5-FU and oxaliplati (FOLFOX), followed by folinic acid, 5-FU and irinotecan (FOLFIRI), and paclitaxel or docetaxel plus 5-FU, with or without epirubicin. Arm B was defined as FP or FOLFOX, followed by paclitaxel or docetaxel plus 5-FU, and FOLFIRI. RESULTS: The median OS of all patients was 16.0 months (95% confidence interval, 13.6 to 18.3 months), which is longer than historical control of patients who did not receive third-line chemotherapy. The sequence of second and third-line regimen, including irinotecan and taxane, did not present significant difference in OS or TTP after failure of 5-FU with platinum chemotherapy. In survival analysis of patients' clinicopathologic characteristics, poor prognosis was shown in patients with poorly differentiated histologic features, elevated serum carcinoembryonic level, and shorter TTP of first line chemotherapy. CONCLUSION: It is possible for patients to respond differently to chemotherapy due to differences in clinical features and underlying gene expression profiles. Development of individualized chemotherapy regimens based on gene expression profiles is warranted.