Résumé
Brucea javanica, a Chinese herbal medicine, combined with conventional anticancer modalities, has been widely used for treatment of various cancers. Based on researches over the last decades, authors briefly summarized its active constituents, molecular mechanisms and clinical application for cancer treatment.
Sujets)
Humains , Antinéoplasiques d'origine végétale , Utilisations thérapeutiques , Apoptose , Recherche biomédicale , Méthodes , Brucea , Chimie , Médicaments issus de plantes chinoises , Utilisations thérapeutiques , Tumeurs , Traitement médicamenteux , Anatomopathologie , PhytothérapieRésumé
Either cetuximab or bevacizumab can improve the survival of patients with metastastic colorectal cancer (mCRC) if administered combided with cytotoxic agents. However, the effect of two or more target agents in combination is uncertain in these patients. Here, we reported a patient with mCRC successfully treated by a combination of target agents after the failure of chemotherapy. The patient received palliative resection of primary tumor followed by 9 cycles of postoperative XELOX regimen, cytokine-induced killer cell (CIK)-based biotherapy, traditional Chinese medicine, particle implantation in the lung metastatic lesions. The tumor progressed 20 months after the standard treatments. Then, the regimen cetuximab, bevacizumab and cefitinib was applied. During the treatment with targeted agents, grade IV acne-like rash and relatively severe parionychia of the toes occurred. Both of them recovered smoothly. The PET-CT reexamination at 40 days after the target treatment showed that the metabolism of mediastinal lymph nodes basically recovered to a normal level. The combination of multiple targeted agents obtained a progression-free survival(PFS) of 11 months and the patient with a good quality of life during this period.
Sujets)
Humains , Mâle , Adulte d'âge moyen , Adénocarcinome , Imagerie diagnostique , Traitement médicamenteux , Anatomopathologie , Inhibiteurs de l'angiogenèse , Utilisations thérapeutiques , Anticorps monoclonaux , Utilisations thérapeutiques , Anticorps monoclonaux humanisés , Utilisations thérapeutiques , Antinéoplasiques , Utilisations thérapeutiques , Protocoles de polychimiothérapie antinéoplasique , Utilisations thérapeutiques , Bévacizumab , Ablation par cathéter , Cétuximab , Cellules CIK , Allergie et immunologie , Désoxycytidine , Utilisations thérapeutiques , Survie sans rechute , Systèmes de délivrance de médicaments , Fluorouracil , Utilisations thérapeutiques , Immunothérapie adoptive , Tumeurs du foie , Chirurgie générale , Tumeurs du poumon , Chirurgie générale , Métastase lymphatique , Imagerie multimodale , Stadification tumorale , Tomographie par émission de positons , Qualité de vie , Quinazolines , Utilisations thérapeutiques , Récepteurs ErbB , Tumeurs du sigmoïde , Imagerie diagnostique , Traitement médicamenteux , Anatomopathologie , TomodensitométrieRésumé
<p><b>BACKGROUND AND OBJECTIVE</b>Male breast cancer (MBC) in China usually has been studied retrospectively with small sample size, and studies analyzing the prognostic factors are rare. This study was to investigate the prognostic factors of Chinese patients with MBC based on the data from a single institute with a relatively large sample.</p><p><b>METHODS</b>Clinical data of 72 patients with histopathologically confirmed MBC who received treatment at Sun Yat-sen University Cancer Center between January 1969 and March 2009, were collected. Kaplan-Meier, log-rank test and Cox regression model were used for statistical analysis.</p><p><b>RESULTS</b>The 5-year overall survival rate was 72.4%, and the survival rates for stage I, II, III, and IV were 100%, 74.2%, 57.2%, and 0%, respectively. Univariate analysis showed that the tumor size (P < 0.001), axillary lymph node status (P = 0.001), TNM stage (P = 0.001), operation model (with vs. without: P < 0.001; classic radical resection vs. modified radical resection, P = 0.336) and endocrine therapy(P = 0.02) significantly influenced the survival. Multivariate Cox regression showed that TNM stage (P = 0.035), operation model (P = 0.021) and endocrine therapy (P = 0.019) were independent prognostic factors for MBC.</p><p><b>CONCLUSIONS</b>Early diagnosis and comprehensive treatment strategy consisting of surgery and endocrine treatment is essential to improve the survival of the patients with MBC, and TNM stage, operation and endocrine treatment are the significant prognostic factors for MBC.</p>
Sujets)
Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Humains , Mâle , Adulte d'âge moyen , Antinéoplasiques hormonaux , Utilisations thérapeutiques , Tumeurs osseuses , Tumeur du sein de l'homme , Anatomopathologie , Chirurgie générale , Thérapeutique , Carcinome canalaire du sein , Anatomopathologie , Chirurgie générale , Thérapeutique , Carcinome intracanalaire non infiltrant , Anatomopathologie , Chirurgie générale , Thérapeutique , Carcinome lobulaire , Anatomopathologie , Chirurgie générale , Thérapeutique , Traitement médicamenteux adjuvant , Études de suivi , Métastase lymphatique , Mastectomie , Méthodes , Récidive tumorale locale , Stadification tumorale , Modèles des risques proportionnels , Radiothérapie adjuvante , Études rétrospectives , Taux de survie , Tamoxifène , Utilisations thérapeutiques , Torémifène , Utilisations thérapeutiques , Charge tumoraleRésumé
<p><b>BACKGROUND</b>It is not clear if there is a difference in prognosis between male breast cancer (MBC) and female breast cancer (FBC) patients. The aim of this study was to compare the prognosis of MBC and FBC patients in China and the prognosis of MBC and their corresponding postmenopausal FBC patients.</p><p><b>METHODS</b>Thirty-five MBC patients who were treated at the Sun Yat-sen University Cancer Center between 1969 and 2004 were enrolled in the study. Seventy FBC patients who were matched with the MBC patients for TNM stage, year of diagnosis, and age at diagnosis were simultaneously enrolled in the study. A second group comprising 18 MBC patients and their corresponding 36 matched postmenopausal FBC patients were also enrolled. The whole group and the postmenopausal groups were compared for five- and ten-year survivals.</p><p><b>RESULTS</b>All the factors that could potentially affect prognosis were comparable among the groups except more FBC than MBC patients underwent endocrine therapy and a modified radical mastectomy. The 5- and 10-year survivals in the whole group were 81.6% and 60.3% for men and 90.7% and 73.5% for women (P = 0.02). The 5- and 10-year survival in the postmenopausal group was 82.5% and 100% for men and 66.0% and 85.9% for women (P = 0.159).</p><p><b>CONCLUSIONS</b>Chinese FBC patients had a better prognosis than Chinese MBC patients. However, MBC patients and their corresponding postmenopausal FBC patients had a similar prognosis.</p>
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Tumeurs du sein , Mortalité , Anatomopathologie , Thérapeutique , Tumeur du sein de l'homme , Mortalité , Anatomopathologie , Thérapeutique , Chine , Stadification tumorale , Récepteur ErbB-2 , Récepteurs des oestrogènes , Récepteurs à la progestérone , Caractères sexuels , Taux de survieRésumé
<p><b>OBJECTIVE</b>To summarize our experiences with the treatment of non-small cell lung cancer (NSCLC) with cetuximab and compare the therapeutic effects of cetuximab applied in the first line and non-first line settings.</p><p><b>METHODS</b>From October 1, 2006 to December 31, 2009, 16 NSCLC patients were treated with cetuximab combined with standard chemotherapy in Sun Yat-sen University Cancer Center. The short-term efficacy of the therapeutic protocols were analyzed.</p><p><b>RESULTS</b>A total of 115 cycles of cetuximab treatment were administered in these patients with a median of 6 cycles (7.5 in the first line setting and 2 in non-first line setting). In the 10 patients with cetuximab treatment in the first line setting, the ORR was 40.0% (4/10), DCR was 80.0% (8/10), median TTP was 6.5 months (2-19), and median OS was 8.5 months (2-48); in the non-first line setting, these indices were 33.3% (2/6), 33.3% (2/6), 3.5 months (3-4) and 18 months (4-28), respectively. Both ORR and DCR were similar between the first and non-first line settings (P=0.790, P=0.062). Ten of the patients (62.5%) developed acne-like rash within 3 weeks, who had an ORR of 60% (6/10) and DCR of 90% (9/10); the ORR and DCR in patients without acne-like rash were both 10.4% (1/6), showing no significant difference in ORR (P=0.080) but a significant difference in DCR between the two groups (P=0.003). No treatment-associated death or cetuximab-associated discontinuation occurred. Altogether 11 patients (68.8%) developed acne-like rash, which occurred within 3 weeks in 10 cases. Seven patients showed side effects associated with the chemotherapy.</p><p><b>CONCLUSION</b>Cetuximab combined with standard chemotherapy is a good option for Chinese patients with NSCLC and the current data support the application of cetuximab in the first line setting.</p>
Sujets)
Adulte , Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Anticorps monoclonaux humanisés , Protocoles de polychimiothérapie antinéoplasique , Utilisations thérapeutiques , Carcinome pulmonaire non à petites cellules , Traitement médicamenteux , Cétuximab , Tumeurs du poumon , Traitement médicamenteux , Résultat thérapeutiqueRésumé
<p><b>OBJECTIVE</b>To study the efficacy and safety of cetuximab combined with chemotherapy for patients with advanced colorectal cancer (ACRC) and unclear K-ras status.</p><p><b>METHODS</b>Clinical data of 102 ACRC patients, treated by cetuximab combined with chemotherapy in Sun Yat-sen Cancer Center from March 2005 to December 2008, were collected. The cumulative survival rate, objective response rate (ORR), disease control rate (DCR), progression free survival (PFS) of the cases were calculated. The difference in ORR, DCR, PFS and oval survival (OS) between the regimens used as first-line and non-first-line treatment, and between the regimens including oxaliplatin and irinotecan were compared.</p><p><b>RESULTS</b>The overall ORR of cetuximab plus chemotherapy was 43.1%, DCR 73.5%, median PFS 4.0 months, OS 28.5 months, and the 1-year, 3-year, and 5-year survival rate was 89.2%, 50.9% and 27.5%, respectively. The differences in ORR (50.0% vs. 40.0%, P = 0.344), DCR (78.1% vs. 72.9%, P = 0.571) and OS (51.0 months vs. 35.0 months, P = 0.396) between the regimens as first line and as non-first line treatment were not statistically significant. However, the PFS of the regimen as first-line was longer than that as non-first-line treatment (PFS 5.5 months vs. 3.0 months, P = 0.001). The differences in ORR (54.2% vs. 40.0%, P = 0.223), DCR (79.2% vs. 74.7%, P = 0.654), PFS (5.0 months vs. 3.0 months, P = 0.726) and OS (36.0 months vs. 40.0 months, P = 0.759) between cetuximab plus oxliplatin and irinotecan were not statistically significant. The most common side effects of cetuximab plus chemotherapy were acneiform eruption (80.4%, grade 3-4 in 9.8%), neutropenia (66.7%, grade 3-4 in 18.6%), and diarrhea (19.6%, grade 3-4 in 5.9%). No treatment-related death was recorded.</p><p><b>CONCLUSION</b>Patients with advanced colorectal cancer and unclear K-ras treated by cetuximab combined with chemotherapy have good ORR and OS, and the regimen is safe with less adverse events for them. There is no significant difference between the efficacies of regimens as first line and as non-first line treatment, and between cetuximab plus oxliplatin and cetuximab plus irinotecan regimens.</p>