Case Report: Detection of Double ROS1 Translocations, SDC4-ROS1 and ROS1-GK, in a Lung Adenocarcinoma Patient and Response to Crizotinib.

ROS1 rearrangement, identified in ~2% of non-small cell lung cancer (NSCLC), has defined a distinctive molecular subtype. Patients with ROS1 fusion have been shown to be highly sensitive to treatment with crizotinib. However, the efficacy of crizotinib in NSCLC patients with double ROS1 fusions remains to be elucidated. Here, we report a 40-year-old male diagnosed with stage IIIA lung adenocarcinoma. Two ROS1 fusions [SDC4-ROS1 (EX2:EX32) and ROS1-GK (EX31:EX13)] were detected simultaneously in tumor tissue of this patient by next-generation sequencing. Crizotinib was administered, and the patient showed a partial response in lung lesions. Nevertheless, a brain lesion was found at 8 months after treatment. The slightly short duration of response may be related to the presence of ROS1-GK rearrangement. This case proved that patients with SDC4-ROS1 and ROS1-GK fusions may be sensitive to crizotinib, but short progression-free survival of this case showed that the presence of ROS1-GK rearrangement may affect the efficacy of crizotinib. A large-scale investigation on the efficacy of ROS1 inhibitors in patients with complex ROS1 fusions should be conducted in the future.

Lambert-Eaton myasthenic syndrome in a patient with small-cell lung cancer: A case report.

Lambert-Eaton myasthenic syndrome (LEMS) is a neuromuscular junction disorder characterized by fluctuating proximal limb muscle weakness, decreased deep tendon reflexes and various autonomic symptoms. LEMS is reportedly the most common neurological paraneoplastic syndrome. This is the case report of a patient with small-cell lung cancer (SCLC) who developed LEMS. A 68-year-old male patient presented with a 6-month history of progressive weakness of the proximal limbs and a 2-month history of xerostomia. The patient was admitted to the Department of Neurology of the People's Liberation Army General Hospital of Shenyang Military Region (Shenyang, China). The symptoms of the patient were not relieved with supportive therapy. Further laboratory tests, electrodiagnostic studies, chest computed tomography and immunohistochemical staining confirmed the diagnosis of LEMS in the presence of SCLC. Following administration of two cycles of rescue chemotherapy with a combination of etoposide and cisplatin, the symptoms of the patient were gradually relieved and, after six cycles of therapy, the primary malignancy completely regressed. In conclusion, a diagnosis of LEMS may lead to the timely detection of SCLC, significantly improving patient prognosis and survival.

Trastuzumab monotherapy for bone marrow metastasis of breast cancer: A case report.

The current study presents the case of a 41-year-old female patient who received modified radical mastectomy and adjuvant chemotherapy and radiotherapy for infiltrating ductal cancer of the left breast. The pathological stage of the disease was IIA. In addition, the patient was negative for the estrogen and progesterone receptors, and human epidermal growth factor receptor-2 gene amplification was identified. At one year following surgery, the patient presented with severe pancytopenia and pain at multiple sites all over the body. Furthermore, the patient's Eastern Cooperative Oncology Group performance status score was 3 and numeric rating scale pain score was 8. The bone marrow puncture indicated bone marrow metastatic cancer, and the positron emission tomography/computed tomography (CT) indicated multiple internal organ metastases and osseous metastasis. Chemotherapy treatment posed great risks due to the patient's poor performance status and severe bone marrow suppression. Therefore, trastuzumab monotherapy was administered at a loading dose of 8 mg/kg and a maintenance dose of 6 mg/kg every three weeks. Following four doses of trastuzumab treatment, the patient's performance status significantly improved and the peripheral blood cell counts had returned to within the normal ranges. Taxol was added to the trastuzumab treatment and seven cycles were completed. No metastatic cancer cells were found in the subsequent bone marrow smear test; however, CT showed metastatic foci in the left lung. Furthermore, the enlarged lymph nodes had subsided and the tumor in the right appendix region had decreased in size by 50%. The patient's disease condition was maintained stable for 11 months.

Small breast epithelial mucin tumor tissue expression is associated with increased risk of recurrence and death in triple-negative breast cancer patients.

BACKGROUND: Small breast epithelial mucin (SBEM) has been implicated in tumor genesis and micrometastasis in breast cancer. Triple-negative breast cancer (TNBC) was characterized by high incidence in young women,early relapse and a very poor prognosis. The aim of this study was to evaluate the association of SBEM expression in tissues of TNBC with disease-free survival (DFS) and overall survival (OS). METHODS: SBEM protein expression was detected in 87 available formalin-fixed paraffin-embedded (FFPE) tissue specimens from TNBC patients by means of immunohistochemistry (IHC). We analyzed the correlation between the SBEM protein expression and DFS and OS during a 5 year follow-up period, respectively. And a SBEM cut-off value of prognosis was established associated with DFS and OS. SBEM was analyzed against other risk factors in multivariate analysis. RESULTS: SBEM 3+ score was cut-off value of prognosis and significantly correlated with DFS (p = 0.000) and OS (p = 0.001) in TNBC patients. There was a marked associations (p <0.05) between SBEM 3+ score and tumor size, grade, node status, TNM stage and Ki67. Multivariate analysis showed that patients with SBEM 3+ represented a higher risk of recurrence and mortality than those with a lower SBEM expression (HR = 3.370 with p = 0.008 for DFS and HR = 4.185 with p = 0.004 for OS). CONCLUSIONS: SBEM is an independent risk predictor and may offer utility as a prognostic marker in TNBC patients.

[Preventive effect of low-dose carvedilol combined with candesartan on the cardiotoxicity of anthracycline drugs in the adjuvant chemotherapy of breast cancer].

OBJECTIVE: To investigate the effect of low-dose carvedilol combined with candesartan in the prevention of acute and chronic cardiotoxicity of anthracycline drugs in adjuvant chemotherapy of breast cancer. METHODS: Forty patients were randomly divided into two groups: the experimental group with chemotherapy plus low-dose carvedilol combined with candesartan (20 cases) and control group with chemotherapy alone (20 cases). The same chemotherapy was given to the two groups. All the 40 patients had no contraindication for carvedilol and candesartan. Patients of the experimental group received low-dose carvedilol from 2.5 mg orally twice a day at first cycle to 5 mg twice a day gradually if no side reactions, and candesartan 2.5 mg orally once a day. Electrocardiogram, ultrasonic cardiogram, arrhythmia, troponin and non-hematologic toxicity were recorded and compared after the second, forth and sixth cycle of chemotherapy. Each cycle included 21 days. RESULTS: LVEF was decreased along with the prolongation of chemotherapy in the experimental group and control group. LVEDD and LVESD showed no significant changes in the experimental group, but gradually increased in the control group. After four and six cycles of chemotherapy, LVEF were (57.00 ± 5.13)% and (45.95 ± 3.68)%, respectively, in the control group, significantly lower than that of (67.00 ± 5.13)% and (57.50 ± 2.57)%, respectively, in the experimental group (P < 0.05). After six cycles of chemotherapy, LVEDD and LVESD were (50.00 ± 10.48) mm and (35.01 ± 2.99) mm, respectively, in the control group, significantly higher than those before chemotherapy (P < 0.05) and experimental group (P < 0.001). The rate of ST segment and T wave abnormalities was 80.0% in the control group after six cycles of chemotherapy, significantly higher than that of 25.0% after four cycles of chemotherapy (P = 0.001) and 10.0% after two cycles of chemotherapy (P < 0.001). The reduction of QRS voltage, arrhythmia and abnormal troponin were 55.0%, 45.0% and 45.0%, respectively, in the control group, significantly higher than those in the experimental group (20.0%, P < 0.05), (10.0%, P = 0.010) and (10.0%, P < 0.05), respectively. The rate of abnormal expression of troponin was 45.0% in the control group, significantly higher than the 10.0% in the experimental group (P < 0.05). CONCLUSIONS: The use of low-dose carvedilol combined with candesartan can reduce the acute and chronic cardiotoxicity of anthracycline drugs, and with tolerable toxicities. This may provide a new approach to prevent cardiotoxicity of anthracycline drugs in adjuvant chemotherapy of breast cancer.

[Clinical controlled trial of first-line treatment for advanced kidney cancer].

OBJECTIVE: To estimate the efficacies of different first-line treatments for advanced stage kidney cancer. METHODS: For this observation controlled trial, a total of 82 cases with advanced stage kidney cancer from 2006 to 2011 were recruited. They were divided into 3 groups and accepted gemcitabine plus interleukin-2 (IL-2) (Group A), oxaliplatin plus capecitabine (Group B) or sorafenib alone (Group C). RESULTS: Among them, 76 patients had complete data. The overall response rates of A-C groups were 39.3% (11/28), 37.0% (10/27) and 38.1% (8/21) respectively. And there was no significant difference (χ(2) = 0.029, P = 0.986). And their progression-free survival (PFS) rates were 9.1 (95%CI: 7.9 - 10.3), 7.5(95%CI: 5.5 - 9.5) and 10.9 (95%CI: 10.5 - 11.3) months respectively. And there were significant differences (P = 0.013). Average daily treatment costs were 490, 498 and 501 Chinese yuan respectively. And there was no significant difference (P = 1.240). Because of toxicity, 2 and 3 cases withdrew in Groups A and B respectively. CONCLUSION: Gemcitabine plus IL-2 and oxaliplatin plus capecitabine have similar early efficacies and tolerance profiles for the patients who can not accept sorafenib as first-line treatment.

Understanding the role of Fe(III)/Fe(II) couple in mediating reductive transformation of 2-nitrophenol in microbial fuel cells.

The Fe(III)/Fe(II) couple can play a significant role in the abiotic reduction of 2-nitrophenol (2-NP) at the cathode chamber of a microbial fuel cell (MFC). Experimental results demonstrate that Fe(II) addition to the cathode chamber contributes to a significant increase in the reaction rate of 2-NP removal and the power performance of MFC. Observed pseudo first-order rate constants and power densities are heavily dependent on the identity of the Fe(II)-complexing ligands. The Fe(II) complex coordinated with citrate results in the highest rate constant up to 0.12 h(-1) as compared to other organically complexed iron species including Fe(II)-EDTA, Fe(II)-acetate and Fe(II)-oxalate, and iron species uncomplexed with any organic ligands. In addition, the presence of Fe(II)-citrate species leads to a maximum volumetric power density of 1.0 W m(-3), which is the highest value among those obtained with other iron species for the similar MFC system.

[Hepatic and renal injury induced by Radix Aristolochiae or Guanxin Suhe Wan for a long-term in rats].

OBJECTIVE: To evaluate the toxicity of Radix Aristolochiae supplied experimental evidence of rational use of drug in clinic. METHOD: After treatment with small dose Radix Aristolochiae, Guanxin Suhe Wan (with Radix Aristolochiae) and Guanxin Suhe Wan (without Radix Aristolochiae) in different group for a long- term, respectively, the biochemical indicator of PT, ALT, AST, ALB, ALP, Crea and BUN were detected, and the kidney, liver, stomach and urinary bladder were examined by pathologic assaying. RESULT: In Radix Aristolochiae group and Guanxin Suhe Wan (with Radix Aristolochiae) group, all of biochemical indicator were changed significantly, and hepatonecrosis, renal tubular necrosis, gastric carcinoma and bladder carcinoma were discovered. CONCLUSION: Radix Aristolochiae and Guanxin Suhe Wan (with Radix Aristolochiae) can damage kidney and liver, and cause gastric carcinoma and bladder carcinoma by intensive toxicity.

[Nephrotoxicity of Radix Aristolochice and it's substitution material Radix Inulae in rats].

OBJECTIVE: To evaluate the toxicity of Radix Aristolochiae and Radix Inulae, and to supply the toxicity experimental data that Radix Inulae supersedes Radix Aristolochiae in clinic. METHOD: A long dose of Radix Aristolochice and Radix Inulae was given intragastrically to rats for six months, then drug withdrawal for a month. The hematology and biochemical indicators were measured, and the pathologic changes of kidney, liver, stomach and urinary bladder were examined. RESULT: The rats of Radix Aristolochice showed serious toxic responses of renal tubule atrophy and necrosis, meanwhile, the levels of BUN, Cr and NAG were increased obviously. Hepatonecrosis, renal tubular necrosis, gastric carcinoma and bladder carcinoma were discovered with pathologic assaying. But the rats of Radix Inulae did not. CONCLUSION: Radix Aristolochiae could damage kidney and liver, and cause gastric carcinoma and bladder carcinoma by intensive toxicity. Radix Inulae could take the place of Radix Aristolochiae to use in clinic.

[Effects of Nasea on prevention of gastrointestinal side effects caused by chemotherapeutic drugs].

OBJECTIVE: To investigate the effects of Nasea on prevention of gastrointestinal side effects caused by chemotherapeutic drugs. METHODS: Eighty-five in-patients with cancer undergoing chemotherapy were randomly divided into 2 groups: Nasea group (group A, n = 43, Nasea, ramosetron hydrochloride was injected intravenously 30 minutes before chemotherapy) and ondansetron group (group B, n = 42, ondamsetron was injected intravenously 30 minutes before chemotherapy). The side effects of chemotherapy, including nausea, vomiting, anorexia, etc, were observed during the 3 days after chemotherapy. RESULTS: The complete effective rate and effective rate of prevention of nausea, vomiting, and anorexia during the periods 0 - 6 hours, 6 - 12 hours, 24 - 48 hours, and 48 - 62 hours after chemotherapy were similar in these 2 groups. However, these rates during the period 12 approximately 24 hours after chemotherapy were significantly higher in group A than in group B (all P < 0.05). The side effects of these 2 drugs included carebarja, headache, fatigue, etc, all being mild and not significantly different between these 2 groups. CONCLUSION: Effectively preventing the gastrointestinal side effects caused by chemotherapeutic drugs with an efficacy similar to that of ondansetron and seemingly lasting longer, Nasea is a promising drug.