The efficacy and safety of capecitabine plus bevacizumab combination as first-line treatment in elderly metastatic colorectal cancer patients

Aim: The optimal treatment in older persons with metastatic colorectal cancer (mCRC) is complicated by a lack of general agreement. The aim of this study was to evaluate the activity of bevacizumab plus capecitabine combination in elderly mCRC patients who were not suitable for chemotherapy with irinotecan and oxaliplatin-containing regimens. Materials and methods: Seventy years and older patients with metastatic colorectal carcinoma were included in this retrospective study. Bevacizumab was administered at a dose of 7.5 mg/kg on day 1 as an intravenous (IV) infusion over 30-90 min every 21 days, and capecitabine was prescribed at 1000 mg/m2 twice daily on days 1-14 of the same 21-day schedule. Results: Eighty-two consecutive patients (47 men, 35 women) were included in the study. The mean age was 75.5 (SD 3.9, range 70-87). Half of the patients were older than 75 years. There were 55 patients (67.1 %) with a good Eastern Cooperative Oncology Group (ECOG) performance status (PS: 0-1) and the remaining 27 patients (32.9 %) had a poor ECOG performance status (PS: 2). With a median follow-up period of 18.5 months, the median progression-free survival (PFS) was 10 months (95 % CI, 7.8-12.1) and the median OS was 25 months (95 % CI, 18.6-31.3). The main toxicities recorded were non-hematological. Thirty-one patients (37 %) experienced grade 3/4 adverse events, the most common being hand–foot syndrome (9.8 %). No fatal toxicity resulting from this regimen was recorded. Conclusions: Considering the toxicity profile and survival outcomes, the combination regimen of capecitabine and bevacizumab is a potentially feasible treatment option in elderly mCRC patients (AU)

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The differences of clinicopathological factors for breast cancer in respect to time of recurrence and effect on recurrence-free survival

Purpose. In the literature, small number of study has addressed time of recurrence in breast cancer. We analyzed clinicopathological factors predicting early or late recurrence in breast cancer patients and also prognostic factors related with recurrence-free survival (RFS) in recurrent patients. Patients/methods. We evaluated retrospectively 1980 breast cancer patients. Relapsed was defined as early if it was occured first 5 year of follow-up (Group 1) and late if it was occured after 5 years (Group 2). The clinicopathological factors were compared in respect of time of recurrence. The prognostic factors were evaluated using univariate and multivariate analyses. Results. Recurrence wase detected in 141 patient during follow-up. Tumors recurred after 5 years more likely to have lower stage (p = 0.05), tumors without lymphovascular invasion (LVI) (p < 0.001) and perineural invasion (PNI) (p = 0.01), and also HER2 negative (p < 0.001). The median RFS time and 5 years RFS rates were 42.9 months and 31.9 %, respectively. LVI (p = 0.01), PNI (p = 0.03), HER2 (p = 0.003), progesterone receptor (PR) (p = 0.04), the presence of neoadjuvant chemotherapy (p = 0.003), adjuvant hormonotherapy (p = 0.05) were found to be related with RFS. Axillary lymph node metastasis (p = 0.05) and the presence of PNI (p = 0.009) were poor prognostic factors for early recurrent group. PR-positive tumors (p = 0.001) and luminal subtypes (p = 0.03) had instances of late recurrences significantly. Conclusions. Clinicopathological factors predicting the recurrence time in breast cancer were important to modify adjuvant therapy (AU)

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Clinical importance of posphatase of regenerating liver-3 expression in breast cancer

BACKGROUND: Several biomarkers have been previously studied for breast cancer to define risk of recurrence and metastasis. Phosphatase of regenerating liver-3 (PRL-3) is one of them. High PRL-3 expression has been found to be correlated with axillary lymph node metastasis and survival in breast cancer. Herein, we evaluated the prognostic significance of PRL-3 expression and the relationship between PRL-3 and other clinicopathological factors. METHODS: PRL-3 expression was analyzed immunohistochemically in 122 invasive breast cancer tissues. We evaluated the correlation between PRL-3 and other clinicopathological factors by χ² test. Kaplan-Meier test and log rank method were used to define prognostic importance of PRL-3 expression. RESULTS: Of 122 breast cancer tumor samples, 46 (37.7 %) were negative while 76 (62.3 %) were positive in respect to PRL-3 expression. There was significant correlation between PRL-3 expression and other clinicopathological factors, such as histology, lymphovascular invasion (LVI), necrosis, progesterone receptor (PR) status, and the presence of triple negative disease. Tumors with LVI and necrosis had more positive PRL-3 expression compared to tumors without LVI or necrosis (P = 0.05 and 0.03, respectively). Triple negative and cerb-B overexpressed breast cancers were found to be more positive PRL-3 expression than hormone receptor positive with cerb-B negative groups (luminal A) (P = 0.02).We could not find any relationship between PRL-3 expression and overall survival (OS) or disease-free survival (DFS) (P > 0.05). CONCLUSION: Although PRL-3 expression was related to LVI or necrosis which is important for tumor invasiveness, we could not find that PRL-3 as an important prognostic factor in breast cancer patients. In addition, triple negative and cerb-B overexpressed tumors, which had worse prognosis compared to hormone receptor positive without cerb-B expressed group, associated with also PRL-3 positivity more than PRL-3 negative group (AU)