[Show abstract][Hide abstract] ABSTRACT: The prognostic value of phosphorylated Akt (pAkt) overexpression in breast cancer has been investigated by many studies with inconsistent results. This systematic review was conducted to evaluate the association of pAkt overexpression with breast cancer prognosis in terms of overall survival and disease-free survival. Three electronic databases (PubMed, EMBASE and Chinese Biomedical Literature Database) were comprehensively searched. Hazard ratios (HRs) with 95% confidence intervals (CIs) from different studies were combined using the random-effects model. In total, 33 studies with 9,836 patients were included for final analysis. The summary HR for overall survival and disease-free survival was 1.52 (95% CI: 1.29-1.78) and 1.28 (95% CI: 1.13-1.45), respectively, indicating higher risk of death and disease recurrence associated with pAkt overexpression. The results were robust in sensitivity analyses by omitting one study each time and by using the fixed-effects model instead. Subgroup and meta-regression analyses did not show that the prognostic effect of pAkt overexpression would change materially with such factors as population, status of hormone receptors, hormonal or trastuzumab treatment given, analyzing method (univariate versus multivariate) and methodological quality of the original studies. In conclusion, the available evidence suggests that pAkt overexpression is an adverse prognostic factor for breast cancer.
[Show abstract][Hide abstract] ABSTRACT: Background
This study aims to comprehensively summarize the currently available evidences on the efficacy and safety of gemcitabine plus erlotinib for treating advanced pancreatic cancer.
PubMed, EMBASE, The Cochrane Library and abstracts of recent major conferences were systematically searched to identify relevant publications. Studies that were conducted in advanced pancreatic cancer patients treated with gemcitabine plus erlotinib (with or without comparison with gemcitabine alone) and reporting objective response rate, disease control rate, progression-free survival, time-to-progression, overall survival, 1-year survival rate and/or adverse events were included. Data on objective response rate, disease control rate, 1-year survival rate and adverse events rate, respectively, were combined mainly by using Meta-Analyst software with a random-effects model. Data on progression-free survival, time-to-progression and overall survival were summarized descriptively. Sixteen studies containing 1,308 advanced pancreatic cancer patients treated with gemcitabine plus erlotinib were included. The reported median progression-free survival (or time-to-progression), median overall survival, 1-year survival rates, objective response rates and disease control rates were 2–9.6 months, 5–12.5 months, 20%–51%, 0%–28.6% and 25.0%–83.3%, respectively. The weighted 1-year survival rate, objective response rate and disease control rate based on studies reporting robust results were 27.9%, 9.1% and 57.0%, respectively. According to the studies with relevant data, the incidences of total and severe adverse events were 96.3% and 62.9%, respectively. The most frequently reported adverse events were leucopenia, rash, diarrhea, vomitting, neutropenia, thrombocytopenia, anaemia, stomatitis, drug-induced liver injury, fatigue and fever. Compared with gemcitabine alone, the progression-free survival and overall survival with gemcitabine plus erlotinib were significantly longer, but there were also more deaths and interstitial lung disease-like syndrome related to this treatment.
Gemcitabine plus erlotinib represent a new option for the treatment of advanced pancreatic cancer, with mild but clinically meaningful additive efficacy compared with gemcitabine alone. Its safety profile is generally acceptable, although careful management is needed for some specific adverse events.
PLoS ONE 03/2013; 8(3):e57528. DOI:10.1371/journal.pone.0057528 · 3.23 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background:
The authors conducted a systematic review and meta-analysis to examine whether patients who had metastatic colorectal cancer (mCRC) with the v-Ki-ras2 Kirsten rat sarcoma viral oncogene homolog (KRAS) p.G13D mutation (an amino acid substitution at position 13 in KRAS from a glycine to an aspartic acid) and received cetuximab treatment had better clinical outcomes than patients who had mCRC tumors with KRAS codon 12 mutations.
Relevant studies were identified by a search of MEDLINE, EMBASE, the Chinese Biomedical Database, and Wan Fang Digital Journals from inception to October 2011. The primary clinical outcomes included the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS). The pooled relative risk (RR) or hazard ratio (HR) was estimated by using fixed-effects or random-effects models according to heterogeneity between studies.
Ten studies were considered eligible that included 1487 patients with mCRC. Patients who had tumors with the KRAS p.G13D mutation had a significantly higher ORR (10 studies; RR, 1.642; 95% confidence interval [CI], 1.131-2.384), longer PFS (1 study; HR, 0.54; 95% CI, 0.36-0.81), and longer OS (1 study; HR, 0.52; 95% CI, 0.33-0.80) than patients who had tumors with KRAS codon 12 mutations. Compared with patients who had KRAS wild-type tumors, patients with the p.G13D mutation had a significantly lower ORR (9 studies; RR, 0.540; 95% CI, 0.381-0.765) and nonsignificantly shorter PFS (1 study; HR, 0.99; 95% CI, 0.68-1.45) and OS (1 study; HR, 1.01; 95% CI, 0.66-1.54).
Patients who had mCRC with the KRAS p.G13D mutation appeared to benefit more from cetuximab than patients who had tumors with KRAS codon 12 mutations. However, because of the limited sample sizes in the current meta-analysis, these results should be interpreted with caution.
Cancer 02/2013; 119(4). DOI:10.1002/cncr.27804 · 4.89 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Epidermal growth factor receptor gene copy number (EGFR GCN) has been heavily investigated as a potential predictive biomarker for the treatment of metastatic colorectal cancer (mCRC) with anti-EGFR monoclonal antibodies (MAbs). The objective of this study was to systematically review current evidences on this issue.
PubMed, EMBASE, The Cochrane Library, Chinese Biomedical Literature Database, Wanfang Data, and the conference abstracts of American Society of Clinical Oncology and European Society of Medical Oncology were comprehensively searched. Studies that reported the objective response rate (ORR), progression-free survival, and/or overall survival of mCRC patients treated with anti-EGFR MAbs, stratified by EGFR GCN status, were included. The effect measures for binary outcome (response) and time-to-event outcomes (progression-free survival and overall survival) were risk difference and hazard ratio, respectively. Statistical heterogeneity among the studies was assessed by the Cochran's Q-test and the I2 statistic. If appropriate, a quantitative synthesis of data from different studies would be conducted with a random-effects model.
Nineteen eligible studies were identified. The criteria for increased EGFR GCN (GCN+) were highly inconsistent across different studies. The prevalence of GCN + ranged from 6.9% to 88.9%, and the difference in ORR between patients with GCN + and those with non-increased EGFR GCN (GCN-) varied from -28% to 84%. Because of the significant heterogeneity, no quantitative synthesis of data was performed. There was a general trend towards higher ORR in patients with GCN+. The difference in ORRs between patients with GCN + and those with GCN- was even greater in KRAS wild-type patients, while in KRAS mutated patients the difference often did not exist. Almost all patients with EGFR amplification responded to the treatment. However, the prevalence of EGFR amplification was generally low. Incomplete data on progression-free survival and overall survival seemingly supported the findings on ORR.
Although increased EGFR GCN is generally associated with a better outcome of anti-EGFR MAbs treatment, especially among patients with wild-type KRAS, the clinical utility of this biomarker for selecting recipients of anti-EGFR MAbs would be severely limited by the heterogeneous scoring system and the poor reproducibility of EGFR GCN enumeration due to technical reasons.
[Show abstract][Hide abstract] ABSTRACT: A 51-year-old Chinese male with a 20-year history of hepatitis B was diagnosed with hepatocellular carcinoma in the right anterior portion of the liver, sized 3.5 cm × 3.2 cm, and was treated with radiofrequency ablation (RFA) on December 18, 2001. The patient did not receive antiviral therapy for hepatitis B virus after RFA. The treated lesion reduced gradually and reached its minimum size of 1.7 cm × 1.5 cm seven years later on November 18, 2008. However computed tomography findings revealed that a recurrence lesion of 6.0 cm × 4.8 cm which was histologically confirmed overlapped the previous treated lesion at the 8th year on December 3, 2009. Although recurrence at 8 years after curative RFA is a rare event, such a possibility must be kept in mind. To find and treat the recurrence lesion promptly, long-term and close monitoring is warranted after RFA. Meanwhile, the recurrence-prevention therapy is as important as close monitoring for those patients with a history of hepatitis B.
World Journal of Gastroenterology 10/2010; 16(40):5135-8. · 2.37 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: To compare the short-term curative effect of photodynamic therapy (PDT), PDT combined with chemotherapy and chemotherapy alone on the advanced esophageal cancer patients.
Retrospective analysis of 90 patients of esophageal cancer underwent PDT, PDT combined with chemotherapy and chemotherapy alone from 2004 to 2007 (stages III-IV), including 27 cases received PDT alone, 33 cases received PDT combined with chemotherapy and 30 cases chemotherapy alone. The enrolled patients were treated with intravenous administration of Photofrin as the photosensitizer at a dose of 2mg/kg. 630 nm laser irradiation was performed through optical fiber that passed through the biopsy channel of a flexible endoscope after 48 h. Two days later, the necrotic tissue was removed, and the primary sites and other newly identified lesions were subjected to a second irradiation and then the residual necrotic tissue was removed according to the patients' condition. Electronic endoscopy was performed to observe the effectiveness on tumor after 1 month. In PDT combined with chemotherapy group, chemotherapy regimen was 5-FU and DDP, administered 4 cycles after PDT and chemotherapy alone group only chemotherapy regimen 5-FU and DDP for four cycles. All the 90 patients were followed up for 2 years.
Symptomatic palliation rate of the PDT alone group, the complex treatment group and chemotherapy alone group was 85.2%, 93.9% and 60.0%, respectively, and effective rate under endoscopy was 85.2%, 90.9% and 63.3%, respectively, there is no statistically significant difference; the survival rate of 2 years was 29.6%, 54.5% and 16.7%, respectively, and medium survival time is longer (III stages 13 m, 22 m, 10 m; IV stages 7 m, 5m, 4m), there is statistically significant difference (p=0.046).
PDT combined with chemotherapy for the advanced esophageal cancer is superior to PDT alone and chemotherapy alone.
[Show abstract][Hide abstract] ABSTRACT: To assess the value of (18)F-fluoro-2-deoxy-D-glucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in ultrasound-guided local ablation of malignant liver tumors.
Thirteen patients with 35 local residual tumor foci following previous tumor ablation underwent (18)F-FDG PET-CT and ultrasound-guided local ablation with intratumoral alcohol injection.
After the second local ablation guided by (18)F-FDG PET-CT and ultrasound, radioactive defects were detected in the corresponding location in 31 of the 35 residual foci, and after the third local ablation, the other 4 foci also showed radioactive defects.
(18)F-FDG PET-CT can sensitively and accurately identify tissue necrosis and residual tumors, and serves as an excellent approach for ultrasound-guided local ablation of local residual tumors.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 09/2009; 29(8):1641-2.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the efficacy of bevacizumab in combination of irinotecan,fluorouracil and leucovorin for metastatic colorectal cancer treated by failed prior oxaliplatin -based regiment.
Sixty-two patients were randomly divided into two groups, group A of 30 patients received bevacizumab plus irinotecan, fluorouracil and leucovorin, group B of 32 patients received irinotecan, fluorouracil and leucovorin. The response rate,change of tumor markers,one year survival rate and safety were observed.
Tumor response rate was 30% in group A, 21.8% in group B respectively. Disease control rate(CR+PR+SD) was 80% in group A, 50% in group B. The obvious change of concentration of tumor markers was observed between pre-treatment and post-treatment, which was significantly different in group A(P<0.05). One year survival rate, median of time to progression and median duration of survival between group A and group B were 26.7% vs 18.8%, 5.9 months vs 3.9 months, 10.9 months vs 8.9 months(P<0.05). The adverse effect in group A was the same as group B. Bevacizumab was associated with hypertension and bradycardia.
The chemotherapy of bevacizumab combined with irinotecan, fluorouracil and leucovorin results in better efficacy in patients with progressive metastatic colorectal cancer.
Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery 07/2009; 12(4):374-7.
[Show abstract][Hide abstract] ABSTRACT: To investigate the clinical significance of vascular endothelial growth factor (VEGF) levels in serums of colorectal cancer patients at stage IV.
Using enzyme linked immunosorbent assay (ELISA) to detect the VEGF levels in serums of 45 colorectal cancer patients at stage IV, and 20 healthy served as normal control.
The mean concentration of VEGF in 45 colorectal cancer patients at the 7 day after operation were significantly lower than that before operation (P<0.01). The mean concentration of VEGF in the patients who benefit from bevacizumab showed no statistical difference from the levels of who did not benefit (P=0.554).
The VEGF levels in colorectal patients at stage IV are lowed as the load of tumor decrease. The circulating levels of VEGF seem not predict the response to bevacizumab in colorectal cancer patients at stage IV.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 02/2009; 29(2):278-9.
[Show abstract][Hide abstract] ABSTRACT: To assess the correlations between Survivin and vascular endothelial growth factor (VEGF) in hepatocellular carcinoma (HCC) and their clinical significance.
The expressions of Survivin and VEGF in 50 HCC specimens and 20 normal hepatic tissue specimens were detected by immunohistochemistry, and the results were analyzed in relation to the patients' clinicopathologic characteristics.
Of the 50 HCC specimens, 32 (64.0%) were positive for Survivin expression, and 34 (68.0%) were positive for VEGF expression. Survivin expression was not detected in normal hepatic tissues, and 2 (10%) of these tissues were positive for VEGF, showing significant difference in Survivin and VEGF expressions between HCC specimens and normal hepatic tissues. Survivin and VEGF expressions were not correlated to the patients' gender, age, tumor size, degree of differentiation and alpha fetoprotein level (P<0.05), but related to the clinical stage and lymph node metastasis of HCC (P<0.05). Correlation analysis indicated a close correlation between the expressions of survivin and VEGF in the HCC specimens (chi 2=6.69, P<0.05).
Survivin and VEGF are over-expressed in HCC tissues, and may theoretically serve as the targets of molecular targeted drugs. Detection of the expressions of Survivin and VEGF in HCC tissues may provide assistance for prognostic evaluation of the patients.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 05/2008; 28(5):761-3.
[Show abstract][Hide abstract] ABSTRACT: To establish a nude mouse model of malignant ascites with human ovarian carcinoma cell line OVCAR3 which highly expresses VEGF and evaluate the therapeutic of Avastin combined with cisplan.
Forty-eight nude mice with malignant ascites resulting from intraperitoneal transplantation of human ovarian carcinoma cell line OVCAR3 were treated with intraperitoneal injection of Avastin, cisplan, their combination, and PBS, respectively, to observe the effect on ascites development, VEGF content in the ascites, peritoneal permeability, development of new vessels and number of tumor cells in the ascites.
Avastin obviously inhibited ascites accumulation and peritoneal capillary permeability, reduced VEGF protein level and microvascular density in the tumor tissues and the number of red cells and tumor cells in the malignant ascites, and prolonged the survival of the mice. The combination of Avastin and cisplan further enhanced the therapeutic efficacy of Avastin.
The bio-chemotherapeutic strategy with Avastin combined with cisplan can be a promising method for treatment of malignant ascites.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 06/2007; 27(5):647-9.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the efficacy of Avastin in combination with irinotecan for metastatic colorectal cancer.
Ninety patients were randomly divided into 3 equal groups to receive Avastin plus irinotecan (group A), FOLFIRI (group B) and FOLFOX7 (group C) for two cycles, respectively. The response rate and changes in tumor maker levels were observed.
The tumor response rate was 43.3% in group A, 27.7% in group B and 30.0% in group C. The disease control rate (complete response+partial response+stable disease) was 80% in group A, 53.3% in group B and 50.0% in group C. Obvious changes in tumor marker levels were observed in the 3 groups after treatment, which were most conspicuous in group A (P<0.05).
The addition of Avastin to irinotecan chemotherapy results in significant improvement of clinical efficacy in patients with metastatic colorectal cancer.
Nan fang yi ke da xue xue bao = Journal of Southern Medical University 06/2006; 26(5):689-91.
[Show abstract][Hide abstract] ABSTRACT: To compare the therapeutic effects of biochemotherapy regimen with Herceptin plus taxol (TAX) and the chemotherapy regimen with epirubicin plus TAX against Her-2/neu-positive breast cancer and observe the changes in serum tumor markers in patients receiving biochemotherapy.
Seventy-three patients with advanced breast cancer positive for Her-2/neu as revealed by immunohistochemistry were divided into the study group (n=32) to receive treatment with the regimen of Herceptin plus TAX and control group (n=41) with the regimen of epirubicin(EPI) plus TAX. The therapeutic effects of the regimens were observed and in the study group, the relationship of the therapeutic effect with Her-2/neu positivity and changes in serum tumor markers were examined.
The objective response rate and clinical benefit response rate were obviously higher in the study group than in the control group. In the study group, the clinical response rate of patients with positive immunostaining for Her-2/neu of grades 1+, 2+ and 3+ were 0%, 44.4% and 63.6%, respectively, as compared with those in the control group of 8.3%, 36.4%, and 38.9%, respectively, and the treatment resulted in lowered levels of serum tumor markers without significant changes in CA153, tps and CEA (P<0.05) after treatment, but CA125 showed no significant difference (P>0.05).
In patients with advanced breast cancer with positive immunostaining for Her-2/neu of grade 3+, the regimen of Herceptin plus TAX can be more effective than the chemotherapeutic regimen of EPI plus TAX. Patients with Her-2/neu (+++) benefit more from the treatment than those with Her-2/neu (++). Serum CEA, CA153 and TPS levels also possess some value in evaluating the therapeutic effects of the regimens.
Di 1 jun yi da xue xue bao = Academic journal of the first medical college of PLA 01/2006; 25(12):1533-6.