Recent Advances in Breast Cancer (The 37th ASCO Meeting,May 2001)

SUMMARY

Data from phase III clinical trials suggest that high dose chemotherapy (HDC) is currently not indicated for any stage of breast cancer. Therefore HDC should only be considered within the context of clinical trials. Furthermore, there is no significant evidence to support the routine use of taxanes in women with metastatic breast cancer (MBC) and further research is required to address this issue. A well-designed randomised controlled trial has shown that expressive support psychosocial therapy does not improve survival of women with MBC. Her2 overexpression seems to be a significant predictor of response to taxanes and anthracyclines, and FISH testing for Her2 seems to be superior to IHC in predicting response to Herceptin.

Recent evidence confirms the independent prognostic value of VEGF, UPA and PAI-1 in women with early breast cancer and suggests that such parameters may have a role in selecting systemic therapy.

Biological therapy using

inhibitors/antagonists of angiogenesis and EGFR seems to be safe and well tolerated. Although the response rates are currently unimpressive, further research using survival as an endpoint is required.     

《PARP抑制剂在卵巢癌中的应用：ASCO指南》解读

        2014年，美国食品和药物监督管理局（FDA）批准了第一个多聚ADP核糖多聚酶（PARP抑制剂）奥拉帕利（Olaparib）治疗已接受≥3线化疗的胚系BRCA突变（gBRCA）卵巢上皮性癌患者；2016年批准卢卡帕利（Rucaparib）用于治疗胚系和体细胞BRCA突变（g/sBRCA）的复发性卵巢癌患者；2017年批准了尼拉帕利（Niraparib）和Olaparib用于对含铂化疗完全或部分缓解患者的维持治疗。 浏览更多请关注本刊微信公众号及当期杂志。     

Rising Cost of Cancer Pharmaceuticals: Cost Issues and Interventions to Control Costs

The rising cost of pharmaceuticals and, in particular, cancer drugs has made headline news in recent years. Several factors contribute to increasing costs and the burden this places on the health care system and patients. Some of these factors include costly cancer pharmaceutical research and development, longer clinical trials required to achieve drug approval, manufacturing costs for complex compounds, and the economic principles surrounding oncology drug pricing. Strategies to control costs have been proposed, and some have already been implemented to mitigate cancer drug costs such as the use of clinical treatment pathways and tools to facilitate cost discussions with patients. In this article, we briefly review some of the potential factors contributing to increasing cancer pharmaceutical costs and interventions to mitigate costs, and touch on the role of health care providers in addressing this important issue.     

2016年美国ASCO年会乳腺癌内分泌治疗进展

内分泌治疗是乳腺癌治疗的主要手段之一,近年来,辅助内分泌治疗强化或延长治疗策略、内分泌治疗新型药物以及围绕内分泌治疗耐药的液态检测都是临床研究关注的热点,现将2016年美国ASCO会议内分泌治疗的进展进行综述.     

Putative circulating markers of the early and advanced stages of breast cancer identified by high-resolution label-free proteomics

This study evaluated the plasmatic proteomic profile of breast cancer patients in the early (ED) and advanced (AD) stages, employing high-throughput proteomics. We identified 92 differentially expressed proteins in ED and 73 proteins in AD patients. Gelsolin, lumican, clusterin, SALL4 and PMS2, as well hTERT, TNF-α and GRHL3 were chosen for further investigation. ED presented augmented expression of GRHL3 and reduced circulating TNF-α with high expression of GRHL3 in tumors. AD displayed high TNF-α and a significant expression of PMS2 in tumors. These findings suggest processes enrolling stem cell division in ED, with TNF-α signaling and DNA mismatch repair in the advanced stage.     

从2017 ASCO年会看肿瘤代谢及营养支持研究的进展

 肿瘤是世界范围内居民死亡的最主要原因之一。肿瘤异常的代谢状态及靶向代谢抗肿瘤治疗正成为肿瘤研究领域的热点。值2017年美国临床肿瘤学会(American Society of Clinical Oncology,ASCO)年会闭幕之际,本文就靶向代谢通路药物的临床研究、基于代谢原理的肿瘤显像技术、代谢分子在肿瘤发生发展中的作用和机制、临床营养方案和营养评估等4个方面综述肿瘤代谢及营养支持研究的进展。     

A systematic review of dual targeting in HER2-positive breast cancer

Background

Human epidermal growth factor receptor 2 (HER2) is overexpresed in 15–20% of all breast cancers. Treatment with trastuzumab has led to an improved outcome and prolonged survival of HER2-positive breast cancer patients and today the drug is established as standard of care in both the adjuvant and metastatic settings. However, trastuzumab resistance is common and a major focus in the treatment of HER2-positive breast cancer has been developing therapeutic agents to either potentiate the effect of trastuzumab or to target cells which have become resistant to trastuzumab. The present review addresses efficacy and toxicity of dual targeting in HER2-positive breast cancer.

Materials and methods

A computer-based literature search was carried out using PubMed; data reported at international meetings and clinicaltrials.gov was included.

Results

This paper describes efficacy and safety of lapatinib, pertuzumab or trastuzumab-DM1 in combination with trastuzumab in the (neo)adjuvant and metastatic settings. Furthermore, combinations of trastuzumab and drugs targeting the downstream pathway are described.

Conclusion

Dual blockade is likely to represent a substantial advance for patients with HER2-positive breast cancer. However, the relevant subpopulation remains to be defined and side effects including cardiotoxicity might be a limiting factor to the use. There is an urgent need for prospective biomarker-driven trials to identify patients for whom dual targeting is cost-effective.     

Classifying Ischemic Stroke,from TOAST to CISS

SUMMARY Ischemic stroke classification is critical in conducting basic research and clinical practice. A precise analysis of stroke subtypes requires the integration of clinical features, findings from diagnostic tests, and knowledge about potential etiologic factors by competent diagnostic investigators. We performed a literature review of the published stroke classification systems and examined each for its benefits and limitations in the evaluation of the stroke etiology. Two major approaches to etiologic classifications of ischemic stroke are currently being used: the causative and phenotypic subtyping. The most widely used causative system is the Trial of Org 10172 in acute stroke treatment (TOAST) classification. With the advances in modern diagnostic technology, new stroke subclassification systems, such as the causative classification system (CCS) and Chinese ischemic stroke subclassification (CISS) system, have been developed to enhance the accuracy of TOAST. The A‐S‐C‐O ( A therosclerosis, S mall‐vessel disease, C ardiac source, O ther cause) phenotypic classification system makes efforts to identify the most likely etiology but not neglecting the possibility of other potential multiple causes. We conclude that the ideal stroke classification system needs to be valid, easy to use, evidence‐based, and incorporate new information as it emerges.