Serum levels of MMP-11 correlate with clinical outcome in Chinese patients with advanced gastric adenocarcinoma

Background  

The aim of the present study was to investigate the association between serum levels of matrix metalloproteinase 11 (MMP-11) and responses to front-line chemotherapy and prognosis in advanced unresectable gastric adenocarcinoma.     

TX方案治疗铂类治疗失败的进展期胃癌的临床疗效分析

目的:评价紫杉醇联合卡培他滨作为含铂类药物治疗失败的进展期胃癌二线治疗的疗效及安全性。方法:既往接受FP或者FOLFOX4方案化疗的进展期胃癌患者36例,采用TX方案化疗,紫杉醇145mg/m2静脉滴注3h,d1;卡培他滨2000mg/m2,分2次口服,d1-14,21天为一个周期,随访观察疗效,不良反应,进展时间和生存期。结果:36例患者共接受142个周期的化疗,中位化疗周期数4个。全组36例患者中有35例可评价疗效及不良反应,其中8例部分缓解,有效率为22.8%(95%CI:8.2%-37.5%)。中位进展时间和生存时间分别为4.8个月(95%CI:2.9-6.2)和8.1个月(95%CI:6.4-12.7)。Ⅲ/Ⅳ度不良反应主要为骨髓抑制、手足综合征及脱发。结论:紫杉醇联合卡培他滨方案二线治疗进展期胃癌疗效确切,不良反应小,尤其对老年患者耐受性好。     

TX方案治疗铂类治疗失败的进展期胃癌的临床疗效分析

目的：评价紫杉醇联合卡培他滨作为含铂类药物治疗失败的进展期胃癌二线治疗的疗效及安全性。方法：既往接受FP或者FOLFOX4方案化疗的进展期胃癌患者36例,采用TX方案化疗,紫杉醇145mg/m2静脉滴注3h,d1;卡培他滨2000mg/m2,分2次口服,d1-14,21天为一个周期,随访观察疗效,不良反应,进展时间和生存期。结果：36例患者共接受142个周期的化疗,中位化疗周期数4个。全组36例患者中有35例可评价疗效及不良反应,其中8例部分缓解,有效率为22.8%（95%CI：8.2%-37.5%）。中位进展时间和生存时间分别为4.8个月（95%CI：2.9-6.2）和8.1个月（95%CI：6.4-12.7）。Ⅲ/Ⅳ度不良反应主要为骨髓抑制、手足综合征及脱发。结论：紫杉醇联合卡培他滨方案二线治疗进展期胃癌疗效确切,不良反应小,尤其对老年患者耐受性好。     

紫杉醇联合卡培他滨一线治疗晚期胃癌的临床观察

目的　观察紫杉醇联合卡培他滨一线治疗晚期胃癌的疗效和毒副反应。方法　晚期胃癌患者２０例,给予紫杉醇８０ｍｇ／ｍ２静脉滴注,第１、８天;卡培他滨１０００ｍｇ／ｍ２,分早晚各口服１次,第１～１４天;２１天为１周期。每２周期评价疗效。结果　１９例可评价疗效,获ＣＲ１例,ＰＲ７例,总有效率（ＲＲ）为４２.１％。中位无进展生存期和总生存期分别为４.８个月和９.７个月,１年生存率为３６.８％。主要的毒副反应为血液学毒性、脱发和手足综合症。结论　紫杉醇联合卡培他滨治疗晚期胃癌安全、有效,值得临床进一步应用。     

紫杉醇联合奥沙利铂和卡培他滨治疗晚期胃癌的临床观察

目的　评价紫杉醇联合奥沙利铂和卡培他滨（ＰＯＸ方案）治疗晚期胃癌的疗效和不良反应。方法　２１例晚期胃癌患者均采用ＰＯＸ方案治疗：紫杉醇８５ｍｇ／ｍ^２,第１、８天,静脉滴注;奥沙利铂１３０ｍｇ／ｍ２,第１天,静脉滴注;卡培他滨１０００ｍｇ／ｍ^２分２次口服,第１～１４天,２１天为１周期。２周期评价疗效。结果　全组２１例均可评价疗效,其中ＰＲ１３例,ＳＤ６例,ＰＤ２例,客观有效率为６１.９％;中位肿瘤进展时间为５.７个月,中位总生存期为１１个月。不良反应主要为骨髓抑制、恶心呕吐和外周神经毒性。结论　紫杉醇联合奥沙利铂和卡培他滨治疗晚期胃癌疗效较好,不良反应可耐受,值得临床进一步研究。     

A phase II study of capecitabine plus 3-weekly oxaliplatin as first-line therapy for patients with advanced gastric cancer

Capecitabine plus oxaliplatin every 3 weeks (XELOX regimen) has proven efficacy in patients with colorectal carcinoma. We investigated this combination in patients with previously untreated advanced gastric carcinoma. The study population comprised patients with histologically confirmed nonresectable advanced gastric adenocarcinoma. Patients received intravenous oxaliplatin 130 mg m(-2) over 2 h on day 1 plus oral capecitabine 1000 mg m(-2) twice daily on days 1-14, every 3 weeks. Patients received a maximum of eight cycles. Twenty evaluable patients (17 men, 3 women) with a median age of 64 years (range 38-75) were enrolled. The overall response rate was 65% (95% confidence interval (CI), 44-86%), with complete responses in two patients and partial responses in 11 patients. Median progression-free survival was 7.5 months (95% CI, 3.2-11.7 months); median overall survival was not reached during the study period. There was no grade 4 and little grade 3 toxicity. The most common haematological adverse event was anaemia (65% of patients) and the most common nonhaematological toxicities were vomiting (65%), neuropathy (60%), diarrhoea (30%), and hand-foot syndrome (20%). In conclusion, XELOX is apparently as effective as triplet combinations and is well tolerated as first-line therapy for advanced gastric carcinoma. We are starting a large multi-institutional phase II study of XELOX in this setting.     

Gemcitabine plus paclitaxel as first-line chemotherapy for patients with advanced breast cancer

OBJECTIVES: To assess the efficacy and tolerability of gemcitabine and paclitaxel as first-line treatment in advanced breast cancer. METHODS: Patients with histologically confirmed metastatic or metastatic plus locally advanced breast cancer received gemcitabine 1,200 mg/m(2) on days 1 and 8 and paclitaxel 175 mg/m(2) on day 1 every 21 days for 8 cycles. RESULTS: From December 1999 to August 2001, 45 patients, with a median age of 53.5 years (range, 22-77), received a total of 260 cycles. All were assessable for response and toxicity. Twenty-seven patients had prior adjuvant therapy. Hormonal receptor status was positive in 31.1% and negative in 40.0% of patients. Main metastatic sites included soft tissue (62.2%) and lung (53.3%). The objective response rate was 66.7%; complete response, 22.2%; partial response, 44.4%; stable disease, 15.6%; progressive disease, 17.8%. Median duration of response was 18 months and median time to tumor progression was 11 months. Grade 3/4 leukopenia, neutropenia, and thrombocytopenia developed in 13.3% of patients, and 15.5% developed grade 3/4 mucositis. No treatment-related deaths occurred. Median overall survival was 19 months. CONCLUSIONS: Gemcitabine plus paclitaxel is an active combination with a favorable toxicity profile as first-line treatment for patients with advanced breast cancer.     

奥沙利铂联合卡培他滨一线治疗进展期胃癌的临床疗效观察

背景与目的：奥沙利铂联合卡培他滨（XELOX方案）是治疗进展期胃癌（advanced gastric cancer,AGC）的有效方案,但是该方案作为一线方案治疗AGC患者的疗效和安全性尚不确定。本研究旨在探讨XELOX方案作为一线方案治疗AGC的疗效及安全性。方法：33例既往未接受过化疗的AGC患者采用XELOX方案化疗．奥沙利铂130mg／m^2,静脉滴注2h,d1;卡培他滨2000mg／m^2,分2次口服．d1～14,21天为一个周期。患者最多接受8个周期化疗。结果：33例患者共接受159个周期的化疗,中位化疗周期数为5个。31例患者可评价疗效,其中完全缓解1例（3．2％）,部分缓解16例（51．6％）,稳定8例（25．8％）,进展6例（19．4％）。客观有效率54．8％（95％可信区间37．3％-72．3％）,临床获益率80．6％（95％可信区间66．7％～94．5％）。平均随访10．5个月,中位疾病进展时间5．9个月（95％可信区间4．7～7．1个月）,中位生存时间10．4个月（95％可信区间7．9～12．9个月）。常见不良反应有骨髓抑制、外周神经毒性、胃肠道反应、手足综合征等,经对症治疗后均好转．无治疗相关性死亡。结论：XELOX方案一线治疗AGC疗效显著,耐受性良好。     

卡培他滨联合多西紫杉醇一线治疗晚期胃癌的临床观察

目的 探讨卡培他滨联合多西紫杉醇一线治疗晚期胃癌的近期疗效、不良反应及生存情况。方法 2010年1月至2012年7月共24例晚期胃癌患者采用卡培他滨联合多西紫杉醇一线化疗,具体方案为：卡培他滨1000mg／m2口服,每天2次,d1～d14;多西紫杉醇75mg／m2静滴1h,d1,或者多西紫杉醇35mg／m2静滴1h,d1、d8。21天为1周期,至少化疗2个周期。2个周期评价疗效,每周期评价不良反应。结果 24例患者均可评价疗效。无CR病例,获PR 3例,SD 20例,PD 1例;有效率为12.5％,疾病控制率为95.8％。中位总生存时间为10.5个月（95％CI：2.47～18.47个月）;10例患者死于疾病进展,其中7例的疾病进展时间为1.7～15.2个月。主要不良反应为骨髓抑制和手足综合征,以1～2级为主,全组患者无治疗相关性死亡。结论 卡培他滨联合多西紫杉醇一线治疗晚期胃癌的疗效确切,不良反应可耐受,值得深入研究。     

Phase II study of capecitabine plus cisplatin as first-line chemotherapy in advanced gastric cancer.

BACKGROUND: A phase II study was conducted to assess the efficacy and tolerability of combination therapy with capecitabine and cisplatin in patients with advanced gastric cancer. PATIENTS AND METHODS: Patients with previously untreated metastatic or unresectable measurable gastric adenocarcinoma received oral capecitabine 1250 mg/m(2) twice daily, days 1-14, and i.v. cisplatin 60 mg/m(2) on day 1. This cycle was repeated every 3 weeks. RESULTS: Forty-two patients were enrolled in this study. Of these, 38 patients were assessable for efficacy and 40 were assessable for toxicity. One patient achieved a complete response and 22 patients had partial responses, giving an overall response rate of 54.8% in the intention-to-treat population (95% confidence interval 39.8% to 69.8%). The median time to progression was 6.3 months and the median overall survival was 10.1 months. The principal adverse events were neutropenia and hand-foot syndrome. Grade 3/4 adverse events were neutropenia (32.5% of patients), thrombocytopenia (10%), stomatitis (2.5%) and diarrhea (5%). Grade 2 and 3 hand-foot syndrome occurred in 20% and 7.5% of patients, respectively. There were no treatment-related deaths. CONCLUSIONS: The combination of capecitabine and cisplatin is active and well tolerated in patients with advanced gastric cancer.     

Weekly oral paclitaxel as first-line treatment in patients with advanced gastric cancer.

BACKGROUND: Pharmacokinetic study has shown that co-administration of cyclosporin A (CsA), which acts as a P-glycoprotein (P-gp) and CYP-3A blocker, resulted in an 8-fold increase in the systemic exposure of oral paclitaxel. Two doses of oral paclitaxel on 1 day in combination with CsA resulted in higher systemic exposure than single dose administration. PATIENTS AND METHODS: In this phase II study, chemona?ve patients with advanced gastric cancer received oral paclitaxel weekly in two doses of 90 mg/m(2) on the same day; CsA (10 mg/kg) was given 30 min before each dose of oral paclitaxel. RESULTS: In 25 patients, the main toxicities were: nausea CTC grade 2/3, 10 patients (40%); vomiting grade 2/3, 4 patients (20%); diarrhea grade 2/3, 6 patients (24%); neutropenia grade 3/4, 5 patients (20%). In the 24 evaluable patients, eight partial responses were observed, resulting in an overall response rate (ORR) of 33% [95% confidence interval (CI) 18% to 52%]. Eleven patients had stable disease (46%) and 5 patients showed progressive disease (21%). The ORR in the total population was 32% (95% CI 17% to 50%). The median time to progression was 16 weeks (95% CI 9-22). Pharmacokinetic analyses revealed that the mean area under the plasma concentration-time curve (AUC) of orally administered paclitaxel (+/- standard deviation) was 3757.6 +/- 939.4 ng.h/ml in week 1 and 3928.4 +/- 1281 ng.h/ml in week 2. The intrapatient variability in the AUC was 12%. CONCLUSIONS: Oral paclitaxel in combination with CsA is both active and safe in chemona?ve patients with advanced gastric cancer. Toxicities were mainly gastrointestinal.     

紫杉醇联合卡培他滨治疗进展期胃癌的临床观察

目的：观察紫杉醇联合卡培他滨（希罗达）作为二线方案治疗晚期胃癌的有效性和安全性。方法：采用紫杉醇１７５ｍｇ／ｍ２,静脉滴注３ｈ,第ｌ天;希罗达１０００ｍｇ／ｍ２,每天２次,第１～１４天,２１天为１个周期,连用２个周期后评价疗效。结果：３０例中,获得完全缓解（ＣＲ）２例,占６.７％;部分缓解（ＰＲ）１２例,占４０.０％;稳定（ＳＤ）１１例,占３６.７％;进展（ＰＤ）５例,占１６.７％。总有效率（ＣＲ＋ＰＲ）为４６.７％。不良反应主要为恶心呕吐、骨髓抑制、腹泻、手足综合征及脱发等。结论：紫杉醇联合卡培他滨二线治疗晚期胃癌疗效较高,安全性好。     

紫杉醇联合卡培他滨治疗复发转移性胃癌临床疗效分析

目的 观察紫杉醇联合卡培他滨治疗晚期进展期胃癌的临床疗效和不良反应.方法 20例晚期胃癌患者,均采用紫杉醇联合卡培他滨化疗方案.卡培他滨1 000 mg/m2,早、晚饭后30分钟内口服,第1-14天,间歇7天;紫杉醇135 mg/m2,分2次静脉滴注(第1、8天).21天为1疗程.结果 20例患者治疗后,部分缓解5例(25.0％),稳定12例(60.0％),进展3例(15.0％),治疗有效率为25.0％,疾病控制率为85.0％;中位缓解期5月,中位生存期12月.不良反应主要为骨髓抑制和手足综合征,且多为Ⅰ～Ⅱ度,大部分患者可耐受.结论 紫杉醇联合卡培他滨治疗晚期胃癌有一定疗效,对多程化疗失败的晚期胃癌患者可通过该化疗方案获益,值得临床进一步研究应用.     

TUBB3的表达对晚期胃癌紫杉类药物化疗疗效和预后的影响

  目的  检测晚期胃癌组织中β-微管蛋白Ⅲ(class Ⅲ β-tubulin,TUBB3)的表达,分析TUBB3的表达与紫杉类药物化疗疗效及患者预后的相关性。  方法  选取邵阳市中心医院2008年12月至2011年12月接受含多西他赛或紫杉醇为基础化疗的晚期胃癌患者49例,免疫组织化学检测胃癌组织中TUBB3蛋白的表达水平,分析TUBB3的表达与化疗疗效、无进展生存期(progressionfree survival,PFS)和总生存期(overall survival,OS)的关系。  结果  49例患者接受含多西他赛或紫杉醇为基础的化疗,有3例患者因组织标本太少被剔除,化疗疗效达完全缓解(complete response,CR)1例、部分缓解(partial response,PR)17例、稳定(stable disease,SD)22例、进展(progression disease,PD)6例,化疗总有效率(CR+PR)为39.13%(18/46),TUBB3低表达组有效率为54.17%,TUBB3高表达组有效率为22.73%,两者比较差异具有统计学意义(χ2=4.736,P=0.029)。TUBB3低表达组患者的中位PFS和OS分别为5.9个月和11.6个月,TUBB3高表达组患者的中位PFS和OS分别为3.9个月和7.9个月,TUBB3低表达组较高表达组的PFS和OS均延长,差异有统计学意义(PFS:P=0.032;OS:P=0.001)。单因素及多因素分析得出,TUBB3均为晚期胃癌的独立预后因素。  结论  晚期胃癌组织中TUBB3的表达与紫杉类药物化疗疗效及预后具有相关性,低表达组的化疗疗效及生存预后好于高表达组。可为临床上晚期胃癌个体化治疗的制定及判断预后提供参考。      

奥沙利铂联合卡培他滨治疗晚期胃癌的临床分析

目的:研究奥沙利铂(LOHP)联合卡培他滨(CAPE)治疗进展及转移性胃癌的疗效和毒性作用。方法:LOHP85mg/m2,静滴2小时,第1、8天,CAPE2500mg/m2,第1～14天,每3周重复,行2周期后判断疗效。结果:19例病人中完全有效3例(15.8%),部分有效7例(36.8%),稳定5例(26.3%),进展4例(21.1%),总有效率52.6%,中位生存期11月,毒性反应以手足综合症、神经毒性反应、骨髓抑制为主,无化疗相关死亡。结论:奥沙利铂联合卡培他滨治疗晚期胃癌疗效肯定,毒性反应可耐受。     

多西紫杉醇联合卡培他滨治疗进展期胃癌疗效观察简

目的：评价多西紫杉醇联合卡培他滨治疗进展期胃癌疗效。方法：试验组采用多西他赛联合希罗达方案姑息化疗,对照组采用DCF方案姑息化疗,比较两种方案治疗进展期胃癌的疗效。结果：试验组及对照组患者有效率分别为38．24％和29．41％,两组之间未见统计学差异。两组患者在手足综合征和Ⅲ-Ⅳ骨髓抑制方面有统计学差异。结论：多西他赛联合卡培他滨方案一线治疗进展期胃癌疗效肯定,毒副反应能耐受。     

紫杉醇和卡培他滨联合恩度治疗晚期胃癌腹膜转移的临床观察

目的:评价周剂量紫杉醇/卡培他滨(TX)加恩度方案治疗腹膜转移晚期胃癌的疗效和不良反应。方法:43例经病理学或组织细胞学确诊为腹膜转移的晚期胃癌患者分为试验组和对照组。试验组:TX方案加恩度,紫杉醇80mg/(m2.d),静脉滴入,d1、d8;卡培他滨2 000mg/(m2.d),分早晚2次口服,d1～d14;恩度7.5mg/(m2.d),静脉滴入,d1～d14;每21d重复。对照组:TX方案,紫杉醇80mg/(m2.d),静脉滴入,d1、d8;卡培他滨2 000mg/(m2.d),分早晚2次口服,d1～d14;每21d重复。观察有效率(RR)、疾病控制率(DCR)、1年生存率、中位生存时间(MST)以及安全性。结果:43例患者中,23例患者加用恩度(试验组),其余20例患者未加用恩度(对照组)。试验组17例有可评价靶病灶,对照组12例有可评价靶病灶,RR分别为58.8%(10/17)和41.7%(5/12),χ2=3.948,P=0.039;DCR分别为88.2%(15/17)和83.4%(10/12),χ2=0.882,P=0.365;1年生存率分别为69.7%和54.9%,MST分别为16.5和12.5个月。两组生存曲线比较,试验组优于对照组,P=0.042;两组在血液学毒性及非血液学毒性反应方面差异均无统计学意义,P>0.05。结论:周剂量紫杉醇联合卡培他滨加恩度方案能提高腹膜转移晚期胃癌的疗效和生存,且毒副作用可耐受,值得临床进一步研究。