Xelox方案联合沙利度胺治疗胃癌术后淋巴结转移的近期疗效

目的探讨奥沙利铂、卡培他滨联合沙利度胺治疗胃癌手术后淋巴结转移的近期疗效。方法50例胃癌手术后淋巴结转移患者采用奥沙利铂,卡培他滨联合沙利度胺方案治疗共189个周期。结果完全缓解（CR）4例,部分缓解（PR）28例,无变化（NC）13例和进展（PD）5例,总有效率（CR＋PR）为64%（32/50）。中位缓解期6.2个月,中位生存期12.3个月,1年生存率为60.5%,临床受益者共45例（90%）。毒副反应可耐受,无患者因为毒副反应终止治疗,无相关死亡出现。结论奥沙利铂,卡培他滨联合沙利度胺方案治疗胃癌手术后淋巴结转移疗效较好,毒副反应能够耐受,可作为一线方案在胃癌手术后淋巴结转移的患者中应用。     

Geriatric assessment and biomarkers in patients with metastatic breast cancer receiving first-line mono-chemotherapy: Results from the randomized phase III PELICAN trial

Objectives

To determine predictive/prognostic factors for patients with metastatic breast cancer (MBC) receiving first-line monochemotherapy using biomarker analysis and geriatric assessment (GA).

卡培他滨联合放疗与单纯放疗治疗消化道恶性肿瘤的临床可行性

目的分析卡培他滨联合放疗与单纯放疗治疗消化道恶性肿瘤临床可行性和疗效,为临床治疗提供参考。方法选取消化道恶性肿瘤患者72例为研究对象,采取抽签法随机分为观察组和对照组,对照组患者实施单纯放疗,观察组患者实施卡培他滨联合放疗,依照WHO制定实体肿瘤评价标准判断治疗效果,并采用WHO抗癌药物剂型反应分度标准评价不良反应。结果观察组总有效率(75.0%)显著高于对照组(52.8%)(P<0.05)。两组患者1年生存率差异不明显(P>0.05),观察组患者2年生存率(47.2%)显著高于对照组(16.7%)(P<0.05)。在治疗中,观察组患者主要不良反应为血液毒性白细胞毒性、手足综合征等,经对症处理后缓解,患者均耐受,没有出现退出试验者。观察组患者不良反应发生率显著低于对照组(P<0.05)。结论消化道恶性肿瘤患者实施卡培他滨联合放疗能够提高疗效,提高生存率,同时能够减少不良反应的出现,具有使用价值。     

TYMP基因多态性对结直肠癌患者R0切除术后辅助化疗疗效的影响

目的 探讨胸苷磷酸化酶（thymidine phosphorylase, TYMP）基因变异是否对R0术后结直肠癌患者接受辅助化疗疗效有影响。方法 纳入198例术后接受辅助化疗的结直肠癌患者。收集患者外周血及术后癌组织标本分别用来进行TYMP基因5633C>T位点基因分型及TYMP基因表达测定。通过不同的分析方法分析该位点和其他变量的关系。Real-time PCR分析该位点不同基因型患者的TYMP mRNA表达水平。结果 TYMP基因5633C>T位点在CRC患者中的基因型分布频率为CC型126例（63.64%）,CT型61例（30.81%）,TT型11例（5.55%）,最小等位基因频率为0.21,三种基因型分布频率符合哈迪温伯格平衡（P=0.323）。不同基因型患者基线资料均衡,预后分析上将CT/TT基因型合并。单变量生存分析结果显示：野生型的CC型患者OS较差,显著低于携带突变基因的CT型和TT型患者,差异有统计学意义（P=0.009）。多变量Cox模型校正之后发现CC基因型对OS有独立的影响（P=0.015）。另外,进一步在87例癌组织标本的mRNA表达分析中发现,突变的CT或TT型患者相对于野生型的CC型患者,癌组织中TYMP mRNA表达明显较高,差异有统计学意义（P=0.019）。结论 TYMP基因5633C>T位点可能通过影响TYMPmRNA的表达从而影响接受含卡培他滨辅助化疗方案的CRC患者的预后。     

A Phase I Trial of the PI3K Inhibitor Buparlisib Combined With Capecitabine in Patients With Metastatic Breast Cancer

Background

Buparlisib is an oral pan-class I phosphotidyinositol-3-kinase (PI3K) inhibitor. The present phase I study evaluated the safety, pharmacokinetics, and efficacy of buparlisib with capecitabine in patients with metastatic breast cancer.

卡培他滨联合奥沙利铂对晚期胃癌患者疾病控制率及毒副反应的影响

目的:探讨卡培他滨联合奥沙利铂对晚期胃癌患者疾病控制率及毒副反应的影响。方法:回顾性分析2016年9月至2020年3月江西医学高等专科学校第一附属医院收治的60例晚期胃癌患者临床资料,根据治疗方式不同分组,将采用卡培他滨治疗30例归为对照组,将采用卡培他滨联合奥沙利铂治疗30例归为观察组;治疗1个疗程,对比两组患者疾病控制率、毒副反应及肿瘤标志物水平。结果:观察组疾病控制率高于对照组,差异有统计学意义(P<0.05);两组化疗期间皮疹、恶心呕吐、肝功能损害、白细胞减少发生率相比,差异无统计学意义(P>0.05);两组治疗后癌胚抗原(CEA)、糖原抗原125(CA125)、糖链抗原19-9(CA19-9)均明显低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:卡培他滨与奥沙利铂联合治疗晚期胃癌效果较好,可以有效控制病情的发展,降低肿瘤标志物水平,且不增加毒副作用,安全性高。     

1例卡培他滨联合奥沙利铂致非糖尿病患者血糖升高的病例分析

结直肠癌是一种常见的消化道恶性肿瘤。目前,指南推荐结直肠癌术后使用卡培他滨联合奥沙利铂作为辅助化疗方案,化疗过程中常出现手足综合征、恶心、白细胞减少等不良反应,较少引起血糖异常。本文报道1例37岁男性结肠癌患者（既往无糖尿病）术后使用卡培他滨联合奥沙利铂化疗5个周期后,血糖持续升高;化疗第7周期后,停用卡培他滨和奥沙利铂,给予胰岛素及口服降糖药物治疗,患者血糖逐渐好转。停用化疗药物6个月后,患者仅服用二甲双胍即可控制血糖正常。     

Pathological response and outcome after neoadjuvant chemotherapy with DOC (docetaxel,oxaliplatin, capecitabine) or EOF (epirubicin,oxaliplatin, 5-fluorouracil) for clinical T3-T4 non-metastatic gastric cancer

PurposeIn this prospective observational study, we sought to compare the efficacy and safety of docetaxel + oxaliplatin + capecitabine (DOC) with epirubicin + oxaliplatin + 5-fluouracil (EOF) as neoadjuvant chemotherapy (NAC) for clinical T3 or T4 non-metastatic gastric cancer (GC) patients.MethodsThe DOC NAC consisted of docetaxel 35 mg/m² (days 1–8), oxaliplatin 85 mg/m² (day 1), and capecitabine 750 mg/m² twice daily (days 1–14), every 3 weeks. The EOF NAC consisted of intravenous (IV) epirubicin 50 mg/m2 combined with IV oxaliplatin 130 mg/m2 on day 1 and continuous infusion 5-fluouracil 750 mg/m2 on days 1–5, every 3 weeks. After 4 cycles of NAC or upon progression during chemotherapy, patients underwent gastrectomy with standard D2 or D3 lymphadenectomy. Pathological complete response rate per Becker tumor regression grading system was the primary endpoint and the secondary endpoints included progression-free survival (2-yr PFS) and 2-year overall survival (2-yr OS) and tolerability.ResultsOverall, we identified 63 patients with T3-4 non-metastatic GC starting either NAC regimen between January 2010 and December 2017 at our Institution: 34 in the DOC group and 29 in EOF group. Thirty patients (88%) in the DOC group and 22 (76%) in the EOF group completed the 4 planned cycles of NAC. Fifty-seven patients received surgery. Results indicated no statistical significant differences between the two groups, and only a trend for some better data in favour of the DOC group. The R0 resection rate was 90.6% and 88.0% for the DOC and EOF cohorts, respectively. The pathological complete response rate was 6.2% in the DOC group and 4.0% in the EOF group. Becker 1–2 pathological response was found in 46.8% of the DOC cohort and 28.0% of the EOF cohort (p = .14). The 2-yr PFS rate was 54.1% for DOC vs. 41.4% for EOF (p = .14) and the 2-yr OS rate was 80.8% for DOC vs. 58.6% for EOF (p = .05). Neutropenia was the most common grade ≥3 toxicity and occurred in 8 (23.5%) patients of the DOC group and 10 (34.4%) patients of the EOF group (p = .33).ConclusionsThese findings seem to confirm the feasibility of NAC for clinically T3 and T4 non-metastatic GC and, despite no statistical significant difference was documented, suggest a trend for better activity and tolerability for the docetaxel-based regimen (DOC) compared to the epirubicin-based combination (EOF).     

Fixed dose combination of capecitabine and cyclophosphamide in metastatic breast cancer: Results from THE ENCLOSE phase 2/3 randomized multicenter study

AimTo evaluate pharmacokinetics, efficacy and safety of fixed-dose combination (FDC) of oral capecitabine + cyclophosphamide in metastatic breast cancer (MBC) patients progressing after anthracycline and/or taxane chemotherapy.MethodsIn this prospective, adaptive, phase-2/3, open-label study (CTRI/2014/12/005234), patients were randomized (1:1:1) to three FDC doses (doses/day: D1, capecitabine + cyclophosphamide 1400 mg + 60 mg; D2, 1800 mg + 80 mg; D3, 2200 mg + 100 mg) for 14 days, in 21-day cycles. In Part-I, multiple-dose pharmacokinetics and optimal dose(s) were evaluated with futility analysis. Group(s) with <3 responders based on best overall response rate (BOR, complete response [CR]+partial response [PR]), were discontinued. Efficacy (BOR, disease control rates [DCR; CR + PR + stable disease]) and safety of optimal dose(s) were evaluated in Part-II.ResultsOf 66 patients (n = 22/group) in Part-I, pharmacokinetics (D1 = 7/22, D2 = 9/22, D3 = 8/22) showed dose-proportionality for cyclophosphamide and greater than dose-proportionality for capecitabine. Modified intent-to-treat (mITT) analysis showed BOR of 7.14% (1/14) in D1 (discontinued), and 22.22% (4/18) each in D2 and D3, respectively. In Part-II, 50 additional patients were randomized in D2 and D3 (n = 144; total 72 [22 + 50] patients/group). mITT analysis in D2 (n = 54) and D3 (n = 58) showed BOR of 29.63% (16/54, 95%CI: 17.45–41.81%) and 22.41% (13/58, 95%CI: 11.68–33.15%), respectively. DCR in D2 and D3 were 87.04% (47/54, 95%CI: 78.08–96.00%) and 82.76% (48/58; 95%CI: 73.04–92.48%) after 3 and 57.41% (31/54; 95%CI: 52.41–79.50%) and 50.00% (29/58; 95%CI: 40.40–67.00%), after 6-cycles, respectively. Hand-foot syndrome (16.67%), vomiting (9.72%) in D2, and hand-foot syndrome (18.06%), asthenia (15.28%) in D3 were most-common adverse events.ConclusionFDC of capecitabine + cyclophosphamide (1800 + 80 mg/day) showed high disease control rates and good safety profile in MBC patients.     

口服卡培他滨联合三维适形放疗在胰腺癌治疗中的应用效果分析

目的探讨口服卡培他滨联合三维适形放疗在治疗胰腺癌患者的临床应用效果。方法选择2006年1月～2010年12月收治于我院的42例胰腺癌患者,分为研究组和对照组进行研究,研究组患者采用口服卡培他滨联合三维适形放疗进行治疗,对照组仅使用三维适形放疗进行治疗,然后观察并比较两组患者的临床应用效果。结果经过治疗,观察组的总有效率为57.14%,对照组的总有效率为38.09%。结论胰腺癌患者经口服卡培他滨联合三维适形放疗治疗后,其临床疗效较好且无严重副反应,值得临床推广应用。