Adjuvant chemotherapy could not bring survival benefit to HR-positive, HER2-negative, pT1b-c/N0-1/M0 invasive lobular carcinoma of the breast: a propensity score matching study based on SEER database.
辅助化疗不能给 HR 阳性、 HER2-negative 、 pT1b-c/N0-1/M0 浸润性乳腺小叶癌带来生存获益: 基于 SEER 数据库的倾向评分匹配研究。
- 作者列表："Hu G","Hu G","Zhang C","Lin X","Shan M","Yu Y","Lu Y","Niu R","Ye H","Wang C","Xu C
BACKGROUND:The benefit of adjuvant chemotherapy in invasive lobular carcinoma (ILC) is still unclear. The objective of the current study was to elucidate the effectiveness of adjuvant chemotherapy in hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative, pT1b-c/N0-1/M0 ILC. METHODS:Based on Surveillance, Epidemiology, and End-Results (SEER) database, we identified original 12,334 HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC patients, who were then divided into adjuvant chemotherapy group and control group. End-points were overall survival (OS) and breast cancer-specific mortality (BCSM). Aiming to minimize the selection bias of baseline characteristics, Propensity Score Matching (PSM) method was used. RESULTS:In a total of 12,334 patients with HR-positive, HER2-negative, pT1b-c/N0-1/M0 ILC, 1785 patients (14.5%) were allocated into adjuvant chemotherapy group and 10,549 (85.5%) into control group. Used PSM, the 1785 patients in adjuvant chemotherapy group matched to the 1785 patients in control group. By Kaplan-Meier survival analyses, we observed no beneficial effect of adjuvant chemotherapy on OS in both original samples (P = 0.639) and matched samples (P = 0.962), however, ineffective or even contrary results of adjuvant chemotherapy on BCSM both in original samples (P = 0.001) and in matched samples (P = 0.002). In both original and matched multivariate Cox models, we observed ineffectiveness of adjuvant chemotherapy on OS (hazard ratio (HR) for overall survival = 0.82, 95% confidence interval (CI) [0.62-1.09]; P = 0.172 and HR = 0.90, 95%CI [0.65-1.26]; P = 0.553, respectively), unexpectedly promoting effect of adjuvant chemotherapy on BCSM (HR = 2.33, 95%CI [1.47-3.67]; P = 0.001 and HR = 2.41, 95%CI [1.32-4.39]; P = 0.004, respectively). Standard surgery was beneficial to the survival of patients. Lymph node metastasis was detrimental to survival and radiotherapy brought survival benefit in original samples, but two issues had unobvious effect in matched samples. CONCLUSION:In this study, adjuvant chemotherapy did not improve survival for patients with HR-positive, HER2-negative pT1b-c/N0-1/M0 ILC.
背景: 辅助化疗对浸润性小叶癌 (ILC) 的益处仍不清楚。本研究的目的是阐明辅助化疗对激素受体 (HR) 阳性、人表皮生长因子受体 2 (HER2) 阴性、 pT1b-c/N0-1/M0 ILC。 方法: 基于监测流行病学学和最终结果 (SEER) 数据库，我们确定了 12,334 例 HR 阳性、 HER2-negative 、 pT1b-c/N0-1/M0 ILC 患者, 分为辅助化疗组和对照组。终点是总生存期 (OS) 和乳腺癌特异性死亡率 (BCSM)。旨在最小化基线特征的选择偏倚，使用倾向评分匹配 (PSM) 方法。 结果: 在 12,334 例 HR 阳性、 HER2-negative 、 pT1b-c/M0 ILC 患者中，1785 例 (14.5%) 患者被分配到辅助化疗组，10,549 例 (85.5%) 进入对照组。使用 PSM，辅助化疗组的 1785 例患者与对照组的 1785 例患者相匹配。通过 Kaplan-Meier 生存分析，我们在原始样本 (p = 0.639) 和匹配样本 (p = 0.962) 中未观察到辅助化疗对 OS 的有益影响，然而, 原始样本 (p = 0.001) 和匹配样本 (p = 0.002) 中 BCSM 辅助化疗的无效甚至相反结果。在原始和匹配的多变量 Cox 模型中，我们观察到辅助化疗对 OS 的无效性 (总体生存的风险比 (HR) = 0.82，95% 置信区间 (CI)) [0.62-1.09]; p = 0.172 和 hr = 0.90，95% CI [0.65-1.26]; p = 0.553), 辅助化疗对 BCSM 的促进作用出乎意料 (hr = 2.33,95% CI [1.47-3.67]; p = 0.001 和 hr = 2.41，95% CI [1.32-4.39]; p = 0.004)。标准手术有利于患者的生存。淋巴结转移对生存不利，放疗在原始样本中带来生存获益，但两个问题在匹配样本中效果不明显。 结论: 在这项研究中，辅助化疗并没有改善 HR 阳性患者的生存，HER2-negative 的 pT1b-c/N0-1/M0 ILC。
METHODS::In colorectal cancer (CRC), hepatic arterial infusion (HAI) chemotherapy may convert primarily unresectable CRC liver metastases (CLM) into resectability, although the risk of metastatic recurrence remains high after CLM ablation. We investigated the role of antitumour immunity invoked by first-line oxaliplatin-HAI for long-term CLM outcome. In a prospective study cohort of primarily unresectable CLM, we assessed patients' fms-related tyrosine kinase 3 ligand (FLT3LG) in serum, reflecting opportune intratumoural immune activity, at baseline and following 1-3 sequences of oxaliplatin-HAI. The end points were CLM resectability and overall survival. Patients who presented an immediate twofold increment of circulating FLT3LG during the treatment and at its completion were scored as CLM resectable (16.4% with both features), were alive at final follow-up 8-12 years later. All patients experienced FLT3LG increase during the treatment course, but those who remained unresectable or had the disease converted but presented a slow and gradual FLT3LG accretion, later died of the metastatic disease. These data provide further support to our previous findings that tumour-directed immunity invoked by oxaliplatin-containing therapy predicts excellent outcome of early advanced CRC if macroscopic tumour ablation is rendered possible by the 'classic' tumour response to the cytotoxic treatment.
METHODS::Prostate cancer is one of the primary causes of death around the world. As an important drug, flutamide has been used in the clinical diagnosis of prostate cancer. However, the over dosage and improper discharge of flutamide could affect the living organism. Thus, it necessary to develop the sensor for detection of flutamide with highly sensitivity. In this paper, we report the synthesis of lanthanum cobaltite decorated halloysite nanotube (LCO/HNT) nanocomposite prepared by a facile method and evaluated for selective reduction of flutamide. The as-prepared LCO/HNT nanocomposite shows the best catalytic performance towards detection of flutamide, when compared to other bare and modified electrodes. The good electrochemical performance of the LCO/HNT nanocomposite modified electrode is ascribed to abundant active sites, large specific surface area and their synergetic effects. Furthermore, the LCO/HNT modified electrode exhibits low detection limit (0.002 μM), wide working range (0.009-145 μM) and excellent selectivity with remarkable stability. Meaningfully, the developed electrochemical sensor was applied in real environmental samples with an acceptable recovery range.
METHODS::Several studies have indicated that cancer-associated fibroblasts (CAFs) could promote cancer progression in many malignancies. However, the mechanism by which CAFs promote the growth and metastasis of lung cancer remains poorly defined. In the present study, CAFs and normal fibroblasts (NFs) were isolated from human lung cancer and adjacent tissue. The data showed that the conditional medium (CM) of CAFs could increase the proliferation, migration and invasion of lung cancer cells. Vascular cell adhesion molecule-1 (VCAM-1) showed a higher expression in CAF-CM than NF-CM, and blocking VCAM-1 in CAF-CM attenuated the proliferation and invasion of cancer cells. Further, the results showed that VCAM-1 secreted from CAFs activated AKT and MAPK signaling via receptor α4β1 integrin (very-late antigen (VLA)-4) in lung cancer cells. Moreover, CAFs promoted VCAM-1 expression and tumor growth in vivo. Additionally, bioinformatics analysis indicated a positive correlation on the CAF marker protein alpha-smooth muscle actin (α-SMA) and VCAM-1 expression, which was associated with a poor prognosis in lung cancer patients. These findings demonstrate that the VCAM-1 secreted from CAFs enhances growth and invasion by activating the AKT and MAPK signaling of lung cancer cells.