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Xu B.-H.,Chinese Academy of Sciences | Jiang Z.-F.,PLA 307 Hospital | Chua D.,Queen Mary Hospital | Shao Z.-M.,Shanghai Cancer Hospital | And 10 more authors.
Chinese Journal of Cancer | Year: 2011

Over expression of human epidermal growth factor receptor-2 (HER2) in metastatic breast cancer (MBC) is associated with poor prognosis. This single-arm open-la bel trial (EGF109491; NCT00508274) was designed to confirm the efficacy and safety of lapatinib in combination with capecitabine in 52 heavily pretreated Chinese patients with HER2-positive MBC. The primary endpoint was clinical benefit rate (CBR). Secondary endpoints included progression-free survival (PFS), time to response (TTR), duration of response (DoR), central nervous system (CNS) as first site of relapse, and safety. The results showed that there were 23 patients with partial responses and 7 patients with stable disease, resulting in a CBR of 57.7%. The median PFS was 6.34 months (95% confidence interval, 4.93-9.82 months). The median TTR and DoR were 4.07 months (range, 0.03 -14.78 months) and 6.93 months (range, 1.45 -9.72 months), respectively. Thirteen (25.0%) patients had new lesions as disease progression. Among them, 2 (3.8%) patients had CNS disease reported as the first relapse. The most common toxicities were palmar-plantar erythrodysesthesia (59.6%), diarrhea (48.1%), rash (48.1%), hyperbilirubinemia (34.6%), and fatigue (30.8%). Exploratory analyses of oncogenic mutations of PIK3CA suggested that of 38 patients providing a tumor sample, baseline PIK3CA mutation status was not associated with CBR (P = 0.639) or PFS (P = 0.989). These data confirm that the lapatinib plus capecitabine combination is an effective and well-tolerated treatment option for Chinese women with heavily pretreated MBC, irrespective of PIK3CA status.

Yang Y.,Zhejiang Provincial Cancer Hospital
Zhonghua fu chan ke za zhi | Year: 2010

To investigate the pathogenesis, high risk factors, clinical characteristics, methods of diagnosis and treatment, and prognosis of vaginal intraepithelial neoplasia (VAIN). The clinical data of thirteen cases of VAIN treated in Zhejiang Provincial Cancer Hospital dated Mar. 2002 through Dec. 2008 were reviewed and analyzed retrospectively. Twelve of 13 VAIN cases were performed the human papillomavirus (HPV) detection with 92% (11/12) HPV positive rate. None of the cases shown specific clinical manifestation. Among the 13 cases, 6 of them accompanied with cervical cancer, 4 cases with cervical intraepithelial neoplasia (CIN), and 3 cases with vulvar intraepithelial neoplasma (VIN). Five cases synchronously diagnosed with cervical lesion and 3 with vulva lesion were underwent surgery, while the other 5 cases were diagnosed metachronously. Among 8 cases underwent surgery, 1 case with CIN underwent argon plasma coagulation (APC) after surgery, 1 case with the positive edge of VIN underwent APC. During follow up, 1 case with locally advanced cervical cancer underwent radiotherapy again, 3 cases with VAIN received APC, while 1 cervical cancer cases with VAIN received no treatment. The average follow-up time was 25.6 months (range 6-87 months). Two cases died of cervical cancer metastasis. The other 11 cases were normal and still alive. None of them progressed to invasive carcinoma. The main reason of VAIN is HPV infection. There are not specific clinical manifestations, usually diagnosed when reviewing cervical or vulva lesions and rarely progressed to invasive carcinoma. The main treatment of VAIN is surgery with the adjuvant treatment of APC.

Shi Y.,Peking Union Medical College | Shi Y.,National Center for Anticancer Drugs Clinical Study | Shi Y.,Beijing Key Laboratory of Clinical Study on Anticancer Molecular Targeted Drugs | Xing P.,Peking Union Medical College | And 13 more authors.
Thoracic Cancer | Year: 2015

Background: The treatment status of small cell lung cancer (SCLC) in Mainland China has never been reported; therefore, this study is the first multicenter survey investigating the status of epidemiology and treatment options of SCLC in Mainland China. Methods: Two questionnaires were designed to obtain information in 12 medical centers in five major Chinese cities. The hospital information questionnaire was designed to outline SCLC patients' characteristics and treatment preferences in each medical institution, and the patient information questionnaire collected detailed treatment information of 298 SCLC cases in these hospitals. Results: SCLC represented 13.7% and 18.3% of all lung cancer patients in 2005 and 2010, respectively. Clinical management of SCLC follows mainstream clinical guidelines in general. The most widely applied first-line treatment mode for limited-stage patients was combined chemoradiotherapy (66.2%), while 77.0% of the extensive-stage patients received chemotherapy alone as initial treatment. Etoposide with cisplatin or carboplatin were the most accepted first-line chemotherapy regimens. The objective response rate was 58.3% after first-line chemotherapy and 23% of the patients who responded well to first-line treatment received prophylactic cranial irradiation. As for second-line chemotherapy, single regimen topotecan or a combined regimen containing topotecan were preferred (53.0%). Conclusions: The treatment options indicated in our study are in accordance with the international clinical guidelines, which is valuable for the improvement of future guidelines, health care standard, and even the better distribution of health care resources in China. © 2015 The Authors. Thoracic Cancer published by Tianjin Lung Cancer Institute and Wiley Publishing Asia Pty Ltd.

Shi Z.,Zhejiang Provincial Cancer Hospital | Fan Y.,Zhejiang Provincial Cancer Hospital
Chinese Journal of Lung Cancer | Year: 2015

Although epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have been widely used in non-small cell lung cancer (NSCLC) patients, it is still controversial about how to combine EGFR-TKI with chemotherapy and other targeted drugs. We have made a summary on the current therapeutic models of EGFR-TKI combined with chemotherapy/bevacizumab in this review and aimed to find the optimal therapeutic strategy for NSCLC patients with EGFR mutation. © 2015 Chinese Journal of Lung Cancer. All rights reserved.

Liu X.-J.,Fudan University | Guo Y.,Fudan University | Fan Y.,Zhejiang Provincial Cancer Hospital | Gu K.-S.,Anhui Medical University | And 6 more authors.
Cancer Chemotherapy and Pharmacology | Year: 2012

Purpose: Nodal peripheral T-cell lymphomas (PTCLs) have particularly poor prognoses. Few data enabling establishment of an accepted standard treatment modality for PTCLs are available. We hypothesized that fludarabine-based regimens are tolerable and effective in treatment for nodal PTCLs. Therefore, this study was to analyze the toxicity of, response rate for, and outcome of treatment for nodal PTCLs with oral fludarabine, doxorubicin, and dexamethasone (FAD). Methods: Patients with PTCLs received FAD every 28 days, consisting of oral fludarabine at 40 mg/m 2 on days 1-3, doxorubicin at 50 mg/m 2 on day 1, and oral dexamethasone at 20 mg/day on days 1-5. Patients who did not exhibit disease progression received at least four courses of treatment. Results: Thirty-one of 35 patients with previously untreated nodal PTCLs enrolled in the study from 2007 to 2008 were evaluable. The incidence of grade 3-4 neutropenia was 55%. Nine patients had to have dose reductions of fludarabine and doxorubicin, none of whom had grade 3 or 4 toxic effects at the lower dose. Five of 31 patients had pneumonitis. No treatment-related mortality occurred. The response rate for the entire patient population was 71%, and the complete remission rate was 48%. The PFS and OS rates at 2 years were 54.2 and 77.1%, respectively. Four patients had died of cancer progression at the time of this analysis. The serum lactate dehydrogenase level had a significant effect on PFS and OS. Conclusion: The FAD regimen had encouraging efficacy with an acceptable toxicity profile in patients with nodal PTCLs. © 2011 Springer-Verlag.

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