Objective To study the long-term effect of neoadjuvant chemotherapy on advanced breast cancer. Methods The CAF neoadjuvant chemotherapy 〔CTX 500 mg/m2（1st day, 8th day), 5-FU 500 mg/m2（1st day, 8th day), and ADM 30 mg/m2 (1st day) every 3 weeks〕 was carried out in 31 breast cancer patients (stageⅢ,Ⅳ) for 2 cycles before operation, compared with 30 patients (stage Ⅲa) whose therapies were never done and operations could be feasible. Results The overall response rate was 87.1%(27/31). The stages of 19 patients among 31 (61.3%) declined (6 patients to stage Ⅲa, 8 to stageⅡb, 4 to stageⅡa, 1 to stage 0, 1 to complete response and none to pathological complete response). The diseasefree survival time of the patients was 56.3 months which was obviously longer than that of the patients without neoadjuvant chemotherapy (43.5 months, P＜0.05). The 5-year diseasefree survival rate of the patients with neoadjuvant chemotherapy was 38.7% which was a little higher than that (33.3%) of the patients without the chemotherapy, and the two groups had no significant difference. Conclusion The neoadjuvant chemotherapy can reduce the stages of patients with advanced breast cancer, obviously prolong the diseasefree survival time of patients, and reduce or delay recurrence or metastasis.
ObjectiveTo investigate the effects of Huaier granule combined with systemic chemotherapy on immunologic function and prognosis for advanced breast cancer patients. MethodsNinety-eight cases ofⅣstage breast cancer from March 2006 to March 2009 in this hospital were divided into control group and research group. Only systemic chemotherapy was performed in the control group, while Huaier granule combined with systemic chemotherapy was applied in the research group, and Huaier granule was given on day 1 systemic chemotherapy start. The changes of T lymphocyte subsets and IL-2 level were detected on day 1 before systemic chemotherapy and on month 6 after Huaier granule combined with systemic chemotherapy. The fatality rate and median survival time were also observed between two groups. ResultsCompared with the control group, the changes of T lymphocyte subsets and IL-2 level had no signi-ficant differences on day 1 before systemic chemotherapy between these two groups(P > 0.05). On month 6 after Huaier granule combined with systemic chemotherapy, the CD4+, CD4+/CD8+ T lymphocyte, and IL-2 level were significantly increased, the CD8+ T lymphocyte was significantly decreased in the research group as compared with the control group〔CD4+:(47.35±6.23)% versus(41.33±5.61)%, P < 0.05; CD4+/CD8+: 1.84±0.42 versus 1.47±0.33, P < 0.05; IL-2 level:(1.78±0.45)μg/L versus(1.58±0.30)μg/L, P < 0.05; CD8+:(23.26±3.25)% versus(29.77±4.12)%, P < 0.05〕. The rate of chemotherapy complications and fatality rate within 3 years were significantly decreased in the research group as compared with the control group〔rate of chemotherapy complications: 58.3%(28/48) versus 86.0%(43/50), P < 0.01; fatality rate within 3 years: 62.5%(30/48)versus 82.0%(41/50), P < 0.05〕. The median survival time in the research group was significantly longer than that in the control group(33.5 months versus 24.5 months, P < 0.01). ConclusionsThe preliminary results from this study show that Huaier granule combined with systemic chemotherapy could greatly enhance immune function, reduce side-toxicity of chemotherapy and improve prognosis in advanced breast cancer patients. It provides a beneficial exploration for cancer treatment by integration of traditional and western medicine.
ObjectiveTo expolre the effect and safety of gemcitabine combined with docetaxel in the treatment of advanced breast cancer. MethodsForty-eight breast cancer patients who got treatment by gemcitabine combined with docetaxel from March 2013 to March 2014 were prospectively enrolled in this study. ResultsOf all the 48 patients, the completely responded (CR) rate was 16.7%(8/48), partial responded (PR) rate was 35.4%(17/48), stable disease (SD) rate was 33.3% (16/48), progressive disease (PD) rate was 14.6% (7/48), and the response rate was 52.1% (25/48), the clinical benefit rate was 85.4% (41/48). The response rates of hormone receptor (HR)-positive group, human epidermal growth factor receptor 2 (HER-2)-positive group, and Basal-like group were 43.5% (10/23), 54.5% (6/11), and 64.3% (9/14) respectively, the clinical benefit rates of HR-positive group, HER-2-positive group, and Basal-like group were 82.6% (19/23), 81.8% (9/11), and 92.9% (13/14) respectively. There was no significant difference among the 3 groups in the effect, response rate, and clinical benefit rate (P=0.293, P=0.462, P=0.663). All patients suffered from varying degrees of toxicities during chemotherapy, including leukopenia, neutropenia, decreased hemoglobin, thrombocytopenia, rash, nausea, vomiting, hair loss, diarrhea, fatigue, and elevated alanine aminotransferase, wherein leukopenia (27.1%, 13/48), neutropenia (22.9%, 11/48), thrombocytopenia (4.2%, 2/48), and fatigue (10.4%, 5/48) were included inⅢ-Ⅳ degree of adverse reactions. In addition, all of 48 patients were followed-up for 1-19 months, with a median follow-up time of 12 months. During follow-up period, 6 patients died, and the overall survival rate was 87.5% (42/48). There was no significant difference among the 3 groups in overall survival and progression free survival (P > 0.050). ConclusionGemcitabine combined with docetaxel may be an effective therapy in treatment of advanced breast cancer.
ObjectiveTo systematically review the efficacy and safety of CDK4/6 inhibitors combined with endocrine therapy for advanced breast cancer.MethodsPubMed, EMBase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of CDK4/6 inhibitors combined with endocrine therapy for advanced breast cancer from inception to October 13th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 4 RCTs involving 2 524 patients were included. The results of meta-analysis showed that: compared with placebo combined with endocrine therapy, CDK4/6 inhibitors combined with endocrine therapy could improve the median progression free survival rate (RR=0.53, 95%CI 0.47 to 0.60, P<0.000 01) and the objective response rate (RR=1.67, 95%CI 1.47 to 1.91,P<0.000 01). While there was no statistical difference in clinical benefit rate (RR=0.59, 95%CI 0.75 to 1.19,P=0.64). In terms of adverse reactions, CDK4/6 inhibitors combined with endocrine therapy had higher rates of neutropenia (RR=49.76, 95%CI 26.85 to 90.21, P<0.000 01), leukopenia (RR=48.69, 95%CI 18.74 to 133.61,P<0.000 01), fatigue (RR=3.11, 95%CI 1.37 to 7.08,P=0.007) and anemia (RR=2.96, 95%CI 1.61 to 5.42, P=0.000 3). There were no significant differences between two groups in nausea, diarrhea and decreased appetite.ConclusionCDK4/6 inhibitors combined with endocrine therapy for the patients with advanced breast cancer can improve median progression free survival and objective response rate, while increase the incidence of adverse events such as neutropenia, leukopenia, fatigue and anemia. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.