Objective To explore value of multidisciplinary team (MDT) model in diagnosis and treatment of patients with advanced special thyroid cancer who lost chance of operation. Method Two patients with the advanced special thyroid cancer who lost chance of operation were treated by low dose apatinib (250 mg/d) after the MDT discussion. Results One medullary thyroid cancer patient with the compressing of the trachea for mediastinal metastatic lymphadenopathy and inability to lie down underwent the multiple surgical treatment, the therapeutic effect was poor. Then low dose apatinib (250 mg/d) was performed, the patient could supine, breathe smoothly, and move freely, whose life quality was obviously improved, the mediastinal lymph nodes reduced and no serious drug toxicity occurred on month 1 after the treatment. One undifferentiated thyroid cancer patient with the lung metastasis, hemoptysis, and tumor invasion resulted in the inability to lie down and having difficulty in breathing, these symptoms still existed and more pleural effusion occurred after the resection of the invaded trachea. Then low dose apatinib (250 mg/d) was performed, the patient could supine, the pleural effusion disappeared, the hemoptysis stopped, the breathing was smooth, and could do some minor housework, no drug toxicity occurred on month 1 after the treatment. Conclusion After MDT discussion, low dose apatinib in treatment of advanced special thyroid cancer is reliable and safe and has a good short-term effect, which could be used as a new remedy, but long-term effect should be further researched by increasing case samples and a long-term following-up.
ObjectiveTo evaluate the efficacy of multicycle neoadjuvant chemotherapy combined with apatinib in the treatment of advanced rectal cancer through the Database from Colorectal Cancer (DACCA).MethodsA total of 173 patients with advanced rectal cancer who underwent surgery after 2–4 cycles of neoadjuvant chemotherapy combined with apatinib were selected from the DACCA (Version January 20, 2019). The patients were grouped by treated cycle and clinical TNM (cTNM) stage, and the overall variation of clinical and pathological indicators before and after treatment were compared.ResultsAmong 173 cases, 63 cases (36.42%), 45 cases (26.01%), and 65 cases (37.57%) were respectively in the 2, 3, and 4-cycle group; 54 cases (31.21%), 91 cases (52.60%), and 28 cases (16.18%) in stage Ⅱ, Ⅲ, and Ⅳ-group. Clinical response degree: complete pathologic response (cPR) was observed in 23 cases (13.29%), and the rate of conversion resection was 100% (173/173). Clinical response grade: complete response (CR) in 58 cases (33.53%), partial response (PR) in 93 cases (53.76%), stable disease (SD) in 21 cases (12.14%), progressive disease (PD) in 1 cases (0.58%). Tumor regression grade: TRG0 in 21 cases (12.57%), TRG1 in 22 cases (13.17%), TRG2 in 84 cases (50.30%), TRG3 in 40 cases (23.95%). There was a statistical difference in CEA before and after the treatment (P<0.001). All cases underwent radical resection, and the successful rate of transformed resection was 100%. There was significant difference on the clinical response grade among the cases of different treatment cycle (H=18.513, P<0.001), and the longer treatment cycle was correlated with better clinical response (G=–0.474, P<0.001). In addition, there was significant difference on the cPR rate among the cases of different cTNM stage (χ2=6.450, P=0.040).ConclusionsMulticycle neoadjuvant chemotherapy combined with apatinib in treating patients with advanced rectal cancer is efficient. More treatment cycles lead to better efficacy. The lower cTNM stage maybe means more chance of achieving cPR and a satisfactory rate of conversion resection.
Objective To screen the lapatinib resistance-related hub genes of breast cancer by bioinformatics initially in order to lay the foundation for further study. Methods We screened and downloaded the gene expression profile data of GSE16179 and GSE38376 from the gene expression omnibus (GEO), and used the limma package of R software to identify the differential expressed genes (DEGs) in breast cancer cells. Then we used the DAVID online website for pathway and function enrichment. With the usage of STRING and Cytoscape, the protein-protein interaction network (PPI) was constructed, and the plug-in app MCODE in Cytoscape was applied to screen hub genes. Then we performed the function enrichment and co-expression analysis of hub genes by DAVID and GeneMANIA. Kaplan-Meier Plotter was used to conduct survival analysis of hub genes. Results A total of 206 kinds of DEGs were screened, and there were 126 kinds of up-regulated genes and 80 kinds of down-regulated genes. DAVID results showed that DEGs were mainly enriched in the biological processes of extracellular space and extracellular region, including extracellular matrix organization, oxygen binding, integrin binding, cell adhesion, positive regulation of angiogenesis, Hippo signaling pathway, transforming growth factor-β signaling pathway and so on. PPI network visualized 74 nodes, the top 10 kinds of hub genes with high connectivity in the gene expression network were screened by MCODE. The Kaplan-Meier Plotter analysis confirmed that 6 of the 10 kinds of hub genes, including peroxisome proliferator activated receptor gamma, transforming growth factor beta receptor 2, tissue inhibitor of metalloproteinase 1, transforming growth factor beta induced, serpin family E member 1, and thrombospondin 1, were correlated with the prognosis of breast cancer patients. Conclusion This 6 kinds of genes may play a significant role in lapatinib resistance of breast cancer.