Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancer. Nowadays, gemcitabine and cisplatin in combination have been adopted as the first-line chemotherapy for patients with NSCLC. This study aimed to monitor early response to combined chemotherapy of gemcitabine plus cisplatin in a mouse model of NSCLC by using 18F-fluorodeoxyglucose and 18F-fluorothymidine small animal positron emission tomography (PET). Lewis lung carcinoma-bearing C57BL/6 mice were treated with gemcitabine-cisplatin or saline. Small animal PET with 18F-FDG and 18F-FLT was performed before (baseline) and after treatment (on Day 3), respectively. Imaging results were confirmed by histopathological studies (hematoxylin and eosin staining, Ki67 staining). Compared to the results in the control group, gemcitabine-cisplatin in the treated group significantly inhibited tumor growth (P<0.05). In the treated group, the maximum standardized uptake value (SUVmax) of 18F-FLT decreased significantly from 0.59±0.05 (baseline) to 0.28±0.05 (Day 3) (P<0.05). There was no significant difference between baseline (4.35±0.46) and that on Day 3 (4.02±0.47) on 18F-FDG SUVmax (P>0.05). The proliferation of tumor assessed by Ki67 staining decreased significantly after treatment of one dose of gemicitabine-cisplatin (P<0.05). The staining of HE showed an increase in necrotic and inflam- matory cells after the treatment. This study demonstrated that the uptake of 18F-FLT reduced more rapidly and signi-ficantly than that of 18F-FDG and was less disturbed by the increase of inflammatory cells after chemotherapy.
目的:评价国产吉西他滨(泽菲)联合顺铂二线治疗晚期乳腺癌的疗效和不良反应。方法:34例晚期乳腺癌患者采用国产吉西他滨1000mg/m2,静脉滴注30min,第1、8天;顺铂25mg/m2,静脉滴注,第1～3天。21d为一个周期,至少完成两周期后评价疗效。结果:完全缓解2例(588%),部分缓解16例(4706%),总有效率为5294%。中位疾病进展时间为65月,中位生存期为114月;主要不良反应为骨髓抑制和胃肠道反应,所有不良反应在停药后或对症处理后均可恢复正常。结论:国产吉西他滨联合顺铂二线治疗晚期乳腺癌疗效较好,毒副反应可耐受,值得进一步研究。
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 effectiveness and safety of Kanglaite combined with gemcitabine in treating patients with advanced non-small cell lung cancer (NSCLC). MethodsThe randomized controlled trials (RCTs) about Kanglaite ombined with gemcitabine treating advanced NSCLC was retrieved in PubMed, EMbase, The Cochrane Library (Issue 9, 2013), CBM, CNKI, VIP, and WanFang Data from the dates of their establishment to September 2013. Literature screening according to the inclusion and exclusion criteria, data extraction and methodological quality assessment were completed by two reviewers independently. Meta-analysis was then conducted using RevMan 5.2 software. ResultsA total of seven RCTs involving 506 patients were finally included. The results of meta-analysis indicated that:a) Kanglaite injection combined with gemcitabine chemotherapy increased short-term effectiveness (OR=1.85, 95%CI 1.29 to 2.65, P=0.000 8), patients' quality of life (OR=3.02, 95%CI 1.90 to 4.78, P < 0.000 1), and immune function (MD=0.64, 95%CI 0.31 to 0.97, P=0.000 1); and reduced the incidences of leukopenia decrease (OR=0.30, 95%CI 0.19 to 0.47, P < 0.000 01), nausea and vomiting (OR=0.49, 95%CI 0.34 to 0.73, P=0.000 3), bone marrow suppression (OR=0.27, 95%CI 0.16 to 0.45, P < 0.000 01), and liver and renal impairments (OR=0.43, 95%CI 0.28 to 0.68, P=0.000 3), all with significant differences. b) Both groups were alike in reducing thrombocytopenia (OR=0.67, 95%CI 0.40 to 1.14, P=0.14) without significant differences. ConclusionApplying Kanglaite injection combined with gemcitabine in treating patients with advanced NSCLC could increase short-term effectiveness, improve patients' quality of life and immune function; and reduce the incidences of adverse reaction caused by chemotherapy. However, it has no obvious advantage in reducing thrombocytopenia. Due to the limited quantity and quality of the included studies, more larger sample size, multicenter, high quality RCT are needed to verify the above conclusion.
Objective To observe the early efficacy and toxicity of gemcitabine plus tegafur, gimeracil and oteracil potassium (S-1) regimen (GS regimen) in patients with metastatic castration-resistant prostate cancer (mCRPC) after docetaxel failure. Methods From July 2013 to December 2015, sixteen mCRPC patients who failed in the treatment of docetaxel-based chemotherapy in West China Hospital of Sichuan University were collected. And the patients were treated with gemcitabine 1 000 mg/m2 intravenously on Day 1 and S-1 40–60 mg/m2 orally dividedly twice daily on Day 1–10, which repeated every two weeks. The main outcome measures were total prostate-specific antigen (T-PSA) decline rate and pain remission rate. Results Of the 13 evaluable patients, the T-PSA decline rate≥50% was observed in 4 patients (30.8%). Among the 11 patients with bone pain, remarkable pain relief was observed in 4 cases (36.4%). Myelosuppression, gastrointestinal reaction, rash and fatigue were the commonly observed adverse reactions and the toxicity of chemotherapy was tolerable. Conclusion The GS regimen is active and tolerable in patients with mCRPC after docetaxel failure.
Objective To introduce the research progress in the effect of chemotherapeutic resistance of metabolic enzymes of gemcitabine to pancreatic cancer.Methods Recent literatures about metabolic enzymes that played key roles in mediating gemcitabine chemotherapeutic resistance of pancreatic cancer were collected and reviewed. Results The metabolic enzymes of gemcitabine, such as hENT1, dCK, RRM1 and CDA, were closely related to chemotherapeutic resistance of pancreatic cancer. The relationship between the single nucleotide polymorphism of metabolic enzymes and the resistance to gemcitabine remained to be clarified. Conclusion Multiple factors are involved in the mechanism of chemotherapeutic resistance of pancreatic cancer to gemcitabine, which needs further research.
ObjectiveTo observe the alteration of serum homocysteine (Hcy) levels of advanced non-small cell lung cancer (NSCLC) patients during gemcitabine with cis-platinum (GP) program of chemotherapy and to explore the clinical value of monitoring Hcy in evaluating chemotherapy curative effect. MethodsA total of 49 advanced NSCLC patients (including 28 squamous carcinoma and 21 adenocarcinoma) first treated between May 2012 and April 2015 were selected. The Hcy, cytokerantin-19-fragment (CYFRA21-1) and carcinoembryonic antigen (CEA) levels of the morning fasting venous blood were measured before the first and after the second cycle of chemotherapy. Combined the pathological types of NSCLC, statistical analysis was carried out on the test results. ResultsAll of the 49 patients completed two cycles of GP chemotherapy, and the chemotherapy was effective on 31 and ineffective in 18. Before the chemotherapy, the differences in the positive rates of Hcy, CYFRA21-1, and CEA were statistically significant respectively between squamous carcinoma and adenocarcinoma patients (P < 0.05). But when combined the two types, the differences of three indicators's positive rates were not significant (P > 0.05). After two cycles of GP chemotherapy, in the patients with effective chemotherapy, the Hcy, CYFRA21-1 and CEA levels were lower in both squamous carcinoma and adenocarcinoma patients compared with that before the chemotherapy; the difference in the decrease of Hcy levels in both of the two pathological types was significant (P < 0.05), while CEA levels was significant only in adenocarcinoma patients (P < 0.05) and CYFRA21-1 levels was significant only in squamous carcinoma patients (P < 0.05). Among the patients with ineffective chemotherapy, the Hcy, CYFRA21-1 and CEA levels increased compared with those before the chemotherapy; the difference in the increase of Hcy levels were significant in both of the two pathological types (P < 0.05), while CYFRA21-1 levels was significant only in squamous carcinoma patients (P < 0.05) and CEA levels was not significant in both of the two pathological types (P > 0.05). ConclusionThe effect of chemotherapy and the pathogenetic condition can be assessed by monitoring serum Hcy levels of NSCLC patients during the chemotherapy.
目的 探讨吉西他滨+米托蒽醌+足叶乙甙（GME）方案诱导化学疗法（化疗）治疗复发难治性急性白血病的疗效。 方法 2010年5月－2011年4月对20例复发难治性急性白血病应用GME方案化疗，以了解其有效性、毒副反应。 结果 随访7个月20例复发难治性白血病经过GME方案诱导化疗1个疗程后总反应率为50%，其中5例完全缓解，4例部分缓解，1例形态学完全缓解而血细胞计数未完全缓解，均无早期死亡患者。 结论 GME方案可作为复发难治性急性髓系白血病的一种安全、有效的诱导化疗方案，值得临床尝试。
Objective To evaluate the short-term efficacy and safety of nedaplatin combined with gemcitabine compared with cisplatin combined with gemcitabine in the treatment of advanced lung squamous cell carcinoma. Methods The Cochrane Library, EMbase, PubMed, Web of Science, Wanfang, VIP, CNKI and China General Library of Biomedical Literature were searched. Literatures related to the efficacy and safety of nedaplatin combined with gemcitabine (nedaplatin group) versus cisplatin combined with gemcitabine (cisplatin group) in the treatment of advanced lung squamous cell carcinoma published from the inception to October 2021 were searched. The quality of included studies was assessed by Cochrane bias assessing tool and the meta-analysis was conducted by using RevMan 5.4. Results A total of 10 articles were included covering 914 patients. Meta-analysis showed that the objective remission rate (OR=1.51, 95%CI 1.13-2.01, P=0.005), disease control rate (OR=1.54, 95%CI 1.10-2.15, P=0.01) and 1-year survival rate (OR=2.29, 95%CI 1.25-4.18, P=0.007) of the nedaplatin group were better than those of the cisplatin group. In terms of side effects, the incidence of white blood cell and hemoglobin decline, nausea and vomiting, and diarrhea in the nedaplatin group was lower than that in the cisplatin group (P≤0.05). The differences in the platelet decline and liver and kidney damage between the two groups were not statistically significant (P>0.05). Conclusion For patients with advanced lung squamous cell carcinoma, the short-term efficacy of nedaplatin combined with gemcitabine may be better than cisplatin combined with gemcitabine, and the incidence of adverse reactions is lower.