简介：Objective:Therecurrenceorprogressionunderendocrinetherapyinhormonereceptor-positive(HR+)advancedbreastcancer(ABC)remainedacriticalclinicalchallenge.Chidamideisanoralsubtype-selectivehistonedeacetylase(HDAC)inhibitorwithmultiplefunctionsintumorgrowthinhibitionandmicroenvironmentmodulationviaepigeneticreprogramming.Thepurposeofthisstudywastoevaluatethesafety,pharmacokinetics(PK),andpreliminaryefficacyofchidamideincombinationwithexemestaneinHR+ABCpatients.Methods:EligiblepatientswerepostmenopausalwomenwithHR+ABCrecurrentorprogressedtoatleastoneendocrinetherapy.Bloodsampleswereobtainedintherun-inperiodandthefirstdayofcombinationtreatmentforPKanalysis.Incombinationtreatment,patientsweregivenexemestane25mgdailyandchidamide30mgtwiceaweek(BIW)untilprogressionofdiseaseorintolerabletoxicities.Atreatmentcyclewasdefinedas4weeks.Safety,PKparameters,andpreliminaryefficacywereevaluated.Results:Atotalof20patientswereenrolledbetweenJulyandDecember,2015.Themediannumberoftreatmentscyclewas5.2(20.8weeks)with2patientsstillontreatmentatthedatacut-offdateofOctober,2017.Thetreatment-relatedadverseevents(AE)≥grade3inmorethan2patientswereneutropenia(35%),thrombocytopenia(30%),andleucopenia(20%).Theplasmaexposureofexemestanewasconsistentinthepresenceorabsenceofchidamide.Aslightincreaseinchidamideexposurewasnotedinthepresenceofexemestane,probablyduetotheinter-andintra-patientvariations.Thebestresponsein16evaluablepatientswasassessedbyResponseEvaluationCriteriainSolidTumors(RECIST),including4patientswithpartialresponse,10patientswithstabledisease.Themedianprogression-freesurvival(PFS)was7.6months.Conclusions:ThecombinationofchidamidewithexemestanewasgenerallywelltoleratedwithpromisingpreliminaryefficacyinHR+ABCpatients.Theoverallresultsfromthisstudyencouragefurtherpivotaltrialinthispatie

简介：Objectiveandbackground:Althoughp21rashasbeenreportedtobeupregulatedinhepatocellularcarcinomacomplicatingchronichepatitisCtypeI,p21rashasadifferentroleinadvancedstages,asithasbeenfoundtobedownregulated.Thegoalofthisstudywastoinvestigatethestatusofp21rasinearly-stage/low-gradeandlate-stage/high-gradehepatocellularcarcinomaanditspossiblelinktoapoptosis.Materialandmethods:Thirty-fivecaseseachofchronicHCVhepatitistype4(groupI)andcirrhosiswithhepatocellularcarcinoma(HCC)complicatingchronicHCVhepatitis(groupsIIandIII)wereimmunohistochemicallyevaluatedusingap21raspolyclonalantibody.Theapoptoticindexwasdeterminedinhistologicsectionsusingtheterminaldeoxynucleotidyltransferase-mediatedd-UTPbiotinnickendlabeling(TUNEL)assay.Results:Significantdifferences(P=0.001)weredetectedinp21rasproteinexpressionbetweenthethreegroups.Anear2-foldincreaseinp21rasstainingwasobservedinthecirrhoticcasescomparedtothehepatitiscases,andp21rasexpressionwasdecreasedintheHCCgroup.p21rasexpressioncorrelatedwithstage(r=0.64,P=0.001)andgrade(r=-0.65,P=0.001)intheHCCgroupandgradeintheHCVgroup(r=0.44,P=0.008).Bothp21rasexpressionandTUNEL-LIweresignificantlylowerinlargeHCCscomparedtosmallHCCs(P=0.01each).TheTUNELvalueswerenegativelycorrelatedwithstageintheHCCgroup(r=-0.85,P=0.001).TheTUNELvalueswerealsonegativelycorrelatedwithgradeinboththeHCVandHCCgroups(r=0.89,P=0.001andr=-0.53,P=0.001,respectively).Thep21rasscoresweresignificantlycorrelatedwiththeTUNEL-LIvaluesintheHCCgroup(r=0.63,P=0.001)andHCVgroup(r=0.88,P=0.001).Conclusions:p21rasactsasaninitiatorinHCCcomplicatingtype4chronicHCVandisdownregulatedwithHCCprogression,whichmostlikelypromotestumorcellsurvivalbecauseitfacilitatesthedownregulationofapoptosiswithtumorprogression.

简介：Objective:Toclarifytheprognosticvalueofpost-treatment18F-fluorodeoxyglucose(FDG)positronemissiontomography(PET)/computedtomography(CT)inpatientswithadvancedheadandnecksquamouscellcarcinoma(HNSCC)aftercombinedintra-arterialchemotherapyandradiotherapy(IACR).Methods:Thirty-sixpatientswithHNSCCwhounderwentIACRwererecruited.TheperiodfromtheendofIACRtothelastpost-treatment18F-FDGPET/CTexaminationwas8-12weeks.Bothpatient-basedandlesion-basedanalyseswereusedtoevaluatethePET/CTimages.Forlesion-basedanalysis,36regions(12lesionsofrecurrencesand24scarsatprimarysites)wereselected.TheKaplan-Meiermethodwasusedtoassesstheoverallsurvival(OS)stratifiedby18F-FDGuptakeorvisualinterpretationresults.Results:TwelvepatientswithrecurrencewereidentifiedbysixmonthsafterIACR.Thesensitivityandspecificityinthepatient-basedanalysiswere67%(8/12)and88%(21/24),respectively.ThemeanOSwasestimatedtobe12.1months(95%CI,6.3-18.0months)forthehighermaximumstandardizeduptakevalue(SUVmax)group(n=7)and44.6months(95%CI,39.9-49.3months)forthelowerSUVmaxgroup(n=29).OSinthehigherSUVmaxgroup(cut-offpoint,6.1)orpositivevisualinterpretationgroupwassignificantlyshorterthanthatinthelowerSUVmaxornegativevisualinterpretationgroup(P<0.001andP<0.05,respectively).Conclusions:TheSUVmaxandvisualinterpretationofHNSCConpost-IACR18F-FDGPET/CTcanprovideprognosticsurvivalestimates.

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