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sequential neoadjuvant chemotherapy using pegylated liposomal doxorubicin and cyclophosphamide followed by taxanes with complete trastuzumab and pertuzumab treatment for HER2-positive breast cancer: A phase Ⅱ single-arm study

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Chinese Journal of Cancer Research 2024年第1期36卷 55-65页

作者： Yaping Yang Liang Jin Yudong Li Nanyan Rao Chang Gong Shunrong Li Jiannan Wu Jinghua Zhao Linxiaoxiao Ding Fengxia Gan Jun Zhang Ruifa Feng Zhenzhen Liu Qiang Liu Breast Tumor Center Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene RegulationGuangzhou 510120China Department of Thyroid and Breast Surgery Shenzhen Qianhai Shekou Free Trade Zone HospitalShenzhen 518000China Breast and Thyroid Surgery Guilin Medical College Second Affiliated HospitalGuilin 541199China Department of Breast Disease Henan Breast Cancer Centerthe Affiliated Cancer Hospital of Zhengzhou University&Henan Cancer HospitalZhengzhou 450008China

Objective: Despite cardiotoxicity overlap, the trastuzumab/pertuzumab and anthracycline combination remains crucial due to significant benefits. Pegylated liposomal doxorubicin(PLD), a less cardiotoxic anthracycline, was evaluated for efficacy and cardiac safety when combined with cyclophosphamide and followed by taxanes with trastuzumab/pertuzumab in human epidermal growth factor receptor-2(HER2)-positive early breast cancer(BC).Methods: In this multicenter, phase II study, patients with confirmed HER2-positive early BC received four cycles of PLD(30-35 mg/m^(2)) and cyclophosphamide(600 mg/m^(2)), followed by four cycles of taxanes(docetaxel,90-100 mg/m^(2) or nab-paclitaxel, 260 mg/m^(2)), concomitant with eight cycles of trastuzumab(8 mg/kg loading dose,then 6 mg/kg) and pertuzumab(840 mg loading dose, then 420 mg) every 3 weeks. The primary endpoint was total pathological complete response(tp CR, yp T0/is yp N0). Secondary endpoints included breast p CR(bp CR),objective response rate(ORR), disease control rate, rate of breast-conserving surgery(BCS), and safety(with a focus on cardiotoxicity).Results: Between May 27, 2020 and May 11, 2022, 78 patients were treated with surgery, 42(53.8%) of whom had BCS. After neoadjuvant therapy, 47 [60.3%, 95% confidence interval(95% CI), 48.5%-71.2%] patients achieved tp CR, and 49(62.8%) achieved bp CR. ORRs were 76.9%(95% CI, 66.0%-85.7%) and 93.6%(95% CI,85.7%-97.9%) after 4-cycle and 8-cycle neoadjuvant therapy, respectively. Nine(11.5%) patients experienced asymptomatic left ventricular ejection fraction(LVEF) reductions of ≥10% from baseline, all with a minimum value of >55%. No treatment-related abnormal cardiac function changes were observed in mean N-terminal pro-BNP(NT-pro BNP), troponin I, or high-sensitivity troponin.Conclusions: This dual HER2-blockade with sequential polychemotherapy showed promising activity with rapid tumor regression in HER2-positive BC. Importantly, this regimen showed an acceptable safety profile,especially a low risk of cardiac events,

关键词： Breast cancer HER2-positive breast cancer dual HER2 blockade neoadjuvant therapy sequential therapy

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Characteristics of retinal vein occlusion with final vision better than 78 letters after sequential therapy with ranibizumab and triamcinolone acetate

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International Journal of Ophthalmology(English edition) 2017年第2期10卷 271-276页

作者： Yao-Wu Qin Jia Yu Quan Zhang Ophthalmology Department of EENT Hospital Affiliated to Fudan UniversityShanghai Key Laboratory of Visual Impairment and RestorationShanghai 200031China

AIM： To analyze the reasons that may lead to the different vision result by combining the ranibizumab and triamcinolone acetate（TA） in sequence to treat macular edema in retinal vein occlusion（RVO）.METHODS： Ranibizumab and TA were combined in sequence to treat 43 patients with macular edema secondary to RVO.Six months after the treatment,patients with central fovea thickness（CFT） less than 300 μm in optical coherence tomography（OCT） were collected into Groups I and II,based on vision acuity（VA） better than 78 letters or less than 60 letters.The age,baseline VA,duration from onset to treatment,CFT at the baseline,sub-retinal fluid（SRF）,sub-foveal exudates and injection times of TA and ranibizumab were taken into comparison.RESULTS： The mean age of the subjects was 46.4y in Group I but 57.5y in Group II.The difference of age was significant between groups（P〈0.01）.The mean baseline VA was 51.4 letters in Group I and 43.9 letters in Group II（P〈0.05）.The baseline CFT were 670.9 μm in Group I with SRF in 54.3% patients and 678.1 μm in Group II with SRF in 52.9%（P〉0.05）.The mean number of injections of TA was 0.9 and the mean number of injections of ranibizumab was 2.3 in Group I but 1.7 and 2.9 respectively in Group II.The treatment times of ranibizumab had no difference between the 2 groups（P〉0.05） but the difference of TA injection times was significant（P〈0.05）.Subfoveal exudates at final stage happened in no subjects in Group I but in 45.83% subjects in Group II.CONCLUSION： This combined treatment is safer than TA injection and cheaper than ranibizumab injection alone.Younger patients and earlier treatment will help to get better vision outcome.Subfoveal exudates at the final stage have significant relationship with vision outcome.No relationship existed between the baseline CFT,SRF and the vision outcome.

关键词： retinal vein occlusion macular edema ranibi-zumab triamcinolone acetate sequential therapy

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Clinical Observations of sequential therapy with Chinese Medicine and Hysteroscopic Mechanical Stimulation of the Endometrium in Infertile Patients with Repeated Implantation Failure Undergoing Frozen-Thawed Embryo Transfer

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Chinese Journal of Integrative Medicine 2015年第4期21卷 249-253页

作者：章晓乐傅永伦康艳齐聪张勤华匡延平 Department of Gynecology Shuguang HospitalShanghai University of Traditional Chinese Medicine Department of Assisted Reproduction the 9th HospitalShanghai Jiaotong University School of Medicine

Objectives： To investigate the clinical effect of sequential therapeutic intervention Yupei Qisun [compensating for weakness by invigorating Kidney （Shen） and Spleen （Pi） in advance] in Chinese medicine （CM） and hysteroscopic endometrial mechanical stimulation on the treatment of infertile patients with repeated implantation failure （RIF）; and to study the differences in patients＇ endometrial thickness and type on the day of embryo transfer, serum hormone levels on embryo transfer day and clinical pregnancy outcomes. Methods： In the clinical study, 168 frozen-thawed embryo transfer （FET） cycles for couples with RIF conforming to the research protocol were randomly divided into three groups： a CM group with 56 cycles （CM combined with FET）, a hysteroscopy group with 55 cycles （hysteroscopic endometfial mechanical stimulation）, and a control group with 57 cycles （conventional FET）. Differences in endometrial thickness on the embryo transfer day, levels of serum estradiol （E2） and progesterone （P） on the embryo transfer day, the E2/P ratio on the embryo transfer day, biochemical and clinical pregnancy rates, implantation rate, abnormal pregnancy rate and other indices were compared among the three groups. Results： Endometrial thickness, E2 and P levels, and the EJP ratio on embryo transfer day and other factors had no significant differences among groups. The biochemical pregnancy, clinical pregnancy, and implantation rates of the CM and hysteroscopy groups were significantly higher than the control group （P〈0.05）, and there were no significant differences between these two groups. The abnormal pregnancy rate had no significant difference among the three groups. Conclusions： sequential therapy of Yupei Qisun could significantly improve the clinical outcomes of RIF-FET cycles, being equivalent to hysteroscopic endometrial mechanical stimulation, and provided a reliable method to treat such infertile couples.

关键词： sequential therapy Chinese medicine Yupei Qisun repeated implantation failure frozen embryo transfer hysteroscopy

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sequential therapy with zoledronic acid and teriparatide for osteoporotic vertebral compression fracture:case report and review of literature

Sequential therapy with zoledronic acid and teriparatide for...

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2016年浙江省骨科学学术年会

作者：徐三中张益均余列道沈淼达林向进浙江大学医学院附属第一医院骨科

Despite the existence of numerous case series,no evidenced-based medical management for osteoporotic vertebral compression fracture has been established.We report the outcome of zoledronic acid administration followed by teriparatide in an elder woman with painful osteoporotic vertebral compression fracture.Twelve months later,the patient experienced complete pain relief and function improvement.Bone mineral density testing revealed increase of 33.3%at the lumbar spine.Plain radiographs of the thoracolumbar spine revealed fracture totally healing with vertebral body of T12 in high density.During the therapy,the βisomer of C-terminal telopeptide of type I collagen decreased significantly with zoledronic acid injection while the N-terminal propeptide of typelcollagen increased significantly after 6 months of teriparatide administration.Our case indicated that sequential therapy with teriparatide following zoledronic acid in cases of osteoporotic vertebral compression fracture might be a rational treatment option.

关键词： sequential therapy osteoporotic vertebral compression fracture zoledronic acid teriparatide

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sequential therapy or standard triple therapy for Helicobacter pylori infection:a systematic review and meta-analysis

Sequential therapy or standard triple therapy for Helicobact...

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第十七届西南地区消化病学术会议暨2014贵州省消化病及...

作者： Li Feng MaoYao Wen YongJun Zhu RuoTing Men Li Yang Division of Digestive Diseases West China Hospital of Sichuan University Division of Digestive Diseases Affiliated Hospital of North Sichuan Medical Collage

BACKGROUND:The effectiveness of standard triple therapy(STT)for the eradication of Helicobacter pylori(HP)has decreased recently.sequential therapy(SQT)is a new regimen proposed to address this problem.OBJECTIVE:To compare the efficacy of SQT versus STT for HP eradication.METHODS:We performed a systematic review of the literature and pooled-data analysis.The eradication rates were based on an intention-to-treat(ITT)and per-protocol(PP)basis.The risk ratios(RR)of eradication rate were pooled,with a 95%CI.RESULTS:A total of 33 trials met the inclusion criteria.The ITT and PP eradication rates were 80.4%and 88.7%in SQT,and 74.9%and 78.6%in STT,respectively.The RR for eradication of HP with SQT compared with STT was 1.14(95%CI:1.09-1.18)for ITT analysis and 1.14(95%CI:1.10-1.19)for PP analysis.There was significant heterogeneity between trial results(I=72%,P<0.0001).Subgroup analyses showed that SQT was superior to both 7-day and 10-day STT,but was not significantly better than 14-day STT.There were no significant differences between groups in terms of the risk of adverse effects.CONCLUSIONS:SQT is more efficacious than STT(7-day and 10-day)in the eradication of HP,but the pooled rate seemed suboptimal.Further research is needed to develop more effective therapeutic approaches,regional monitoring of resistance rates should performed to help guide treatment.

关键词： Eradication Helicobacter pylori Meta-analysis Triple therapy sequential therapy

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Standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori eradication

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World Journal of Gastroenterology 2010年第34期16卷 4357-4362页

作者： Gao, Xiao-Zhong Qiao, Xiu-Li Song, Wen-Chong Wang, Xiao-Feng Liu, Feng Weihai Municipal Hosp Div Gastroenterol Weihai 264200 Shandong Peoples R China

AIM: To compare the effectiveness of standard triple, bismuth pectin quadruple and sequential therapies for Helicobacter pylori (H. pylori ) eradication in a randomized, double-blinded, comparative clinical trial in China. METHODS: A total of 215 H. pylori -positive patients were enrolled in the study and randomly allocated into three groups: group A (n = 72) received a 10-d bismuth pectin quadruple therapy (20 mg rabeprazole bid , 1000 mg amoxicillin bid , 100 mg bismuth pectin qid , and 500 mg levofloxacin qd ); group B (n = 72) received the sequential therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , in 5 d, followed by 20 mg omeprazole bid , 500 mg tinidazole bid , 500 mg clarithromycin bid , for another 5 d); group C (n = 71) received a standard 1-wk triple therapy (20 mg omeprazole bid , 1000 mg amoxicillin bid , 500 mg clarithromycin bid ). After all these treatments, 20 mg omeprazole bid was administrated for 3 wk. H. pylori status was assessed by histology, 13C-urea breath test and rapid urease test at baseline and 4-6 wk after completion of treatment. Ulcer cicatrization was assessed by gastroscopy. χ 2 test (P sequential therapy yielded a higher eradication rate and ulcer cicatrisation rate than the standard triple and bismuth pectin quadruple therapies. Statistically, the eradication rate of group B was significantly different from groups A and C (P 0.05). The three protocols were generally well tolerated. CONCLUSION: The sequential therapy has achieved a significantly higher eradication rate, and is a more suitable first-

关键词： Helicobacter pylori sequential therapy Triple therapy Bismuth pectin quadruple therapy Eradication rate

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Efficacy and safety of intravenous itraconazole followed by oral itraconazole solution in the treatment of invasive pulmonary mycosis

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Chinese Medical Journal 2011年第20期124卷 3415-3419页

作者： ZHANG Ying-ying ZHOU Xin Department of Respiratory Medicine Shanghai First People＇sHospital Affiliated to Shanghai Jiao Tong University Shanghai200080 China

Background Invasive pulmonary mycosis is the most common type of invasive fungal infection. It is often severe and difficult to treat, and is accompanied by high mortality. In this study, we aimed to evaluate the efficacy and safety of intravenous itraconazole followed by oral itraconazole solution in the treatment of invasive pulmonary mycosis and to determine the distribution of different fungi species. Methods This was a multi-center, open-label study which enrolled 71 patients who were diagnosed as invasive pulmonary mycosis between July 2007 and January 2009. All patients received intravenous itraconazole therapy followed by oral itraconazole solution with a total treatment duration of 6 weeks. Intravenous itraconazole was given at a dose of 200 mg bid （intravenous infusion every 12 hours） for the first two days, 200 mg qd for the subsequent 12 days. sequential oral itraconazole solution was given at a dose of 100 mg bid for 4 weeks. Efficacy and safety were assessed according to clinical as well as microbiological criteria. Results Seventy one patients participated in this study. Of the 60 patients in the full analysis dataset, the clinical response rate was 61.7% and the mycological eradication rate was 66.7%. The overall response rate was 66.7%. Drug-related adverse events occurred in 18.0% of patients： hypokalemia, liver function impairment and mild gastrointestinal side effects were the most common. One patient suffered from severe adverse event, with limb and facial swelling. Conclusion This study showed that in patients with invasive pulmonary mycosis, intravenous itraconazole followed by oral itraconazole solution therapy was safe and effective.

关键词： itraconazole invasive pulmonary mycosis sequential therapy

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Indirect comparison between abiraterone acetate and enzalutamide for the treatment of metastatic castration-resistant prostate cancer： a systematic review

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Asian Journal of Andrology 2017年第2期19卷 196-202页

作者： Wei Zhang Teng-Yun Wu Qi Chen Xiao-Lei Shi Guang-An Xiao Lin Zhao Chuan-Liang Xu Tie Zhou Ying-Hao Sun Department of Urology Changhai Hospital Second Military Medical University Shanghai China Air Force General Hospital of Chinese People's Liberation Army Beijing China Department of Health Statistics Faculty of Health Service Second Military Medical University Shanghai China

This study was designed to evaluate the efficacy, tolerability, and sequential administration of abiraterone acetate （AA） and enzalutamide （Enz） for metastatic castration-resistant prostate cancer （mCRPC）. A literature search was performed with PubMed, Embase, and Web of Science databases to identify relevant studies. Reviewed literature included published phase III trials of AA or Enz in mCRPC and studies regarding their sequential administration. Given the difference in control arms in AA （active comparator） and Enz （true placebo） randomized phase III studies, indirect comparisons between AA and Enz in mCRPC showed no statistically significant difference in overall survival in prechemotherapy and postchemotherapy settings （HR. 0.90, 95% CI, 0.73-1.11; HR： 0.85, 95% CI, 0.68-1.07）. Compared with AA, Enz may better outperform control arms in treating mCRPC both before and after chemotherapy regarding secondary endpoints based on indirect comparisons： time to prostate-specific antigen （PSA） progression （HR. 0.34, 95% CI, 0.28-0.42; HR： 0.40, 95% CI, 0.30-0.53）, radiographic progression-free survival （HR： 0.37, 95% CI, 0.28-0.48; HR： 0.61, 95% CI, 0.50-0.74）, and PSA response rate （OR： 18.29, 95% CI, 11.20-29.88; OR： 10.69, 95% CI, 3.92-29.20）. With regard to the effectiveness of Enz following AA or AA following Enz, recent retrospective case series reported overall survival and secondary endpoints for patients with mCRPC progression after chemotherapy. However, confirmatory head-to-head trials are necessary to determine the optimal sequencing of these agents.

关键词： abiraterone acetate enzalutamide indirect comparison metastatic castration-resistant prostate cancer sequential therapy

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Treatment of Helicobacter pylori infection in children:A systematic review

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World Journal of Meta-Analysis 2020年第4期8卷 292-308页

作者： Filipe Antônio França da Silva Breno Bittencourt de Brito Maria Luísa Cordeiro Santos Hanna Santos Marques Mariana Miranda Sampaio Ronaldo Teixeira da Silva Júnior Jonathan Santos Apolonio Lorena Sousa de Carvalho Camilo Santana Silva Luana Kauany de SáSantos Márcio Vasconcelos Oliveira Gifone Aguiar Rocha Dulciene Maria de Magalhães Queiroz Fabrício Freire de Melo Instituto Multidisciplinar em Saúde Universidade Federal da BahiaVitória da Conquista 45029-094BahiaBrazil Campus Vitória da Conquista Universidade Estadual do Sudoeste da BahiaVitória da Conquista 45083-900BahiaBrazil Laboratory of Research in Bacteriology Faculdade de MedicinaUniversidade Federal de Minas Gerais(UFMG)Belo Horizonte 30130-100Minas GeraisBrazil

BACKGROUND Helicobacter pylori(H.pylori)infection is predominantly acquired in childhood.When indicated,the most accepted treatment for H.pylori eradication in this age group is first-line triple therapy.However,the increasing resistance to clarithromycin and nitroimidazoles has been associated with treatment failure,and thus,alternative treatment regimens have been proposed.AIM To perform a systematic review of randomized controlled trials on treatment regimens for H.pylori infection in children.METHODS We surveyed relevant articles published in English from 2010 to April 2020 in the PubMed and MEDLINE databases.Keywords included“Helicobacter pylori“/”children or childhood“/”treatment or eradication.”The risk of bias was evaluated according to the Cochrane Handbook of Systematic Reviews for Interventions.RESULTS Among the 1144 records identified through the database,20 articles were selected.Four studies compared the eradication rates of H.pylori infection between standard triple therapies,changing only the main antibiotic used.Seven studies evaluated the effectiveness of standard triple therapy with the addition of probiotics.One study investigated the relationship between the effectiveness in the eradication rates of standard triple therapy and vitamin E levels.Six studies analyzed the eradication rates of sequential therapy.CONCLUSION The findings suggest that although standard triple therapy is the most recommended regimen for children by the current guidelines,other therapeutic schemes have shown promising results and may also be recommended for clinical practice in the future.

关键词： Helicobacter pylori Children Pediatric treatment Standard triple therapy Probiotics sequential therapy Eradication therapies

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Current Helicobacter pylori treatment in 2014

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World Journal of Methodology 2015年第2期5卷 101-107页

作者： Fatih Ermis Elif Senocak Tasci Department of Gastroenterology Duzce University Faculty of Medicine Department of Internal Medicine Duzce University Faculty of Medicine

Helicobacter pylori is one of the most commonly seen bacterium worldwide.It's in the etiology of multiple gastrointestinal diseases,ranging from gastritis to gastric carcinoma.The antimicrobial therapies,which are frequently prescribed empirically,are losing their effectivity as a result of the increasing antimicrobial resistance.As the standard triple therapy is now leftespecially in areas with high-clarithromycin resistance due to decreased eradication rates,quadruple therapies are recommended in most regions of the world.Alternatively,concomitant,sequential and hybrid therapies are used.There is still a debate going on about the use of levofloxacin-based therapy in order to prevent the increase in quinolone resistance.If no regimen can achieve the desired eradication rate,culture-guided individualized therapies are highly recommended.Probiotics,statins and n-acetylcysteine are helpful as adjuvant therapies in order to increase the effectiveness of the eradication therapy.Herein,we focused on different eradication regimens in order to highlight the current Helicobacter pylori treatment.

关键词： Helicobacter pylori Eradication Treatment Bismuth-quadruple therapy sequential therapy Concomitant therapy Hybrid therapy

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