The Efficacy of Pyrotinib as a Third- or Higher-Line Treatment in HER2-Positive Metastatic Breast Cancer Patients Exposed to Lapatinib Compared to Lapatinib-Naive Patients: A Real-World Study.

Background: Pyrotinib is a novel irreversible pan-ErbB receptor tyrosine kinase inhibitor. Evidence of the efficacy of pyrotinib-based treatments for HER2-positive metastatic breast cancer (MBC) in patients exposed to lapatinib is limited. Methods: Ninety-four patients who received pyrotinib as a third- or higher-line treatment for HER2-positive MBC were included in this retrospective study. The primary and secondary endpoints were overall survival (OS) and progression-free survival (PFS). Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were implemented to balance important patient characteristics between groups. Results: Thirty (31.9%) patients were pretreated with lapatinib and subsequently received pyrotinib as an anti-HER2 treatment, and 64 (68.1%) patients did not receive this treatment. The OS and PFS indicated a beneficial trend in lapatinib-naive group compared to lapatinib-treated group in either the original cohort (PFS: 9.02 vs 6.36 months, p = 0.05; OS: 20.73 vs 14.35 months, p = 0.08) or the PSM (PFS: 9.02 vs 6.08 months, p = 0.07; OS: 19.07 vs 18.00 months, p = 0.61) or IPTW (PFS: 9.90 vs 6.17 months, p = 0.05; OS: 19.53 vs 15.10 months, p = 0.08) cohorts. Subgroup analyses demonstrated lapatinib treatment-related differences in PFS in the premenopausal subgroup and the no prior trastuzumab treatment subgroup, but no significant differences were observed in OS. Conclusion: Pyrotinib-based therapy demonstrated promising effects in HER2-positive MBC patients in a real-world study, especially in lapatinib-naive patients, and also some activity in lapatinib-treated patients.

[Comparison of radiofrequency catheter ablation for paroxysmal supraventricular tachycardia guided by three dimensional navigation with X-ray].

Objective: To compare the therapeutic efficiency and safety of radiofrequency catheter ablation (RFCA) for paroxysmal ventricular tachycardia (PSVT) guided by three-dimensional navigation with X-ray. Methods: One hundred and seventy-six patients with PSVT hospitalized in Department of Cardiology, Zhejiang Provincial People's Hospital between January 2013 and December 2014 were enrolled in this study. RFCA was performed on 95 patients (Group A) guided by the three dimensional electric-field navigation system (NavX) and the procedures were done with the spatial localization method, unless X-ray was needed in some cases.Eighty-one patients (Group B) underwent RFCA guided by X-ray only.The success rate, complications, recurrence rate, operation time, and X-ray exposure were compared between the two groups. Results: The immediate success rate of operation was 100% in the 176 PSVT patients without complications.There were recurrences in 2 cases of Group A, while in 1 case of Group B. The average operation time in Group A was (97±20) min, while (91±26) min in Group B. The median X-ray fluoroscopy time was 3.0 min and radiation dose was 18.5 µGym2 in Group A, which were significantly reduced compared with those in Group B (34.5 min, 167.3 µGym2) (P<0.05). There was no significant difference in immediate procedure success rate, complications, recurrence, and operative time between this two groups (P>0.05). Conclusions: The RFCA for PSVT guided by three-dimensional navigation is safe and feasible in the experienced electrophysiological center.Most patients suffer less or no X-ray radiation.

Lung resistance protein and multidrug resistance protein in non-small cell lung cancer and their clinical significance.

This study examined lung resistance protein (LRP) and multidrug resistance protein (MRP) in lung tumour tissue from 92 patients with non-small cell lung cancer (NSCLC) and normal lung tissue from 20 patients with benign lung tumours. The rates for LRP- and MRP-positive tumours among the NSCLC cases were 54% and 59%, respectively, and their combined positive rate was 45%. These rates were significantly higher than in normal lung tissue. The rates of LRP- and MRP-positive tumours were significantly higher among cases of adenocarcinoma than in cases of squamous cell carcinoma, and in highly differentiated tumours compared with tumours of low or moderate differentiation. There was a significant association between LRP- and MRP-positive tumours and a decrease in overall survival. In conclusion, LRP and MRP play a role in multidrug resistance in NSCLC and are related to prognosis in patients with NSCLC.

Microvessel density and expression of thrombospondin-1 in non-small cell lung cancer and their correlation with clinicopathological features.

Microvessel density and thrombospondin-1 (TSP-1) expression were analysed in 42 non-small cell lung cancer (NSCLC) specimens and 40 normal lung tissue specimens using immunohistochemistry. Microvessel density was significantly higher and TSP-1 expression significantly lower in NSCLC tissue compared with normal tissue. Significantly lower levels of TSP-1 expression and higher microvessel densities were found in late-stage NSCLC compared with early-stage NSCLC, and in those with lymph node metastasis compared with those without metastasis. A statistically significant inverse correlation was observed between TSP-1 expression and microvessel density in squamous cell carcinoma but not in adenocarcinoma. These results suggest a close relationship between microvessel density and NSCLC tumour progress, and that a high expression of TSP-1 may play an important role in inhibiting tumour occurrence and development. The lack of correlation between microvessel density and TSP-1 expression in adenocarcinoma suggests that the mechanism of tumour inhibition by TSP-1 varies according to histological type.

Overexpression of RhoA is associated with poor prognosis in hepatocellular carcinoma.

AIMS: The aim of this study was to investigate the relationship between RhoA expression and clinic pathological parameters of hepatocellular carcinoma (HCC), and to evaluate the prognostic value of RhoA for HCC patients. METHODS: Three methods, including reverse transcription and polymerase chain reaction, Western blot and immunohistochemical staining were employed to detect RhoA expression in 128 HCC specimens. The correlation between RhoA expression and clinicopathologic outcome, and prognostic value of RhoA for HCC patients were analyzed. RESULTS: HCC tissues revealed significantly higher levels of both RhoA mRNA and protein than pericarcinomatous liver tissues (PCLT) (P=0.001). The mRNA and protein expression levels of RhoA in HCC tissues showed strongly positive correlation (correlation coefficient=0.712, P=0.01). There was significant correlation among RhoA mRNA and protein overexpression, and venous invasion (P=0.009 and P=0.040, respectively) and cell differentiation (P=0.021 and P=0.017). HCC patients with RhoA-positive expression showed a significantly poor prognosis than those with RhoA-negative expression (P=0.039). CONCLUSIONS: Our data strongly suggested that increased RhoA expression in HCC correlated with venous invasion and cell differentiation of HCC, overexpression of RhoA indicated a poor prognosis in HCC patients.