Trastuzumab, leuprorelin, letrozole, and palbociclib as first-line therapy in HER2-positive and hormone receptor-positive metastatic breast cancer: A case report.

RATIONALE: Cyclin-dependent kinase 4/6 inhibitors are promising candidates for patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer. However, current international guidelines recommend endocrine therapy alone or with HER2-targeted therapy to treat HER2-positive and hormone receptor (HR)-positive metastatic breast cancer in patients who cannot tolerate first-line chemotherapy. Moreover, data on the effectiveness and safety of cyclin-dependent kinase 4/6 inhibitors combined with trastuzumab and endocrine therapy as a first-line treatment for HER2-positive and HR-positive metastatic breast cancer are limited. PATIENT CONCERNS: A 50-year-old premenopausal woman was with epigastric pain for more than 20 days. Ten years ago, she was diagnosed with left breast cancer and underwent surgical treatment, chemotherapy, and endocrine therapy. DIAGNOSES: After relevant examination, the patient was diagnosed with liver, lung, and left cervical lymph node metastatic HER2-positive and HR-positive carcinoma from the left breast after systemic therapy. INTERVENTIONS: The laboratory investigations showed that the patient's liver function was seriously damaged due to the liver metastases, and the patient was assessed as unable to tolerate chemotherapy. She was treated with trastuzumab, leuprorelin, letrozole, and piperacillin combined with percutaneous transhepatic cholangic drainage. OUTCOMES: The patient's symptoms were relieved, her liver function returned to normal, and the tumor showed partial response. Neutropenia (Grade 3) and thrombocytopenia (Grade 2) occurred during treatment but improved after symptomatic treatment. To date, the progression-free survival of the patient is over 14 months. LESSONS: We believe that trastuzumab, leuprorelin, letrozole, and palbociclib is a feasible and effective treatment for HER2-positive and HR-positive metastatic breast cancer in premenopausal patients who cannot tolerate first-line chemotherapy.

Direct Transformation of Aryl 2-Pyridyl Esters to Secondary Benzylic Alcohols by Nickel Relay Catalysis.

A direct transformation of aryl esters to secondary benzylic alcohols via tandem Ni-catalyzed cross-coupling reactions of aromatic 2-pyridyl esters with alkyl zinc reagents and carbonyl group reduction by Ni-H species is achieved. Preliminary mechanistic studies reveal that the Ni-H species is generated in situ via ß-hydride elimination of the Negishi reagents. The reaction is catalyzed by bench-stable nickel salts under mild conditions with wide functional group tolerance.

Total synthesis and absolute configuration of nocardioazine B.

The first total synthesis of the indole alkaloid nocardioazine B was accomplished in 10 steps with an overall yield of 11.8%, establishing the absolute stereochemistry of the natural product.

[Changes and clinical significance of serum soluble Apo-1/Fas in pancreatic cancer].

OBJECTIVE: To detect changes of serum soluble Apo-1/Fas (sApo-1/Fas) in pancreatic cancer patients and to investigate its clinical value in assessing the effect of chemotherapy. METHODS: The serum level of sApo-1/Fas in 30 normal control subjects and 58 pancreatic cancer patients were detected using enzyme-linked immunosorbent assay (ELISA), and the sApo-1/Fas level of 48 pancreatic cancer patients, before and after chemotherapy was compared. RESULTS: Compared with the level of the control group, the level of serum soluble Apo-1/Fas was significantly correlated with clinical stage but not with age, sex or pathologic type of pancreatic cancer. It was elevated gradually from stage II to IV (P < 0.01). However, it would obviously decrease in pancreatic cancer patients after chemotherapy (P < 0.01). CONCLUSION: The serum soluble Apo-1/Fas may be involved in the development of pancreatic cancer, and it may be used as one parameter to assess the disease status and prognosis of pancreatic cancer patient.

[Clinicel study on treatment of advanced primary liver cancer by Yanshu injection combining with chemotherapy].

OBJECTIVE: To study the effects of Yanshu injection on the combined treatment in the advanced primary liver cancer. METHOD: Eighty-five cases of advanced primary liver cancer were treated with Yanshu injection combining with chemotherapy or only chemotherapy. The curative effects, pain genesic rate, one year survival rate, survival quality of life and cell immune functions were observed. RESULT: The remission rate and one year survival rate of the trial group were 60.5% and 51.2%, respectively, and were significantly higher than those (45.2% and 40.5%) of the control group (P < 0.05). The pain relief rate of the trial group was significantly higher than that of the control group (P < 0.05). The improvement of the quality of life was higher than that of the contral group (P < 0.01). The ability of the T-cell subgroup and NK-cell of the trail group were significantly difference between pre-and post-treatment (P < 0.01 or 0.05); however, that of the control group was no obviously change. CONCLUSION: Yanshu injection combination with chemotherapy can raise the curative effect, one year survival rate and cellular immune function, reduce pain genesic rate and toxicity of chemotherapy, and improve the quality of life of the patients with advanced primary liver cancer, which is worthy to be recommended for clinical application.

[Clinical value of serum soluble Apo-1/Fas for predicting biological behaviors and prognosis of gastric carcinoma].

BACKGROUND & OBJECTIVE: Literatures reported that the soluble Apo-1/Fas(sApo-1/Fas) levels in serum of patients with malignant carcinoma were higher than that in normal control subject, but there were fewer studies was seldom to detect the level of sApo-1/Fas in patients with malignancy carcinoma and effect of chemotherapy; the subject is to detect the level of sApo-1/Fas in patients with gastric carcinoma and effect of chemotherapy on it, and to investigate its clinical value. METHODS: Enzyme linked immunosorbent assays(ELISA) was available to detect the level of sApo-1/Fas in 42 case of patients with gastric carcinoma before and after chemotherapy, as compared with 30 case of normal control subject. RESULTS: Levels of sApo-1/Fas were elevated in all subgroups of patients with gastric carcinoma as compared to the controls (P < 0.01), sApo-1/Fas was correlated with clinical stage and histological grade, and not with sex, age; the sApo-1/Fas level in stage IV was higher in comparison with stage III and II (P < 0.05-0.01), and in stage III it was higher than in stage II (P < 0.05); being lower in the well differentiated and moderately differentiated than the poorly differentiated(P < 0.05-0.01), that the sApo-1/Fas levels were remarkably reduced in complete remission or partial remission patients(P < 0.01) after chemotherapy. CONCLUSION: sApo-1/Fas may play closely reflect growth and regulation in gastric carcinoma, it may be a predictor for biological behaviors and prognosis of gastric carcinoma; sApo-1/Fas may be a new target in treating gastric carcinoma.