Tumor histological subtyping determined by hormone receptors and HER2 status defines different pathological complete response and outcome to dose-dense neoadjuvant chemotherapy in breast cancer patients

PURPOSE

To assess the impact in pathological complete response (pCR) and outcome of two dose-dense neoadjuvant chemotherapy (DDNC) regimens among different histological subtypes determined by hormonal receptor (HR) and HER2 status in breast cancer patients.

METHODS

A total of 127 breast cancer patients were treated with DDNC in two prospective studies. A: adriamycin 40 mg/m(2) on day (d) 1 plus paclitaxel 150 mg/m(2) and gemcitabine 2,000 mg/m(2) on d2 for six cycles (n = 54). B: epirubicin 90 mg/m(2), cyclophosphamide 600 mg/m(2) on d1 for three cycles, followed by paclitaxel 150 mg/m(2) and gemcitabine 2,500 mg/m(2) on d1 ± trastuzumab according to HER2 status (n = 73). Histological subtypes of breast cancer were 49 % HR+/HER2-, 17.5 % HR+/HER2+, 13.5 % HR-/HER2+ and 20 % HR-/HER2-.

RESULTS

pCR (absence of invasive cells in breast and lymph node) was achieved in 35 patients (28 %). The pCR rate was significantly different between histological subtypes: HR+/HER2- (9 %), HR+/HER2+ (23 %), HR-/HER2+ (50 %), HR-/HER2- (56 %) (p < 0.001). The median follow-up was 81 months (r: 15-150 months). HR-/HER2- tumor subtype had a significantly worse DFS compared to HR+/HER2- (p = 0.02), RH+/HER2+ (p = 0.04) and HR-/HER2+ tumor subtypes (p = 0.02). HR-/HER2- tumor subtype had a significantly shorter OS compared to HR+/HER2- (p = 0.007), RH+/HER2+ (p = 0.05), and HR-/HER2+ (p = 0.03) tumor subtypes. However, no significant difference was observed in DFS and OS among HR-/HER2- tumors that achieved a pCR.

CONCLUSIONS

HR-/HER2- and HR-/HER2+ subtypes had a high pCR rate to DDNC. HR-/HER2- tumors had a worse outcome compared to other tumor subtypes but no significant difference was observed among HR-/HER2- tumors that achieved a pCR.

Dietary intake of polyphenols and major food sources in an institutionalised elderly population

BACKGROUND

Polyphenols are bioactive compounds widely found in fruit, vegetables and beverages of plant origin. Epidemiological studies have suggested an association between polyphenol intake and health; antioxidant, anti-inflammatory, anti-carcinogenic and other bioactivities may contribute to these beneficially protective effects. To date, most epidemiological studies describing polyphenol intake have been limited by the information available in nutrient databases. The present study aimed to determine the total and individual polyphenol intake among institutionalised elderly people living in Asturias (North of Spain) and to identify the major dietary sources of polyphenol classes and subclasses.

METHODS

The study sample comprised 304 subjects with a mean age of 73.2 years for men and 76.8 years for women. Dietary intake was assessed by means of a food frequency questionnaire. Phenol content was estimated from the Phenol-Explorer database, as developed at the French National Institute for Agricultural Research. The contribution of each food to the total and subgroup intake of polyphenols was calculated as a percentage.

RESULTS

Except for flavonones, total polyphenol intake, groups and subgroups, was higher in men than women. The main polyphenol groups contributing to total polyphenol intake were flavonoids (62%) and phenolic acids (35.5%). We identified red wine, coffee, apples, oranges and green beans as the major food sources providing total polyphenol intake. Flavonoid and lignan intake was lower for those aged >80 years. Smoking habit, red wine consumption, physical activity and a Mediterranean diet score were associated with a greater polyphenol intake.

CONCLUSIONS

The present study provides information on polyphenol intake in an elderly Mediterranean population with a level of detail that has not been achieved previously. The identification of age and lifestyle factors associated with the intake of polyphenols may be useful in future studies regarding polyphenols.

Bevacizumab plus preoperative chemotherapy in operable HER2 negative breast cancer: biomarkers and pathologic response

Purpose

The primary aim of this trial was to assess the rate of pathologic complete responses (pCR) of doxorubicin/cyclophosphamide (AC) followed by bevacizumab/docetaxel (BT), as neoadjuvant therapy for breast cancer (BC). Furthermore, the association between biomarkers and the pCR was explored.

Methods

Patients with HER-negative operable stage II–III BC ≥2 cm were enrolled. Four cycles of AC (A 60 mg/m² and C 600 mg/m², every 3 weeks) followed by 4 cycles of BT (B 15 mg/kg and T 75 mg/m², every 3 weeks), were planned. A core-biopsy was performed for biological markers assessment.

Results

Seventy-two women were included. Forty-three (63 %) patients were hormone receptor-positive. Sixty-four (89 %) completed the planned treatment, and 66 evaluable patients underwent surgery (92 %): a pCR was achieved in 16 of them (24, 95 % CI 15–36 %). pCR was significantly higher in tumors hormone receptor-negative, and in those with Angiotensin II type 1 receptor (AGTR1) protein overexpression. The overall clinical response rate was 86 % (95 % CI 76–93 %), including 42 complete responses. No unexpected toxicities or treatment-related deaths were observed.

Conclusion

This regimen showed a remarkable clinical and pathological activity: the suggested relation between pCR and AGTR1 overexpression should be confirmed in larger trials.

Biorefinery process for production of paper and oligomers from Leucaena leucocephala K360 with or without prior autohydrolysis

Lignocellulosic material from Leucaena leucocephala was subjected to a two-stage fractionation process to obtain a valorized effluent containing hemicellulose derivatives and a solid phase for producing cellulose pulp by conventional soda-anthraquinone delignification. This solid phase allows the production of cellulose pulp, under less rigorous conditions from NaOH-AQ process (177 °C, 21%, 120 min) than without pretreatment delignification (185 °C, 25%, 150 min) and better or similar properties in the paper sheets obtained (yield 27.6 and 34.0%, brightness 39.3 and 31.6% ISO, tensile index 7.8 and 10.5 N m/g, burst index 0.43 and 0.29 MPa m(2)/kg with and without previous autohydrolysis) have be found. Also, the first autohydrolysis stage allows up to 46.6% of the initial hemicellulose in the raw material to be extracted as xylooligomers, xylose and furfural into the liquid phase.

Controlled release of rasagiline mesylate promotes neuroprotection in a rotenone-induced advanced model of Parkinson's disease

Microencapsulation of rasagiline mesylate (RM) into PLGA microspheres was performed by method A (O/W emulsion) and method B (W/O/W double emulsion). The best formulation regarding process yield, encapsulation efficiency and in vitro drug release was that prepared with method A, which exhibited constant drug release for two weeks (K(0)=62.3 μg/day/20mg microspheres). Exposure of SKN-AS cells to peroxide-induced oxidative stress (1 mM) resulted in cell apoptosis which was significantly reduced by RM (40.7-102.5 μM) as determined by cell viability, ROS production and DNA fragmentation. Daily doses of rotenone (2 mg/kg) given i.p. to rats for 45 days induced neuronal and behavioral changes similar to those occurring in PD. Once an advanced stage of PD was achieved, animals received RM in saline (1 mg/kg/day) or encapsulated within PLGA microspheres (amount of microspheres equivalent to 15 mg/kg RM given on days 15 and 30). After 45 days RM showed a robust effect on all analytical outcomes evaluated with non-statistically significant differences found between its administration in solution or within microparticles however; with this controlled release system administration of RM could be performed every two weeks thereby making this new therapeutic system an interesting approach for the treatment of PD.

[New toxicological patterns of nanomaterials, nanostructures and nanoparticles]

Nanomaterials engineered as nanotubes, quantum-dots, dendrimers or hybrid systems are increasing themselves by an annual mean rate of 4-5%, with rapid spread in various sectors e.g. biomedical. The liposolubility through membranes and the hydrosolubility through active transport do not interfere with nanoparticles below a certain size, which without activation processes and carrier, transport through thanks to capillaries, to intracellular pores (60 - 70 nm) and fissures (4 - 6 nm) in the same membranes. Conversely, in the processes of pinocytosis/endocytosis energy and carrier are required and endocytosis clathrin/caveolae mediated,is respectively for nanoparticles higher or lower than 200 nm. In occupational hazard nanostructures ranging from a few nm up to 100 - 150 nm have the ability to affect several organs through inhalation, intestinal, parental or dermal route of access. New toxicological aspects are associated to the capacity of nanomaterials of being more or less biocompatible or hydrosoluble, of creating bonds with proteins or to determine accumulation in the cells due to an incomplete elimination process.

Effects of the combined administration of propranolol plus sorafenib on portal hypertension in cirrhotic rats

Low doses of sorafenib have been shown to decrease portal pressure (PP), portal-systemic shunts, and liver fibrosis in cirrhotic rats. Nonselective beta blockers (NSBB) are the only drugs recommended for the treatment of portal hypertension. The aim of our study was to explore whether the combination of propranolol and sorafenib might show an additive effect reducing PP in cirrhotic rats. Groups of common bile duct-ligated cirrhotic rats (CBDL) and sham-operated control rats were treated by gavage with vehicle, propranolol (30 mg·kg(-1)·day(-1)), sorafenib (1 mg·kg(-1)·day(-1)), or propranolol+sorafenib. Treatment began 2 wk after the CBDL or sham operation. Hemodynamic evaluation was performed after 2 wk of treatment. In cirrhotic rats, propranolol and sorafenib produced a significant (P < 0.001) and similar reduction in PP (-19 and -15%, respectively). This was achieved through different mechanisms: whereas propranolol decreased PP by reducing portal blood flow (-35%; P = 0.03), sorafenib decreased PP without decreasing portal flow indicating decreased hepatic resistance. After propranolol+sorafenib, the fall in PP was significantly greater (-30%; P < 0.001) than with either drug alone, demonstrating an additive effect. However, the reduction in portal flow (-39%) under combined therapy was not significantly greater than after propranolol alone. Sorafenib, alone or in combination with propranolol, produced significant reduction in portal-systemic shunting (-25 and -33%, respectively), splanchnic vascularization (-37 and -41%, respectively), liver fibrosis (38%), and hepatic neovascularization (-42 and -51%, respectively). These effects were not observed after propranolol alone. In conclusion, the combination of propranolol+sorafenib causes a greater reduction in PP than either drug alone and decreases markedly the extent of portal-systemic shunting, splanchnic and hepatic neovascularization, and liver fibrosis, suggesting that this drug combination is a potentially useful strategy in the treatment of portal hypertension.

Fitness, fatness and cardiovascular profile in South Spanish and North Moroccan women

INTRODUCTION

We studied the differences on physical fitness, fatness and cardiovascular profile in Spanish and Moroccan women.

MATERIAL AND METHODS

The study comprised 63 and 58 women aged 45-65 years from South of Spain and North of Morocco, respectively. We assessed fitness and body composition using standard procedures. We also assessed resting heart rate (RHR), blood pressure, fasting glucose, total cholesterol, LDL-cholesterol, HDL-cholesterol and triglycerides.

RESULTS AND DISCUSSION

Moroccan women had a better performance in the main health-related physical fitness components, i.e. higher levels of cardiorespiratory fitness (P = 0.01) and (lower-body) muscular strength (P < 0.001). Diastolic blood pressure (P = 0.004), RHR and total cholesterol (both P = 0.04) were lower in Moroccan women. No differences were observed in the prevalence of metabolic syndrome.

CONCLUSIONS

The women from Morocco had a healthier fitness and cardiovascular profile than the women from Spain. Further research on physical fitness and other health indicators in understudied populations is needed.