化疗性静脉炎小鼠模型的建立

目的通过静脉注射盖诺(vinorelbine,VNB)为化疗性静脉炎(chemotherapy induced phlebitis,CIP)研究,提供效果稳定的CIP模型。方法49只成年小鼠随机分为6个实验组和1个对照组。实验组小鼠分别从右侧鼠尾静脉注射不同浓度的等体积VNB溶液,对照组则注射等体积生理盐水。注射后第5天对CIP临床表现进行分级评价后处死。制作石蜡切片并进行镜下分级。结果随注射VNB浓度及剂量的增加,小鼠静脉炎发生率也逐渐增高,但浓度剂量过高动物出现中毒死亡。用3.2mg/ml的VNB按38mg/kg注射组CIP发生率达100%,无动物死亡,出现红斑、水肿、条索状改变等典型CIP临床症状和内皮脱落、炎细胞浸润、组织水肿等CIP镜下改变,对照组未出现类似变化。结论本实验通过鼠尾静脉注射VNB成功建立了小鼠CIP模型。     

VEGF neutralizing antibody increases the therapeutic efficacy of vinorelbine for renal cell carcinoma

Renal cell carcinoma (RCC) is currently one of the most treatment‐resistant malignancies and affects approximately three in 10,000 people. The impact of this disease produces about 31,000 new cases in the United States per year; and 12,000 people in the United States alone die from RCC annually. Although several treatment strategies have been investigated for RCC, this cancer continues to be a therapeutic challenge. For this reason, the aim of our study is to develop a more effective combinational therapy to treat advanced RCC. We examined the effect of vinorelbine on the signalling pathways of two human renal cancer cell lines (A498 and 786‐O) and also examined the in vivo effect of vinorelbine treatment alone and vinorelbine in combination with the anti‐VEGF antibody 2C3 on A498 and 786‐O tumour growth in nude mice. Tumour angiogenesis was measured by vWF staining, and apoptosis was determined by the TUNEL assay. We observed a significant tumour growth inhibition when using a combinational therapy of anti‐VEGF antibody 2C3 and vinorelbine in both A498 and 786‐O tumour‐bearing mice. The results suggest a breakthrough treatment for advanced RCC.     

Lobaplatin-based regimens outperform cisplatin for metastatic breast cancer after anthracyclines and taxanes treatment

The goal of this study was to assess the antitumor efficacy and safety of lobaplatin-based regimens as the second line of treatment in patients with metastatic breast cancer (MBC) resistant to anthracyclines and taxanes, compared with that of cisplatin-based regimens. During August 2012 to April 2015, 87 patients who received lobaplatin-based regimens or cisplatin-based regimens were included. Medical records of the patients noted that lobaplatin (30?mg/m²) or cisplatin (25?mg/m²), combined with another chemotherapeutic agent such as Gemcitabine (1000?mg/m²) or Vinorelbine (25?mg/m²), was intravenously given to the patients on a basis of twenty-one days as one treatment cycle. All the patients were followed until August 2017. The endpoint of this study was progression-free survival (PFS), overall survival (OS), and estimated objective response rate (RR). Safety and drug tolerability data were also obtained. Lobaplatin-based regimens prolonged PFS compared to cisplatin-based regimens (median 13.2 vs 4.7?months, hazard ratio?=?0.37, 95% confidence intervals: 0.21–0.67, P?=?.0007), while OS was not significantly different between the two groups (hazard ratio?=?0.72, 95% confidence intervals: 0.40–1.30, P?=?.2767), as was objective RR (37.8% vs 33.4%, $x^2$ = 0.19, P?=?.6653). Nausea/vomiting and renal injury were more frequent with cisplatin-based regimens. Our results show that lobaplatin-based regimens are superior to cisplatin in terms of efficacy and are better tolerated.     

乳腺癌细胞EGFR表达水平与长春瑞滨敏感度的相关性研究

乳腺癌是较早开始个体化治疗的肿瘤之一。表皮细胞生长因子受体（epidermalgrowthfactorreceptor,EGFR）6~表达与乳腺癌组织学分期、生长速度呈正相关,可作为乳腺癌患者预后的指标之一。临床上,长春瑞滨（Vinorelbine,NVB）~要作为耐药性晚期乳腺癌的挽救性化疗药物,单药治疗亦具有一定疗效。该研究结果发现,乳腺癌组织EGFR表达与NVB的敏感性相关（P=0．001）,而与紫杉醇、阿霉素及5．氟尿嘧啶无相关性。EGFRFH性乳腺癌细胞MDA-MB-435s对NVB耐药,而EGFR阳性细胞MCF-7则敏感．但是EGFR中和性抗体会降低敏感性。进一步研究发现,NVB会引起MCF-7表面EGFI滚达上调,以及胞内ERK1／2激酶的磷酸化,且这一效应会被抗EGFR抗体部分抑制。研究结果表明,乳腺癌细胞对NVB的敏感性与膜表面EGFR表达水平相关,提示EGFR可作为NVB治疗敏感性的预测分子。     

长春瑞滨联合顺铂治疗三阴性乳腺癌的临床观察

目的：观察长春瑞滨联合顺铂治疗三阴性乳腺癌临床疗效。方法：选择我院2007年5月～2011年8月期间收治经细胞学或病理学诊断并确诊TNBC患者85例,术后免疫学化疗证实ER、PR、HER-2均呈阴性,随机分组入试,长春瑞滨联合顺铂（NP组）45例,第1、8天予以静脉滴注长春瑞滨25 mg/m2,前3天辅以顺铂25 mg/m2滴注,21天为1个周期,治疗2个周期后观察临床疗效;紫杉醇联合顺铂（TP组）40例,第1天小剂量滴注紫杉醇135～175 mg/m2,,顺铂用量、用法及用药周期同上所示。对比观察病症缓释情况和毒副作用。结果：NP组总有效率（RR）48.89%,控制率（PD）为77.78%,TP组总有效率（RR）为37.50%,控制率（PD）55.56%,两组间有效率及控制率比较差异有统计学意义（P〈0.05）。两组常见毒副反应为骨髓抑制、消化道和胃肠道反应。NP组消化道反应和骨髓抑制微重于TP组,两组间比较有显著差异（P〈0.05）。结论：长春瑞滨联合顺铂（NP）新辅助化疗方案针对三阴性乳腺癌患者耐受性好、毒副反应较小、有效率高、不良反应可逆等优势,可作为临床推广药物。     

不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫功能的影响

目的:探讨不同化疗方案对晚期非小细胞肺癌患者骨髓抑制及免疫功能的影响。方法:选取2011年1月至2013年12月收治的130例晚期非小细胞肺癌患者,按照知情同意原则随机分为三组:NP(长春瑞滨+顺铂)组45例、GP(吉西他滨+顺铂)组43例、TP(紫杉醇+顺铂)组42例,分别于化疗前及化疗2个周期后检测患者的骨髓抑制及免疫水平。结果:三种化疗方案进行治疗后骨髓抑制水平由高到低排列为GP组、TP组、NP组,差异有统计学意义(P0.05);GP组血小板减少发生率高于其他两组,TP组白细胞下降发生率高于其他两组,差异有统计学意义(P0.05);三组患者化疗后的免疫功能指标均较化疗前低,差异有统计学意义(P0.05)。三种化疗方案进行治疗后免疫功能抑制水平由高到低排列为GP组、TP组、NP组,差异有统计学意义(P0.05)。结论:GP组患者血小板下降更明显,TP组白细胞下降更为明显,NP组对骨髓抑制及免疫功能抑制较缓和,更适于老年人,因此临床选择化疗方案时要综合考虑患者骨髓状况、免疫功能情况及年龄等。     

Aspirin boosts the synergistic effect of EGFR/p53 inhibitors on lung cancer cells by regulating AKT/mTOR and p53 pathways

The regimen of afatinib and vinorelbine has been used to treat breast or lung cancer cells with some limitations. Aspirin alone or in combination with other agents has shown unique efficacy in the treatment of cancer. We designed a preclinical study to investigate whether the triple therapy of aspirin, afatinib, and vinorelbine could synergistically inhibit the growth of p53 wild-type nonsmall cell lung cancer (NSCLC) cells. Three NSCLC cells A549, H460, and H1975 were selected to study the effect of triple therapy on cell proliferation and apoptosis. Compared to single agents, triple therapy synergistically inhibited the proliferation of lung cancer cells with combination index <1. Meanwhile, the therapeutic index of triple therapy was superior to that of single agents, indicating a balance between efficacy and safety in the combination of three agents. Mechanistic studies showed that triple therapy significantly induced apoptosis by decreasing mitochondrial membrane potential, increasing reactive oxygen species, and regulating mitochondria-related proteins. Moreover, epidermal growth factor receptor (EGFR) downstream signaling proteins including JNK, AKT, and mTOR were dramatically suppressed and p53 was substantially increased after NSCLC cells were exposed to the triple therapy. We provided evidence that the triple therapy of aspirin, afatinib and vinorelbine synergistically inhibited lung cancer cell growth through inactivation of the EGFR/AKT/mTOR pathway and accumulation of p53, providing a new treatment strategy for patients with p53 wild-type NSCLC.     

不同pH值与电位耦合对牛血清白蛋白包被酒石酸长春瑞滨纳米粒制备工艺的影响

在反溶剂法制备纳米粒过程中,pH值在一定程度上会对其产生影响。本文通过在不同酸碱环境下运用反溶剂法制备牛血清白蛋白包被酒石酸长春瑞滨纳米粒,进而借助于电位耦合作用来研究纳米粒制备工艺。研究结果表明:当pH=4.5至7.5时,酒石酸长春瑞滨和牛血清白蛋白带有异种电荷,而当pH=2.5,3.5,8.5,9.5时它们均带有同种电荷。当pH=7.5时,牛血清白蛋白带有负电荷即-8.52 mV,酒石酸长春瑞滨带有正电荷即+4.48mV。此时得到牛血清白蛋白包被酒石酸长春瑞滨纳米粒粒径为193.3 nm,Zeta电位为-30.86 mV,而且在该pH下对纳米粒制备工艺进行了优化,最终它的载药量和包封率达到了45.6%和90.6%。     

In vitro inhibition of murine hematopoietic progenitors and stromal cells by vinorelbine

Hematopoietic progenitor colony assays were used to establish the effects of the vinca alkaloid vinorelbine (VRB) on murine bone marrow. The in vitro growth of colony-forming units–granulocyte/macrophage (CFU-GM), burst forming units–erythroid (BFU-E) and colony-forming units–mix (CFU-mix) was dose-dependently inhibited by VRB. The highest dose assayed (0.02 μg/ml) suppressed all of the different progenitor cells by 100%. A comparison of the dose–response curves showed that CFU-GM, BFU-E, and CFU-mix exhibited similar patterns of sensitivity to the cytotoxic action of VRB. Long-term bone marrow cultures have provided a valuable in vitro model for studying the role of the microenvironment of bone marrow. Cellularity of stromal layers was reduced with increasing doses of VRB. The appearence of these layers was altered minimally with the lowest dose used; a gradual loss of cellularity was seen in cultures exposed to 0.05 and 0.075 μg/ml; and a marked loss at the dose of 0.1 μg/ml. Our results show that VRB has an important effect on hematopoietic progenitors at the highest dose tested, while the stromal cells were not affected at a similar dose (0.025 μg/ml), suggesting that the stroma is more resistant to this drug. This revised version was published online in July 2006 with corrections to the Cover Date.