Search

Pancreatic ductal adenocarcinoma (PDAC) is one of the leading causes of cancer-related mortality worldwide, but current clinical methods lack effective screening and treatment options. Despite the widespread use of gemcitabine as a first-line chemotherapeutic agent in the treatment of PDAC over the past decade, its efficacy is limited by the development of drug resistance, which significantly shortens patient survival. This review systematically elucidates the critical role of the tumor microenvironment in the development of gemcitabine resistance of PDAC cells, highlighting the contributions of the extracellular matrix barrier, hypoxia-induced adaptive changes in cancer cells, and the formation of an immunosuppressive microenvironment as key factors in gemcitabine resistance. Additionally, we also introduce novel strategies for reversing chemoresistance, including advanced drug delivery systems, and provide a comprehensive overview of the current opportunities and challenges. [ABSTRACT FROM AUTHOR]

Background and purpose: Amplification of the urokinase plasminogen activator receptor (uPAR) gene is closely associated with poor prognosis in pancreatic cancer patients. uPAR regulates epithelial-mesenchymal transition (EMT) and chemoresistance in pancreatic cancer cells through the mitogen-activated protein kinases (MAPK) signaling pathway, though the specific mechanisms remain unclear. This study aimed to investigate the mechanism by which uPAR promotes proliferation, invasion, and chemoresistance of pancreatic cancer cells by inhibiting autophagy. Methods: Pancreatic cancer tissue samples were collected from patients who underwent surgical resection and biopsy at the Changsha Central Hospital, Affiliated to University of South China (Changsha Central Hospital), between December 2021 and Jun 2022. The study was approved by the Ethics Committee of Changsha Central Hospital (Approval No.: 2021-S0182, 2022-S0084). Patient-derived organoids (PDOs) from pancreatic cancer samples were cultured in vitro. Six pancreatic cancer cell lines (AsPC-1, PANC-1, CAPAN-1, CAPAN-2, MIA PaCa-2 and PaTu8988T) were used in this study. uPAR-deficient models were constructed using clustered regularly interspaced short palindromic repeats (CRISPR) Cas9 technology. Cell proliferation and invasion abilities were measured using confocal microscopy, Western blot, enzyme-linked immunosorbent assay (ELISA), and MTS assays. Changes in MAPK and autophagy signaling pathways and gemcitabine-induced cell death were analyzed. The synergistic effects of combined treatments were evaluated using gene silencing (siRNA) or autophagy inhibitors. Results: In AsPC-1 cells, uPAR knockout significantly reduced the proliferation and migration abilities of clone cells compared to wild-type cells, as shown by MTS assays and wound healing experiments, and decreased sensitivity to gemcitabine (P

Objective To investigate the in vitro effect of lncRNA UCA1 on gemcitabine (GEM) resistance of bladder cancer cell line T24 and its related molecular mechanism. Methods The mRNA expression of UCA1 in T24 cells and in T24/GEM cells was detected by RT-qPCR. The T24/GEM cells were incubated with varying concentrations (0.1, 1, and 10 μmol/L) of GEM for 48 hrs. LC3 staining microscopy was employed to visualize autophagic puncta, while the expression of autophagy-related proteins was assessed by Western blot. UCA1-shRNA and UCA1-shRNA+ pcDNA-Bcl-2 were transferred into T24/GEM cells, the sensitivity of cells to GEM was evaluated by MTT method and flow cytometry; the expressions of p53 and Bcl-2 were detected by Western blot. Results The expression level of UCA1 in T24/GEM cells was significantly higher than that of parental T24 cells (P＜0.05). The concentration of GEM in the range of 0-10 μmol/L significantly induced dose-dependent autophagy in T24/GEM cells (P＜0.05). Knockdown of UCA1 enhanced the sensitivity of T24/GEM cells to GEM (P＜0.05), while reducing autophagy (P＜0.05) and down-regulating the expression of p53 and Bcl-2(P＜0.05). Over-expression of Bcl-2 partially reversed the GEM sensitization and autophagy inhibition of UCA1-shRNA in T24/GEM cells (P＜0.05). Conclusions Knockdown of lncRNA UCA1 reduces GEM resistance of T24/GEM cells by inhibiting Bcl-2 mediated autophagy.

Objective To investigate the in vitro effect of IncRNA UCA1 on gemcitabine (GEM) resistance of bladder cancer cell line T24 and its related molecular mechanism. Methods The mRNA expression of UCA1 in T24 cells and in T24/GEM cells was detected by RT-qPCR. The T24/GEM cells were incubated with varying concentrations (0.1, 1, and 10 µmol/L) of GEM for 48 hrs. LC3 staining microscopy was employed to visualize autophagic puncta, while the expression of autophagy-related proteins was assessed by Western blot. UCA1-shRNA and UCA1shRNA+ pcDNA-Bcl-2 were transferred into T24/GEM cells, the sensitivity of cells to GEM was evaluated by MTT method and flow cytometry; the expressions of p53 and Bcl-2 were detected by Western blot. Results The expression level of UCA1 in T24/GEM cells was significantly higher than that of parental T24 cells (P < 0.05) . The concentration of GEM in the range of 0-10 µmol/L significantly induced dose-dependent autophagy in T24/GEM cells (P < 0.05) . Knockdown of UCA1 enhanced the sensitivity of T24/GEM cells to GEM (P < 0.05), while reducing autophagy (P < 0.05) and down-regulating the expression of p53 and Bcl-2( P < 0.05 ) . Over-expression of Bcl-2 partially reversed the GEM sensitization and autophagy inhibition of UCA1-shRNA in T24/GEM cells (P < 0.05) . Conclusions Knockdown of IncRNA UCA1 reduces GEM resistance of T24/GEM cells by inhibiting Bcl-2 mediated autophagy. [ABSTRACT FROM AUTHOR]

objective: To investigate the effects of shenmai injection combined with gemcitabine and cisplatin on tumor markers, T lymphocyte subsets and serum apoptotic molecules in patients with advanced non-small cell lung cancer (NSCLC). Results: 118 patients with advanced NSCLC who were admitted to our hospital from March 2020 to December 2022 were divided into combined group (n=59, treated with shenmai injection combined with gemcitabine and cisplatin) and control group (n=59, treated with gemcitabine and cisplatin ) by random number table method. The tumor marker level, T lymphocyte subsets and apoptotic molecules were compared between two groups. Compared with control group, cytokeratin 19 fragment (CYFRA21-1), carcinoembryonic antigen (CEA), sqamous cell carcinoma antigen (SCC), carbohydrate antigen 125 (CA125), B-cell lymphoma (Bcl-2), Survivin (Survivin), CD8+ were lower in combined group after treatment, and Bcl-2-related X protein (Bax) and CD3+, CD4+, CD4+ /CD8+ were higher (P<0.05). Conclusion: Shenmai injection combined with gemcitabine and cisplatin for the treatment of advanced NSCLC Patients, which can reduce tumor markers level, reduce the immunosuppression of patients, regulate serum apoptotic molecules level. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Cancer Biotherapy is the property of Editorial Office of Chinese Journal of Cancer Biotherapy and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective This study collected a real-world data on survival and efficacy of gemcitabine-containing therapy in advanced breast cancer. Aimed to find the main reasons of affecting the duration of gemcitabine-base therapy in advanced breast cancer patients. Methods Advanced breast cancer patients who received gemcitabine-base therapy from January 2017 to January 2019 were enrolled(10 hospitals). The clinicopathological data, the number of chemotherapy cycles and the reasons for treatment termination were collected and analyzed. To identify the reasons related with continuous treatment for advanced breast cancer and the factors which affect the survival and efficacy. Results A total of 224 patients with advanced breast cancer were enrolled in this study, with a median age of 52 years (26-77 years), 55.4%(124/224) was postmenopausal. Luminal type were 83 cases, TNBC were 97 cases, and human epidermal growth factor receptor 2 (HER's-2) overexpression were 44. At the analysis, 224 patients who received the gemcitabine-based regimens were evaluated, included 5 complete reponse (CR), 77 partial response (PR), 112 stable disease (SD) and 27 progressive disease (PD). The objective response rate (ORR) was 36.6%(82/224). Seventy patients had serious adverse diseases, including leukopenia (9), neutrophilia (49), thrombocytopenia (15), and elevated transaminase (2). The median follow-up time was 41 months (26~61 months), and the median PFS was 5.6 months. The reasons of termination treatment were listed: disease progression were 90 patients; personal reasons were 51 patients; adverse drug reactions were 18 patients; completed treatment were 65 patients. It was found that progression-free survival (PFS) was significantly longer in patients receiving ＞6 cycles than that in patients with ≤6 cycles (8.2 months vs 5.4 months, HR=2.474, 95% CI: 1.730-3.538, P＜ 0.001). Conclusions Gemcitabine-based regimen is generally well tolerated in the Chinese population and has relatively ideal clinical efficacy in the real world. The median PFS is significantly prolonged when the number of treatment cycles are appropriately increased. [ABSTRACT FROM AUTHOR]

Objective: To discuss the effects of genomic instability and MYC gene mutation of non-small cell lung cancer (NSCLC) A549 cells on the resistance of gemcitabine, and to clarify the mechanism. Methods : The A549 cells were continuously treated with 2 mg·L-1 of gemcitabine (A549 group) to establish the resistant cell line A549R (A549R group), and si-NC and si-MYC were transfected into the A549R cells to regarded as si-NC A549R group and si-MYC A549R group, respectively. CCK-8 assay was used to detect the inhibitory rates of the cells in various groups after treated with various concentrations of gemcitabine (0, 1, 2, 4, 8, 16, and 32 mg·L-1)；flow cytometry was used to detect the apoptotic rates of the cells in various groups; transcriptome sequencing technology (RNA-seq) and Kyoto Encyclopedia of Genes and Genomes (KEGG) signaling pathway enrichment analysis were used to identify the differentially expressed genes in the A549 and A549R cells; real-time fluorescence quantitative PCR (RT-qPCR) method was used to detect the expression levels of muts homology 2 (MSH2), muts homology 6 (MSH6), and recombinant DNA repair protein RAD50 (RAD50) in the A549 and A549R cells; Western blotting method was used to detect the expression levels of genome instability-related proteins MYC protooncogene (MYC) and phosphorylated H2AX (γH2AX) in the cells in various groups; chromatin immunoprecipitation (ChIP) was used to detect the enrichment of RNA pol Ⅱ and γH2AX on the MYC gene; PCR method was used to amplify and detect the mutations in MYC gene in the A549R cells. Results: Compared with A549 group, the inhibitory rates of the A549R cells in A549R group treated with 2, 4, 8, 16, and 32 mg·L-1 gemcitabine were decreased, and the apoptotic rate of the cells after treated with 8 mg·L-1 gemcitabine was decreased (P<0. 05). Compared with A549 group, a total of 234 mRNAs in the cells in A549R group were upregulated and 205 mRNAs in the cells were downregulated, and the expression levels of mismatch repair-related genes (MSH2 and MSH6), RAD50, and MYC were significantly increased (P<0. 05). The KEGG signaling pathway enrichment analysis showed that the upregulated genes were mainly involved in non-homologous end-joining, mRNA surveillance pathway, and DNA replication signaling pathways. Compared with A549 group, the expression levels of MYC and γH2AX proteins in the cells in A549R group were increased (P<0. 05). The ChIP assay results showed that the enrichment of RNA pol Ⅱ and γH2AX at the MYC transcription start site and exon 2, with a G254A mutation identified in MYC exon 2 was increased. Compared with si-NC A549R group, the expression levels of MYC mRNA and protein in the cells in si-MYC A549R group were decreased (P< 0. 05), the inhibitory rates of the cells after treated with 2, 4, 8, 16, and 32 mg·L-1 gemcitabine were increased (P<0. 05), and the apoptotic rates were increased (P<0. 05). Conclusion: The genome instability of the A549R NSCLC cells resistant to gemcitabine is increased, and the mutations and amplification occur in the MYC gene. Knockdown of MYC can restore the sensitivity of A549R cells to gemcitabine. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of traditional AG regimen [gemcitabine （1 000 mg/m, d1, d8） + albumin-bound paclitaxel（125 mg/m, d1, d8）, 21 days as a cycle] and other gemcitabine-based regimen [gemcitabine alone or combined with S-1（tegafur, gimeracil and oteracil potassium）/oxaliplatin/arotinib] in the treatment of advanced and metastatic pancreatic cancer. Methods From January 2017 to January 2022, 64 patients with advanced and metastatic pancreatic cancer were retrospectively collected from Sir Run Run Hospital of Nanjing Medical University. There were 33 patients received traditional AG therapy and 31 patients received chemotherapy mainly with gemcitabine. Survival analysis was conducted based on follow-up data, with the study endpoints being overall survival (OS） and progression free survival （PFS）, and the secondary study endpoint being the incidence of grade 3/4 adverse reactions. Results The median OS of the AG regimen group and the gemcitabine group were 12.2 months and 7.9 months, respectively, and there was no significant difference between two groups （χ=1.517, P=0.218）. The median PFS of the AG regimen group and the gemcitabine group was 7.0 months and 3.3 months, respectively（χ=8.683, P=0.003）. There was no significant difference in the incidence of grade 3/4 adverse events between the two groups of patients（P＞0.05）. Conclusion The first-line treatment of albumin-bound paclitaxel combined with gemcitabine in patients with advanced pancreatic cancer has significant clinical effects, which significantly controls the disease progress and extends the PFS of patients.

Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a highly malignant hematological tumor derived from the precursor cells of plasmacytoid dendritic cells. BPDCN that primarily originates in the nasal cavity is clinically rare and easily misdiagnosed or missed. At present, there is no standard treatment for BPDCN in China and abroad. This article reported a female patient with BPDCN primarily in the nasal cavity. The regimen of Azacitidine combined with GemOx had a good clinical effect on this patient and significantly controlled the condition and improved the clinical symptoms. This article analyzed and discussed the clinical diagnosis and treatment of this patient, aiming to improve clinicians' understanding of rare BPDCN.

OBJECTIVE: To probe into the efficacy of internal iliac artery transcatheter arterial chemoembolization (TACE) with gemcitabine combined with cisplatin (GP) and gemcitabine combined with lobaplatin (GL) in the treatment of muscle invasive bladder urothelial carcinoma. METHODS: A total of 104 patients with invasive bladder urothelial carcinoma admitted into the hospital from Jan. 2019 to Jan. 2021 were extracted to be divided into the observation group and the control group via the random number table. Two groups were treated with TACE, 52 patients in the control group were treated with GP regimen, and 52 patients in the observation group received GL regimen. The clinical efficacy and adverse drug reactions, tumor markers, inflammatory response and immune function before and after treatment were compared between two groups. RESULTS: The disease control rate of the observation group was 71. 15% (37 / 52), higher than 51. 92% (27 / 52) of the control group, with statistically significant differences (P< 0. 05). After treatment, the serum levels of CA125 and CEA in the observation group were lower than those in the control group, the serum levels of interleukin(IL)6, IL-1β and TNF-α were lower than those of the control group, and CD3+, CD4+ and CD4+ / CD8+ were higher than those of the control group, the differences were statistically significant (P<0. 05). The incidences of bone marrow suppression, leukopenia, nausea and vomiting in the observation group were respectively 11. 54% ( 6 / 52), 38. 46% ( 20 / 52) and 26. 92% ( 14 / 52), lower than 26. 92% ( 14 / 52), 59. 62% (31 / 52) and 48. 08% (25 / 52) in the control group, the differences were statistically significant (P<0. 05). CONCLUSIONS: GL regimen TACE treatment can improve the level of tumor markers in patients with invasive bladder urothelial carcinoma, alleviate inflammatory response, regulate immune function and reduce adverse drug reactions with definite clinical efficacy. [ABSTRACT FROM AUTHOR]

An increasing number of studies suggested that the tumor microenvironment exerts a substantial influence on the pathophysiology of pancreatic cancer. As a crucial component of the tumor microenvironment,the tumor stroma plays a pivotal role in the occurrence,development,and chemotherapy resistance of pancreatic cancer. By serving as a proxy for the interaction between tumor cells and the microenvironment,the tumor stroma ratio(TSR) has emerged as a focal point of investigation in recent years. At present,numerous studies show that a low TSR is a protective factor for the prognosis of resectable pancreatic cancer. Additionally, patients with a low TSR are more suitable for the gemcitabine and albumin-bound paclitaxel chemotherapy regimen. But these researches are not conclusive, and there is still a gap between guiding precision treatment. Further research and exploration are required. Integration of artificial intelligence deep learning models into traditional pathological and imaging assessments facilitates precise evaluation of the TSR. It can also enable stratification and precision treatment of pancreatic cancer patients based on this index.

Objective To compare the adverse effects and prognosis of locally advanced nasopharyngeal carcinoma (LANC) patients between the gemcitabine combined platinum (GP) regimen and other platinum-containing chemotherapy regimens by meta-analysis. Methods We searched relevant databases and included the studies about comparing GP and other chemotherapy regimens in the treatment of LANC. Methodological quality was assessed for each included study. Statistical analysis was carried out using RevMan5.3 and Stata15 software. Results The patients on GP regimen had a lower incidence of severe leukopenia and severe gastrointestinal reaction but a higher incidence of severe thrombocytopenia and hepatoxicity than those on other regimens (P < 0.05). The patients on GP regimen had a higher distant metastasis-free survival (P=0.004). Conclusion GP regimen can be used as a safe, alternative and economical induction chemotherapy regimen for locally advanced nasopharyngeal carcinoma.

Objective To investigate the effect of quercetin on epithelial-mesenchymal transdifferentiation (EMT) of non-small cell lung cancer (NSCLC) and its molecular mechanism in improving gemcitabine (Gb) resistance from the perspective of microRNA-101 (miR-101)/Zeste gene homologous protein 2 (EZH2) axis. Methods A549 and A549/Gb cells were cultured with different concentrations of quercetin, and CCK-8 method was used to screen suitable quercetin concentration for the follow-up test. A549 cells were divided into the blank group, the A549 + EMT inducer group, the A549+ quercetin group and the quercetin + EMT inducer group. A549 cells and A549/Gb were divided into the A549 group, the A549/Gb group, the A549/Gb + quercetin group, the A549/Gb + EMT inducer group, the miR-101-inhibitor group, the quercetin+miR-101-inhibitor group and the miR-NC group. Real-time fluorescence quantitative PCR (qPCR) was used to detect the expression level of miR-101 in each group. The expression of EZH2, transforming growth factor (TGF) - β1/ drosophila, mother DPP homolog 4 (SMAD4), p-SMAD4, and EMT marker proteins E-cadherin, N-cadherin and Vimentin were detected by Western blot assay. The optical density (OD) of each group was measured by CCK-8 method, and IC50 and IR were calculated. Results The IC50 of quercetin for A549 and A549/Gb were 64 and 128 µmol/L, respectively. After EMT inducer enhanced the EMT characteristics of A549 cells (the expression levels of N-cadherin and Vimentin were increased, the expression of E-cadherin was decreased), the expression of miR-101 was decreased, EZH2, TGF-β1 and p)SMAD4/SMAD4 protein expression, IC50 and IR increased (P＜0.05). Quercetin could inhibit the EMT characteristics of A549 cells, reduce IC50 and IR, up-regulate miR-101, inhibit EZH2, TGF-β1 and p-SMAD4/SMAD4 protein expression (P＜0.05). EMT inducers could reverse the above effects of quercetin (P＜0.05). Compared with A549 cells, the EMT characteristics increased in A549/Gb cells, and IC50, IR, EZH2, TGF- β1 and p-SMAD4/SMAD4 expressions were all increased (P＜0.05). The inhibition of miR-101 or treatment with EMT inducer could further increase the EMT characteristics, IC50, IR, EZH2, TGF-β1 and p-SMAD4/SMAD4 protein expression of A549/Gb cells (P＜0.05). Quercetin could inhibit the EMT process of A549/Gb cells and reduce its IC50, IR and EZH2, TGF-β1 and p-SMAD4/SMAD4 protein expression (P＜0.05). The inhibition of miR-101 expression could reverse the above effects of quercetin (P＜0.05). Conclusion Quercetin can up-regulate miR-101 and inhibit EZH2 expression, thereby inhibiting EMT process and reducing NSCLC cell drug resistance. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and safety of hepatic arterial infusion chemotherapy (HAIC) combined with lenvatinib and tislelizumab in the treatment of unresectable intrahepatic cholangiocarcinoma (ICC). Methods: The clinical data of 12 patients with unresectable ICC who received HAIC combined with lenvatinib and tislelizumab in the First Affliated Hospital of Soochow University from October 2021 to April 2023 were retrospectively analyzed. HAIC included gemcitabine plus oxaliplatin; this regimen was combined with lenvatinib and tislelizumab within 3-7 days after its initial administration. Relevant laboratory examinations were performed before each cycle of HAIC, and enhanced computed tomography/magnetic resonance imaging examinations were performed every 6-9 weeks. Tumor response to treatment was evaluated using the modified Response Evaluation Criteria in Solid Tumors. The objective response rate, disease control rate, progression-free survival, overall survival, and treatment-related adverse reactions of patients with ICC were statistically analyzed. Results: The objective response rate to HAIC combined with lenvatinib and tislelizumab was 6/12; the disease control rate was 8/12; the median progression-free survival was 11.8 months; and the median overall survival was 14.2 months. Three patients had grade Ⅳ adverse reactions (increased alanine aminotransferase and aspartate aminotransferase thrombocytopenia), while three patients had grade Ⅲ adverse reactions (increased total bilirubin, alanine aminotransferase, and aspartate aminotransferase). The remaining patients had grade Ⅰ-Ⅱ adverse reactions. There were no serious complications related to interventional surgery. Conclusions: Use of HAIC (gemcitabine plus oxaliplatin) combined with lenvatinib and tislelizumab in the treatment of unresectable ICC may be safe and feasible. Preliminary clinical studies have shown that this combination can improve the survival and prognosis of patients with ICC.

In the past two decades, significant advances have been made in the treatment of pancreatic cancer.Numerous first-line treatments, such as gemcitabine combined with erlotinib, gemcitabine combined with albumin-bound paclitaxel, FOLFIRINOX, and NALIRIFOX, have emerged;surgery-centered treatment has gradually become the mains clinical strategy.However, behind these achievements, the new drugs developed with substantial funding have not extended the median survival time of patients with advanced pancreatic cancer to more than one year; the 5-year survival rate for postoperative patients remains below 30%. While harboring hope and being proactive, researchers must also soberly reflect and continually reassess our direction, in anticipation of bringing tangible clinical benefits to pancreatic cancer patients at an early date.

Objective: To compare the clinical efficacy of gemcitabine and epirubicin intravesical chemotherapy in patients with non muscle invasive bladder cancer (NMIBC) after transurethral resection of bladder tumor (TURBT) and analyze the risk factors for recurrence. Methods:120 patients with NMIBC who were received in Lianyungang Hospital Affiliated to Xuzhou Medical University from January 2018 to January 2020 were included and all received TURBT treatment. According to the different ways of chemotherapy, 120 patients with NMIBC were divided into epirubicin group (n=58, epirubicin treatment) and gemcitabine group (n=62, gemcitabine treatment). The changes of immune function and tumor markers in epirubicin group and gemcitabine group were compared, and the incidence of adverse reactions and 1-year recurrence were observed. Multivariate logistic regression was used to analyze the risk factors of recurrence in patients with NMIBC after TURBT. Results: After treatment, the levels of CD3+, CD4+, CD4+ /CD8+ in epirubicin group and gemcitabine group were increased, and the gemcitabine group were higher than those in epirubicin group (P<0.05). CD8+ decreased, and gemcitabine group was lower than epirubicin group (P<0.05). After treatment, carcinoembryonic antigen (CEA), cytokeratin 19 (CK19) and cancer antigen 199 (CA199) in epirubicin group and gemcitabine group decreased, and gemcitabine group was lower than that in epirubicin group (P<0.05). There was no significant difference in the incidence of adverse reactions between epirubicin group and gemcitabine group (P>0.05). There was no significant difference in the 1-year recurrence rate between epirubicin group and gemcitabine group (P>0.05). 28 patients in epirubicin group and gemcitabine group who recurred after one year were included in the recurrence group, and the other 92 patients who did not recur were included in the non recurrence group. Univariate analysis showed that the recurrence of NMIBC patients after TURBT was related to the number of tumors, maximum tumor diameter, tumor differentiation grade and clinical stage (P<0.05). Multivariate logistic regression analysis showed that the number of tumors was multiple, the maximum tumor diameter 逸5 cm, the tumor differentiation grade was poorly differentiated, and the clinical stage was T1 stage, which were the risk factors of recurrence in patients with NMIBC after TURBT (P<0.05). Conclusion: Compared with epirubicin chemotherapy, gemcitabine chemotherapy can better control the progression of tumor diseases and effectively protect the immune function. The safety and recurrence rate of the two chemotherapy drugs are similar. At the same time, the study also observed that recurrence was affected by many factors, including tumor number, maximum tumor diameter, tumor differentiation and grade, and clinical stage. [ABSTRACT FROM AUTHOR]

Objective To assess the therapeutic efficacy and safety of the gemcitabine combined with nedaplatin (GN) chemotherapy for metastatic human epidermal growth factor receptor-2 (HER-2) negative breast cancer patients. Methods Forty-five patients with HER-2 negative recurrent metastatic breast cancer who had received prior adjuvant or neoadjuvant therapy with anthracycline and/or taxanes were enrolled. All the patients received GN regime from January 2014 to February 2019. The therapeutic efficacy was evaluated according to response evaluation criteria in solid tumors (RECIST) 1.1. The adverse response was evaluated and monitored according to common terminology criteria for adverse events (CTCAE). The progression-free survival (PFS) and overall survival (OS) and prognostic factors were also analyzed. Results All of the 45 patients received 4 course GN, 1 of them achieved complete response, 21 achieved partial response. The objective response rate was 48.9 (95% CI: 33.7%-64. 1%). Grade 3-4 hematological toxicities include leukopenia occurred in 10 (22.2%) of patients, neutropenia in 13 (28.9%) patients, and thrombocytopenia in 8 (17.6%) patients. The grade 3-4 hematological toxicities mainly manifested as nausea and vomiting, and the incidence was 4.4% (2/45). Among the 45 patients, 34 died, the median PFS was 5.1 (95% CI: 3.9-6.1) months and the median OS was 17.6 (95% CI: 13.1-20.9) months. Conclusion The combination of gemcitabine and nedaplatin is an effective and tolerable treatment for metastatic breast cancer patients previously treated with anthracyclines and/or taxanes. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical outcomes of neoadjuvant versus adjuvant chemotherapy on muscle-invasive bladder cancer patients. Methods We retrospectively reviewed the muscle-invasive bladder cancer patients who were treated with radical cystectomy plus neoadjuvant or adjuvant chemotherapy from 2009 to 2016 in Hubei Cancer Hospital. The primary endpoint was recurrence-free survival (RFS). The secondary endpoint was clinical complete response (CR). Results A total of 38 muscle-invasive bladder cancer patients were included: 22 patients received neoadjuvant chemotherapy and 16 patients received adjuvant chemotherapy. The RFS at median follow-up time was not significantly different between neoadjuvant and adjuvant groups (69.6% vs. 75.4%, P=0.223). The RFS at median follow-up time between maid patients with pT0 and non-pT0 were significantly different (100% vs. 50%, P=0.012). The incidence rates of grade 3 or 4 thrombocytopenia, anemia and neutropenia were not significantly different between the two groups (P=0.36). Conclusion There is no significant difference in RFS between neoadjuvant and adjuvant chemotherapy for muscle-invasive bladder cancer patients treated with radical cystectomy. No recurrence occurs in the patients who achieve pT0 in neoadjuvant chemotherapy group. Further investigations are needed to confirm our results.

Objective To analyze the effectiveness of neoadjuvant and adjuvant bladder intracavitary hyperthermic perfusion chemotherapy (BHPC) on high-risk non-muscle-invasive bladder cancer (NMIBC) patients. Methods We included 40 patients with high-risk NMIBC who received BHPC treatment with a "BR-TRG-Ⅱ type high-precision hyperthermic intraperitoneal perfusion treatment system" before or after transurethral resection of the bladder tumor(TURBT). Among these patients, 16 patients received neoadjuvant BHPC treatment (gemcitabine 1000 mg three instillations every other day, 45℃, 45min) before TURBT (neoadjuvant group) and 24 patients received adjuvant BHPC treatment (gemcitabine 1000 mg three instillations every other day, 45℃, 45min) after TURBT (adjuvant group). Disease recurrence free survivals (RFS) and adverse effects were evaluated between both groups. Results A total of 40 patients completed three times of gemcitabine therapy. In neoadjuvant group, 11 patients (68.8%) showed a complete response (pT0) and 5 patients (32.2%) showed a partial response. The median RFS was 54 months. In adjuvant group, the median RFS was 45 months. The difference of survival rate between them was not statistically significant (P=0.3146). The incidence and severity of side effects were mild in both two groups. Conclusion BHPC on high-risk NMIBC patients using a "BR-TRG-Ⅱ type high-precision hyperthermic intraperitoneal perfusion treatment system" is safe and effective in both neoadjuvant and adjuvant settings.

Objective To investigate the efficacy of gemcitabine plus S-1 on refractory nasopharyngeal carcinoma patients, and to detect the changes of T lymphocyte subsets in the peripheral blood before and after chemotherapy. Methods Forty-two refractory nasopharyngeal carcinoma patients received gemcitabine (1.0 g/m2 on day 1 and day 8) plus oral S-1 chemotherapy (40mg/m2 twice daily, d1-14). Each cycle was repeated every 21 days, two cycles at least for each patient. The peripheral blood samples were collected before and after chemotherapy respectively, then T lymphocyte subsets were analyzed by flow cytometry. Survival analysis included univariate model and multivariate Cox regression model. Results Forty-two patients had completed chemotherapy and follow-up. There was one case of complete response, 21 cases of partial responses, 12 cases of stable disease, 8 cases of progressive disease, the overall response rate was 52.4%(22/42), and the disease control rate was 81.0%(34/42). Median time to progression was 6.8 months and median survival was 14.6 months. The common adverse effects were myelosuppression, gastrointestinal tract reaction, rash and fatigue; no death occurred in relation to the therapy. Compared with PD group, the percentages of CD3+, CD3+CD4+ and CD4+/CD8+ ratios were increased significantly in the response group after chemotherapy. Liver metastasis was an independent prognostic factor for overall survival. Conclusion Gemcitabine plus S-1 are an effective therapy with tolerable toxicity profile for refractory NPC patients. Liver metastasis is an independent prognostic factor for overall survival. Effective chemotherapy influences T lymphocyte subsets obviously.

Objective To investigate the effects of metformin combined with gemcitabine on the proliferation，migra⁃ tion，and epithelial-mesenchymal transition（EMT）of pancreatic cancer cells. Methods The pancreatic cancer PANC-1 cells were selected and subcultured. The cell proliferation activity was measured by MTT assay when the final metformin concentrations were 0，5，10，20，40 mmol/L or the final gemcitabine concentrations were 0，0. 1，0. 2，0. 4，0. 8 μmol/L， and the follow-up experiments were carried out with the concentrations of metformin and gemcitabine that could reduce the cell proliferation activity to about 50%. Besides，PANC-1 cells were selected again and were randomly divided into three groups：the control group，metformin group，gemcitabine group，and combination group. The cells were treated with met⁃ formin or/and gemcitabine. The cell migration rate was measured by cell scratch assay. The expression levels of E-cad⁃ herin and Vimentin was detected by Western blotting. Results The proliferation activity of PANC-1 cells decreased with the increased concentrations of metformin and gemcitabine，in a concentration-dependent manner（F= 29. 14，66. 88， both P<0. 01）. After giving metformin（20 mmol/L）and gemcitabine（0. 4 μmol/L），the proliferation activity of PANC-1 cells decreased to about 50%，so the follow-up experiments were conducted with these concentrations. The cell migration rates and the expression levels of E-cadherin and Vimentin in the metformin group，gemcitabine group，and combination group were lower than those in the control group；the cell migration rate and the expression levels of E-cadherin and Vimen⁃ tin in the combination group were lower than those in the metformin and gemcitabine groups（all P<0. 05）. There was no significant difference in the cell migration rate or expression levels of E-cadherin and Vimentin between the metformin group and gemcitabine group（all P>0. 05）. Conclusion The combination therapy of metformin and gemcitabine can inhibit the proliferation，migration and EMT of pancreatic cancer cells，and metformin improves the chemosensitivity of pancreatic cancer cells to gemcitabine. [ABSTRACT FROM AUTHOR]

To investigate the effect of Fuzheng Jiedu formula combined with gemcitabine and cisplatin on T cell sub- sets and serum tumor markers in patients with advanced non-small cell lung cancer (NSCLC). Methods: 80 patients with advanced NSCLC who were admitted to our hospital from March 2017 to December 2018 were selected, patients were divided into control group (n=40, treatmented with gemcitabine and cisplatin) and study group (n=40, treatmented with Fuzheng Jiedu Fang combined with gemcitabine and cisplatin) according to the random number method. The therapeutic effect, T cell subsets and serum tumor markers were com- pared between the two groups, and the adverse reactions of two groups were recorded. Results: The total clinical effective rate of the study group at 4 cycles after treatment was higher than that of the control group (P<0.05). CD3+, CD4+, CD4+ /CD8+ in the two groups at 4 cycles after treatment decreased compared with those before treatment, but the study group was higher than the control group (P<0.05). CD8+ in the two groups at 4 cycles after treatment increased compared with that before treatment, but the study group was lower than the control group (P<0.05). The levels of carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125) and carbohydrate antigen 199 (CA199) of the two groups at 4 cycles after treatment were lower than those before treatment, the study group was lower than the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Fuzheng Jiedu formula combined with gemcitabine and cisplatin in the treatment of advanced NSCLC patients, the effect is good, which can effectively prevent the progress of disease, reduce the immunosuppression, and has a good safety, and which has a certain clinical ap- plication value. [ABSTRACT FROM AUTHOR]

Objective: This study collected a real-world data on survival and efficacy of gemcitabine-containing therapy in advanced breast cancer. Aimed to find the main reasons of affecting the duration of gemcitabine-base therapy in advanced breast cancer patients. Methods: Advanced breast cancer patients who received gemcitabine-base therapy from January 2017 to January 2019 were enrolled(10 hospitals). The clinicopathological data, the number of chemotherapy cycles and the reasons for treatment termination were collected and analyzed. To identify the reasons related with continuous treatment for advanced breast cancer and the factors which affect the survival and efficacy. Results: A total of 224 patients with advanced breast cancer were enrolled in this study, with a median age of 52 years (26-77 years), 55.4%(124/224) was postmenopausal. Luminal type were 83 cases, TNBC were 97 cases, and human epidermal growth factor receptor 2 (HER's-2) overexpression were 44. At the analysis, 224 patients who received the gemcitabine-based regimens were evaluated, included 5 complete reponse (CR), 77 partial response (PR), 112 stable disease (SD) and 27 progressive disease (PD). The objective response rate (ORR) was 36.6%(82/224). Seventy patients had serious adverse diseases, including leukopenia (9), neutrophilia (49), thrombocytopenia (15), and elevated transaminase (2). The median follow-up time was 41 months (26~61 months), and the median PFS was 5.6 months. The reasons of termination treatment were listed: disease progression were 90 patients; personal reasons were 51 patients; adverse drug reactions were 18 patients; completed treatment were 65 patients. It was found that progression-free survival (PFS) was significantly longer in patients receiving >6 cycles than that in patients with ≤6 cycles (8.2 months vs 5.4 months, HR =2.474, 95% CI: 1.730-3.538, P ＜0.001). Conclusions: Gemcitabine-based regimen is generally well tolerated in the Chinese population and has relatively ideal clinical efficacy in the real world. The median PFS is significantly prolonged when the number of treatment cycles are appropriately increased.

Background and objective Lung cancer is one of the highest morbidity and mortality in the world and it is very important to find an effective anti-tumor method. Microwave hyperthermia, a new treatment technology, has been getting more and more attention. This study was designed to investigate the effects of microwave hyperthermia combined with gemcitabine on the proliferation and apoptosis of human lung squamous cell carcinoma (NCI-H1703 and NCI-H2170) in vitro. Methods The proliferation of cells treated with microwave hyperthermia, the effect of gemcitabine on cell proliferation and the proliferation of cells treated with different methods of microwave hyperthermia and gemcitabine were detected by CCK-8 assay. Colony formation assay was used to measure the colony formation of human lung squamous cell carcinoma cells. Flow cytometry assay was used to detect the total apoptosis rates of the treated cells. Caspase-3, Caspase-8 activity assay was used to detect the activity of Caspase-3, Caspase-8 enzyme in each group of cells. CCK-8 assay was used to detect the effect of control group, AC-DEVD (Caspase-3 inhibitor) group, thermalization combined group, and thermal AC-DEVD combined group on cell proliferation. The levels of p53, Caspase-3, Cleaved-Caspase-3, PARP, Bax and BCL-2 protein expression were detected using Western blot assay. Results Our results demonstrated that microwave hyperthermia inhibited the proliferation of lung squamous cell carcinoma. The IC50 values of gemcitabine for the two cells were 8.89 μmol/L and 44.18 μmol/L, respectively. The first chemotherapy after microwave hyperthermia has synergistic effect on the two lung squamous cell carcinoma cells and can significantly inhibit the cell clone formation (P0.05). Furthermore, Western blot analysis showed that microwave hyperthermia combined with gemcitabine could up-regulate the p53, Caspase-3, Cleaved-Caspase-3, Cleaved-PARP and Bax protein expression. Conclusion Microwave hyperthermia combined with gemcitabine remarkably inhibit the proliferation and induce apoptosis of human lung squamous cell carcinoma in vitro. This effect may be associated with the activation of p53, cleavage of PARP protein, and induced the Caspase-3 dependent apoptosis.

Objective　Based on the data of gemcitabine adverse reactions (ADR), the characteristics and patterns of ADR occurrence were analyzed. The guidance for the rational clinical use of gemcitabine was provided. Methods　From our information system, the patients treated by gemcitabine chemotherapy from September 2008 to September 2018 were selected and their related ADRs were summarized and statistically analyzed by using SPSS 18.0. Results　Among the 750 cases, there were 312 ADRs related to gemcitabine treatment, of which the incidence of ADR was higher in female patients than in male patients (48.68% vs 36.77%) and the highest incidence in the age group of 50-69 years (44.14%). The patients with lower status (KPS) scores were more sensitive to chemotherapeutic drugs, and more likely to develop ADR. During the combination therapy, gemcitabine+paclitaxel chemotherapy had the highest incidence of ADR (61.54%) and the highest incidence of ADR in thymic carcinoma (62.50%), followed by hematological and reproductive system tumors (58.62% and 57.14%, respectively); ADR involvement in organs/systems is mainly caused by hematological toxicity. The bone marrow suppression is common, followed by digestive system damage. The major clinical symptoms were nausea and vomit. Conclusion　Gemcitabine-related ADR has a large individualized difference and is affected by many factors. Chemotherapy should be used according to individual conditions to improve clinical safety and rational use of drugs. [ABSTRACT FROM AUTHOR]

Copyright of Journal of China Medical University is the property of Journal of China Medical University Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To evaluate the clinical effect and safety of high-intensity focused ultrasound(HIFU) combined with gemcitabine in the treatment of advanced pancreatic cancer. Methods SCI,Cochrane Library,Embase,PubMed,Wanfang Data,CNKI,CBM,and VIP were searched for randomized controlled trials(RCTs) of HIFU combined with gemcitabine in the treatment of advanced pancreatic cancer,with the assistance of expanded search,and these RCTs were screened according to the inclusion criteria. Review Manager 5. 3 was used to perform the Meta-analysis. A fixed effects model was used for non-heterogeneous data; heterogeneity was explained by subgroup analysis based on intervention methods,and if it could not be explained by subgroup analysis,a random effects model was used. Relative risk(RR) and 95% confidence interval(CI) were used as evaluation indices,and funnel plots were generated based on the outcome measure involved in the highest number of studies. Results A total of 8 RCTs with 474 patients were included. The patients in the experimental group received gemcitabine-based chemotherapy and HIFU,and those in the control group received gemcitabine-based chemotherapy alone. Compared with the control group,the experimental group had significantly better results in 3-,6-,and 12-month survival rates(3-month: RR = 1. 07,95% CI: 1. 00-1. 14,P < 0. 05; 6-month: RR = 2. 19,95% CI: 1. 75-2. 75,P < 0. 05; 12-month: RR =2. 35,95% CI: 1. 07-5. 14,P < 0. 05),tumor control(RR = 1. 64,95% CI: 1. 21-2. 24,P = 0. 002),and pain control(RR = 3. 15,95% CI: 2. 45-4. 05,P < 0. 05). There were no significant differences between the two groups in the incidence rates of leukopenia(RR =1. 05,95% CI: 0. 85-1. 30,P > 0. 05),gastrointestinal reactions(RR = 0. 89,95% CI: 0. 56-1. 42,P > 0. 05),and liver injury(RR = 1. 29,95% CI: 0. 95-1. 75,P > 0. 05). Since the outcome measure of pain control was involved in the highest number of studies,funnel plots were generated and showed no significant risk of bias. Conclusion Compared with gemcitabine alone,HIFU combined with gemcitabine can increase patients’ survival rate and improve their symptoms,with a similar incidence rate of adverse effects. Further studies are needed for this combined therapy. [ABSTRACT FROM AUTHOR]

Objective To investigate the efficacy and safety of S-1 monotherapy or combined with platinum chemotherapy in the treatment of patients with advanced NSCLC. Methods Systematic searches were performed for randomized controlled trials with the CNKIPubMed, Web of Science and Cochrane Library. S-1 monotherapy or combined with platinum chemotherapy was the observation group. Paclitaxel docetaxel and gemcitabine monotherapy or combined with platinum chemotherapy were the control group. The Cochrane systematic review method was used for literature quality evaluation and RevMan 5. 3. 5 sot-ware was used for statistical analysis. Results 3977 patients were enrolled in 25 studies. The effective rate and disease control rate in the observation group were similar to those in the control group with no statistical significance [ORR:OR=0. 97,95% CI (0. 83? 1. 13), P=0. 66； DCR:OR = 1.11,95% CI (0. 92,1. 32) P = 0. 27* In terms of safety, there were less adverse drug reactions in the observation group compared to the control group with statistical significance (P<0. 05). Conclusion S-1 monotherapy or combined with platinum chemotherapy is recommended for patients with advanced NSCLC. [ABSTRACT FROM AUTHOR]

Copyright of Practical Oncology Journal is the property of Journal of Practical Oncology Editorial Office and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To explore the effect of clostridium butyricum enterococcus triple viable tablet on the efficacy and adverse reactions of gemcitabine plus platinum(GP) regimen for the patients with advanced non-small cell lung cancer(NSCLC). Methods The records of 78 NSCLC patients who treated with GP regimen as first-line palliative chemotherapy were reviewed, and the related data were recorded. Statistical analyses were performed with SPSS 25.0. Results Compared with the control group, the probiotic preparation group showed a significant difference in disease control rate and progression-free survival (P value are 0.048 and 0.012 respectively), while there were no significant differences in objective response rate and the risk of adverse reaction events(P>0.05). Conclusion The clostridium butyricum enterococcus triple viable tablet might improve the efficacy of GP regimen as a first-line palliative chemotherapy for advanced NSCLC patients. [ABSTRACT FROM AUTHOR]

Objective: To explore the clinical efficacy of gemcitabine thermal chemotherapy in the treatment of liver cancer and effect on the serum O6-methylguanine DNA methyltransferase(MGMT) level. Methods: 59 cases of liver cancer patients in our hospital from February 2014 to April 2017 were selected as the research object. All the cases were divided into the observation group(30 cases)and the control group(29 cases) according to the methods of treatment. The control group was given conventional chemotherapy for 3cycles and the observation group was given gemcitabine thermo perfusion chemotherapy based on the control group. The clinical efficacy, incidence of adverse reactions, survival and changes of serum MGMT expression before and after treatment were compared between the two groups. Results: The thermo perfusion chemotherapy was successfully performed in the observation group. There was no significant difference in the body temperature, respiratory rate, heart rate and blood pressure between two groups before and after treatment(P>0.05). The total effective rate of observation group and control group after treatment were 66.7% and 31% respectively,which was significantly higher in the observation group than that of the control group(P<0.05). There was no significant difference in the incidence of digestive tract reaction, blood system reaction, skin reaction and neurotoxic reaction between the two groups(P>0.05). After treatment, the serum MGMT levels of both groups were lower than those before treatment(P<0.05), which was also significantly lower in the observation group than that in the control group(P<0.05). Following up to November 30, 2017, the time to progression and overall survival in the observation group were 8.11±2.19 months and 14.29±1.87 months, respectively, which were significantly higher than those in the control group(6.22±1.82 months and 11.48±2.19 months)(P<0.05). Conclusions: Gemcitabine chemotherapy can improve the curative effect, prolong the survival time with high safety in the treatment of liver cancer, which may be related to effective reduction of serum MGMT level. [ABSTRACT FROM AUTHOR]

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Practical Pharmacy & Clinical Remedies is the property of Editorial Department of Practical Pharmacy & Clinical Remedies and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effects of glutamine（GLN）combined with gemcitabine on proliferation，apop-tosis and XIAP expression of human lung adenocarcinoma A549 cells. Methods A549 cells were cultured in vitro. After acting on A549 cells for 24，48，72 h by the blank control(without medication intervention)，gemcitabine（0.01 mg/L），GLN（32 mmol/L） and combined medication（GLN 32 mmol/L combined with gemcitabine 0.01 mg/L），the proliferation inhibition rate of A549 cells at different time points was detectedby（CK-8），the cellular apoptosis rate was detected by using flow cytometry and the expression of XIAP protein was detected by ELISA. Results The cell proliferation inhibition rate of the combination group was obviously higher than that of the other groups，and the proliferation inhibition effect became stronger with the action time extending，the differences were statistically significant（P<0.05）；the A549 cell apoptosis rate in the combined medication group was significantly higher than that in the other groups，the differences were statistically significant（P<0.05）. Compared with the blank control group，the expression of A549 cell XIAP in the gemcitabine group was significantly increased，while which in the GLN group and combined medication group was significantly decreased，the differences were statistically significant（P< 0.05）. Conclusion GLN combined with gemcitabine can strongly enhance the growth inhibiting effect on human lung cancer A549 cells，its action may be related with down-regulating XIAP expression，thus enhancing the sensitivity of A549 cells to gemcitabine. [ABSTRACT FROM AUTHOR]

Copyright of China Sciencepaper is the property of China Sciencepaper and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objective To investigate the effect of transcriptional internediary factor 1 gamma (Tif1γ) and its signal pathway related proteinson apoptosis of human pancreatic cancer cell line Capan-1 treated with either gemcitabine (GEM) or raltitrexed (RTX). Methods Capan-1 cells were treated with GEM of 559 μmol/L or RTX of 0.86 μmol/L for 36 h. The cell apoptosis of Capan-1 was determined using flow cytometry. Protein levels of Tif1γ, TGF-β1, Smad3, p-Smad3, Smad4, Bcl2, BAX and Caspase3 in Capan-1 cells were determined by Western blot. Results The late apoptosis and death ratio after RTX treatment were 28.7%±5.1% and 3.7%±0.5%, respectively, showing significant difference from that after GEM treatment or untreated control group (P<0.01). The results of Western blot showed that the relative protein levels of Tif1γ, TGF-β1, p-Smad3, BAX and Caspase3 in Capan-1 cells were increased in RTX group compared with those in GEM group or control group (P<0.05). The relative protein levels of Smad4 and the Bcl2/Bax ratio were decreased in RTX group compared with those in GEM group or control group (P<0.05). Conclusions Increased level of Tif1γ by RTX treatment resulted in decreased level of Smad4 to regulate the balance of Bcl2/Bax, increased Caspase3 and increased apoptosis in Capan-1 cells. [ABSTRACT FROM AUTHOR]

Objective To observe the effect of combined therapy with somatostatin(SST) and gemcitabine(Gem)on the proliferation of human metastatic pancreatic cancer As PC-1 cells. Methods The As PC-1 cells were cultured in vitro.(1) The cells were treated with 0, 100, 200, 400, 600, and 800 μg/m L SST for 24, 48, and 72 h, then we calculated the IC50 of SST. (2) The cells were treated with 0, 0. 1,1 5,10, 20, 40, and 60 μmol/L Gem for 48 h, and we calculated the IC50 of Gem. After that, As PC-1 cells were divided into four groups: an untreated control group(group A), a group treated with SST at IC50(group B), a group treated with Gem at IC50(group C), and a group treated with SST + Gem at half of their IC50(group D). At 48 h after treatment, the inhibition rates were calculated. Results For As PC-1 cells,IC50 of SST was 600 μg/m L at 48 h, and IC50 of Gem was 20 μmol/L. The inhibition rates in the groups A,B,C and D were 0. 00% ± 3. 79%, 52. 59% ± 4. 57%, 48. 11% ± 10. 93%, and 64. 86% ± 4. 83%, respectively. The cell growth was significantly inhibited in the groups B,C,and D as compared with that of group A(P < 0. 05), and the inhibition rate was significantly higher in the group D than in the groups B and C(P < 0. 05). Conclusion The combination of SST and Gem can inhibit the growth of As PC-1 cells. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical effects and adverse reactions of transcatheter arterial chemoembolization(TACE)with regimen GEMOX and FAM combined with three-dimensional conformal radiotherapy(3DCRT)for the treatment of advanced inoperable primary hepatocellular carcinoma(HCC). Methods: A total of 138 patients with pathologically or imaging confirmed advanced inoperable primary HCC were enrolled in this study, which were randomly divided into the study group of 70 cases, TACE with GEMOX regimen(gemcitabine 0.8-1.0 g/m~2, oxaliplatin 85-100 mg/m~2, plus super liquefactive iodized oil 10-30 mL was carried out once a month in all patients for 2-3 successive months. Three to four weeks after TACE, 3DCRT was conducted with a total dose of 48-64 Gy, 4-5Gy per fraction at an interval of 48 hours and 3 fractions were given every week; The control group of 68 cases, TACE with FAM regimen(5-fluorouracil 500-1000 mg, adriamycin 50 mg/m~2, mitomycin 12 mg/m~2 plus super liquefactive iodized oil 10-30 mL) was carried out once a month in all patients for 2-3 successive months, Three to four weeks after TACE, 3DCRT was conducted, the same study group scheme. The clinical results were analyzed. Results: Two cases in the study group and one patient in control group died 3-4 months after3 DCRT was completed.The study group of 68 patients in CR 3 cases (4.4%), PR 48 cases (70.6%), SD10 cases (14.7%), PD 7 cases(10.3%), the total effective rate (CR+PR) was 75% (51/67); the control group of 67 patients CR 1 cases (1.5%), PR 36 cases (53.7%), SD13 cases (19.4%), PD17 cases (25.4%), the total effective rate (CR+PR)was 55.2% (37/67); the total efficiency of study group was significantly better than the control group, two groups was statistically significant (X2=20.973, P<0.001). The median overall survival time of study group was 14 months (95%CI 11.5~16.5) which was better than that of the control group (11 months 95%CI 9.7~12.3), the two groups was statistically significant (X2=6.093,P=0.014); The median PFS of study group was 7.0 months (95% CI,5.6~8.3), which was better than that of the control group (6 months 95%CI 5.1~6.8), the two groups was statistically significant (X2=5.460, P=0.019). The overall survival rates at 1, 2 and 3 years in the study group were respectively 63.4%, 39.7%, 23.5%, significantly higher than which in the control group were respectively 46.3%, 23.9%,10.5%; two groups was statistically significant (P<0.05). Two groups of common adverse reactions mainly included leucopenia, thrombocytopenia, anemia, nausea, vomiting and fever, which could be tolerated by the patients.Conclusion: The clinical effect of TACE with GEMOX regimen combined with 3DCRT in the treatment of advanced primary hepatocellular cancer is obviously superior to the FAM scheme of TACE combined with 3DCRT therapy, and its adverse reactions can be tolerated by the patients. It is an ideal method for comprehensive treatment. [ABSTRACT FROM AUTHOR]

Objective: To compare the short-term efficacy and safety of gemcitabine, pemetrexed plug, docetaxel and cisplatin three chemotherapy in the treatment of advanced lung cancer. Methods: A total of 140 cases of patients with ⅢB ~ Ⅳ lung adenocarcinoma confirmed by pathology or cytology admitted in our hospital from July 2014 to 2015 August were randomly divided to three groups, which were treated with docetaxel + cisplatin(docetaxel group, n = 38), pemetrexed plus cisplatin(pemetrexed group, n =56), gemcitabine + cisplatin(gemcitabine group, n = 46) respectively. The efficacy and incidence of Ⅲ, Ⅳ toxicity were compared.Results: The total efficiency(RR) of gemcitabine group was 43.5%, disease control rate(DCR) was 78.3%, which were 42.1%, 73.7%and 50.0%, 85.7% in the docetaxel group and pemetrexed respectively. No significant difference was found in the RR and DCR between three groups(P>0.05). The main adverse reaction of three groups was bone marrow suppression, no Ⅲ ~ Ⅳ degree toxicity reaction such as rash and peripheral neuritis was found. The occurring rate namely the third degree + Ⅳ of leukocyte reduction, reduction of neutrophil and platelet of pemetrexed group was significantly lower than those in the group of gemcitabine and docetaxel,(P<0.05). No significant incidence was observed in the grade Ⅲ + Ⅳ decreased hemoglobin, gastrointestinal reaction, alopecia, abnormal liver and kidney function toxicity between three groups(P>0.05). Conclusion: The curative effect of pemetrexed, docetaxel, gemcitabine combined with cisplatin were equal in the treatment of advanced lung adenocarcinoma, but pemetrexed had higher safety. [ABSTRACT FROM AUTHOR]

Background and objective Due to the various inter-individual differences in the biological characteristics of tumor cells, as well as issues on the efficacy, adverse reactions, and defects of existing drugs, we compared the clinical efficacy and toxicity of pemetrexed and gemcitabine combined with cisplatin for the treatment of previously untreated advanced non-small cell lung cancer (NSCLC). Methods 251 patients were randomly divided into pemetrexed combined with cisplatin group (PP group) with 127 cases and gemcitabine combined with cisplatin group (GP group) with 124 cases. PP group received pemetrexed 500 mg/m2 iv infusion d1 and cisplatin 75 mg/m2 iv infusion d1, whereas GP group received gemcitabine 1,000 mg/m2 iv infusion d1,8 and cisplatin 75 mg/m2 iv infusion d1. The treatment cycle was once every three weeks. In addition, folic acid, vitamin B12, and dexamethasone were administered in both groups. Results The total clinical effective rates in PP group and GP group were 25.20% and 17.74%, respectively. The total efficiencies of non-squamous cell carcinoma were 27.62% and 16.00%. The tumor progression duration in these two groups was 6.5 and 5.6 months, respectively. The median survival time in the two groups was 16.9 and 17.0 months, respectively, with 59.62% and 65.87% survival rates of 1 year and 27.28% and 27.93% survival rates of 2 years, respectively. The total efficacy of non-squamous cell carcinoma in the PP group was significantly higher than that in GP group. The results were statistically significant. However, there were no significant differences in total response rates, tumor progression duration, and median survival rates of 1 and 2 years. The rate of adverse reactions, including white blood cell reduction, lower platelet count, lower hemoglobin, and hair loss in the PP group was significantly lower than that in the GP group. The results were statistically significant. Conclusion The clinical efficacy of pemetrexed and gemcitabine combined with cisplatin for the treatment of previously untreated advanced NSCLC was roughly the same, but the adverse reactions decreased significantly in the PP group compared with those in the GP group. Therefore, pemetrexed combined with cisplatin can be used as a safe and effective drug for clinical first-line treatment for previously untreated NSCLC.

Background and objective Platinum-based doublet chemotherapy is still the standard first-line treatment for non-small cell lung cancer (NSCLC). Previous studies have demonstrated that pemetrexed combined with platinum had promising efficacy and safety profile in NSCLC, especially in patients with nonsquamous NSCLC. This trial was conducted to evaluate the efficacy and safety of pemetrexed made in China as first-line treatment. Methods The present study was a randomized, controlled, multicenter clinical trial. Patients were randomly assigned (1:1) to receive cisplatin plus pemetrexed chemotherapy (PC group) or gemcitabine plus cisplatin (GC group) every 3 weeks. The primary end point was progression free survival (PFS) and the secondary end points included 1 year survival rate, objective response rate (ORR), survival without grade 3/4 toxicity (SWT3/4) and safety profile. Results A total of 288 patients from 20 institutions across China were enrolled into the study. Based on the Full Analyses Set (FAS), the PFS was 168 days (5.6 months) vs 140 days (4.7 months) (P=0.16), one year survival rate was 50.0% vs 54.9% (P=0.47), ORR was 24.4% vs 14.2% (P=0.06) in the PC group and the GC group, respectively; Survival without grade 3/4 toxicity was 11.3 months in GC group vs 8.1 months in PC group (P=0.23). In terms of the safety, side effects were less observed on the PC group (81.95% vs 93.75%, P=0.003). The main side effects included leukopenia, neutropenia, emesis, anemia, thrombopenia. Conclusion The both regimens have similar efficacy as the treatment for advanced nonsquamous NSCLC, but pemetrexed plus cisplatin regimen has better safety profile and seems to have longer PFS, which makes it a new option as the first line setting.

Background and objective The aim of this study is to detect the efficacy and toxicity of gemcitabine and vinorelbine (GN as second-line or further-line treatment) in refractory advanced non-small cell lung cancer (NSCLC) patients in China. Methods We retrospectively reviewed 53 NSCLC patients treated with this agent at four hospital in China from Jan 01, 2004 to Jun 30, 2010. Survival analysis was evaluated by Kaplan-Meier method. Results A total of 53 patients were analyzed in this study (28 patients in second-line and 25 in third- or further-line treatment). The objective response rate (ORR) was 9.4%. The disease control rate (DCR) was 56.6%. The progression-free survival (PFS) and median overall survival (OS) was 3.0 and 17.6 months, respectively. Univariate analysis, revealed performance status (PS) score was an independent prognostic factor for overall survival. Conclusion The GN agent is effective for the second-line or further- line treatment in advanced non-small cell lung cancer. The toxicity is well tolerated .

Background and objective Advanced non-small cell lung cancer (NSCLC) is characterized by poor treatment efficacy and short survival time. Clinical trials have shown that the combination of chemotherapy with thermotherapy exhibits strong efficacy. We performed this meta-analysis to evaluate the clinical efficacy and safety of gemcitabine plus cisplatin (GP) and paclitaxel plus cisplatin (TP) combined with thermotherapy in the treatment of NSCLC, as well as to provide reference for clinical practice and future research. Methods We searched international (Cochrane Library, PubMed, and EMBASE) and Chinese (CBM, CNKI, VIP and Wanfang) databases for relevant articles and imported other retrievable sources, such as tracing-related references. We also corresponded with other authors to obtain certain inaccessible information. Data from all relevant randomized controlled trials (RCT) were collected to compare GP or TP thermochemotherapy with GP or TP chemotherapy alone. The quality of the included studies was assessed by adequate outcome-based standards and clinical circumstances. The meta-analysis was conducted using RevMan 5.1. Results Fifteen RCTs involving 952 patients were included in this meta-analysis. The results showed that the thermochemotherapy group had higher rates of improvement in quality of life (OR=3.84, 95%CI: 2.61-5.64), survival at 1 year (HR=1.94, 95%CI: 1.21-3.12), and survival at 2 years (HR=2.05, 95%CI: 1.18-3.58) compared with the chemotherapy group, with the differences between them being significant. However, these groups did not differ in other indicators of treatment effectiveness, such as myelosuppression, alimentary canal reactions, hepatic lesions, and diarrhea. Conclusion Compared with chemotherapy alone, thermochemotherapy can improve survival rates and curative effects, ameliorate symptoms, and enhance the quality of life of patients with advanced NSCLC, and it has an acceptable safety profile. The results of this meta-analysis warrant further investigation with a larger sample size and using a high-quality RCT design.

Background and objective Chemotherapy has become the mainstay of first-line therapy. Non-platinum containing drugs are characterized by favorable toxicity profiles and is better tolerated than platinum-based regimens. The aim of this study is to detect the efficacy and toxicity of gemcitabine and vinorelbine (GN) in advanced non-small cell lung cancer (NSCLC) first-line treatment in China. Methods We retrospectively reviewed 67 NSCLC patients treated with this agent at five Hospital in China from Jan 2004 to Jun 2010. Survival analysis was evaluated by Kaplan-Meier method, multivariate analyses were performed to find prognostic markers using Cox proportional hazards model. Results A total of 67 patients were analyzed in this study. There were 52 patients with RRM1 negative and ERCC1 positive. The objective response rate was 34.3%. The disease control rate was 76.1%. The progression-free survival and median overall survival was 5.5 and 22.1 months, respectively. On multivariate analysis, performance status score and whether further treatment were independent prognostic factor for overall survival. Conclusion The GN agent is effective for the first line treatment in advanced non-small cell lung cacer. The toxicity is well tolerated.

Background and objective Gemcitabine-platinum-combined with chemotherapy is the most common treatment for advanced non-small cell lung cancer (NSCLC). Gemcitabine is administered once a week in a general three-week schedule. In the present study, gemcitabine is administered on d1 and d5 to improve compliance, and the efficacy and safety of the improved regimen is evaluated in untreated patients with advanced NSCLC. Methods A total of 83 patients were enrolled between October 2007 and October 2009. In each cycle, gemcitabine was administered at a dose of 1,000 mg/m2-1,250 mg/m2 via a 30 min intravenous infusion on d1 and d5 followed by cisplatin at a dose of 75 mg/m2 or carboplatin (AUC=5) on d1 every three weeks. At least two cycles of chemotherapy were completed in each case, and clinical response and toxicity of the regimen were observed. Results The objective response rate was 37.3%. The median progression free survival and overall survival time were 6.1 months and 15.0 months, respectively. The one-year and two-year survival rates were 57.8% and 16.2%, respectively. Myelosuppression and gastrointestinal responses were the main toxicities. The incidence of grade 3/4 of leucopenia, hypohemia, and thrombocytopenia were 26.5%, 10.8% and 7.2%, respectively. A total of 27.5% of the patients in the cisplatin group had grade 3/4 gastrointestinal responses. Treatment related deaths were not observed in this study. Conclusion The regimen is active and well-tolerated in untreated patients with advanced NSCLC. Further randomized controlled studies are necessary.

Background and objective Platinum-based chemotherapy is considered the standard treatment of advanced non-small cell lung cancer (NSCLC). The aim of this study is to evaluate the efficacy and safety of gemcitabine plus oxaliplatin (GO) versus gemcitabine plus cisplatin (GP) regimens as the 1st line chemotherapy for elderly patients with advanced NSCLC. Methods Sixty-six advanced NSCLC patients confirmed with pathology or cytology, who had not received treatment, were randomly divided into GO group (The patients received gemcitabine 1,000 mg/m2 on day 1 and day 8 and oxaliplatin 130 mg/m2 on day 1 by intravenous infusion, with 21 days as one cycle) and GP group (The patients received gemcitabine 1,000 mg/m2 on day 1 and day 8 and cisplatin 25 mg/m2 on day 1, day 2 and day 3) by intravenous infusion, with 21 days as one cycle). All patients who received 2 or more cycles could be evaluated. Results There were no statistical differences between GO and GP groups in the efficiency of disease (36.4% vs 40.6%, P=0.801), the median progression-free survival (24 weeks vs 18 weeks, P=0.565), the median survival time (44 weeks vs 36 weeks, P=0.918), but anemia at grade III and IV (0 vs 33.3%, P

With the development of pharmacogenomics and pharmacogenetics, personal therapy based on genes has become one of the most effective ways to enhance chemotherapeutic effect on non-small cell lung cancer (NSCLC) patients. Much attention has been paid to validate the predictive biomarkers of chemotherapy in order to guide chemotherapy and enhance effect in general. Gemcitabine is one of the common agents treating NSCLC recently. This review is mainly about the recent reports on potential biomarkers of Gemcitabine in tailored therapy of NSCLC.

Background and objective Whether pemetrexed plus platinum (PP) regimen is superior to gemcitabine plus platinum (GP) regimen for patients with advanced non-small cell lung cancer (NSCLC) is unclear. The aim of this study is to evaluate the efficacy and safety of PP versus GP regimens for patients with NSCLC. Methods We searched relevant randomized controlled trials (RCTs) from Pubmed, EMBASE, Cochrane Library, Chinese Journal Full-text Database, Chinese Biomedical Literature Database, Chinese Scientific Journals Full-text Database, and traced the related references to obtain the information that has not been found. We made quality assessment of qualified RCTs assessed by the exclusion and inclusion criteria and used RevMan 5.0 provided by the Cochrane Collaboration to perform meta-analysis. Results Four RCTs involving 2,235 patients were identified. There were no statistical differences between PP and GP regimens in one-year survival rate (OR=1.09, 95%CI: 0.91-1.29), the efficiency of disease (OR=1.00, 95%CI: 0.40-2.52), but overall survival (MD=0.26, 95%CI: 0.21-0.30), alopecia (OR=0.51, 95%CI: 0.39-0.66) and hematologic toxicity were significantly different. Conclusion The clinical efficiency of PP and GP regimens for advanced NSCLC was similar, but the side effects were different. The toxicity of PP regimen has the tendency to be more tolerable.