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Although breast cancer in young women (BCYW) is not as common as in older individuals, the incidence of BCYW is increasing. Due to the particular considerations regarding pregnancy, fertility preservation, early menopause, body image, lactation, and quality of life, BCYW deserves unique management. We sought to estimate the survival and prognosis of such patients. In this article, we extracted 9761 primary breast cancer patients' data between 2010 and 2015 from the Surveillance Epidemiology and End Results (SEER) database. We included patients under 70 years and divided them into two groups by age (＜40 vs. 40-69 years). We defined the clinicopathologic characteristics, comprehensively analyzed and compared the OS and BCSS of breast cancer between two age groups among tumor subtypes. Patients under 40 years have longer OS and BCSS than older patients, while these survival benefits are limited in HR+ or/and HER2+ patients, except for TNBC, which needs further investigation. In addition, we developed an efficient predictive nomogram to predict 1-, 3- and 5-year OS of metastatic BCYW. These nomograms can aid oncologists in distinguishing, assessing and evaluating the risk and prognosis of metastatic BCYW, which can help oncologists select the next treatment strategies for BCYW.

Purpose Lung adenocarcinoma is the most popular histological type of lung cancer. The 5-year survival rate of lung adenocarcinoma is low. Curpotopsis is a new-found regulated cell death mechanism. Copper binding to lipoylated proteins directly leads to iron-sulfur cluster protein loss, proteotoxic stress, and finally cell death. Similarly, ferroptosis is still a research hotspot. Our goal is to predict the survival of lung adenocarcinoma employing the cuproptosis-related ferroptosis genes (CRFGs). Methods First, we conducted the correlation analysis of ferroptosis- and cuproptosis-related genes to identify the most valuable CRFGs. And we illuminated the prognostic value and expression of the four CRFGs. Then, we examined the relevance between CRFGs and the immune microenvironment by ssGSEA analysis and the CIBERSORT algorithm. Lung adenocarcinoma patients in the training set were divided into high- and low-risk groups according to the result of the Lasso-cox analysis. We established a new risk score predictive model according to the CRFGs risk score and critical clinical characteristics, containing N stage and radiation. Finally, we applied receiver operator characteristics (ROC) and calibration curves to verify the prediction ability of the model. Results We identified four CRFGs (PANX1, AURKA, EIF2S1, and ACSL3) and successfully created a risk score dividing patients into the low- and high-risk groups. The area under the curve (AUC) of this risk score model displayed good clinical application value in predicting the survival of lung adenocarcinoma. KEGG enrichment analysis indicated that the CRFGs were primarily enriched in autophagy, PI3K-Akt, mTOR, and ErbB signaling pathways. High-risk score groups were featured by much more infiltration, a high expression of immune checkpoints except TGFB1, and shorter overall survival time, while low-risk score groups were featured by immunosuppression. In addition, this study further proved that CRFGs score might predict prognosis, drug treatment response to chemotherapy, target therapy, and immunotherapy among lung adenocarcinoma cancer patients. Conclusion These results of CRFGs provide new insight into lung adenocarcinoma and might encourage new methods for predicting the survival of lung adenocarcinoma and treating these patients.

Purpose: We examined whether there were differences in major depression outcomes and independent risk factors associated with gonadotropin-releasing hormone agonists (GnRHa) and ovarian ablation (OA) in premenopausal breast cancer patients. Methods: Premenopausal breast cancer patients from seven hospitals who received OFS participated in the study between June 2019 and June 2020. The independent variable was the type of ovarian suppression, categorized as either OA (n = 174) or GnRHa (n = 389). Major depression was evaluated using the Patient Health Questionnaire (PHQ-9), and the Female Sexual Function Index questionnaire was used to assess sexual function.Results: A total of 563 patients completed the surveys. The mean PHQ-9 sum score was slightly lower in the GnRHa cohort than in the OA cohort (11.4 ± 5.7 vs. 12.8 ± 5.8, P = 0.079). There were significantly fewer patients with major depression (PHQ-9 ≥ 15) in the GnRHa cohort (31.1% vs. 40.2%, P = 0.025). Further, the duration of OFS was closely correlated with major depression, indicating a time-dependent trend [duration of OFS > 2 years vs. duration of OFS ≤ 2 years: Exp (B) = 1.651, P = 0.031]. Sexual dysfunction was negatively correlated with major depression [sexual dysfunction vs. normal: Exp (B) = 0.769, P = 0.046].Conclusions: This is the first study to demonstrate that GnRHa results in more favorable depression outcomes than OA. Moreover, most patients preferred alternatives to their OFS treatment. These findings can contribute to improving and alleviating the adverse effects of OFS.

Background: Ovarian function suppression is being widely utilized as endocrine therapy to reduce estrogen release in premenopausal breast cancer patients and was achieved either by medical treatment with bilateral oophorectomy, irradiation, or the Gonadotropin releasing hormone (GnRH) agonist. This study aimed to examine whether GnRHa differed from ovarian ablation on depression, sexual dysfunction and quality of life.Methods: The premenopausal breast cancer patients who received ovarian function suppression were enrolled from seven hospital between June 2019 and June 2020. Our independent variable was the type of ovarian suppression, categorized as Ovarian Ablation (OA cohort, n=174) and medical GnRH agonist (GnRHa cohort, n=389). The self-administered questionnaire (OFS-Q5) was developed and used in this study aimed to assess the depression (PHQ-9), sexual dysfunction (FSFI) and quality of life (EORTC QLQ-BR23).Results: In this cross-sectional study, 563 patients with ovarian function suppression completed surveys were collected. The mean sum score of the PHQ-9 tend to be slight decrease in GnRHa cohort than that in ovarian ablation (OA) cohort (11.4 ±5.7 vs. 12.8 ±5.8, OR=1.910, P=0.079). Patients with major depression (PHQ-9≧15) was indicated significantly fewer in GnRHa cohort (31.1% vs 40.2%, P=0.025). The more surprising correlation is less patients with sexual dysfunction (61.5%, FSFI< 23) in OA cohort, a remarkable increase in GnRHa cohort (72.2%, P = 0.011). The ratio of sexual dysfunction remained lower for ovarian ablation women in long-term ovarian suppression (duration of ovarian suppression > 2 years: OA vs GnRHa, OR=1.555, P=0.037). No significantly difference for most subscales of QLQ-BR23 between two cohorts was evident.Conclusions: Our current investigation demonstrate here for the first time that medical GnRHa resulted in favour depression, worse sexual function than those with ovarian ablation, with similar quality of life. This new understanding should help to improve and alleviate adverse effect in patients with diverse ovarian function suppression.

Background The emergence of new molecular targeted drugs provides new prospects for the treatment of advanced breast cancer; the future therapeutic trend includes chemotherapy combined with molecular targeted therapy. Apatinib mesylate, a novel, small anti-angiogenic agent, highly selectively inhibits the activity of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib mesylate also blocks the signaling of vascular endothelial growth factor binding to its receptor, thereby strongly inhibiting tumor angiogenesis and exerting an anti-tumor effect. However, there have been no reports of a randomized controlled clinical trial of apatinib combined with vinorelbine for the treatment of triple-negative breast cancer (TNBC). We will compare the therapeutic effect of vinorelbine alone or in combination with apatinib mesylate, in patients with recurrent or metastatic TNBC in North China who have received at least two drug treatments, including anthracyclines and taxanes. Methods/analysis This study is a triple-blind, randomized, placebo-controlled, parallel-group clinical trial. We plan to include 238 female patients with locally recurrent or metastatic TNBC, admitted to the Liaoning Cancer Hospital & Institute, Northeast China. All enrolled patients will be randomized to oral vinorelbine alone (40 mg, thrice a week (Mondays, Wednesdays, and Fridays) in each 3-week cycle), or in combination with oral apatinib mesylate (500 mg, once daily in each 3-week cycle). Radiographic assessment will be performed every 6 weeks for 36 weeks and every 9 weeks thereafter. The primary outcome is progression-free survival and secondary outcomes include overall survival, disease control rate, objective response rate, and incidence of adverse events at grades 3 and 4, as defined by the National Cancer Institute Common Toxicity Criteria Version 4.0. Outcome measures will be evaluated at baseline ( Discussion Based on the data from this trial, we hope to identify a treatment plan that is suitable for female patients with TNBC, who have been treated with anthracyclines and taxanes, in Northeast China. Trial registration ClinicalTrials.gov: NCT03932526. Registered on 30 April 2019.

Background: The emergence of new molecular targeted drugs provides new prospects for the treatment of advanced breast cancer; the future therapeutic trend includes chemotherapy combined with molecular targeted therapy. Apatinib mesylate, a novel, small anti-angiogenic agent, highly selectively inhibits the activity of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib mesylate also blocks the signaling of vascular endothelial growth factor binding to its receptor, thereby, strongly inhibiting tumor angiogenesis and exerting an anti-tumor effect. However, a randomized controlled clinical trial of apatinib combined with vinorelbine for triple-negative breast cancer (TNBC) has not been reported. We will compare the therapeutic effect of vinorelbine alone or in combination with apatinib mesylate in patients with recurrent or metastatic TNBC in North China who have received at least two drug treatments including anthracyclines and taxanes. Methods/analysis: This study is a triple-blind, randomized, placebo-controlled, parallel-group clinical trial. We plan to include 164 female patients with locally recurrent or metastatic TNBC and without BRCA1 mutation (as BRCA -positive patients would have poor responses to the therapeutic methods designed in this study), admitted at the Liaoning Cancer Hospital & Institute, Northeast China. All enrolled patients will be randomized to orally take vinorelbine alone (40 mg orally, thrice a week (Mondays, Wednesdays, and Fridays) in each 3-week cycle) or combined with apatinib mesylate (500 mg orally, once daily of each 3-week cycle). Radiographic assessment will be performed every 6 weeks for 36 weeks, and every 9 weeks thereafter. The primary outcome is measurement of progression-free survival and secondary outcomes include overall survival, disease control rate, objective response rate, and incidence of adverse events at grades 3 and 4 as defined by the National Cancer Institute Common Toxicity Criteria [NCI-CTC] Version 4.0. Outcome measures will be evaluated at baseline (< 2 weeks before starting treatment), every 6 weeks during treatment, and at 4 weeks and every 3 months after treatment discontinuation. Discussion: Based on the data from this trial, we hope to identify a treatment plan that is suitable for female TNBC patients in Northeast China who have been treated with anthracyclines and taxanes. Trial registration: ClinicalTrials.gov (identifier: NCT03932526). Registered on April 30, 2019.

Background: The emergence of new molecular targeted drugs provides new prospects for the treatment of advanced breast cancer; the future therapeutic trend includes chemotherapy combined with molecular targeted therapy. Apatinib mesylate, a novel, small anti-angiogenic agent, highly selectively inhibits the activity of vascular endothelial growth factor receptor-2 tyrosine kinase. Apatinib mesylate also blocks the signaling of vascular endothelial growth factor binding to its receptor, thereby, strongly inhibiting tumor angiogenesis and exerting an anti-tumor effect. However, a randomized controlled clinical trial of apatinib combined with vinorelbine for triple-negative breast cancer (TNBC) has not been reported. We will compare the therapeutic effect of vinorelbine alone or in combination with apatinib mesylate in patients with recurrent or metastatic TNBC in North China who have received at least two drug treatments including anthracyclines and taxanes. Methods/analysis: This study is a triple-blind, randomized, placebo-controlled, parallel-group clinical trial. We plan to include 164 female patients with locally recurrent or metastatic TNBC and without BRCA1 mutation (as BRCA-positive patients would have poor responses to the therapeutic methods designed in this study), admitted at the Liaoning Cancer Hospital & Institute, Northeast China. All enrolled patients will be randomized to orally take vinorelbine alone (40 mg orally, thrice a week (Mondays, Wednesdays, and Fridays) in each 3-week cycle) or combined with apatinib mesylate (500 mg orally, once daily of each 3-week cycle). Radiographic assessment will be performed every 6 weeks for 36 weeks, and every 9 weeks thereafter. The primary outcome is measurement of progression-free survival and secondary outcomes include overall survival, disease control rate, objective response rate, and incidence of adverse events at grades 3 and 4 as defined by the National Cancer Institute Common Toxicity Criteria [NCI-CTC] Version 4.0. Outcome measures will be evaluated at baseline (< 2 weeks before starting treatment), every 6 weeks during treatment, and at 4 weeks and every 3 months after treatment discontinuation. Discussion: Based on the data from this trial, we hope to identify a treatment plan that is suitable for female TNBC patients in Northeast China who have been treated with anthracyclines and taxanes.