Targeted therapy is one of the most important treatments for breast cancer. In recent years, an increasing number of target-ed therapeutic drugs have been developed for different subtypes of breast cancer. The clinical application of these drugs has greatly improved the efficacy and changed the clinical practice for breast cancer. Overcoming drug resistance and developing new drugs that can go beyond the efficacy of traditional targeted drugs are two of the most important research directions in the future.

A lot of clinical trials of adjuvant treatment in breast cancer have been done,among which,a number of key clinical trails have changed our clinical practice,this has lead to multi-modality treatment instead of operation alone in breast cancer treatment.These key clinical trails were reviewed and evaluated in this article.

Adjuvant endocrine therapy greatly improves long term survival rate of patients with early breast cancer and is now the most important treatment for all patients with hormone receptor-positive breast cancer, This article reviews the principle and strategies of adjuvant endocrine therapy in early breast cancer.

Recent data of third generation aromatase inhib itors in adjuvant endocrine therapy of postmenopausal women with early breast ca ncer were reviewed in this article. Aromatase inhibitors, especially anastozole, may be the first to become the new standard adjuvant endocrine therapy in opera ble breast cancer patients instead of tamoxifen.

T-DM1 is a novel antibody-drug conjugate that has similar biological activity with that of trastuzumab. T-DM1 specifically delivers DM1, the effective anti-microtubule drug, into the cytoplasm of tumor cells with HER2 overexpression. The efficacy of T-DM1 monotherapy is better than lapatinib in combination with capecitabine and T-DM and is expected to become the standard second-line treatment for HER2-positive advanced breast cancer drugs. Clinical trials that compare T-DM1 with trastuzumab joint taxane as the first-line of treatment for advanced breast cancer trials are currently being performed. T-DM1 is a brand new anti-HER2 drug after trastuzumab. U.S. FDA already approved T-DM1 as a drug for the treatment of HER2-positive advanced breast cancer patients.

Endocrine therapy targeting estrogen pathway is one of the ifrst-line treatment choices of advanced breast cancer. Fulvestrant is a pure estrogen antagonist that blocks and downgrades estrogen receptor, which makes it effective in the treatment of progression after prior endocrine therapy. Fulvestrant 250 mg per month regime was approved for postmenopausal women with hormone-positive advanced breast cancer after progression or recurrence on antiestrogen therapy. Fulvestrant 500 mg per month regime was approved by the EMA and the US FDA in the same population based on the CONFIRM trial which proved improved efifcacy and similar tolerance compared with 250 mg regime. Recent trials were focused in the ifrst-line treatment and combination use with other therapeutics. This review discusses the advances of fulvestrant in postmenopausal women with hormone-positive advanced breast cancer.

Trastuzumab is one of the most important drugs for HER2 overexpressing breast cancer patients. However, even for these patients, the objective response rates to trastuzumab monotherapy are 12%-34%, and the median duration is about 9 months. Many patients progress within 12 months. Study of the mechanisms of resistance to trastuzumab will help us fi nd some new drugs and methods to overcome or delay the resistance.

Background and purpose:Breast cancer is a rare disease in women aged less than 25.Furthermore,there were fewer studies reporting the outcomes of this cohort and the knowledge regarding its biological characteristics and clinical features were limited. The aim of this retrospective study was to examine and audit the experience of our institution in treating the extremely young patients with breast cancer,to focus on the clinical presentation and pathological fi ndings,and to identify the prognostic factors which might be helpful in identifying those patients with a worse prognosis. Methods:From Jan 1980 to Dec 2005,there were 54 breast carcinoma patients in women aged 25 years or less treated in our hospital.We retrospectively analyzed their clinical,histological and treatment variables as well as 5-year overall survival(OS) and 5-year disease-free survival(DFS) . Results:There were 0.48% of all breast cancer cases who occurred in age of 25 or less in our institute in the period. We found 77.8% to be invasive ductal carcinoma and none of the patients had any family history of breast cancer or ovarian cancer. Clinically,68.5% were stage Ⅰ or Ⅱ,53.7% had lymph node metastasis. 79.6% were classifi ed as T1 or T2. Regarding the biological features,the frequencies of positive ER and PR were low(29.6%,36.0%,respectively) ,and the frequency of positive c-erbB2(22.2%) was higher. Lymphovascular invasion occurred in eight patients. Thirty-eight patients received adjuvant chemotherapy. 26 patients in this study died of breast cancer. The 5-year DFS and OS were 54.3% and 55.5%,respectively. In lymph node-positive patients,chemotherapy improved their 5-year OS signifi cantly(P=0.007) . The patients who might have a worse prognosis were usually with diagnostic delay more than 3 months(P=0.019) ,higherclinical stage(P=0.000) ,larger tumor size(P=0.007) ,lymph node-positive(P=0.000) and lymphovascular invasion(P=0.011) . Multivariate’ analysis revealed that both diagnostic delay more than 3 months and lymph node-positive were the independent prognostic factors(P=0.034,P=0.027,respectively) . Conclusion:Breast cancer is a rare condition in women aged 25 or less. Invasive breast cancer occurring at this subgroup has more aggressive biological behaviors. Diagnostic delay of more than 3 months and lymph node metastasis are considered adverse prognostic factors in the current study. The general principles of managing adolescents and very young women with breast cancer are no different to those applying to older women in current study,but development of tailored treatment for this population is still crucial.

Single nucleotide polymorphism(SNP)is the single base pair variation in genomic DNA that occurs in more than 1% of the general population.SNPs sometimes cause structural and functional changes in protein encoded by the gene.In the treatment of malignant tumors,SNPs may be key factors in determining responses and prognosis of the treatment.Main genes that have been studied on the correlation of SNP with response and prognosis after the treatment of non-small cell lung cancer include:DNA excision and repair gene,matrix metalloproteinase gene,apoptosis related gene,drug metabolism related gene,cell cycle control gene,etc.This review will focus on the advances in correlation of single nucleotide polymorphism with response and prognosis of lung cancer after chemotherapy.

Purpose:To evaluate the efficacy and safety of combination chemotherapy of gemcitabine(GEM) and cisplatin(DDP) for anthracycine(ANT)-resistant advanced breast cancer(ABC). (GEM 1 200 mg/m 2 on day1 and 8,DDP 30mg/m 2 on day 3 to 5 in cycles of 21 days) Methods:From January 2000 to April 2003,fifty patients with ANT-resistant ABC were treated with combination chemotherapy of GEM and DDP. The median number of cycles was 3(range 2-4). Results:The overall response rate was 42.6%,The median time to progression was 4.5 months. The main side effect included gastrointestinal and hematologic toxicities,related grade 3 to 4 clinical adverse effect was nausea and vomiting in 12 cases (24%),anemia in 2 cases (4), leukopenia in 7 cases (14%),neutropenia in 4 cases (8%) and thrombocytopenia in 16 cases (32%).Conclusions:GEM and DDP combination is active in ANT-resistant ABC with an acceptable toxicity pattern and may well represent an interesting therapeutic choice after ANT regimen.