1.Abemaciclib plus non-steroidal aromatase inhibitor or fulvestrant in women with HR+/HER2- advanced breast cancer: Final results of the randomized phase III MONARCH plus trial.
Xichun HU ; Qingyuan ZHANG ; Tao SUN ; Yongmei YIN ; Huiping LI ; Min YAN ; Zhongsheng TONG ; Man LI ; Yue'e TENG ; Christina Pimentel OPPERMANN ; Govind Babu KANAKASETTY ; Ma Coccia PORTUGAL ; Liu YANG ; Wanli ZHANG ; Zefei JIANG
Chinese Medical Journal 2025;138(12):1477-1486
BACKGROUND:
In the interim analysis of MONARCH plus, adding abemaciclib to endocrine therapy (ET) improved progression-free survival (PFS) and objective response rate (ORR) in predominantly Chinese postmenopausal women with HR+/HER2- advanced breast cancer (ABC). This study presents the final pre-planned PFS analysis.
METHODS:
In the phase III MONARCH plus study, postmenopausal women in China, India, Brazil, and South Africa with HR+/HER2- ABC without prior systemic therapy in an advanced setting (cohort A) or progression on prior ET (cohort B) were randomized (2:1) to abemaciclib (150 mg twice daily [BID]) or placebo plus: anastrozole (1.0 mg/day) or letrozole (2.5 mg/day) (cohort A) or fulvestrant (500 mg on days 1 and 15 of cycle 1 and then on day 1 of each subsequent cycle) (cohort B). The primary endpoint was PFS of cohort A. Secondary endpoints included cohort B PFS (key secondary endpoint), ORR, overall survival (OS), safety, and health-related quality of life (HRQoL).
RESULTS:
In cohort A (abemaciclib: n = 207; placebo: n = 99), abemaciclib plus a non-steroidal aromatase inhibitor improved median PFS vs . placebo (28.27 months vs . 14.73 months, hazard ratio [HR]: 0.476; 95% confidence interval [95% CI]: 0.348-0.649). In cohort B (abemaciclib: n = 104; placebo: n = 53), abemaciclib plus fulvestrant improved median PFS vs . placebo (11.41 months vs . 5.59 months, HR: 0.480; 95% CI: 0.322-0.715). Abemaciclib numerically improved ORR. Although immature, a trend toward OS benefit with abemaciclib was observed (cohort A: HR: 0.893, 95% CI: 0.553-1.443; cohort B: HR: 0.512, 95% CI: 0.281-0.931). The most frequent grade ≥3 adverse events in the abemaciclib arms were neutropenia, leukopenia, anemia (both cohorts), and lymphocytopenia (cohort B). Abemaciclib did not cause clinically meaningful changes in patient-reported global health, functioning, or most symptoms vs . placebo.
CONCLUSIONS:
Abemaciclib plus ET led to improvements in PFS and ORR, a manageable safety profile, and sustained HRQoL, providing clinical benefit without a high toxicity burden or reduced quality of life.
TRIAL REGISTRATION
ClinicalTrials.gov (NCT02763566).
Humans
;
Female
;
Fulvestrant/therapeutic use*
;
Breast Neoplasms/metabolism*
;
Aminopyridines/therapeutic use*
;
Benzimidazoles/therapeutic use*
;
Middle Aged
;
Aromatase Inhibitors/therapeutic use*
;
Aged
;
Receptor, ErbB-2/metabolism*
;
Adult
;
Letrozole/therapeutic use*
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Anastrozole/therapeutic use*
2.Machine learning models established to distinguish OA and RA based on immune factors in the knee joint fluid.
Qin LIANG ; Lingzhi ZHAO ; Yan LU ; Rui ZHANG ; Qiaolin YANG ; Hui FU ; Haiping LIU ; Lei ZHANG ; Guoduo LI
Chinese Journal of Cellular and Molecular Immunology 2025;41(4):331-338
Objective Based on 25 indicators including immune factors, cell count classification, and smear results of the knee joint fluid, machine learning models were established to distinguish between osteoarthritis (OA) and rheumatoid arthritis (RA). Methods 100 OA and 40 RA patients scheduled for total knee arthroplasty were enrolled respectively. Each patient's knee joint fluid was collected preoperatively. Nucleated cells were counted and classified. The expression levels of immune factors, including tumor necrosis factor alpha (TNF-α), interleukin-1 beta (IL-1β), IL-6, IL-8, IL-15, matrix metalloproteinase 3 (MMP3), MMP9, MMP13, rheumatoid factor (RF), serum amyloid A (SAA), C-reactive protein (CRP), and others were measured. Smears and microscopic classification of all the immune factors were performed. Independent influencing factors for OA or RA were identified using univariate binary logistic regression, Lasso regression, and multivariate binary logistic regression. Based on the independent influencing factors, three machine learning models were constructed which are logistic regression, random forest, and support vector machine. Receiver operating characteristic curve (ROC), calibration curve and decision curve analysis (DCA) were used to evaluate and compare the models. Results A total of 5 indicators in the knee joint fluid were screened out to distinguish OA and RA, which were IL-1β(odds ratio(OR)=10.512, 95× confidence interval (95×CI) was 1.048-105.42, P=0.045), IL-6 (OR=1.007, 95×CI was 1.001-1.014, P=0.022), MMP9 (OR=3.202, 95×CI was 1.235-8.305, P=0.017), MMP13 (OR=1.002, 95× CI was 1-1.004, P=0.049), and RF (OR=1.091, 95×CI was 1.01-1.179, P=0.026). According to the results of ROC, calibration curve and DCA, the accuracy (0.979), sensitivity (0.98) and area under the curve (AUC, 0.996, 95×CI was 0.991-1) of the random forest model were the highest. It has good validity and feasibility, and its distinguishing ability is better than the other two models. Conclusion The machine learning model based on immune factors in the knee joint fluid holds significant value in distinguishing OA and RA. It provides an important reference for the clinical early differential diagnosis, prevention and treatment of OA and RA.
Humans
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Arthritis, Rheumatoid/metabolism*
;
Machine Learning
;
Male
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Female
;
Middle Aged
;
Aged
;
Synovial Fluid/immunology*
;
Osteoarthritis, Knee/metabolism*
;
Knee Joint/metabolism*
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ROC Curve
;
Diagnosis, Differential
3.Mechanism by which KLF9 regulates IFN-β expression in macrophages.
Xiurui YAN ; Zhaoqing GUAN ; Jianli SONG ; Yaolin ZHANG
Chinese Journal of Cellular and Molecular Immunology 2025;41(10):882-887
Objective To investigate the role and mechanism of the zinc finger protein Kruppel-like transcription factor 9 (KLF9) in the stimulation of type I interferon expression induced by herpes simplex virus type 1 (HSV-1) in macrophages. Methods Agarose Gel electrophoresis, quantitative real-time PCR (qRT-PCR) and western blot analyses were employed to detect the KLF9 relative expression in bone marrow-derived macrophages (BMDMs) from Klf9-/- (gKO) mice and wild-type (WT) mice. RNA-seq analysis was utilized to identify the potential targeted genes upon HSV-1 stimulation in BMDMs. ELISA was used to measure the potent of IFN-β in the supernatant of BMDMs derived from gKO and WT mice after HSV-1 stimulation. qRT-PCR analysis was employed to further confirm the changes of Ifnb1 and interferon-stimulated gene (ISG) such as interferon-induced protein with tetratricopeptide repeats 1 (Ifit1), interferon-stimulated exonuclease gene 20 (Isg20), cholesterol 25-hydroxylase (Ch25h) and 2'-5' oligoadenylate synthetase-like 1 (Oasl1). Western blot was used to detect the expression of phosphorylated interferon regulatory factor-3 (p-IRF3), IRF3, phosphorylated interferon regulatory factor-7 (p-IRF7), IRF7, phosphorylated nuclear factor-kappa B p65 (p-NF-κB p65) and NF-κB p65. CUT-Tag and ChIP-qPCR assay were utilized to confirm the binding region of KLF9 in Ifnb1. Results The KLF9 expression was significantly decreased in BMDMs from gKO mice compared with that from WT mice. The RNA-seq analysis showed that Klf9 deletion in BMDMs resulted in an impaired type I interferon signaling pathway. The qRT-PCR analysis revealed that Klf9 deletion in BMDMs led to a significant decrease of Ifnb1 and ISG such as Ifit1, Ch25h and Oasl1 except Isg20. Moreover, ELISA revealed that Klf9 knockout in BMDMs resulted in a significant decrease of IFN-β secreted from BMDMs. Mechanistically, KLF9 directly binds to the promoter of Ifnb1. Conclusion KLF9 is essential for macrophages to resist HSV-1 infection.
Animals
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Kruppel-Like Transcription Factors/physiology*
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Interferon-beta/metabolism*
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Macrophages/virology*
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Mice
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Herpesvirus 1, Human/physiology*
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Mice, Knockout
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Signal Transduction
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Mice, Inbred C57BL
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Interferon Regulatory Factor-3/genetics*
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Interferon Regulatory Factor-7/genetics*
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Gene Expression Regulation
4.Correlations of MicroRNA-487a-3p and A Kinase-Interacting Protein 1 mRNA Levels in Endometrial Cancer Tissue With Patient Survival Within Five Years After Surgery.
Dan-Dan ZHAO ; Su-E ZHANG ; Li-Ye MIAO ; Yan WANG
Acta Academiae Medicinae Sinicae 2025;47(5):792-800
Objective To investigate the relationships of the expression of microRNA-487a-3p (miR-487a-3p) and A kinase-interacting protein 1 (AKIP1) mRNA in the endometrial cancer (EC) tissue with the patient survival within 5 years after surgery. Methods The EC tissue and adjacent normal tissue samples were collected from 130 EC patients who underwent surgical treatment at the Fourth Hospital of Shijiazhuang from September 2016 to April 2019.qRT-PCR was employed to determine the expression levels of miR-487a-3p and AKIP1 mRNA.The patients were followed up for 5 years after surgery to record the survival status.After removal of the patients who missed follow-up,78 surviving patients were recorded as the EC survival group,and 34 deceased patients were recorded as the EC death group.The dual luciferase reporter gene assay was conducted to verify the targeting relationship between miR-487a-3p and AKIP1 mRNA.Comparison was conducted for the expression levels of miR-487a-3p and AKIP1 mRNA between adjacent normal tissue and EC tissue,the expression levels of miR-487a-3p and AKIP1 mRNA in the EC tissue among patients with different clinical pathological parameters,and the clinical pathological parameters and the expression levels of miR-487a-3p and AKIP1 mRNA in the EC tissue between the EC survival group and the EC death group.The correlations of miR-487a-3p and AKIP1 mRNA levels in the EC tissue with the degree of tumor differentiation,International Federation of Gynecology and Obstetrics (FIGO) stage,lymph node metastasis,and depth of muscle invasion were analyzed.The relationships of miR-487a-3p and AKIP1 mRNA with patient prognosis and the risk factors affecting the survival of EC patients within 5 years after surgery were analyzed to evaluate the value of miR-487a-3p and AKIP1 mRNA levels in predicting the survival of EC patients within 5 years after survival. Results The EC tissue showed lower miR-487a-3p level (0.41±0.08 vs. 1.00±0.05;t=71.306,P<0.001) and higher AKIP1 mRNA level (2.35±0.37 vs. 1.00±0.03;t=41.465,P<0.001) than the adjacent normal tissue.The miR-487a-3p low expression group and AKIP1 mRNA high expression group had higher proportions of patients with low tumor differentiation,FIGO stage Ⅲ to Ⅳ,lymph node metastasis,and deep invasion of muscle layer than the miR-487a-3p high expression group and AKIP1 mRNA low expression group,respectively (all P<0.05).The results of dual luciferase reporter gene assay showed that the relative activity of luciferase in the miR-487a-3p small interfering RNA (siRNA)+AKIP1 mRNA-wild type (WT) group was higher than that in the miR-487a-3p empty vector+AKIP1 mRNA-WT group (2.85±0.19 vs. 1.00±0.04;t=23.339,P<0.001).There was no significant difference in the relative activity of luciferase between the miR-487a-3p empty vector+AKIP1 mRNA-mutant type (MUT) group and the miR-487a-3p siRNA+AKIP1 mRNA-MUT group (1.04±0.05 vs. 1.05±0.03;t=0.420,P=0.683).MiR-487a-3p in the EC tissue had negative correlations with AKIP1 mRNA,FIGO stage,lymph node metastasis,and depth of muscle invasion and a positive correlation with the degree of tumor differentiation (all P<0.001).AKIP1 mRNA had positive correlations with FIGO stage,lymph node metastasis,and depth of muscle invasion and a negative correlation with the degree of tumor differentiation (all P<0.001).The 5-year overall survival rates in the miR-487a-3p high expression group and AKIP1 mRNA low expression group (89.47% and 84.91%) were higher than those in the miR-487a-3p low expression group and AKIP1 mRNA high expression group (49.09% and 55.93%),respectively (both P<0.05).The EC death group had higher proportions of patients with low tumor differentiation,FIGO stage Ⅲ to Ⅳ,lymph node metastasis,and deep invasion of muscle layer,higher AKIP1 mRNA level in the EC tissue,and lower miR-487a-3p level than the EC survival group (all P<0.05).Low tumor differentiation,FIGO stage Ⅲ to Ⅳ,lymph node metastasis,deep invasion of muscle layer,low miR-487a-3p level,and high AKIP1 mRNA level were independent risk factors for the survival of EC patients within 5 years after surgery (all P<0.05).The area under curve (AUC) values of miR-487a-3p and AKIP1 mRNA alone (0.785 and 0.789,respectively) were lower than that of their combination (0.908) in predicting the survival of EC patients within 5 years after surgery (both P<0.05). Conclusion The EC tissue has a low miR-487a-3p level and a high AKIP1 mRNA level,both of which are correlated with clinicopathological parameters and prognosis and can be used to predict the survival of EC patients within 5 years after surgery.
Humans
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Female
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Endometrial Neoplasms/pathology*
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MicroRNAs/genetics*
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RNA, Messenger/genetics*
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Adaptor Proteins, Signal Transducing/genetics*
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Middle Aged
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Survival Rate
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Nuclear Proteins
5.Determination of the Contents of Three Lignans in Dendrobium fimbriatum Hook
Ying-Hua HUANG ; Lin ZHANG ; Jin-Yan LI ; Zhi-Bin LI ; Zhi-Yun LIANG ; Li-E YANG ; Gang WEI ; Yue-Chun HUANG
Journal of Guangzhou University of Traditional Chinese Medicine 2024;41(1):207-212
Objective To establish the method for content determination of three lignans of Dendrobium Fimbriatum Hook..Methods The lignans in Dendrobium tasselii were identified by high-performance liquid chromatography/multi-stage mass spectrometry(HPLC-ESI/MSn)coupled with ultraviolet absorption spectrometry(UV)coupled with retention time localization of high-performance liquid chromatography(HPLC).The separation was carried out on a Kromasil 100-5 C18 column(4.6 mm×250 mm,5 μm)using a gradient elution of acetonitrile-0.1%formic acid solution as the mobile phase,the volume flow rate was 0.8 mL·min-1 and the column temperature was 35℃,and the mass spectrometry was performed using an ESI ion source with the data collected in the negative ion mode.The HPLC content was determined on the same column as that of MS analysis,with the mobile phase methanol + acetonitrile(V/V=1∶1)-0.01 mol/L ammonium acetate solution,gradient elution,flow rate of 0.8 mL·min-1,column temperature of 40℃,and detection wavelength of 215 nm.Results Syringaresinol di-O-glucoside and(-)-Syringaresinol 4-O-β-D-glucopyranoside and DL-Syringaresinol were identified from Dendrobium fimbriatum Hook.,and the results of content determination showed that the linear ranges of above three components were respectively 0.1701-3.4020,0.1020-2.0400,0.0403-0.8060 μg(r≥0.9995),the average recoveries were in the range of 97.71%-101.67%,and the relative standard deviations(RSDs)were all less than 3.0%.The contents of Syringaresinol di-O-glucoside and(-)-Syringaresinol 4-O-β-D-glucopyranoside and DL-Syringaresinol in the 10 batches of samples were 0.7779-1.3852,0.0734-0.1966,0.0295-0.1882 mg·g-1.Conclusion This research method can provide a reference basis for the quality evaluation method of Dendrobium fimbriatum Hook..
6.Investigation on the relationship between chronic disease prevention literacy and health anxiety among chronic disease residents an urban-rural comparison
Yulian WEI ; Xin′e MAO ; Miao TIAN ; Jiahui ZHANG ; Shangping YU ; Yichen LU ; Yan WANG
Chinese Journal of Practical Nursing 2024;40(24):1879-1884
Objective:To understand the current status of the level of chronic disease prevention and treatment literacy and health anxiety among chronic disease residents, as well as the urban-rural differences, in order to provide a basis for improving the level of chronic disease prevention and treatment literacy among chronic disease residents.Methods:This was a cross-sectional study. From July to August 2022, a multi-stage random sampling method was adopted to select 201 rural residents with chronic diseases in one rural health center and 242 urban residents with chronic diseases in two community health service centers. General demographic characteristics questionnaire, Chronic Disease Prevention and Control Literacy Questionnaire and Short version of Health Anxiety Scale were used for questionnaire survey.Results:There were 93 males and 108 females with chronic diseases in 201 rural chronic disease residents, and the age range was 19-69 years. There were 116 males and 126 females with chronic diseases in 242 urban chronic disease residents, and the age range was 18-69 years old. The score of chronic disease prevention and control literacy of rural chronic disease residents (7.86 ± 2.25) was lower than that of urban chronic disease residents (8.55 ± 2.03). The score of health anxiety of rural chronic disease residents (13.69 ± 5.26) was higher than that of urban chronic disease residents (11.67 ± 5.95). Both differences were statistically significant ( t=-3.43, 3.79, both P<0.05). After controlling the general demographic data, the layered linear regression analysis of rural chronic disease residents and urban chronic disease residents showed that health anxiety can negatively affect rural chronic disease residents and urban chronic disease residents of chronic disease prevention and treatment literacy level ( β=-0.185, -0.129, both P<0.05). Conclusions:There are urban-rural differences in chronic disease prevention and treatment literacy and health anxiety of chronic disease residents in community. It is necessary to strengthen psychological construction among rural chronic disease residents in order to improve their chronic disease prevention and treatment literacy.
7.Research progress of single-cell RNA sequencing in the immune microenvironment of spinal cord injury.
Nan ZHANG ; Huazheng YAN ; Jianxiong GAO ; Lin ZHANG ; Chengchen ZHAO ; Qianhui BAO ; Jianguo HU ; Hezuo LYU
Chinese Journal of Cellular and Molecular Immunology 2024;40(12):1133-1137
Spinal cord injury (SCI) represents a complex pathophysiological process involving the interaction of multiple cell types. Conventional sequencing methods can only detect the average gene expression level of the damaged local cell populations, which is difficult to reflect its heterogeneity. Therefore, new technologies are needed to reveal the intercellular heterogeneity and the complex intercellular interactions of the damaged lesions. The single-cell RNA sequencing (scRNA-seq) technique facilitates high-resolution profiling of gene expression at the single-cell level, providing insights into cellular heterogeneity and function, potential molecular pathways, cell fate transitions, and the intercellular interactions pertinent to disease progression. This technology generates valuable gene expression data that support both basic and translational research efforts aiming at the identification of therapeutic targets for intervention. The scRNA-seq technique and its multifaceted application in the local immune microenvironment of injury after SCI were discussed, which will contribute to a more comprehensive understanding of the pathophysiological processes in the immune microenvironment of SCI.
Spinal Cord Injuries/genetics*
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Humans
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Single-Cell Analysis/methods*
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Sequence Analysis, RNA/methods*
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Animals
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Gene Expression Profiling/methods*
;
Cellular Microenvironment/genetics*
8.Investigation and analysis of airborne allergenic pollen in 4 districts and 5 counties of Hohhot City.
Hui Yu NING ; Hui Jiao CAI ; Ting Ting MA ; Chang E FAN ; Dong Dong WU ; Feng Ying GAO ; Fan KONG ; Fu Jun ZHANG ; Rong WANG ; Hui Hui GUO ; Run Lan MA ; Cai Ying ZHENG ; Bo HAO ; Hong Tian WANG ; Jun Jing ZHANG ; Luo ZHANG ; Xue Yan WANG
Chinese Journal of Preventive Medicine 2023;57(9):1364-1372
Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
Humans
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Cross-Sectional Studies
;
Pollen
;
Hospitals
9.Investigation and analysis of airborne allergenic pollen in 4 districts and 5 counties of Hohhot City.
Hui Yu NING ; Hui Jiao CAI ; Ting Ting MA ; Chang E FAN ; Dong Dong WU ; Feng Ying GAO ; Fan KONG ; Fu Jun ZHANG ; Rong WANG ; Hui Hui GUO ; Run Lan MA ; Cai Ying ZHENG ; Bo HAO ; Hong Tian WANG ; Jun Jing ZHANG ; Luo ZHANG ; Xue Yan WANG
Chinese Journal of Preventive Medicine 2023;57(9):1364-1372
Objective: To investigate the species, concentration and seasonal trends of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. Methods: The Department of allergy, Beijing Shijitan Hospital Affiliated to Capital Medical University conducted a cross-sectional study about monitoring the airborne allergenic pollen from August 1, 2021 to July 31, 2022 by the gravitational method in 4 districts and 5 counties of Hohhot City, which include Yuquan District, Xincheng District, Huimin District, Saihan District, Tuoketuo County, Helingeer County, Tumotezuoqi County, Wuchuan County and Qingshuihe County. Daily pollens were counted and identified by optical microscopy, and the data were analyzed. Results: The airborne allergenic pollen was collected every month all year round in 4 districts and 5 counties of Hohhot city. Through the whole year of the total quantity of pollens ranged from 24 850 to 50 154 grains per 1 000 mm2 and two peaks of pollen concentration in air were observed,which happened in spring (from March to May) and in summer and autumn (from July to September). In spring, the main pollens were tree pollens, which principally distributed in Populus pollen (18.29%), Ulmus pollen (8.36%), Pinus pollen (6.20%), Cupressaceae pollen (5.23%), Betulaceae pollen (2.73%), Salix pollen (1.80%) and Quercus pollen (1.16%). In summer and autumn, the main pollens were weed pollens, which mainly included Artemisia pollen (42.73%), Chenopodiaceae pollen or Amaranthaceae pollen (7.46%), Poaceae pollen (2.26%), Humulus pollen or Cannabis pollen (0.60%). Conclusion: There were two peaks of main airborne allergenic pollen in 4 districts and 5 counties of Hohhot City. In the spring peak of pollen, the main airborne pollens were tree pollens. In the summer and autumn peak of pollen, the main airborne pollens were weed pollens. The Artemisia pollen was the most major airborne pollen in this area.
Humans
;
Cross-Sectional Studies
;
Pollen
;
Hospitals
10.Neoadjuvant chemotherapy in the treatment of locally advanced olfactory neuroblastoma in 25 cases.
Yan SUN ; Shu Rong ZHANG ; Ming Jie WANG ; Qian HUANG ; Shun Jiu CUI ; Ben Tao YANG ; E QIU ; Cheng LI ; Bing ZHOU
Chinese Journal of Otorhinolaryngology Head and Neck Surgery 2023;58(5):425-430
Objective: To evaluate the efficacy of neoadjuvant chemotherapy (NACT) in the treatment of locally advanced olfactory neuroblastoma (ONB), and to explore the factors related to the efficacy of NACT. Methods: A total of 25 patients with ONB who underwent NACT in Beijing TongRen Hospital from April 2017 to July 2022 were retrospectively analyzed. There were 16 males and 9 females, with an average age of 44.9 years (ranged 26-72 years). There were 22 cases of Kadish stage C and 3 cases of stage D. After multiple disciplinary team(MDT) discussion, all patients were treated sequentially with NACT-surgery-radiotherapy. Among them, 17 cases were treated with taxol, cis-platinum and etoposide (TEP), 4 cases with taxol, nedaplatin and ifosfamide (TPI), 3 cases with TP, while 1 case with EP. SPSS 25.0 software was used for statistical analysis, and survival analyses were calculated based on the Kaplan-Meier method. Results: The overall response rate of NACT was 32% (8/25). Subsequently, 21 patients underwent extended endoscopic surgery and 4 patients underwent combined cranial-nasal approach. Three patients with stage D disease underwent cervical lymph node dissection. All patients received postoperative radiotherapy. The mean follow-up time was 44.2 months (ranged 6-67 months). The 5-year overall survival rate was 100.0%, and the 5-year disease-free survival rates was 94.4%. Before NACT, Ki-67 index was 60% (50%, 90%), while Ki-67 index was 20% (3%, 30%) after chemotherapy [M (Q1, Q3)]. The change of Ki-67 before and after NACT was statistically significant (Z=-24.24, P<0.05). The effects of age, gender, history of surgery, Hyams grade, Ki-67 index and chemotherapy regimen to NACT were analyzed. Ki-67 index≥25% and high Hyams grade were related to the efficacy of NACT (all P<0.05). Conclusions: NACT could reduce Ki-67 index in ONBs. High Ki-67 index and Hyams grade are clinical indicators sensitive to the efficacy of NACT. NACT-surgery-radiotherapy is effective for patients with locally advanced ONB.
Male
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Female
;
Humans
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Adult
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Middle Aged
;
Aged
;
Neoadjuvant Therapy/methods*
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Retrospective Studies
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Esthesioneuroblastoma, Olfactory/etiology*
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Ki-67 Antigen
;
Paclitaxel
;
Antineoplastic Combined Chemotherapy Protocols/therapeutic use*
;
Nasal Cavity
;
Nose Neoplasms/therapy*
;
Neoplasm Staging

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