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Efficacy and safety of neoadjuvant chemotherapy with dose de-escalation tri-weekly nanoparticle albumin-bound paclitaxel and FEC for human epidermal growth factor receptor 2-positive breast cancer
Efficacy and safety of neoadjuvant chemotherapy with dose de-escalation tri-weekly nanoparticle albumin-bound paclitaxel and FEC for human epidermal growth factor receptor 2-positive breast cancer
Kazumi Kawase, Kazuhiko Yoshida, Keigo Hara, Suguru Hidaka, Hiroshi Takeyama
Introduction: Neoadjuvant chemotherapy (NAC) is widely used for human epidermal growth factor receptor 2-positive (HER2+) breast cancer. The standard NAC regimen for HER2+ breast cancer is an anthracycline, followed by taxane in combination with anti-HER2 drugs. However, the risk of toxicities such as cardiac dysfunction and peripheral neuropathy occasionally requires dose reduction. Nanoparticle albumin-bound paclitaxel (nab-PTX) is a new taxane used in NAC. The aim of this study was to examine the effects of tri-weekly low-dose nab-PTX with anti-HER2 drugs followed by fluorouracil, epirubicin, and cyclophosphamide (FEC) as NAC in patients with HER2+ breast cancer.
Methods: Patients with operable primary HER2+ breast cancer in clinical stages I–III were enrolled in this study. The NAC regimen included four courses of nab-PTX (220 mg/m2) concurrently with trastuzumab (6 mg/kg) tri-weekly, followed by four courses of FEC75 (5-fluorouracil: 500 mg/m2, epirubicin: 75 mg/m2, and cyclophosphamide: 500 mg/m2). Pathological responses, adverse events, and follow-up data at 36 months were evaluated.
Results: Among the 20 patients enrolled, 15 completed the treatment protocol. The pathological complete response (pCR) rates were 60.0% overall and 85.7% in hormone receptor-negative/HER2+ patients. At 36 months, one secondary malignancy was observed. The most frequent adverse event was peripheral sensory neuropathy (25/42, 59.5%), which persisted in four (16%) patients at 36-month follow-up.
Conclusions: NAC with low-dose tri-weekly nab-PTX followed by FEC demonstrated favorable pCR and disease-free survival. Peripheral sensory neuropathy remains a concerning long-term adverse effect in some patients, even after reducing the nab-PTX dosage.
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The Biophysical Modelling of the System Theory
The Biophysical Modelling of the System Theory
Janos Vincze, Gabriella Vincze- Tiszay
Modelling in this case should just complicate the situation. In this sense there are explicitly good models but it’s well known that there are also wrong things which, by modification, may work well. In this case model has given even more than it was originally for seen. In this respect, it’s without doubt that the biological modelling is a useful way of collaboration between the biologist and physicist. The system is a fundamental concept which is not defined. The biophysical approximation of the life processes leads always to the application of some kind of physical model. This definition has three essential factors. In the first place, it should need an object to be realized by the system. Secondly, it is necessary for the components a well-defined settlement to be arranged. At last the information about the distribution of energy and matter according to the programme. The hierarchy of the systems will be built up according to a spiral line expanding in breadth and depth towards the infinity. One important mode to construct general systems is if we recognize the common phenomena occurring in the different specialized sciences and construct the systems applicable for such phenomena. Let’s sketch out the hierarchy of the systems according to Boulding
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