Breast cancer recurrence

乳腺癌复发
  • 文章类型: Journal Article
    仿生纳米颗粒代表了减轻网状内皮系统(RES)快速清除的有希望的途径;然而,当前的挑战包括肿瘤靶向不足,次优附着力,和肿瘤区域内局部药物释放不足。这些缺点导致了持续的比赛,如复发和肺转移,即使有先进的乳腺癌疗法。刺激敏感的药物释放可以使膜包覆的纳米颗粒具有克服所述问题的效率。为了增强仿生纳米粒子在解决这些问题方面的功效,我们提出了一个多才多艺的,通过将多柔比星(Dox)和全氟己烷(PFH)封装在聚(乳酸-羟基乙酸共聚物)(PLGA)纳米颗粒中,随后用巨噬细胞衍生的细胞膜包被。在这个框架内,PFH充当超声(US)辐射触发的药物释放的介质,特别是在肿瘤微环境中,而巨噬细胞来源的细胞膜涂层增强细胞粘附,实现免疫逃避,和自然的肿瘤归巢能力。表征测定和体外评估产生了令人鼓舞的结果,表明增强的靶向和释放效率。体内研究表明,对乳腺癌复发和肺转移均具有明显的抑制作用。得到的数据表明,这些工程纳米颗粒具有明显的靶向递送和控制释放的潜力,从而对原发性乳腺癌提供显著的治疗效果,肺转移,和复发性恶性肿瘤。我们的发现为一种新的临床方法奠定了基础,代表着肿瘤学家正在进行的研究的一个有趣的方向。
    Biomimetic nanoparticles represent a promising avenue for mitigating rapid clearance by the reticuloendothelial system (RES); however, current challenges include insufficient tumour targeting, suboptimal adhesion, and inadequate localized drug release within tumour regions. These shortcomings contribute to persistent contests, such as recurrence and pulmonary metastasis, even with advanced breast cancer therapies. Stimuli-sensitive drug release can furbish the membrane coated nanoparticles for their efficiency against the stated problems. To enhance the efficacy of biomimetic nanoparticles in addressing these issues, we proposed a versatile, stimuli-responsive drug delivery system by encapsulating doxorubicin (Dox) and perfluorohexane (PFH) within poly (lactic-co-glycolic acid) (PLGA) nanoparticles, subsequently coated with macrophage-derived cell membranes. Within this framework, PFH serves as the mediator for ultrasonic (US)-irradiation-triggered drug release specifically within tumour microenvironment, while the macrophage-derived cell membrane coating enhances cell adhesion, enables immune evasion, and natural tumour-homing ability. The characterization assays and in vitro evaluations yielded encouraging results, indicating enhanced targeting and release efficiencies. In vivo studies demonstrated marked inhibitory effects on both breast cancer recurrence and pulmonary metastasis. The resulting data indicate that these engineered nanoparticles have notable potential for targeted delivery and controlled release upon US irradiation, thereby offering significant therapeutic efficacy against primary breast cancer, pulmonary metastasis, and recurrent malignancies. Our findings lay the groundwork for a novel clinical approach, representing an intriguing direction for ongoing investigation by oncologists.
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  • 文章类型: Meta-Analysis
    我们进行了一项荟萃分析,以评估乳房切除术和立即乳房重建后伤口并发症妇女的肿瘤结果。到2022年8月进行了系统的文献检索,在研究的基线时进行了乳房切除术和立即乳房重建的1618例受试者;其中443例患有伤口并发症,和1175没有伤口并发症作为对照。计算赔率比(OR)和平均差异(MD)以及95%置信区间(CIs),以使用随机或固定效应模型使用二分法或有争议的方法评估乳房切除术和立即乳房重建术后伤口并发症的女性的肿瘤学结果。伤口并发症的辅助治疗时间明显更长(MD,9.44;95%CI,4.07-14.82,P<.001)与乳房切除术和立即乳房重建的受试者相比,无伤口并发症。然而,在乳腺癌复发的乳房切除术和立即乳房重建的受试者中,伤口并发症和无伤口并发症之间没有显着差异(OR,1.96;95%CI,0.95-4.06,P=0.07),死亡率(或,1.95;95%CI,0.89-4.27,P=.09),和一种立即乳房重建(或者,1.01;95%CI,0.53-1.92,P=.98)。伤口并发症的辅助时间明显延长,然而,乳腺癌复发无显著差异,死亡率,立即进行乳房重建。即使在荟萃分析中没有发现较低的样本量,但在某些比较中发现的研究数量较少,也应谨慎进行结果分析。
    We performed a meta-analysis to evaluate the oncological results in women with wound complications following mastectomy and immediate breast reconstruction. A systematic literature search up to August 2022 was performed and 1618 subjects with mastectomy and immediate breast reconstruction at the baseline of the studies; 443 of them were with wound complications, and 1175 were with no wound complications as a control. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the oncological results in women with wound complications following mastectomy and immediate breast reconstruction using dichotomous or contentious methods with a random or fixed-effect model. The wound complications had a significantly longer length of time to adjuvant therapy (MD, 9.44; 95% CI, 4.07-14.82, P < .001) compared with no wound complications in subjects with mastectomy and immediate breast reconstruction. However, no significant difference was found between wound complications and no wound complications in subjects with mastectomy and immediate breast reconstruction in breast cancer recurrence (OR, 1.96; 95% CI, 0.95-4.06, P = .07), death rates (OR, 1.95; 95% CI, 0.89-4.27, P = .09), and kind of immediate breast reconstruction (OR, 1.01; 95% CI, 0.53-1.92, P = .98). The wound complications had a significantly longer length of time to adjuvant, however, no significant difference was found in breast cancer recurrence, death rates, and kind of immediate breast reconstruction. The analysis of outcomes should be done with caution even though no low sample size was found in the meta-analysis but a low number of studies was found in certain comparisons.
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    文章类型: Journal Article
    乳腺癌(BC)每年影响美国超过250,000名妇女。耐药癌细胞是大多数乳腺癌死亡的原因。科学家正在开发新的化疗药物和靶向治疗组合,以克服癌细胞的耐药性。结合药物可以减少肿瘤对治疗产生抗药性的机会。临床研究表明,联合化疗可提高或改善生存率,取决于患者对治疗的反应。联合治疗是一种非常成功的补充癌症治疗。本文综述了对BC药物的内在耐药性以及联合治疗对BC治疗的重要性。除了BC的复发和转移,文章讨论了BC的生物标志物。
    Breast cancer (BC) affects over 250,000 women in the US each year. Drug-resistant cancer cells are responsible for most breast cancer fatalities. Scientists are developing novel chemotherapeutic drugs and targeted therapy combinations to overcome cancer cell resistance. Combining drugs can reduce the chances of a tumor developing resistance to treatment. Clinical research has shown that combination chemotherapy enhances or improves survival, depending on the patient\'s response to treatment. Combination therapy is a highly successful supplemental cancer treatment. This review sheds light on intrinsic resistance to BC drugs and the importance of combination therapy for BC treatment. In addition to recurrence and metastasis of BC, the article discussed biomarkers for BC.
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  • 文章类型: Journal Article
    Electrospun nanofibers (NFs)-based drug delivery approaches are of particular interest as a hopeful implantable nanoplatform for localized cancer therapy and treating tissue defect after resection, allowing the on-site drug delivery with minimal side effect to healthy cells. To maintain therapeutic concentrations of anticancer molecules for a relatively long time through a combination of burst and sustained drug release mechanisms, a hybrid of polycaprolactone and gelatin (PCL/GEL) was used for co-encapsulation of free curcumin (CUR) and CUR-loaded mesoporous silica nanoparticles (CUR@MSNs) via electrospinning, resulting in a novel drug-loaded nanofibrous scaffold, CUR/CUR@MSNs-NFs. The as-prepared MSNs and composite NFs were characterized via TGA, FTIR, FE-SEM, TEM, and BET. In vitro release profile of CUR from CUR/CUR@MSNs-NFs was examined, and the in vitro antitumor efficacy against MDA-MB-231 breast cancer cells was also evaluated through MTT, scratch assay, DAPI staining, and real-time PCR. The results disclosed that the smooth, bead-free, and randomly oriented CUR/CUR@MSNs-NFs displayed a combination of initial rapid discharge and sustained release for CUR, which led to higher cytotoxicity, lower migration as well as a more pronounced effect on apoptosis induction than CUR-NFs and CUR@MSNs-NFs. The present study illustrated that the dual drug release mechanisms through MSN/NF-mediated drug delivery systems might have a highly hopeful application as a localized implantable scaffold for potential postoperative breast cancer therapy.
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  • 文章类型: Journal Article
    Engineering biocompatible hydrogels using functional nanoparticles has attracted considerable attention because of their uniquely appealing cooperative effects that can enable multimodality imaging and treatment with improved efficacy against serious diseases. However, the effects of high-content nanoparticle dopants on the rheological properties of hydrogels frequently lead to an unsatisfactory therapeutic result, which is particularly notable in the design of magnetic hydrogel formulations for cancer therapy. Herein is reported a novel magnetic hydrogel functionalized by ferromagnetic vortex-domain iron oxide (FVIOs) with optimally adaptive functions for prevention of breast cancer recurrence. The FVIOs can perfectly incorporate into the dynamic hydrogel networks with an extremely low concentration (0.6 mg mL-1 ), 17 times lower than that of conventional superparamagnetic iron oxide nanoparticles with sufficient heating capacity. Such magnetic hydrogels exhibit high inductive heating and remarkable rheological properties simultaneously. Moreover, the self-healing, self-conformal ability, controlled release of loaded doxorubicin, biodegradation, and pH-responsiveness of the magnetic hydrogel project their efficient sustainable therapeutic ability. In vivo postoperative treatment has further demonstrated the high efficacy of FVIO-based magnetic hydrogels, as evidenced by the significant suppression of the local tumor recurrences compared to chemotherapy or hyperthermia alone. This unique magnetic hydrogel formulation with optimally adaptive functions shows strong potential in preventing relapses of various cancers.
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  • 文章类型: Journal Article
    OBJECTIVE: Cell penetrating peptides (CPPs) were widely used as motifs for drug delivery to tumor. In former study, an RGD reverse sequence dGR was used to develop active-targeting liposome R8dGR-Lip, which showed well penetrating ability and treatment efficiency on glioma model. However, recurrence after tumor resection caused by post-operative residual cancer cells was a huge obstacle in tumor treatment. In consideration of the effective anti-cancer effect of PTX-R8dGR-Lip when treating glioma in former study, we decide to evaluate its pharmacodynamics on tumor resection models, which were more invasive and resistant.
    METHODS: In vitro, the effectiveness of PTX-R8dGR-Lip in reducing tumor initiating cell (TIC) was investigated using mammosphere formation. In vivo, the inhibition efficiency of PTX-R8dGR-Lip on C6 glioma recurrence and 4 T1 breast cancer recurrence model were evaluated, including tumor bioluminescence imaging, survival rate and immumohistochemical staining, etc..
    RESULTS: C6 mammosphere formation rate of PTX-R8dGR-Lip group was 48.06 ± 2.72%, and 4 T1 mammosphere formation rate of PTX-R8dGR-Lip group was 39.51 ± 4.02% when PBS group was set as 100%. C6 and 4 T1 bioluminescent tumor resected model were established, then effectiveness of different PTX-loaded preparations were evaluated on these two models. PTX-R8dGR-Lip could obviously inhibit tumor recurrence, prolong survival rate and reduce tumor tissue invasion.
    CONCLUSIONS: PTX-R8dGR-Lip could reduce post-operative recurrence rate, prolong survival time, and decrease the proliferation of residual cancer cells through regulating the expression of recurrence-related cytokines.
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