Neoadjuvant chemotherapy and trastuzumab versus neoadjuvant chemotherapy followed by post-operative trastuzumab for patients with HER2-positive breast cancer

Neoadjuvant chemotherapy plus trastuzumab (NCT) increases the rate of pathological complete response (pCR) and event-free survival (EFS) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting is associated with improved EFS. Whether NCT preferentially improves EFS in comparison to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT) has not been addressed. Using clinical data from women with HER2 positive BC treated at 7 European institutions between 2007 and 2010 we sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early BC. The unadjusted hazard ratio (HR) for event free survival with NCT compared with NCAT was 0.63 (95% CI 0.37–1.08; p = 0.091). Multivariable analysis revealed that treatment group, tumour size and ER status were significantly associated with EFS from diagnosis. In the whole group NCT was associated with a reduced risk of an event relative to NCAT, an effect that was confined to ER negative (HR: 0.25; 95% CI, 0.10–0.62; p = 0.003) as opposed to ER positive tumours (HR: 1.07; 95% CI, 0.46–2.52; p = 0.869). HER2 positive/ER negative BC treated with NC gain greatest survival benefit when trastuzumab is administered in both the neoadjuvant and adjuvant period rather than in the adjuvant period alone. These data support the early introduction of targeted combination therapy in HER2 positive/ER negative BC

Neoadjuvant chemotherapy and trastuzumab versus neoadjuvant chemotherapy followed by post-operative trastuzumab for patients with HER2-positive breast cancer

Neoadjuvant chemotherapy plus trastuzumab (NCT) increases the rate of pathological complete response (pCR) and event-free survival (EFS) compared to neoadjuvant chemotherapy (NC) alone in women with HER2 positive breast cancer (BC). pCR in this setting is associated with improved EFS. Whether NCT preferentially improves EFS in comparison to NC followed by adjuvant trastuzumab initiated postoperatively (NCAT) has not been addressed. Using clinical data from women with HER2 positive BC treated at 7 European institutions between 2007 and 2010 we sought to investigate the impact on breast cancer outcomes of concomitant (NCT) versus sequential (NCAT) treatment in HER2 positive early BC. The unadjusted hazard ratio (HR) for event free survival with NCT compared with NCAT was 0.63 (95% CI 0.37–1.08; p = 0.091). Multivariable analysis revealed that treatment group, tumour size and ER status were significantly associated with EFS from diagnosis. In the whole group NCT was associated with a reduced risk of an event relative to NCAT, an effect that was confined to ER negative (HR: 0.25; 95% CI, 0.10–0.62; p = 0.003) as opposed to ER positive tumours (HR: 1.07; 95% CI, 0.46–2.52; p = 0.869). HER2 positive/ER negative BC treated with NC gain greatest survival benefit when trastuzumab is administered in both the neoadjuvant and adjuvant period rather than in the adjuvant period alone. These data support the early introduction of targeted combination therapy in HER2 positive/ER negative BC

Progranulin Gene Variability and Plasma Levels in Bipolar Disorder and Schizophrenia

Basing on the assumption that frontotemporal lobar degeneration (FTLD), schizophrenia and bipolar disorder (BPD) might share common aetiological mechanisms, we analyzed genetic variation in the FTLD risk gene progranulin (GRN) in a German population of patients with schizophrenia (n = 271) or BPD (n = 237) as compared with 574 age-, gender- and ethnicity-matched controls. Furthermore, we measured plasma progranulin levels in 26 German BPD patients as well as in 61 Italian BPD patients and 29 matched controls

Socio-demographic differences in food habits and preferences of school adolescents in Jiangsu Province, China

Objective: To identify the differences in food habits and preferences among the adolescents according to socio-demographic characteristics. Design: Cross-sectional, cluster design survey in 2002. Setting: Eight middle schools in two distinct socio-economic areas of the Jiangsu province, China. Subjects: Some 824 young adolescents (12–14 y) attending public schools with a response rate of 99%. Methods: A self-administered questionnaire containing questions on food and meal frequencies, food preferences and socio-demographic characteristics was used. Results: High socio-economic status (SES) and urban residence was positively associated with intake of high-energy foods, such as foods of animal origin, Western style foods and dairy products. In all, 76% of the students had three meals a day regularly , but 8.1% urban students vs 3.4% rural students had breakfast only 1–3 times per week or less often. Daily fruit consumption was fairly common, but with clear differences by SES. Only about 42% of the boys and 55% of the girls from low SES families ate fruit daily, compared with 66% and 72%, respectively in the high SES families. Urban boys had the lowest proportion of daily consumers of vegetables (67.0%). More urban students drank milk daily than the rural students (68.7 vs 38.5%). The frequency of milk drinking also showed a strong positive association with SES. About 10% of the high SES boys consumed hamburgers daily compared with 2.8% of the low SES boys. More than half of the students reported a liking for Western style fast foods including hamburgers, soft drinks and chocolate. Among high SES boys, 21.5% consumed soft drinks on a daily basis; however, as many as 72.3% wanted to drink soft drinks more often if they could afford it. Conclusions: SES and urban location were positively associated with frequency of intake of high-energy foods. Reported food preferences may enforce this trend. Nutrition education for adolescents and parents is needed to promote healthy eating. Health Authorities should strengthen the monitoring of food intake and its association with overweight/obesity.Z Shi, N Lien, BN Kumar and G Holmboe-Ottese