Introduction: In the northwest of Iran, gastric cancer is the first and third common form of malignancy in men and women, respectively. Homeobox protein CDX2, was proposed as a prognostic biomarker in gastric cancer. Objectives: This study aimed to assess the association of CDX2 expression overall survival as well as clinicopathologic variables in patients with gastric cancer. Materials and Methods: CDX2 expression was examined by the immunohistochemistry method in the formalin-fixed paraffin-embedded surgical specimens of gastric cancer. The association between CDX2 expression and overall survival, stage of the disease, metastasis status, pathology type of the tumor, and serum levels of tumor markers serum levels of tumor markers carcinoembryonic antigen (CEA), cancer antigen 125 (CA-125), cancer antigen 19-9 (CA 19-9) was then evaluated. Results: Ninety-two patients with primary gastric cancer were recruited. CDX2 expression was positive in 72 (78%) of the subjects. Overall survival was not significantly different between two groups of patients (CDX2 positive versus negative). However, the risk of death was 21% lower in CDX2 positive patients, after adjusting for age and gender (P = 0.565). Disease stage and metastasis rate were significantly lower in CDX2 positive patients (P = 0.027, and P = 0.021, respectively). Additionally, 71% of the CDX2 positive subjects had intestinal pathology type of the disease (P = 0.025). Accordingly, a significant lower level of CA19-9 was found in CDX2 positive patients as well (P = 0.002). Conclusion: There was not any significant association between CDX2 expression and overall survival in patients with gastric cancer, although the risk of death was lower in CDX2 positive subjects. However, there was a less invasive pattern of gastric carcinoma in this group of patients.
Purpose Peripheral neuropathy is a complication of taxane that in severe cases can limit the optimal treatment. The aim of this study was to evaluate the efficacy of memantine in prevention of docetaxel induced peripheral neuropathy in patients with breast cancer. Methods In this randomized clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer (stages I to III) were included (registry number: IRCT20160310026998N9 and registry date: 26 March 2019). All patients were treated with the AC-T regimen (with docetaxel). Patients in intervention group received memantine at a dose of 20 mg for 8 weeks at the beginning of the first cycle of docetaxel. Patients in control group did not take any medication for neuropathy prevention. To assess the neuropathy, DN4 and CTCAE questionnaires were used at baseline, one months, three months and six months after the intervention. Results The DN4 questionnaire score was remarkably less in memantine group in follow up one (p-value: 0.033) and three (p < 00.1). The CTCAE follow up score did not change during study. The Neuropathy duration and Neuropathy onset, were shown significant difference between the intervention and control groups, p = 0.050 and p = 0.001, respectively. From 40 patients, 8 (40%) in memantine group and 2 (10%) in control group, did not experience any kind of neuropathy. Conclusion Data showed that prophylactic administration of memantine 20 mg/day has been effective in prevention of severity and incidence of docetaxel induced neuropathy in patients with breast cancer.
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