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However, in the evaluation of adverse reactions, the incidence of neutropenia in Japanese patients was higher than that in Western patients (76, 77) Thus, a randomized, multicentre, double-blind phase 3 RAINBOW-Asia trial (78, 79) (a bridging study similar to RAINBOW) was initiated, in which patients were randomized to receive ramucirumab plus paclitaxel (n=294) or placebo plus paclitaxel (n=146), the primary outcome was (mPFS 4.14 months vs 3.15 months, mOS 8.71 months vs 7.92 months), and the most common adverse reaction was also decreased neutrophil count (54% vs 39%)

No statistically significant pCR differences were noticed between the groups, however, the subgroup analysis showed that for HR+ patients under 40 years old, combination therapy with paclitaxel + olaparib can lead to higher pCR rates

Additionally, UA promotes skeletal muscle angiogenesis through modulation of the silent information regulator 1 and peroxisome proliferator-activated receptor-gamma coactivator-1-alpha signaling pathways, resulting in increased capillary density and improved muscular endurance (8)