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1.
Sci Transl Med ; 15(683): eade6023, 2023 02 15.
Artículo en Inglés | MEDLINE | ID: mdl-36791210

RESUMEN

The emergence of the SARS-CoV-2 Omicron sublineages resulted in increased transmission rates and reduced protection from vaccines. To counteract these effects, multiple booster strategies were used in different countries, although data comparing their efficiency in improving protective immunity remain sparse, especially among vulnerable populations, including older adults. The inactivated CoronaVac vaccine was among the most widely distributed vaccine worldwide and was essential in the early control of SARS-CoV-2-related hospitalizations and deaths. However, it is not well understood whether homologous versus heterologous booster doses in those fully vaccinated with CoronaVac induce distinct humoral responses or whether these responses vary across age groups. We analyzed plasma antibody responses from CoronaVac-vaccinated younger or older individuals who received a homologous CoronaVac or heterologous BNT162b2 or ChAdOx1 booster vaccine. All three evaluated boosters resulted in increased virus-specific IgG titers 28 days after the booster dose. However, we found that both IgG titers against SARS-CoV-2 Spike or RBD and neutralization titers against Omicron sublineages were substantially reduced in participants who received homologous CoronaVac compared with the heterologous BNT162b2 or ChAdOx1 booster. This effect was specifically prominent in recipients >50 years of age. In this group, the CoronaVac booster induced low virus-specific IgG titers and failed to elevate neutralization titers against any Omicron sublineage. Our results point to the notable inefficiency of CoronaVac immunization and boosting in mounting protective antiviral humoral immunity, particularly among older adults, during the Omicron wave. These observations also point to benefits of heterologous regimens in high-risk populations fully vaccinated with CoronaVac.


Asunto(s)
Formación de Anticuerpos , COVID-19 , Humanos , Anciano , Vacuna BNT162 , SARS-CoV-2 , Inmunoglobulina G , Anticuerpos Antivirales
2.
Acta Paul. Enferm. (Online) ; 36: eAPE01914, 2023. tab, graf
Artículo en Portugués | LILACS-Express | LILACS, BDENF | ID: biblio-1505430

RESUMEN

Resumo Objetivo Mapear os cuidados em saúde do dispositivo Pegfilgrastim on-body injector na prevenção de neutropenia em adultos com câncer em assistência domiciliar após quimioterapia ambulatorial. Métodos Revisão de escopo baseada na metodologia do Joanna Briggs Institute . Foram incluídos somente estudos com adultos com câncer submetidos à quimioterapia ambulatorial. A busca foi realizada nas bases de dados Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO e Web of Science, além da literatura cinzenta ProQuest, Scielo, Banco de Dados em Enfermagem, Google Scholar, Open Grey, bula do medicamento e websites . Foram esgotadas as buscas nas referências dos estudos elegidos. Todos os estudos identificados foram exportados para o gerenciador de referências EndNote para organização e remoção das duplicadas. Utilizou-se o aplicativo web Rayyan para seleção das evidências. Os estudos foram selecionados por pares e de forma independente, sendo os conflitos solucionados por um terceiro pesquisador. Resultados Foram incluídos 10 artigos cujos resultados foram subdivididos nas categorias: adesão do paciente, opinião da equipe de saúde, carga de trabalho do paciente em tratamento do câncer e uso do dispositivo na prática clínica. O dispositivo apresenta poucas falhas e foi aceito pelas equipes de saúde e pacientes na maioria dos estudos. Conclusão Os principais cuidados em saúde para o uso do dispositivo Pegfilgrastim on-body injector estão relacionados à técnica de preparo da pele onde o dispositivo será aplicado, o preparo e a administração do dispositivo. Além disso, salienta-se a importância da avaliação do conhecimento do paciente e seu familiar sobre o dispositivo, o fornecimento de todas as orientações necessárias, verbalmente e por escrito, de forma clara e objetiva, e a validação dessas informações, certificando-se que o paciente compreendeu todas elas e está seguro.


Resumen Objetivo Mapear los cuidados de la salud al utilizar el dispositivo Pegfilgrastim on-body injector para prevenir la neutropenia en adultos con cáncer en atención domiciliaria después de quimioterapia ambulatoria. Métodos Revisión de alcance basada en la metodología del Joanna Briggs Institute . Se incluyeron solamente estudios con adultos con cáncer sometidos a quimioterapia ambulatoria. La búsqueda se realizó en las bases de datos Cochrane, CINAHL, EMBASE, LILACS , PubMed, Scopus, LIVIVO y Web of Science, además de la literatura gris ProQuest, Scielo, Banco de Datos de Enfermería, Google Scholar, Open Grey, prospecto del medicamento y sitios web. Se concluyeron las búsquedas en las referencias de los estudios seleccionados. Todos los estudios identificados se exportaron al programa de gestión de referencias EndNote para organizarlas y remover las duplicadas. Se utilizó la aplicación web Rayyan para seleccionar las evidencias. Se seleccionaron los estudios por pares y de forma independiente, y los conflictos se solucionaron mediante un tercer investigador. Resultados Se incluyeron diez artículos cuyos resultados fueron subdivididos en las siguientes categorías: adhesión del paciente, opinión del equipo de salud, carga de trabajo del paciente en tratamiento de cáncer y uso del dispositivo en la práctica clínica. El dispositivo presenta pocas fallas y fue aceptado por los equipos de salud y por los pacientes en la mayoría de los estudios. Conclusión Los principales cuidados de la salud para el uso del dispositivo Pegfilgrastim on-body injector se relacionan con la técnica de preparación de la piel donde se aplicará el dispositivo, la preparación y la administración del dispositivo. Además, se destaca la importancia de la evaluación de conocimientos del paciente y su familiar sobre el dispositivo, la entrega de todas las instrucciones necesarias, verbalmente y por escrito, de forma clara y objetiva, la validación de la información y la verificación de que el paciente haya comprendido todo y esté seguro.


Abstract Objective To map the health care of Pegfilgrastim On-body Injector in neutropenia prevention in adults with cancer in home care after outpatient chemotherapy. Methods This is a scoping review based on the JBI methodology. Only studies with adults with cancer undergoing outpatient chemotherapy were included. The search was carried out in the Cochrane, CINAHL, EMBASE, LILACS, PubMed, Scopus, LIVIVO and Web of Science databases, in addition to gray literature ProQuest, SciELO, Database in Nursing, Google Scholar, Open Grey, drug leaflet and websites. The searches in the references of selected studies were exhausted. All identified studies were exported to the EndNote reference manager for organization and removal of duplicates. The Rayyan web application was used for evidence selection. The studies were selected by pairs independently, with conflicts resolved by a third researcher. Results A total of 10 articles were included, whose results were subdivided into categories: patient compliance, health team opinion, patient workload in cancer treatment and device use in clinical practice. The device has few flaws and was accepted by health care teams and patients in most studies. Conclusion The main health care for Pegfilgrastim On-body Injector use is related to the skin preparation technique where the device will be applied, in addition to device preparation and administration. Moreover, the importance of assessing the knowledge of patients and their family about the device is highlighted, providing all the necessary guidelines, verbally and in writing, clearly and objectively, and validating this information, making sure that patients have understood all of them and are safe.

3.
Future Oncol ; 12(23): 2755-2764, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27549331

RESUMEN

AIM: Concomitant chemoradiotherapy (with cisplatin or carboplatin) is an option of definitive treatment for squamous head and neck cancer. We aimed to perform a meta-analysis comparing those two platinum agents. MATERIALS & METHODS: We carried out a systematic search on English literature between 1990 and 17 April 2015 according to the Cochrane review guidelines. RESULTS: Five of 60 studies fulfilled inclusion criteria with 491 patients. There was no difference in response rate. Cisplatin tends to be more active systemically than carboplatin, without statistically significance; 5-year survival rate: 30 and 27%, respectively (p = 0.33). CONCLUSION: Despite the trend to improved outcomes in using cisplatin, carboplatin is also active and can be a reasonable option to treat patients.


Asunto(s)
Carcinoma de Células Escamosas/terapia , Quimioradioterapia , Neoplasias de Cabeza y Cuello/terapia , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Carboplatino/administración & dosificación , Carcinoma de Células Escamosas/mortalidad , Carcinoma de Células Escamosas/patología , Quimioradioterapia/efectos adversos , Quimioradioterapia/métodos , Cisplatino/administración & dosificación , Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Humanos , Recurrencia Local de Neoplasia , Resultado del Tratamiento
4.
Immunotherapy ; 8(9): 1011-9, 2016 09.
Artículo en Inglés | MEDLINE | ID: mdl-27485075

RESUMEN

BACKGROUND: Recent studies with nivolumab (a monoclonal antibody against programmed cell death 1 [PD-1] receptor) have shown promise non-small-cell lung cancer (NSCLC) treatment. METHODS: To review available clinical trials data in order to assess nivolumab efficacy and the role of tumoral PDL-1 expression as a biomarker. RESULTS: Nine eligible studies included 2102 patients. In the second line setting, nivolumab achieved a 1-year survival rate of 41%; and in the first line, a 1-year survival rate of 76%. For those with PD-L1 expression <1%, nivolumab showed a trend for improved survival compared with docetaxel. CONCLUSIONS: The available data reinforce nivolumab activity against NSCLC in first-line or subsequent lines. Although PD-L1 expression is related to greater response, PD-L1 negative patients had also some benefit.


Asunto(s)
Anticuerpos Monoclonales/uso terapéutico , Antineoplásicos/uso terapéutico , Antígeno B7-H1/metabolismo , Biomarcadores de Tumor/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Antígeno B7-H1/genética , Biomarcadores de Tumor/genética , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Docetaxel , Humanos , Nivolumab , Valor Predictivo de las Pruebas , Pronóstico , Análisis de Supervivencia , Taxoides/uso terapéutico
5.
Immunotherapy ; 8(4): 479-88, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26973128

RESUMEN

BACKGROUND: Tumor programmed death ligand one (PD-L1) expression has been studied in several trials in non-small-cell lung cancer. METHODS: We assessed the potential role of PD-L1 expression according to Cochrane Collaboration's Guidelines. RESULTS: 13 studies with 1979 patients were included. Among 915 PD-L1 negative patients this rate was 13% (RR 2.08; 95% CI: 1.49-2.91; p < 0.01). The response rate has increased concurrent to the PD-L1 expression (Pearson's correlation, r = 0.43). PD-L1 expression was also related to better 24-weeks progression-free rate (RR 0.79; 95% CI: 0.71-0.89) and a trend toward better 1-year overall survival rate (RR 0.96; 95% CI: 0.87-1.06). CONCLUSION: Taking this data in account, PD-L1 overexpression could not be currently considered a robust biomarker to tailor the immune checkpoint inhibitors treatment.


Asunto(s)
Antígeno B7-H1/metabolismo , Biomarcadores de Tumor/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico , Animales , Antígeno B7-H1/genética , Biomarcadores Farmacológicos/metabolismo , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Regulación Neoplásica de la Expresión Génica , Humanos , Valor Predictivo de las Pruebas , Pronóstico , Análisis de Supervivencia
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