Effectiveness and safety of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma.

BACKGROUND: Treatment based on nab-paclitaxel plus gemcitabine is one of the standard treatments for locally advanced or metastatic pancreatic adenocarcinoma. Not much information is available about its use in clinical practice. Looking for prognostic markers may aid in improving treatment plans for patients. OBJECTIVE: To describe the effectiveness and safety profile of nab-paclitaxel/gemcitabine in locally advanced or metastatic pancreatic adenocarcinoma. We also tried to evaluate prognostic markers of response to treatment. SETTING: Retrospective descriptive study carried out in a tertiary hospital of Spain. METHOD: Patients with locally advanced or metastatic pancreatic adenocarcinoma treated with nab-paclitaxel/gemcitabina between January 2014 and December 2017 were included in the analyses. MAIN OUTCOME MEASURE: Effectiveness was measured in terms of overall survival, progression-free survival and response rate. To evaluate the safety profile, every adverse event from the start of the treatment and up to 10 days after its completion was registered. RESULTS: Fifty patients were included. Thirty-three (66%) had metastatic disease. Median overall survival was 8.8 months (95%CI: 5.1-12.5) and the median progression-free survival was 5.6 months (95%CI: 4.3-6.9). Relevance of carbohydrate antigen 19-9 baseline levels as prognostic response marker was confirmed, while neutrophil-to-lymphocyte ratio did not show conclusive results for overall survival. Safety profile was similar to that observed in clinical trials, with a single case of treatment discontinuation due to grade 3 neuropathy. CONCLUSION: The studied schedule for locally advanced or metastatic pancreatic adenocarcinoma seems to be an effective therapeutic option, with an easy to manage toxicity profile, similar to other schedules used in pancreatic adenocarcinoma.

Battle of Thermopylae: 300 Spartans (natural killer cells plus obinutuzumab) versus the immortal warriors (chronic lymphocytic leukemia cells) of Xerxes' army.

AIM: To analyze the effects of subcutaneous or intravenous rituximab + lymphokine-activated killer cells, obinutuzumab or ibrutinib on natural killer (NK) cell levels in chronic lymphocytic leukemia and follicular lymphoma patients. PATIENTS & METHODS: The distribution of peripheral blood NK cells of 31 patients was analyzed by flow cytometry. RESULTS: We detected a decrease of NK cells in peripheral blood below normal range after obinutuzumab treatment. During maintenance treatment with subcutaneous rituximab, an NK cell reduction was less pronounced than after intravenous rituximab treatment, despite lymphokine-activated killer cell infusions. CONCLUSION: After one dose of obinutuzumab, each NK cell in peripheral blood destroys 25 leukemic cells.

Prevalence of the consumption of anticholinergic drugs in HIV patients.

OBJECTIVE: To analyse anticholinergic agent consumption in HIV patients 50  years or older; to determine anticholinergic risk using the ACB and ARS scales;  and to determine if these patients use any type of benzodiazepine. METHOD: A descriptive observational study of 256 HIV patients 50 years or  older. RESULTS: 73.1% were men. Mean age was 56 ± 5.9 years. 55.9% of the  patients were coinfected with HCV. Excluding HIV drugs, mean drug consumption was 2.9 ± 2.9 drugs per patient. The ACB and ARS scales showed that 26.2% and 17.2% of the patients took an anticholinergic agent, and that 43.3% and 36.4% presented high anticholinergic  risk, respectively. 30.5% of patients consumed benzodiazepines. CONCLUSIONS: The percentage of HIV patients aged 50 years or older who were  taking anticholinergic agents was statistically significantly higher on the ACB  scale than on the ARS scale. No studies are available on the HIV population with  which to compare our results, but there is evidence that this group of drugs can  affect older adults.

Objetivo: Analizar el consumo de fármacos con efecto anticolinérgico en  pacientes con VIH ≥ 50 años. Determinar el riesgo anticolinérgico mediante las  escalas ACB y ARS. Determinar si consumen alguna benzodiacepina.Método: Estudio observacional descriptivo de 256 pacientes con VIH cuya edad  era ≥ 50 años.Resultados: El 73,1% eran hombres. La media de edad fue de 56 ± 5,9 años.  El 55,9% de los pacientes estaban coinfectados por el VHC. El consumo medio  de fármacos por paciente, sin incluir los fármacos para el VIH, fue de 2,9 ± 2,9.  Según la escala ACB y ARS, el 26,2% y el 17,2% de los pacientes,  respectivamente, tomaba un fármaco con efecto anticolinérgico. El 43,3%  presentaba alto riesgo anticolinérgico con la escala ACB y el 36,4% alto riesgo  según la escala ARS. El 30,5% de los pacientes consumía alguna  benzodiacepina.Conclusión: El porcentaje de pacientes con VIH ≥ 50 años que toma fármacos  con efecto anticolinérgico es mayor utilizando la escala ACB que utilizando la  escala ARS, obteniendo una diferencia estadísticamente significativa). No hay  estudios disponibles en población con VIH con los que comparar nuestros  resultados, pero sí una evidencia de que este grupo de fármacos puede afectar a  la población anciana.