RESUMO
BACKGROUND: Recently published randomized controlled trials (RCTs) showed improved overall survival (OS) and progression-free survival (PFS) with the combination of immunotherapy and chemotherapy as compared to chemotherapy alone in advanced non-small cell lung cancer (NSCLC). We aimed to provide a systematic review and meta-analysis of RCTs regarding the efficacy and safety of immunotherapy and chemotherapy combinations for advanced NSCLC. METHODS: On December 23rd, 2021, we searched databases for RCTs that reported PFS and OS as primary outcomes. RESULTS: We included 11 RCTs with 6,386 patients (3,850 in the combination therapy group and 2,536 in the chemotherapy group). Combination therapy was associated with an improvement in PFS (HR: 0.60; 95% CI: 0.54, 0.66; P < 0.00001) andOS (HR: 0.77; 95% CI: 0.68, 0.87; P ≤ 0.0001), compared to chemotherapy. There were no significant differences between both groups in terms of treatment-related adverse events (TRAEs) (RR: 1.07; 95% CI: 0.99, 1.16; P = 0.09). CONCLUSION: The combination of immunotherapy and chemotherapy as first-line treatment for advanced NSCLC significantly improved PFS and OS compared to chemotherapy alone without a significant increase in the overall TRAEs.
Assuntos
Antineoplásicos , Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Antineoplásicos/efeitos adversos , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Humanos , Imunoterapia , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/etiologia , Ensaios Clínicos Controlados Aleatórios como AssuntoRESUMO
Tracheobronchial aspiration is a very common and serious medical condition. It can present acutely with an aspiration pneumonia, or it can be chronic and occur over a long period of time. In some instances, the diagnosis can be missed, and patients may be treated for years for other medical conditions such as asthma, with no significant improvement. We present here a very interesting case of a 69-year-old gentleman with multiple comorbidities who presented with a fever and shortness of breath. He was initially diagnosed with aspiration pneumonia, but when he did not improve, a bronchoscopy was performed, which showed a mass in the right bronchus suspicious for a carcinoid tumor. However, a biopsy was taken and sent to pathology for analysis, which showed food material. He underwent a rigid bronchoscopy for mass removal, which indeed confirmed that the whole mass was composed of food material as a result of tracheobronchial aspiration.