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1.
Medicine (Baltimore) ; 103(20): e38132, 2024 May 17.
Artigo em Inglês | MEDLINE | ID: mdl-38758856

RESUMO

Ovarian cancer, ranked as the second leading cause of gynecologic malignancy-related deaths globally, poses a formidable challenge despite advances in early detection and treatment modalities. This paper explores the efficacy and safety of mirvetuximab soravtansine, the first folate receptor alpha (FRα)-targeting antibody-drug conjugate, in platinum-resistant ovarian cancer expressing FRα. A review of 4 key studies involving 453 participants consistently demonstrates mirvetuximab soravtansine's clinically meaningful antitumor activity and favorable safety profile. Clinical implications emphasize mirvetuximab soravtansine's pivotal role in targeted therapy, especially for high FRα-expressing tumors, potentially reshaping platinum-resistant ovarian cancer management. The combination therapy approach introduces a novel dimension, suggesting enhanced therapeutic outcomes. Even in heavily pretreated patients, mirvetuximab soravtansine's favorable tolerability positions it as a viable option. The reliability of archival tissue for FRα assessment simplifies patient selection, streamlining accessibility to targeted therapies. However, identified gaps, including limited diversity in patient populations, sparse quality of life data, and the need for long-term safety information, indicate areas for future research. Exploration of additional biomarkers predicting mirvetuximab soravtansine responsiveness is essential for personalized treatment.


Assuntos
Anticorpos Monoclonais Humanizados , Resistencia a Medicamentos Antineoplásicos , Imunoconjugados , Maitansina , Neoplasias Ovarianas , Humanos , Feminino , Neoplasias Ovarianas/tratamento farmacológico , Maitansina/análogos & derivados , Maitansina/uso terapêutico , Maitansina/efeitos adversos , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais Humanizados/efeitos adversos , Imunoconjugados/uso terapêutico , Imunoconjugados/efeitos adversos , Receptor 1 de Folato , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos
2.
Artigo em Inglês | MEDLINE | ID: mdl-38445529

RESUMO

Group B streptococcus (GBS) poses a significant threat to neonates, leading to morbidity and mortality. Intrapartum antibiotics, although effective, have limitations, prompting the exploration of maternal vaccination. This study reviews the current evidence for maternal GBS vaccination in the prevention of early-onset GBS disease in newborns. A search on Google Scholar, PubMed, and Scopus identified studies assessing the impact of maternal GBS vaccination on early-onset GBS disease. Inclusion criteria comprised English-language clinical trials or observational studies. Data extraction included study details, immunogenicity profiles, effectiveness, safety outcomes, and relevant findings. Qualitative synthesis was employed for data analysis. Five studies meeting the inclusion criteria were reviewed. Maternal GBS vaccines demonstrated efficacy with sustained immunogenicity. Adverse events, although documented, were predominantly non-severe. Variability in immune responses and maternal-to-infant antibody ratios show the need for tailored vaccination approaches. Long-term follow up and surveillance are essential to assess persistence and identify unintended effects. Positive outcomes in vaccine efficacy support GBS vaccination integration into maternal health programs. Implementation challenges in diverse healthcare infrastructures require tailored approaches, especially in resource-limited settings. Overcoming cultural barriers and ensuring healthcare provider awareness are crucial for successful vaccination.

3.
Cureus ; 15(9): e45794, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37872937

RESUMO

To date, loop diuretics are the mainstay treatment for decongestion in patients with acute decompensated heart failure (HF). In clinical practice, loop diuretics have also been utilized for patients with chronic HF with reduced and preserved ejection fractions. There is a paucity of quality evidence of the effect of loop diuretics use and dosing on clinical outcomes in HF patients beyond symptomatic relief. In this review, we aimed to summarize recently published data on the use of loop diuretics in patients with HF, focusing on efficacy and safety outcomes in patients with HF with reduced and preserved ejection fraction. We searched EMBASE, PubMed, CINAHL, and the "Web of Science" databases. Cohort studies and randomized controlled trials published after 2018 and written in English were included in this review. Case reports, case series, cross-sectional studies, review articles, commentaries, articles published more than five years ago, and studies involving children were excluded. Results were divided into the efficacy and safety of loop diuretics in HF with reduced ejection fraction (HFrEF) and HF with preserved ejection fraction (HFpEF). A registry-based study included in our review observed a reduced 30-day all-cause mortality in patients with HFrEF receiving loop diuretics compared to those not receiving loop diuretics (HR=0.73; 95% CI=0.57-0.94; p=0.016), but there was no statistically significant association at the 60-day follow-up of the same group of patients. Most studies reviewed showed that the choice of loop diuretics did not influence clinical outcomes such as mortality and HF rehospitalization in patients with HF with reduced and preserved ejection fraction despite differences in oral bioavailability and half-life. Studies have consistently shown that patients with HF who receive a higher dose of loop diuretics are likely to experience a decline in renal function and hypotension, regardless of their type of HF. Discontinuation or reduction of the dose of loop diuretics should be considered in patients with HF after decongestion.

4.
Medicine (Baltimore) ; 102(52): e36793, 2023 Dec 29.
Artigo em Inglês | MEDLINE | ID: mdl-38206732

RESUMO

Breast cancer remains a significant global health challenge, necessitating innovative therapeutic strategies. This review synthesizes findings from multiple studies investigating the safety profile and efficacy of the AE37 human epidermal growth factor receptor 2 (HER2)-targeted vaccine, offering insights into its potential role in breast cancer immunotherapy. A systematic search of electronic databases, including PubMed, MEDLINE, Scopus, and Web of Science, was conducted to identify relevant articles published up to October 2023. The search strategy utilized a combination of keywords, including "AE37 HER2 vaccine," "breast cancer recurrence prevention," and related terms. Boolean operators (AND, OR) were employed to refine the search. The AE37 vaccine exhibited a favorable safety profile across all studies, with minimal adverse effects reported. Efficacy outcomes varied, with promising trends observed in specific breast cancer subgroups, such as advanced-stage, HER2 under-expressed, and triple-negative breast cancer patients. Subgroup analyses suggested potential benefits, emphasizing the need for precise patient stratification. While the AE37 HER2-targeted vaccine demonstrates a promising safety profile and potential efficacy in specific breast cancer subgroups, an understanding requires addressing identified limitations and advancing research in nuanced directions. This paper provides a foundation for navigating the complex landscape of breast cancer immunotherapy with the AE37 vaccine.


Assuntos
Neoplasias da Mama , Vacinas Anticâncer , Neoplasias de Mama Triplo Negativas , Humanos , Feminino , Neoplasias da Mama/tratamento farmacológico , Receptor ErbB-2 , Vacinas Anticâncer/uso terapêutico , Neoplasias de Mama Triplo Negativas/tratamento farmacológico
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