RESUMO
OBJECTIVES: In patients with refractory or recurrent non-small-cell lung cancer (NSCLC) after first line chemotherapy, phase III trials showed superiority of nivolumab, an IgG4 programmed death-1 immune-checkpoint-inhibitor antibody, over docetaxel. We evaluated case mix, effectiveness and safety of nivolumab upon implementation in general practice. MATERIALS AND METHODS: In 20 general hospitals, all consecutive NSCLC patients treated with nivolumab within the medical need program (inclusion period 12 months) in Flanders - Belgium were evaluated. RESULTS: There were 267 patients, Eastern Cooperative Oncology Group (ECOG) score was 2 in 24% and 0-1 in 76%. In 48%, two or more systemic regimens were given before nivolumab. The median overall survival was 7.8 months (95% confidence interval (CI) 6.3-9.3). At one year, the overall survival rate was 36.5±0.34%. Median progression-free survival was 3.7 months (95% CI 2.9-4.5). An objective response was obtained in 23.2%. ECOG score 2 and presence of liver metastasis strongly correlated with worse survival (p<0.00001). Treatment related adverse events grade 3 or 4 were reported in 21%, colitis (4%) and pneumonitis (7%) were most frequent. CONCLUSION: Upon implementation of nivolumab therapy in general hospitals, the case mix was characterized by a more heavily pretreated population with a substantial fraction of patients with ECOG score 2. The median overall survival is slightly inferior to what was published in the randomized phase III trials. An ECOG score 2 and the presence of liver metastasis correlated strongly with a worse survival. We report a high prevalence of serious adverse events.
Assuntos
Antineoplásicos/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Imunoterapia/métodos , Neoplasias Pulmonares/tratamento farmacológico , Nivolumabe/uso terapêutico , Pneumonia/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antineoplásicos/efeitos adversos , Bélgica , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Colite/etiologia , Feminino , Hospitais Gerais , Humanos , Imunoterapia/efeitos adversos , Neoplasias Pulmonares/mortalidade , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Recidiva Local de Neoplasia , Estadiamento de Neoplasias , Nivolumabe/efeitos adversos , Pneumonia/etiologia , Receptor de Morte Celular Programada 1/imunologia , Estudos Retrospectivos , Análise de SobrevidaRESUMO
Solvent stable polymeric membranes with morphologies ranging from highly porous to dense were prepared via UV curing using dedicatedly designed photopolymerizable compositions. To optimize the UV curing efficiency, various parameters including the photoinitiator type, cross-linker functionality, as well as membrane thickness were investigated. UV modified polysulfone membranes showed excellent solvent stability in addition to a 91% Rose Bengal (1017 Da) retention at a superior ethyl acetate permeance of 8 l m(-2) h(-1) bar(-1) in a typical solvent resistant nanofiltration (SRNF) experiment.