RESUMO
Objective: Endometrial carcinoma is the most widespread gynecological cancer, with increasing morbidity and mortality. Pembrolizumab, a monoclonal antibody that targets PD1 receptor tumors, is approved for patients with microsatellite instability-high (MSI-H) solid tumors. Many clinical trials and observational studies have been conducted to assess the safety and efficacy of Lenvatinib and Pembrolizumab combination therapy in the setting of endometrial cancer. However, results have been inconsistent, and current data is based on a heterogeneous population. The primary objective was to assess the safety and efficacy of Lenvatinib plus Pembrolizumab for endometrial cancer. Data sources: The search was conducted from inception from four databases; PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov. The electronic database search was conducted from inception to August 20, 2023. Study eligibility criteria: We considered randomized controlled trials and single-arm observational studies, i.e. cohort, case-control and cross-sectional studies. Methodology: We performed a single-arm meta-analysis, involving 7 studies having a total of 495 patients with endometrial cancer were eventually included which had the following outcomes: Complete response, Partial response, Progression-free survival, stable disease, progressive disease, safety outcomes, Adverse events, and the total number of deaths. Results: Our results showed that 88.6 % of the patients were positive for non-MSI-H/pMMR tumors (95 % CI = 0.825-0.927) whereas 6.5 % (95 % CI = 3.8-9.8 %) of the patients for MSI-H/dMMR tumors. The pooled objective response of endometrial cancer patients treated with Lenvatinib and Pembrolizumab was 36.5 % (95 % CI = 0.258-0.471), the pooled estimate of complete and partial response was 47 % (95 % CI = 0.024-0.070) and 31.3 % (95 % CI = 0.230-0.396). 38.2 % patients had stable disease (95 % CI = 0.329-0.435) and 24.0 % patients had progressive disease (95 % CI = 0.103-0.378). The pooled median progression-free survival was 5.97 (95 % CI 5.43-7.63) months and, whereas the median overall survival was 17.19 months (95 % CI 15.34-19.31). All grade adverse events occurred in 85 % and Grade 3 or worse adverse events occurred in 39 % of patients during the therapy whereas death occurred in 23.8 % during the treatment. Conclusion: The results of this meta-analysis concludes that although the combined treatment of a Lenvatinib and Pembrolizumab had a PFS and OS that was inferior to the standard therapy used to treat advanced and recurrent endometrial cancer, it is still a novel treatment and shows potential for further research with a greater sample size.
RESUMO
The use of natural solar radiation is a low-cost significant technology for water pollution remediation and production of clean energy. In this work, S-scheme Ag2CO3/g-C3N4 heterojunctions were engineered for carefully eradicating Rhodamine B dye under natural sunlight irradiation. Solid thermal decomposition reactions generate g-C3N4 sheets by annealing urea at 520 °C. Ag2CO3 nanoparticles are directed and localized sonochemically to the active centers of g-C3N4 sheets. The physicochemical properties of the solid specimen were determined by PL, DRS, XRD, HRTEM, mapping, EDX, N2-adsorption-desorption isotherm and XPS analyses. As elucidated by HRTEM, PL and DRS analyses, 5 wt% of spherical Ag2CO3 nanoparticles deposited on the g-C3N4 sheet surface and nearly equidistant from each other elevate the electron-hole separation efficiency and broaden the absorption capacity of photocatalysts. Rhodamine B dye was degraded at a rate of 0.0141 min-1 by heterojunctions containing 5 wt% Ag2CO3 and 95 wt% g-C3N4, which is three-fold higher than that on pristine g-C3N4 nanosheets. Free radical scrubber experiments revealed the contribution of charge carriers and reactive oxygen species to the decomposition of RhB dye with a preferential role of positive holes and superoxide species. PL measurements of terephthalic acid and scrubber trapping experiments provide confirmatory evidence for charge diffusion via the S-scheme mechanism that accounts for the production of electron-hole pairs with strong redox power. This novel research work is contributory to manipulate the S-scheme heterojunction for efficient and low-cost wastewater treatment under natural solar irradiation.