RESUMEN
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.
Asunto(s)
Antineoplásicos/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Inmunoterapia/métodos , Neoplasias Pulmonares/tratamiento farmacológico , Nivolumab/uso terapéutico , Neumonía/epidemiología , Adulto , Anciano , Anciano de 80 o más Años , Antineoplásicos/efectos adversos , Bélgica , Carcinoma de Pulmón de Células no Pequeñas/mortalidad , Colitis/etiología , Femenino , Hospitales Generales , Humanos , Inmunoterapia/efectos adversos , Neoplasias Pulmonares/mortalidad , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Estadificación de Neoplasias , Nivolumab/efectos adversos , Neumonía/etiología , Receptor de Muerte Celular Programada 1/inmunología , Estudios Retrospectivos , Análisis de SupervivenciaRESUMEN
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.