Clinical Activity of Olvimulogene Nanivacirepvec-Primed Immunochemotherapy in Heavily Pretreated Patients With Platinum-Resistant or Platinum-Refractory Ovarian Cancer: The Nonrandomized Phase 2 VIRO-15 Clinical Trial.

Importance: Patients with platinum-resistant or platinum-refractory ovarian cancer (PRROC) have limited therapeutic options, representing a considerable unmet medical need. Objective: To assess antitumor activity and safety of intraperitoneal (IP) olvimulogene nanivacirepvec (Olvi-Vec) virotherapy and platinum-based chemotherapy with or without bevacizumab in patients with PRROC. Design, Setting, and Participants: This open-label, nonrandomized multisite phase 2 VIRO-15 clinical trial enrolled patients with PRROC with disease progression following their last prior line of therapy from September 2016 to September 2019. Data cutoff was on March 31, 2022, and data were analyzed between April 2022 and September 2022. Interventions: Olvi-Vec was administered via a temporary IP dialysis catheter as 2 consecutive daily doses (3 × 109 pfu/d) followed by platinum-doublet chemotherapy with or without bevacizumab. Main Outcomes and Measures: Primary outcomes were objective response rate (ORR) via Response Evaluation Criteria in Solid Tumors, version 1.1 (RECIST 1.1) and cancer antigen 125 (CA-125) assay, and progression-free survival (PFS). Secondary outcomes included duration of response (DOR), disease control rate (DCR), safety, and overall survival (OS). Results: Twenty-seven heavily pretreated patients with platinum-resistant (n = 14) or platinum-refractory (n = 13) ovarian cancer were enrolled. The median (range) age was 62 (35-78) years. The median (range) prior lines of therapy were 4 (2-9). All patients completed both Olvi-Vec infusions and chemotherapy. Median follow-up duration was 47.0 months (95% CI, 35.9 months to NA). Overall, ORR by RECIST 1.1 was 54% (95% CI, 33%-74%), with a DOR of 7.6 months (95% CI, 3.7-9.6 months). The DCR was 88% (21/24). The ORR by CA-125 was 85% (95% CI, 65%-96%). Median PFS by RECIST 1.1 was 11.0 months (95% CI, 6.7-13.0 months), and the PFS 6-month rate was 77%. Median PFS was 10.0 months (95% CI, 6.4-NA months) in the platinum-resistant group and 11.4 months (95% CI, 4.3-13.2 months) in the platinum-refractory group. The median OS was 15.7 months (95% CI, 12.3-23.8 months) in all patients, with a median OS of 18.5 months (95% CI, 11.3-23.8 months) in the platinum-resistant group and 14.7 months (95% CI, 10.8-33.6 months) in the platinum-refractory group. Most frequent treatment-related adverse events (TRAEs) (any grade, grade 3) were pyrexia (63.0%, 3.7%, respectively) and abdominal pain (51.9%, 7.4%, respectively). There were no grade 4 TRAEs, and no treatment-related discontinuations or deaths. Conclusions and Relevance: In this phase 2 nonrandomized clinical trial, Olvi-Vec followed by platinum-based chemotherapy with or without bevacizumab as immunochemotherapy demonstrated promising ORR and PFS with a manageable safety profile in patients with PRROC. These hypothesis-generating results warrant further evaluation in a confirmatory phase 3 trial. Trial Registration: ClinicalTrials.gov Identifier: NCT02759588.

Swinepox dermatitis in backyard pigs in Northeastern Brazil / Varíola em suínos no Nordeste do Brasil

This article describes five outbreaks of swinepox in backyard pigs in Northeastern Brazil. It affected backyard pigs from herds of poor hygienic-sanitary conditions with severe fly and lice infestations. The morbidity ranged from 33.3 to 100% among affected herds, with mortality reaching up to 60%. The affected pigs developed multifocal to coalescent gray to white papules and blisters in the skin, with eventual eruptions, evolving to erosions and crusts. In addition to skin lesions, affected piglets presented apathy, anorexia and fever. The disease was auto-limiting, resolving within 15 to 25 days. Histological examination revealed proliferative and ulcerative vesiculopustular dermatitis with ballooning degeneration of epithelial cells, perivascular inflammatory infiltrates of lymphocytes, plasma cells, neutrophils, eosinophils and some macrophages in the dermis. Intracytoplasmic eosinophilic inclusions were consistently observed in keratinocytes. Total DNA extracted from fresh tissue fragments obtained from one outbreak and formalin-fixed, paraffin-embedded (FFPE) tissue from the other four outbreaks was submitted to polymerase chain reaction (PCR) for Swinepox virus (SWPV) and Vaccinia virus (VACV). Genetic SWPV material was identified by PCR in fresh material from one outbreak. Nucleotide sequencing and phylogenetic analysis of the PCR amplicons (viral polymerase gene) demonstrated 100% homology with sequences from SWPV. All tissues were PCR negative for VACV. Swine poxvirus is present in backyard pigs in Northeastern Brazil, indicating the need of including SWPV in the differential diagnosis of dermatitis in pigs.(AU)

Em cinco surtos de varíola em suínos no Nordeste do Brasil foram acometidos leitões e suínos adultos, de rebanhos domésticos criados em condições higiênico-sanitárias precárias, que apresentavam graves infestações por moscas e piolhos. A morbidade variou de 33,3-100% entre os rebanhos afetados e a mortalidade atingindo 60%. Os animais afetados desenvolveram pápulas cinzentas ou esbranquiçadas coalescentes e vesículas, que evoluíram para erosões e crostras. Além das lesões de pele, os leitões afetados apresentavam apatia, anorexia e febre. A doença foi autolimitante, com resolução em 15 a 25 dias. Histologicamente, observou-se dermatite proliferativa e ulcerativa com degeneração balonosa das células do epitélio, infiltrado inflamatório perivascular de linfócitos, plasmócitos, neutrófilos, eosinófilos e escassos macrófagos na derme. Inclusões eosinofílicas intracitoplasmáticas foram consistentemente observadas em queratinócitos. DNA total extraído a partir de fragmentos de tecido frescos obtidos a partir de um surto, e de tecido fixado em formol e embebido em parafina dos outros quatro surtos, foram submetidos à reação em cadeia da polimerase (PCR) para o vírus da varíola suína (SWPV) e o vírus vaccínia (VACV). Material genético do SWPV foi identificado por PCR em material fresco de um surto. O sequenciamento e análise filogenética dos produtos de amplificação da PCR (gene da polimerase viral) demonstraram 100% de homologia com sequências do SWPV. Todos os fragmentos de tecidos foram negativos para VACV na PCR. Este artigo relata a circulação de poxvírus suíno no Nordeste do Brasil, indicando a necessidade de incluir SWPV no diagnóstico diferencial de dermatite em suínos.(AU)

Infecciones virales de interés odontológico / Viral infections of odontologic interest

En el presente trabajo se hace una revisión sobre las principales enfermedades virales que presentan manifestaciones bucales. Representando el odontólogo una población de alto riesgo para transmisión de enfermedades infecto-contagiosas, dadas las características del tipo de trabajo y la cercanía a los pacientes, es importante que conozca las principales manifestaciones que pueden aparecer en la cavidad bucal como consecuencia de infecciones virales

Varíola. Diagnóstico etiológico de 1967 a 1970, no Instituto Adolfo Lutz / Smalpox. Etiological diagnosis 1967-1970 at Instituto Adolfo Lutz, São Paulo, Brasil

Com 332 materiais suspeitos de varíola, encaminhados ao Inst. Adolfo Lutz através da Campanha de Erradicação da Varíola no período de junho de 1967 a agôsto de 1970, foram realizadas provas de cultivo do vírus, pesquisa direta em microscopia eletrônica, pesquisa do antígeno solúvel viral e reações sorológicas para detectar anticorpo específico de grupo, no sentido de estabelecer o diagnóstico etiológico da infecção (AU).