RESUMEN
Background: The RESORT trial showed no longer relapse free survival (RFS) with sorafenib following radical metastasectomy in metastatic renal cell carcinoma. We present the updated 42-month follow-up data.Methods: The phase II RESORT trial randomized patients to sorafenib or observation within 12 weeks from surgery. RFS was the primary endpoint.Results: We analyzed 68 patients (32 in sorafenib and 36 in the observation arm), randomized between November 2012 and November 2017. Eighty-one percent in the sorafenib arm and 80% in the observation arm had one metastasis . At a median follow-up of 42 months (interquartile range 31-58), in the observation arm the median RFS was 35 months, RFS probability was 57% (95% CI 42-76%) at 24 and 44% (95% CI 30-65%) at 48 months. In the sorafenib arm, median RFS was 21 months, RFS probability was 50% (95% CI 34-71%) at 24 and 32% (95% CI 18-57%) at 48 months (p = 0.342;HR 1.35;95% CI 0.72-2.54). Forty-seven percent and 37.5% of the patients in the two arms, respectively, are disease free. The site of relapses was independent of the previous metastasectomy site.Expert commentary: Sorafenib after metastasectomy did not improve RFS, but surgery in selected patients should be considered in order to potentially improve survival.Clinical trial registration: www.clinicaltrials.gov identifier is NCT0144480.
Asunto(s)
Carcinoma de Células Renales/terapia , Neoplasias Renales/terapia , Metastasectomía/métodos , Sorafenib/administración & dosificación , Antineoplásicos/administración & dosificación , Carcinoma de Células Renales/patología , Supervivencia sin Enfermedad , Estudios de Seguimiento , Humanos , Neoplasias Renales/patología , Recurrencia Local de Neoplasia , ProbabilidadRESUMEN
Implants containing Norgestomet (G. D. Searle and Co., Chicago) were inserted subcutaneously in ewes on selected days of the estrous cycle. When ewes were treated for 13 days with 2 or 3 mg Norgestomet, implantation 13 days post-estrus reduced the number of ewes in estrus within 5 days of implant removal and reduced the number of estrous ewes that lambed compared with ewes implanted 4 days post-estrus. When ewes were implanted with 3 or 6 mg Norgestomet 4 or 13 days post-estrus, no difference in estrus response was found. Conception rate was not influenced by day of treatment, but was higher in those ewes treated with 6 mg than ewes treated with 3 mg. Compared to no treatment, treatment with 3 or 6 mg Norgestomet reduced the number of uterine and oviducal sperm recovered 12 or 24 hr after insemination from ewes implanted for 12 days 2 or 12 days post-estrus. However, more sperm were recovered from ewes treated 2 days than 12 days post-estrus with the principal increase occurring in ewes treated with 6 mg of Norgestomet.
RESUMEN
Autologous SCT is a potentially curative procedure for patients with relapsed lymphoma (NHL). We analyzed the outcomes of 34 patients > or =60 years old, including eight patients > or =70 years old, who received BU and CY and SCT for NHL. Patients received BU 0.8 mg/kg i.v. (n=25) or 1 mg/kg p.o. (n=9) q 6 h x 14 doses and CY 60 mg/kg i.v. q day x 2 days. The median age was 66 (range, 60-78) years. Twenty-two patients had large cell, 10 follicular and two-mantle cell lymphoma. Fifteen patients were in a second or greater CR and 19 patients were in a PR. The median days to ANC >500/microl and platelet count >50,000/microl were 10 and 13 days respectively. The 100-day transplant-related mortality was 0%. Toxicities included interstitial lung disease (n=2), seizures in a patient with CNS lymphoma (n=1), mild veno-occlusive disease (n=2), and transient atrial fibrillation (n=4). With a median follow-up of 40 months, the 2-year overall survival and PFS were 67 and 54% respectively. BU/CY is a well-tolerated conditioning regimen for older patients with NHL. Age alone should not be used as an exclusion criterion for autologous SCT.