[Efficacy and safety evaluation of immunotherapy combined with targeted therapy as second-line treatment in patients with metastatic non-clear cell renal cell carcinoma].

Objective: This study aimed to evaluate the efficacy and safety of programmed death-1 (PD-1) inhibitor combined tyrosine kinase inhibitor (TKI) therapy versus TKI monotherapy as the second-line regimen for patients with metastatic non-clear cell renal carcinoma (nccRCC) who failed first-line TKI therapy. Methods: The clinicopathological data of 67 patients with metastatic nccRCC who failed first-line TKI therapy between October 2011 and September 2020 were retrospectively analyzed, including 22 patients who received TKI monotherapy and 45 patients who received TKI plus PD-1 inhibitor as the second-line therapy. The efficacy was assessed according to Response Evaluation Criteria in Solid Tumors version 1.0/1.1 (RECIST 1.0/1.1), the Kaplan-Meier method was used to plot the survival curves, and the Log rank test was used to analyze the differences in the survival between the two groups. Treatment-related adverse events (AEs) after treatment were observed in both groups. Results: The overall objective response rate (ORR) and disease control rate (DCR) were 37.3% (25/67) and 56.7% (38/67), respectively. The overall second-line progression-free survival (PFS) was 7.7 months and Overall Survival (OS) was 25.2 months. The ORR and DCR of patients in the combination therapy group were 48.9% (22/45) and 71.1% (32/45), respectively, which were significantly improved compared with the TKI monotherapy group [13.6% (3/22) and 27.3% (6/22), respectively] (P=0.007 and P=0.001, respectively). The median PFS of 9.2 months for second-line treatment was longer in patients in the combination therapy group than in the TKI monotherapy group (5.2 months, P=0.001), but the median OS was not statistically different between the two groups (28.2 months vs 20.8 months, P=0.068). Common treatment-related AEs included hypertension, diarrhea, fatigue, stomatitis, hand-foot syndrome, and hypothyroidism. The incidence of hypothyroidism was higher in the combination therapy group [40.0% (18/45)] than in the TKI monotherapy group [22.7% (5/22), P=0.044]; the incidence of other treatment-related AEs between the two groups were not statistically significant (all P>0.05). Conclusion: Immune-targeted combination therapy was more effective than TKI monotherapy alone and was well tolerated in the treatment of metastatic nccRCC patients who failed first-line TKIs.

Fluorodeoxyglucose-positron-emission tomography, single-photon emission tomography, and structural MR imaging for prediction of rapid conversion to Alzheimer disease in patients with mild cognitive impairment: a meta-analysis.

BACKGROUND AND PURPOSE: Patients with mild cognitive impairment (MCI) are at risk for developing Alzheimer disease (AD). To diagnose AD at an early stage, one must develop highly specific and sensitive tools to identify it among at-risk subjects. The purpose of this study was to evaluate and compare the ability of fluorodeoxyglucose-positron-emission tomography (FDG-PET), single-photon emission tomography (SPECT), and structural MR imaging to predict conversion to AD in patients with MCI. MATERIALS AND METHODS: Relevant studies were identified with MEDLINE from January 1990 to April 2008. Meta-analysis and meta-regression were done on the diagnostic performance data for each technique from eligible studies. We estimated and compared the weighted summary sensitivities, specificities, likelihood ratios (LRs), and summary receiver operating characteristic curves of each imaging technique. RESULTS: Twenty-four eligible studies were included, with a total of 1112 patients. FDG-PET performed statistically better in LR+ and odds ratio (OR), whereas no statistical difference was found in pooled sensitivity, specificity, and LR- for each technique. No statistical difference was confirmed between SPECT and MR imaging. The Q* index estimates for FDG-PET, SPECT, and structural MR imaging were respectively 0.86, 0.75, and 0.76. In meta-regression, statistical significance was found only between technique and log OR, with a regression coefficient of -0.575. CONCLUSIONS: This meta-analysis showed that FDG-PET performs slightly better than SPECT and structural MR imaging in the prediction of conversion to AD in patients with MCI; parallel performance was found between SPECT and MR imaging.

Effects of Coriolus versicolor polysaccharides on superoxide dismutase activities in mice.

AIM: To study if Coriolus versicolor polysaccharides (CVP) influence the superoxide dismutase (SOD) activities in mice. METHODS: Normal, tumor-bearing, and radiated ICR mice were injected ip with CVP daily for 3-15 d. The SOD activity was assayed by epinephrine autoxidation test. RESULTS: The SOD activities in lymphocytes and thymus were increased by CVP in both the normal mice with or without delayed hypersensitivity (DH). In tumor-bearing mice, CVP exerted not only inhibitory effects on tumor, growth and SOD activity in tumor tissue but also complete or partial restorative effects on the suppressed DH and on the declined SOD activities in lymphocytes, spleen, and thymus. The total SOD and manganese-containing SOD (MnSOD) activities in lymphocytes and thymus were dose-dependently enhanced by CVP (5-20 mg.kg-1) on d 3 after the tumor transplantation. In the mice exposed to 60Co (3 or 6 Gy), DH and SOD activities were dose-dependently decreased. These changes were completely or partly prevented by CVP. CONCLUSION: CVP exerted the favorable effects on SOD activities in mice. Coriolus versicolor polysaccharides (CVP) exert inhibitory effects on experimental and clinical tumors. These effects are presumed to be mediated mainly by host-defence mechanism, especially immunological responeses. Superoxide dismutase (SOD) plays an important role in protecting cells against superoxide radical (O2-.) damages and over-production of O2-. or SOD abnormities exist in many diseases. The present study was to investigate if the CVP could exert some favorable effects on SOD activities in vivo.