Pembrolizumab for advanced melanoma: experience from the Spanish Expanded Access Program

Background. The programmed death (PD-1) inhibitor pembrolizumab has been recently approved for the treatment of advanced melanoma. We evaluated the clinical activity of pembrolizumab in melanoma patients treated under the Spanish Expanded Access Program. Methods. Advanced melanoma patients who failed to previous treatment lines were treated with pembrolizumab 2 mg/kg every three weeks. Patients with brain metastases were not excluded if they were asymptomatic. Data were retrospectively collected from 21 centers in the Spanish Melanoma Group. Results. Sixty-seven advanced melanoma patients were analyzed. Most patients were stage M1c (73.1%), had high LDH levels (55.2%) and had ECOG PS 1 or higher (59.7%). For cutaneous melanoma patients, median overall survival was 14.0 months; the 18-month overall survival rate was 47.1%. Overall response rate was 27%, including three patients with complete responses (6.5%). Median response duration was not reached, with 83.3% of responses ongoing (3.5 m+ to 20.4 m+). From ten patients included with brain metastases, four (40%) had an objective response, two (20%) of them achieved a complete response. Significant prognostic factors for overall survival were LDH level, ECOG PS and objective response. There were no serious adverse events. Conclusion. Although this was a heavily pretreated cohort, pembrolizumab activity at the approved dose and schedule was confirmed in the clinical setting with long-term responders, also including patients with brain metastases (AU)

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Estudio de prevalencia sobre los hábitos alimentarios y el estado nutricional en población adulta atendida en atención primaria / Prevalence of food habits and nutritional status in adult population served in primary care

Introducción: Identificar los hábitos alimentarios y el estado nutricional de la población entre 18-44 años atendida en un centro de salud (CS) y estudiar los factores asociados. Métodos: Estudio transversal realizado en un CS urbano en el que se seleccionó una muestra aleatoria de 201 personas. Se analizaron datos socio-demográficos, medidas antropométricas, recordatorio ingesta últimas 24 horas, cuestionario de frecuencia alimentaria semanal. Resultados: La edad media de los participantes fue de 32,81 años (Desviación Estándar 6,72). El 63,68%(128) eran mujeres y 62,69%(126) inmigrantes. El 45,27%(91) manifestaba no realizar ejercicio. Alrededor del 60% de los participantes refería un consumo deficitario de lácteos, frutas, cárnicos y farináceos y el 80% de verduras; el 58% lo refería excesivo de lípidos. El 44,4%(56) de inmigrantes era obeso respecto al 20,3%(15) de autóctonos (P= 0,001). La proporción de personas con «cintura de riesgo» era superior entre los inmigrantes respecto a los autóctonos (19,0% vs 6,8%; P= 0,017) y entre los que no hacían ejercicio respecto a los que sí (17,6% vs 8,1%; P= 0,049). Los inmigrantes referían realizar menos ejercicio físico que los autóctonos (42,1% vs 62,7%; P= 0,013). Ser inmigrante era la variable más explicativa de la distribución aceptable de macronutrientes en la ingesta diaria (Odds Ratio 4,7; Intervalo de Confianza del 95% 2,02-11,03). Discusión: Los participantes referían un consumo excesivo de lípidos y deficitario del resto de grupos alimentarios. La obesidad y la «cintura de riesgo» eran más frecuentes entre los inmigrantes y los participantes más sedentarios. Los inmigrantes referían una mejor distribución de macronutrientes en su alimentación diaria (AU)

Objective: To identify dietary patterns and nutritional status of the population between 18-44 years visited at a health center (HC) and explore the associated factors. Methods: Cross-sectional study conducted in an urban HC in a random sample of 201 people. Were analyzed socio-demographic data, anthropometric measurements, 24 hours latest reminder intake, weekly food frequency questionnaire. Results: The mean age of participants was 32.81 years (standard deviation 6.72). 63.68% (128) were women and 62.69% (126) immigrants. 45.27% (91) expressed no exercise. About 60% of participants related a deficit in consumption milk, fruits, meat and farinaceous and 80% vegetables, 58% related excessive fat. 44.4% (56) of immigrants was 20.3% with respect to obese (15) of native (P = 0.001). The proportion of people with «waist-risk» was higher among immigrants as compared to the native (19.0% vs 6.8%, P = 0.017) and among those who did not exercise with respect to each other (17.6% vs 8.1%, P = 0.049). Immigrants perform less physical activity related to the native (42.1% vs 62.7%, P = 0.013). Being an immigrant was the variable explaining of distribution acceptable daily macronutrient intake (Odds Ratio 4.7, Confidence Interval 95% 2.02-11.03). Discussion: The participants related excessive consumption of fats and deficient in the rest of food groups. Obesity and the «risk waist» were more common among immigrants and sedentary population. Immigrants talked of a better distribution of nutrients in your daily diet (AU)