Exploratory analysis of clinical benefit of ipilimumab and nivolumab treatment in patients with metastatic melanoma from a single institution

PurposeWe retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution.Methods and patientsElectronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan–Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models.ResultsForty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2–NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death.ConclusionOverall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.

Productividad energética y financiera en fincas campesinas del departamento de caldas: tres estudios de caso / Enegetic and finnancial productivity in peasants' frms in the depaartment o f caldas: three case studies

Con el objetivo de estimar la productividad energética y financiera, se estudiaron tres fincas campesinas en los municipios de Filadelfia y Manizales en el departamento de Caldas (Colombia). Las fincas estudiadas se seleccionaron de los clústeres resultantes en la investigación: "Flujo de masas y energía en fincas campesinas de la zona cafetera: vínculos entre la racionalidad campesina y el flujo de materiales"5. Para realizar los análisis, se recabó información con base en entrevistas semiestructuradas aplicadas a cada una de las familias de dichas fincas. Con la información, se elaboraron modelos analógicos, que muestran las entradas y salidas del sistema café, componente principal de la unidad familiar. Se estimó la productividad energética y financiera de cada unidad. Se concluyó que la Finca 1 es la que presenta la mayor eficiencia energética y financiera, debido a su diversidad, reciclaje de materiales y uso de mano de obra familiar. En consecuencia, es la más sustentable.

Three peasants' farms in the municipalities of Filadelfia and Manizales, Caldas (Colombia) were studied with the purpose of estimating energetic and financial productivity. The studied farms were selected from the resulting clusters in the research project "Mass and energy flow in peasants' farms in the coffee triangle: links between peasants' rationality and materials flow"5. In order to perform the analysis, information was gathered through semi-structured interviews applied to each family from the above mentioned farms. With this information, analogical models were developed which show the coffee system income and expenditure, a main component in family unit. It was concluded that Farm 1 presents the highest energetic and financial efficiency because of its diversity, materials recycling process and use of family work force. Consequently it is the most sustainable one.