Management of Trastuzumab Deruxtecan-related nausea and vomiting in real-world practice.

Background: Nausea and vomiting are common side effects of Trastuzumab Deruxtecan (T-DXd), but guidelines for optimal management were not initially available. This retrospective single-center study aimed at evaluating the efficacy of two antiemetic regimens in patients receiving T-DXd. Methods: Data from metastatic breast cancer patients receiving T-DXd were collected. Two groups were defined: patients treated with 5-HT3 receptor antagonists (RA) ± dexamethasone (5-HT3-group) and patients treated with a fixed oral combination of netupitant (NK1RA) and palonosetron ± dexamethasone (NK1 group). Physicians preferentially offered the NK1 regimen to patients at higher risk of nausea and vomiting based on internal recommendations. Only nausea and vomiting during cycles 1 and 2 were considered. Comparisons of nausea and vomiting by the antiemetic prophylaxis group were assessed using chi-square. Results: A total of 53 patients were included in the analysis. At cycle 1, 72% and 28% of patients received the 5-HT3 and NK1 prophylaxis, respectively. Overall, 58% reported nausea, with no differences between groups (58% vs. 60%; p = 0.832), but with a trend for lower grade in the NK1 group (33.3% G1; 26.7% G2) compared to the 5-HT3 group (23.7% G1; 31.6% G2; 2.6% G3). Vomiting was reported by 21% and 0% of patients in the 5-HT3 and the NK1 group, respectively (p = 0.054). Among the 15 patients in the 5-HT3 group with nausea at cycle 1 who escalated to NK1 at cycle 2, nausea decreased from 100% to 53% (p = 0.022) and vomiting decreased from 47% to 13% (p = 0.046). Conclusions: The NK1 regimen improved vomiting control at cycle 1 and, when introduced at cycle 2, significantly improved both nausea and vomiting. The biased NK1 selection for higher-risk patients may have dampened the differences between groups at cycle 1. These findings support enhanced control of T-DXd-related nausea and vomiting with NK1RA.

Identificación y aislamiento mediante un anticuerpo monoclonal de un antigeno Trypanosoma cruzi específico de utilidad para serodiagnóstico de la enfermedad de Chagas / Identification and isolation by used of an specific antigen monoclonal antibody (T. cruzi) of value in the serodiagnosticin chagas diseases

En este estudio se presentan resultados obtenidos sobre la identificación, aislamiento y utilización de un antígeno T. cruzi específico de peso molecular 24/25 kDA ("Tc-24-25) de utilidad para el serodiagnóstico de la enfermedad de Chagas

Sinergismo en la acción antiproliferativa de inhibidores de la sintesis de esteroles sobre el trypanosoma cruzi in vitro e in vivo implicaciones terapéuticas / Sinergistic in the antiproliferative action of sterol synthesis inhibitors on in vitro and in vivo thypanosoma cruzi: therapeutic aspects

Los estudios realizados desde el punto de vista molecular, celular y organismico revelan que el Trypanosoma cruzi en su proliferación depende de la producción de esteroles endógenos. Cualquier intervención farmacológica que modifique esta ruta biosintética previene la proliferación del parásito, in vivo e in vitro. Además cuando se combinan estos agentes, ellos pueden tener acción sinergética sobre la proliferación del parásito, lo que permite pensar, que podría ser útil en el tratamiento de la Enfermedad de Chagas, sin efectos secundarios. Las combinaciones hasta ahora conocidas son el ketoconazol (Janssen) Lamisil (Sandoz) y el ketoconazol-Mevacor (Merk Sharp & Dohme). Otras combinaciones han sido evaluadas por nuestro grupo y la OMS, como el itraconazol (Janssen) que posee mayor actividad y menor toxicidad que el anterior, usándolo en combinación con la sinvastatina (Merk Sharp & Dohne) y la fluvastatina (Sandoz). Finalmente, las terapéuticas propuestas pueden ser útiles en el tratamiento de otras enfermedades parasitarias y algunas micosis sistémicas