BACKGROUND: VeriStrat is a blood-based proteomic test with predictive and prognostic significance in second-line treatments for non-small cell lung cancer (NSCLC). This trial was designed to investigate the role of VeriStrat in first-line treatment of advanced NSCLC with standard chemotherapy. Here we present the results for 76 non-squamous patients treated with a combination of carboplatin or cisplatin with pemetrexed. METHODS: The test-assigned classifications of VeriStrat Good or VeriStrat Poor to samples collected at baseline. The primary end point was progression-free survival (PFS); secondary end points included overall survival (OS) and objective response. Exploratory analyses of end points separately in carboplatin/pemetrexed and cisplatin/pemetrexed subgroups were also conducted. RESULTS: Patients classified as VeriStrat Good had longer PFS and OS than VeriStrat Poor: 6.5 vs 1.6 months and 10.8 vs 3.4 months, respectively; the corresponding hazard ratios (HRs) were 0.36 (P<0.0001) and 0.26 (P<0.0001); they were also more likely to achieve objective response. Prognostic significance of VeriStrat was confirmed in multivariate analysis. Significant differences in OS and PFS between Veristrat classifications were also found when treatment subgroups were analysed separately. CONCLUSIONS: The trial demonstrated clinical utility of VeriStrat as a prognostic test for standard first-line chemotherapy of non-squamous advanced NSCLC.
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Blood Chemical Analysis/methods , Carcinoma, Non-Small-Cell Lung/drug therapy , Lung Neoplasms/drug therapy , Proteomics , Adult , Aged , Aged, 80 and over , Carboplatin/administration & dosage , Carboplatin/adverse effects , Carcinoma, Non-Small-Cell Lung/blood , Carcinoma, Non-Small-Cell Lung/diagnosis , Carcinoma, Non-Small-Cell Lung/mortality , Cisplatin/administration & dosage , Cisplatin/adverse effects , Female , Humans , Lung Neoplasms/blood , Lung Neoplasms/diagnosis , Lung Neoplasms/mortality , Male , Middle Aged , Neoadjuvant Therapy , Pemetrexed/administration & dosage , Pemetrexed/adverse effects , Predictive Value of Tests , Prognosis , Standard of Care , Survival Analysis
BACKGROUND: To reduce the rate of recurrence of incisional hernia repair associated with open anatomic techniques, we present an experimental study, focusing on two different sutures, with the aim to apply clinically in a revised version of the Mayo technique. METHODS: Thirteen biological tissue samples from adult pig central brawn and upper and lower fasciae were measured using two techniques defined as "unbroken suture thread" and "separated suture stitches" to test the breaking resistance of the two types of suture. RESULTS: The t test results show that the two sets can be considered as different populations. The mean tensile stress max is greater (with reduced deviation) for the specimens of the set sutured with unbroken thread technique. Student's t-test performed on values obtained for each set of samples indicated that the unbroken thread suture technique corresponds to higher ultimate failure strength. CONCLUSION: Considering these results, a modified Mayo technique with continuous closure could be suggested. Of course a valid clinical study is required to better clarify this experimental hypothesis.
Hernia, Ventral/surgery , Herniorrhaphy/methods , Surgical Mesh , Suture Techniques , Sutures , Adult , Animals , Humans , Italy , Mathematical Computing , Recurrence , Sus scrofa , Tensile Strength , Treatment Outcome
Malignant mesothelioma (MM) is an aggressive tumor, mainly derived from the pleura, which is predominantly associated with exposure to asbestos fibers. The prognosis of MM patients is particularly severe, with a median survival of approximately 9-12 months and latency between exposure and diagnosis ranging from 20-50 years (median 30 years). Emerging evidence has demonstrated that tumor aggressiveness is associated with genome and gene expression abnormalities; therefore, several studies have recently focused on the role of microRNAs (miRNAs) in MM tumorigenesis. miRNAs are small non-protein coding single-stranded RNAs (17-22 nucleotides) involved in numerous cellular processes that negatively regulate gene expression by modulating the expression of downstream target genes. miRNAs are often deregulated in cancer; in particular, the differential miRNA expression profiles of MM cells compared to unaffected mesothelial cells have suggested potential roles of miRNAs as either oncogenes or tumor suppressor genes in MM oncogenesis. In this review, the mechanism of MM carcinogenesis was evaluated through the analysis of the published miRNA expression data. The roles of miRNAs as diagnostic biomarkers and prognostic factors for potential therapeutic strategies will be presented and discussed.
Gene Expression Regulation, Neoplastic , Lung Neoplasms/genetics , Mesothelioma/genetics , MicroRNAs/genetics , Animals , Biomarkers, Tumor/genetics , Humans , Lung/metabolism , Lung/pathology , Lung Neoplasms/diagnosis , Lung Neoplasms/therapy , Mesothelioma/diagnosis , Mesothelioma/therapy , Mesothelioma, Malignant , Oncogenes , Prognosis
