ABSTRACT
Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.
Subject(s)
COVID-19 Drug Treatment , Peptides , Humans , Honduras , Kaplan-Meier Estimate , Peptides/adverse effects , Proportional Hazards ModelsABSTRACT
We present the case of a synovial sarcoma five years after primary total hip arthroplasty in a male 65 year-old patient who was surgically treated for left hip pain due to coxarthrosis. A 32 mm uncemented prosthesis with metal-on-polyethylene tribology was placed in the patient. The latter developed synovial sarcoma that caused lung metastasis. The association between total hip arthroplasty and malignancy is discussed, as well as its frequency worldwide.
Subject(s)
Arthroplasty, Replacement, Hip/adverse effects , Bone Neoplasms/etiology , Hip Prosthesis/adverse effects , Sarcoma, Synovial/etiology , Aged , Humans , Male , Metals , Polyethylene , Prosthesis DesignABSTRACT
In osteogenic sarcoma an increase in patient survival has been observed due to improvement of diagnostic and treatment methods. The objective of the investigation was to determine the usefulness of scintigraphy with 99mTc-MIBI in comparison to clinical revaluation, in order to assess tumor response (sarcoma) to chemotherapy previous to surgery. Patients with histopathological osteogenic sarcoma that received chemotherapy were included, clinical and scintigraphy response was assessed previous to the surgery. The gold standard for comparison was the degree necrosis histopathological analysis of the surgical specimen with measurement. Twelve patients met the inclusion criteria. A was observed a higher correlation between the 99mTc-MIBI and the histopathology. vs. clinical evaluation (0.89 vs. 0.59 respectively). Likewise the sensitivity (Se) and specificity (Sp) were superior (Se and Sp = 100% vs. Se 66.6% and Sp 75%) when therapeutically responses good and null were compared. We may conclude that scintigraphy with 99mTc-MIBI used to asses the response to presurgery chemotherapy in patients with osteogenic sarcoma, together with the clinical assessment, help the physician to make therapeutically decisions with more objectivity and certainly.
Subject(s)
Bone Neoplasms/diagnostic imaging , Osteosarcoma/diagnostic imaging , Adolescent , Adult , Antineoplastic Agents/therapeutic use , Bone Neoplasms/drug therapy , Bone Neoplasms/pathology , Bone Neoplasms/surgery , Female , Humans , Male , Middle Aged , Osteosarcoma/drug therapy , Osteosarcoma/pathology , Osteosarcoma/surgery , Predictive Value of Tests , Radionuclide Imaging , Radiopharmaceuticals , Technetium Tc 99m SestamibiABSTRACT
This study investigated the therapeutic effect of single-agent i.v. weekly Navelbine (vinorelbine), a semisynthetic vinca alkaloid, in women who had received no prior treatment for locally advanced or metastatic breast cancer. Of 68 patients entered into the study, 63 were adequate inclusions, assessable for toxicity and response by WHO criteria; the 5 patients who were not evaluated were excluded from analysis because they were found not to meet the eligibility criteria of the study. Navelbine was given as a weekly 30 mg/m2 short i.v. (20 minutes) infusion; treatment was continued until disease progression. The overall response rate was 44% (complete response 8%, partial response 36%). The response rate according to target was lymph nodes, 62.9%; liver, 50.0%; lung, 50.0%; skin, 37.5%; and primary tumor, 30.8%. The median duration of response was 17.9 weeks (range: 7-52 weeks). The median time to treatment failure was 12.9 weeks, and the median survival was 50.3 weeks. The 63 eligible patients received 501 cycles. The mean dose intensity was 76%. At least one episode of WHO grade 3/4 granulocytopenia was seen in 46% of the patients (13.6% of cycles). Significant nausea/vomiting was seen in only 5% of patients corresponding to 1% of cycles. Only 5% of patients developed WHO grade 3-4 constipation and grade 3 peripheral neuropathy was observed in 1.6% of patients. Alopecia was rare (6.3% of patients), and other side effects were uncommon. This study confirms that Navelbine has major single-agent antitumor activity as frontline therapy in advanced breast cancer. Given its excellent tolerance profile and low morbidity, it should be recommended for inclusion in first-line combination chemotherapy regimens.
Subject(s)
Antineoplastic Agents, Phytogenic/therapeutic use , Breast Neoplasms/drug therapy , Vinblastine/analogs & derivatives , Adult , Aged , Antineoplastic Agents, Phytogenic/administration & dosage , Antineoplastic Agents, Phytogenic/adverse effects , Breast Neoplasms/pathology , Drug Administration Schedule , Female , Humans , Middle Aged , Neoplasm Metastasis , Remission Induction , Vinblastine/administration & dosage , Vinblastine/adverse effects , Vinblastine/therapeutic use , VinorelbineABSTRACT
The objective of the study was to identify the patterns of recurrence in patients with squamous cell carcinoma of the anal canal (SCCAC) vs. the size of the primary tumor and its further possible impact on its treatment outcome. We reviewed 78 patients treated between 1975 to 1991. They were classified according to to the AJC/UICC classification. From 1975 to 1985, 16 patients were treated with radical surgery (RS). From 1985 to 1991, 43 patients were treated with radiotherapy (RT) at doses of 45 Gy/4-5 weeks, to the pelvis and a boost of 15-30 Gy to the perineum. Since 1989, in 19 selected patients, 5-FU and mitomycin-C have been added to the RT schedule (C-RT). There were 55 females and 23 males. The overall recurrence rate was 62%. In T1 tumors, no recurrences occurred. The local recurrence (LR) according to treatment approach and T were: radical surgery: T2, 50%; T3, 71%; T4, 100%. Radiation therapy: T2, 25%; T3, 41%; T4, 66%. Chemoradiation therapy: T2, 12%; T3, 40%; T4, 50%. Regional recurrences were in RS: T2, 16%; T3, 28%; T4, 100%. RT: T2, 0%; T3, 16%; T4, 33%. C-RT: T2, 0%; T3, 20%; T4, 25%. Distant recurrences were in RS: T2 and T3, 0%; T4, 66%. In RT: T2, 0%; T3, 8%; T4, 33%. In C-RT: T2, 0%; T3, 8%; T4, 50%. In T1 patients, no recurrences were observed. In T2 tumors the recurrence pattern was local. In T3 tumors it was locoregional and to the groin area. In T4 tumors it was locoregional and distant.(ABSTRACT TRUNCATED AT 250 WORDS)
Subject(s)
Anus Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Anus Neoplasms/drug therapy , Anus Neoplasms/radiotherapy , Anus Neoplasms/surgery , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/surgery , Combined Modality Therapy , Female , Humans , Lymphatic Metastasis , Male , Middle Aged , Neoplasm Metastasis , Neoplasm Recurrence, LocalABSTRACT
A case of adenosquamous ovarian carcinoma in a 50 years old female is reported. The patient had marked improvement of her symptoms after resection of the tumor and chemotherapy. The knowledge of this association forces to rule out an ovarian carcinoma.
Subject(s)
Adenocarcinoma/surgery , Carcinoma, Squamous Cell/surgery , Dermatomyositis/complications , Ovarian Neoplasms/complications , Adenocarcinoma/drug therapy , Adenocarcinoma/pathology , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/pathology , Combined Modality Therapy , Female , Humans , Hysterectomy , Middle Aged , Ovarian Neoplasms/drug therapy , Ovarian Neoplasms/pathology , Ovarian Neoplasms/surgery , OvariectomyABSTRACT
From July 1984 to November 1987, 89 patients with recurrent measurable squamous-cell cancer of the uterine cervix were randomized in a single institution to receive treatment with either carboplatin (CBDCA) or iproplatin (CHIP). Objective response rates were similar: 2 complete regressions (CRs) and 10 partial regressions (PRs) were recorded both in the 46 evaluable patients treated with CBDCA (response rate, 26.1%; 95% confidence interval, 15-41%) and in the 40 evaluable patients treated with CHIP (response rate, 30%; 95% confidence interval, 17-47%). The median duration of response was 5.5 months for CBDCA and 6 months for CHIP; the median survival was 7.5 and 7.6 months, respectively. Both drugs were given in an outpatient setting and myelosuppression (thrombocytopenia) was the predominant toxicity. Analysis of all toxic events yielded additional interesting observations: the occurrence of moderate to severe platelet nadirs beyond cycle 1 was confined to CHIP, a higher incidence of gastrointestinal toxicity during treatment with CHIP, and five moderate to severe complaints of asthenia (recorded as neurologic events) during CHIP therapy versus only one during treatment with CBDCA. Because of its antitumor activity and its toxicologic advantage, a future role for CBDCA in the treatment of cervical cancer appears likely.
Subject(s)
Antineoplastic Agents/therapeutic use , Carboplatin/therapeutic use , Carcinoma, Squamous Cell/drug therapy , Organoplatinum Compounds/therapeutic use , Uterine Cervical Neoplasms/drug therapy , Carboplatin/adverse effects , Carcinoma, Squamous Cell/mortality , Dose-Response Relationship, Drug , Drug Evaluation , Female , Humans , Organoplatinum Compounds/adverse effects , Remission Induction , Uterine Cervical Neoplasms/mortalitySubject(s)
Humans , Female , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Medroxyprogesterone/administration & dosage , Neoplasm Metastasis/drug therapy , Breast Neoplasms/drug therapy , Antineoplastic Combined Chemotherapy Protocols , Drug Administration ScheduleSubject(s)
Humans , Female , Breast Neoplasms/drug therapy , Cyclophosphamide/administration & dosage , Doxorubicin/administration & dosage , Medroxyprogesterone/administration & dosage , Neoplasm Metastasis/drug therapy , Antineoplastic Combined Chemotherapy Protocols , Drug Administration ScheduleSubject(s)
Antineoplastic Agents/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Organoplatinum Compounds/therapeutic use , Uterine Cervical Neoplasms/drug therapy , Adult , Antineoplastic Agents/adverse effects , Carboplatin , Cisplatin/administration & dosage , Female , Humans , Middle AgedABSTRACT
Antitumor activity has been documented in this pilot study utilizing mitolactol in patients with advanced carcinoma of the cervix. These results may in part be explained by optimal patient selection; however, the results do encourage further testing of this hexitol in this disease.