ABSTRACT
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly fatal disease with limited effective treatment especially after first-line chemotherapy. The human epidermal growth factor receptor 2 (HER-2) immunohistochemistry (IHC) positive is associated with more aggressive clinical behavior and shorter overall survival in PDAC. CASE SUMMARY: We present a case of multiple metastatic PDAC with IHC mismatch repair proficient but HER-2 IHC weakly positive at diagnosis that didn't have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment. A novel combination therapy PRaG 3.0 of RC48 (HER2-antibody-drug conjugate), radiotherapy, PD-1 inhibitor, granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months and overall survival of 14.2 month. She had not developed any grade 2 or above treatment-related adverse events at any point. Percentage of peripheral CD8+Temra and CD4+Temra were increased during first two activation cycles of PRaG 3.0 treatment containing radiotherapy but deceased to the baseline during the maintenance cycles containing no radiotherapy. CONCLUSION: PRaG 3.0 might be a novel strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy but needs more data in prospective trials.
Subject(s)
Carcinoma, Pancreatic Ductal , Pancreatic Neoplasms , Receptor, ErbB-2 , Humans , Female , Gemcitabine , Deoxycytidine/therapeutic use , Prospective Studies , Immune Checkpoint Inhibitors/therapeutic use , Paclitaxel/therapeutic use , Pancreatic Neoplasms/drug therapy , Carcinoma, Pancreatic Ductal/drug therapy , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Albumins/therapeutic useABSTRACT
Objective@#To conduct a comparative study on the specific effects of systematic sex education on adolescent students in terms of sexual cognition, sexual values, and sexual adaptation, and to provide the support for conducting a comprehensive education in middle schools.@*Methods@#A whole group sampling method was used to select 3 369 middle and high school students from six general and vocational middle schools in Sichuan Province, which were divided into systematic sex education schools and non systematic sex education schools, and a comparative study was conducted using the Adolescent Mental Health Scale.@*Results@#The results showed that the adolescent students who received systematic sex education were significantly different from those who did not receive systematic sex education in terms of sex related cognition (7.18±6.24, 5.65±7.40), sexual values(7.60±1.17，7.30±1.24), and sexual adjustment (11.49±1.29，11.10±1.41). All differed significantly ( t =5.95, 6.80,7.57, P <0.01). The students who received systematic education in junior middle school were higher than those who received non systematic education in sex related cognition, sexual values and sexual adaptation ( P <0.01). However, in senior high school, the differences in systematic education are only shown in sexual values control and self adaptation in sexual adjustment ( P <0.01). There were significant differences in sex related cognition, sexual values and sexual adjustment between male and female students who received systematic education and non systematic education ( P <0.01).@*Conclusion@#Systematic sex education is more beneficial to the psychosexual health of adolescent students than non systematic sex education in schools.
