ABSTRACT
BACKGROUND: Small cell lung cancer (SCLC) is a common and aggressive subtype of lung cancer. It is characterized by rapid growth and a high mortality rate. Approximately 10% of patients with SCLC present with brain metastases at the time of diagnosis, which is associated with a median survival of 5 mo. This study aimed to summarize the effect of bevacizumab on the progression-free survival (PFS) and overall survival of patients with brain metastasis of SCLC. CASE SUMMARY: A 62-year-old man was referred to our hospital in February 2023 because of dizziness and numbness of the right lower extremity without headache or fever for more than four weeks. The patient was diagnosed with limited-stage SCLC. He received 8 cycles of chemotherapy combined with maintenance bevacizumab therapy and achieved a PFS of over 7 mo. CONCLUSION: The combination of bevacizumab and irinotecan effectively alleviated brain metastasis in SCLC and prolonged PFS.
ABSTRACT
BACKGROUND: Immune checkpoint inhibitors, including programmed death-ligand 1 (PD-L1) and programmed death-1 (PD-1) have recently been approved to treat locally advanced and metastatic urothelial carcinoma (UC). However, some patients experience rapid tumor progression rather than any clinical benefit from anti-PD-L1/PD-1 therapy. CASE SUMMARY: A 73-year-old woman with bladder UC showed the progression of multiple metastases after surgery and chemotherapy for over 12 mo. The patient could not tolerate further chemotherapy. Next-generation sequencing was performed, and the results indicated that the tumor mutational burden was 6.4 mutations/Mb. The patient received the anti-PD-L1 agent toripalimab combined with albumin-bound paclitaxel. Compared with the baseline staging before immunotherapy, the patient had a treatment failure time of < 2 mo, an increase in tumor burden of > 50%, and a > 2-fold increase in progression, indicating hyperprogression. CONCLUSION: Selecting patients most likely to respond to treatment with immunotherapeutic agents remains challenging. For older patients with advanced UC who have already exhausted multi-line chemotherapy options, immunotherapy should be used prudently if no effective biomarker is available. Further studies are required to clarify the causes and mechanisms of hyperprogression.
ABSTRACT
By adding different concentrations (5%-25%) of polyethylene glycol (PEG) into Hoagland solution to simulate a gradient of drought stress, the photosynthetic characteristics and drought resistance of Jatropha curcas L. seedlings were investigated. The results showed that when treated with lower concentrations (< or = 15%) of PEG, the photosynthetic rate (Pn), stomatal conductance (Gs), and intercellular carbon dioxide concentration (Ci) of the seedlings decreased with increasing PEG concentration, while the chlorophyll fluorescence parameters optimal/maximal quantum yield of PS II (Fv/Fm) decreased slightly and minimal fluorescence (Fo) was almost unaltered. The certain reduction of actual photochemical efficiency of PS II in the light (Phi(PS II)), coefficient of photochemical quenching (qP), and apparent electron transport rate (ETR) was associated with a significant increase in non-photochemical quenching (NPQ), whereas as the PEG concentration was increased to higher than 15%, Ci increased remarkably, Pn, Gs, and WUE had a sustained decrease, while Fv/Fm, Phi(PS II), qP and ETR decreased more significantly, Fo increased rapidly, and NPQ decreased. The reduction of Pn under low concentration PEG was mainly due to stomatal limitation, while that under high PEG concentration was referred to the combination of non-stomatal and stomatal limitation. When the PEG concentration was lower than 20%, Pn decreased but photosynthetic structure was not damaged. The recovery of PS II activity and the survival of plant were found after the severe drought stress was removed 15 days later. It was concluded that Jatropha curcas had stronger tolerance to drought stress.
