RESUMEN
In spite of the advances in immunotherapy and targeted therapies, lung cancer continues to be the leading cause of cancer-related death. The epidermal growth factor receptor is an established target for non-small cell lung cancer (NSCLC), and its overactivation by the ligands can induce accelerated proliferation, angiogenesis, and metastasis as well as proinflammatory or immunosuppressive signals. CIMAvax-EGF is an epidermal growth factor (EGF)-depleting immunotherapy that is approved for the treatment of NSCLC patients in Cuba. The study was designed as a phase IV trial to characterize the safety and effectiveness of CIMAvax-EGF in advanced NSCLC patients treated in 119 community polyclinics and 24 hospitals. CIMAvax-EGF treatment consisted of four bi-weekly doses followed by monthly boosters. Overall, 741 NSCLC patients ineligible for further cancer-specific treatment were enrolled. CIMAvax-EGF was safe, and the most common adverse events consisted of mild-to-moderate injection site reactions, fever, chills, tremors, and headache. For patients completing the loading doses, the median survival was 9.9 months. For individuals achieving at least stable disease to the frontline and completing vaccination induction, the median survival was 12 months. Most of the functional activities and symptoms evaluated through the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 questionnaire improved over time. In conclusion, this real-world trial demonstrated that CIMAvax-EGF was safe and effective in patients who were vaccinated in the maintenance scenario. A larger effect was seen in subjects with poor prognosis like those with squamous tumors and high EGF levels. Remarkably, this community-based intervention was very important because it demonstrated the feasibility of treating advanced lung cancer patients with active immunotherapy in primary care institutions. In addition to CIMAvax-EGF, patients received supportive care at the community clinic. Vaccine administration by the family doctors at the polyclinics reduced the patients' burden on the medical oncology services that continued providing chemotherapy and other complex therapies. We conclude that community polyclinics constitute the optimal scenario for administering those cancer vaccines that are safe and require prolonged maintenance in patients with advanced cancer, despite the continuous deterioration of their general condition. Clinical trial registration: https://rpcec.sld.cu/trials/RPCEC00000205-En, identifier RPCEC00000205.
RESUMEN
El cáncer de pulmón constituye la principal causa de muerte por tumores malignos en la provincia de Villa Clara. Se realizó una investigación descriptiva en el período 2001-2014, con el objetivo de caracterizar la incidencia y mortalidad por cáncer de pulmón en la provincia. Se observó un incremento de un 46,2 por ciento de la mortalidad en el período, la que fue más elevada en los mayores de75 años en los municipios Corralillo, Encrucijada, Caibarién y Ranchuelo. Aunque existen fluctuaciones en los datos sobre la etapa clínica en la que se encontraban los pacientes al momento del diagnóstico; el mayor número se identificó en etapas avanzadas(AU)
Asunto(s)
Humanos , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/mortalidad , Epidemiología DescriptivaRESUMEN
Se realizó un estudio descriptivo en el Hospital Universitario "Celestino Hernández Robau" en el período comprendido entre 1991 y 2001, con el objetivo de analizar los resultados de la aplicación del trasplante autólogo de médula ósea como alternativa en el tratamiento de los linfomas no Hodgkin de alto grado y linfomas Hodgkin en remisión parcial o recaída precoz. La muestra estuvo constituida por 14 pacientes: nueve con diagnóstico histológico de linfoma no Hodgkin y cinco linfomas Hodgkin. La información se procesó mediante el cálculo de valores absolutos y porcentaje, y el método de observación continuada o progresiva. Los resultados más alentadores se observaron en los enfermos afectados por linfomas no Hodgkin, pues hubo remisión completa en 85,7 por ciento del total de pacientes que sobrevivieron al trasplante, y un prolongado intervalo libre de enfermedad; se evidenció que el trasplante autólogo de médula ósea constituye una alternativa terapéutica importante en los pacientes con linfomas(AU)
