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1.
Eur Urol Oncol ; 2024 Jan 06.
Artículo en Inglés | MEDLINE | ID: mdl-38185614

RESUMEN

BACKGROUND AND OBJECTIVE: The impact of prostate cancer of unconventional histology (UH) on oncological and functional outcomes after robot-assisted radical prostatectomy (RARP) and adjuvant radiotherapy (aRT) receipt is unclear. We compared the impact of cribriform pattern (CP), ductal adenocarcinoma (DAC), and intraductal carcinoma (IDC) in comparison to pure adenocarcinoma (AC) on short- to mid-term oncological and functional results and receipt of aRT after RARP. METHODS: We retrospectively collected data for a large international cohort of men with localized prostate cancer treated with RARP between 2016 and 2020. The primary outcomes were biochemical recurrence (BCR)-free survival, erectile and continence function. aRT receipt was a secondary outcome. Kaplan-Meier survival and Cox regression analyses were performed. KEY FINDINGS AND LIMITATIONS: A total of 3935 patients were included. At median follow-up of 2.8 yr, the rates for BCR incidence (AC 10.7% vs IDC 17%; p < 0.001) and aRT receipt (AC 4.5% vs DAC 6.3% [p = 0.003] vs IDC 11.2% [p < 0.001]) were higher with UH. The 5-yr BCR-free survival rate was significantly poorer for UH groups, with hazard ratios of 1.67 (95% confidence interval [CI] 1.16-2.40; p = 0.005) for DAC, 5.22 (95% CI 3.41-8.01; p < 0.001) for IDC, and 3.45 (95% CI 2.29-5.20; p < 0.001) for CP in comparison to AC. Logistic regression analysis revealed that the presence of UH doubled the risk of new-onset erectile dysfunction at 1 yr, in comparison to AC (grade group 1-3), with hazard ratios of 2.13 (p < 0.001) for DAC, 2.14 (p < 0.001) for IDC, and 2.01 (p = 0.011) for CP. Moreover, CP, but not IDC or DAC, was associated with a significantly higher risk of incontinence (odds ratio 1.97; p < 0.001). The study is limited by the lack of central histopathological review and relatively short follow-up. CONCLUSIONS AND CLINICAL IMPLICATIONS: In a large cohort, UH presence was associated with worse short- to mid-term oncological outcomes after RARP. IDC independently predicted a higher rate of aRT receipt. At 1-yr follow-up after RP, patients with UH had three times higher risk of erectile dysfunction post RARP; CP was associated with a twofold higher incontinence rate. PATIENT SUMMARY: Among patients with prostate cancer who undergo robot-assisted surgery to remove the prostate, those with less common types of prostate cancer have worse results for cancer control, erection, and urinary continence and a higher probability of receiving additional radiotherapy after surgery.

5.
Lancet Oncol ; 24(3): e133-e143, 2023 03.
Artículo en Inglés | MEDLINE | ID: mdl-36858729

RESUMEN

As the immuno-oncology field continues the rapid growth witnessed over the past decade, optimising patient outcomes requires an evolution in the current response-assessment guidelines for phase 2 and 3 immunotherapy clinical trials and clinical care. Additionally, investigational tools-including image analysis of standard-of-care scans (such as CT, magnetic resonance, and PET) with analytics, such as radiomics, functional magnetic resonance agents, and novel molecular-imaging PET agents-offer promising advancements for assessment of immunotherapy. To document current challenges and opportunities and identify next steps in immunotherapy diagnostic imaging, the National Cancer Institute Clinical Imaging Steering Committee convened a meeting with diverse representation among imaging experts and oncologists to generate a comprehensive review of the state of the field.


Asunto(s)
Neoplasias , Estados Unidos , Humanos , National Cancer Institute (U.S.) , Inmunoterapia , Procesamiento de Imagen Asistido por Computador , Oncología Médica
6.
Med Phys ; 50(6): 3719-3725, 2023 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-36995245

RESUMEN

BACKGROUND: The RefleXion X1 is a novel radiotherapy delivery system on a ring gantry equipped with fan-beam kV-CT and PET imaging subsystems. The day-to-day scanning variability of radiomics features must be evaluated before any attempt to utilize radiomics features. PURPOSE: This study aims to characterize the repeatability and reproducibility of radiomic features produced by the RefleXion X1 kV-CT. MATERIALS AND METHODS: The Credence Cartridge Radiomics (CCR) phantom includes six cartridges of varied materials. It was scanned 10 times on the RefleXion X1 kVCT imaging subsystem over a 3-month period using the two most frequently used scanning protocols (BMS and BMF). Fifty-five radiomic features were extracted for each ROI on each CT scan and analyzed using LifeX software. The coefficient of variation (COV) was computed to evaluate the repeatability. Intraclass correlation coefficient (ICC) and concordance correlation coefficient (CCC) were used to evaluate the repeatability and reproducibility of the scanned images using 0.9 as the threshold. This process is repeated on a GE PET-CT scanner using several built-in protocols as a comparison. RESULTS: On average, 87% of the features on both scan protocols on the RefleXion X1 kVCT imaging subsystem can be considered repeatable as they met COV < 10% criteria. On GE PET-CT, this number is similar at 86%. When we tighten the criteria to COV <5%, the RefleXion X1 kVCT imaging subsystem showed much better repeatability with 81% of features on average whereas GE PET-CT showed only 73.5% on average. About 91% and 89% of the features with ICC > 0.9 respectively for BMS and BMF protocols on RefleXion X1. On the other hand, the percentage of features with ICC > 0.9 on GE PET-CT ranges from 67% to 82%. The RefleXion X1 kVCT imaging subsystem showed excellent intra-scanner reproducibility between the scanning protocols much better than the GE PET CT scanner. For the inter-scanner reproducibility, the percentage of features with CCC > 0.9 ranged from 49% to 80%. between X1 and GE PET-CT scanning protocols. CONCLUSIONS: Clinically useful CT radiomic features produced by the RefleXion X1 kVCT imaging subsystem are reproducible and stable over time, demonstrating its utility as a quantitative imaging platform.


Asunto(s)
Procesamiento de Imagen Asistido por Computador , Tomografía Computarizada por Tomografía de Emisión de Positrones , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Reproducibilidad de los Resultados , Procesamiento de Imagen Asistido por Computador/métodos , Tomografía Computarizada por Rayos X/métodos , Tomografía de Emisión de Positrones , Fantasmas de Imagen
8.
J Thorac Oncol ; 18(5): 587-598, 2023 05.
Artículo en Inglés | MEDLINE | ID: mdl-36646209

RESUMEN

INTRODUCTION: We aimed to define a baseline radiomic signature associated with overall survival (OS) using baseline computed tomography (CT) images obtained from patients with NSCLC treated with nivolumab or chemotherapy. METHODS: The radiomic signature was developed in patients with NSCLC treated with nivolumab in CheckMate-017, -026, and -063. Nivolumab-treated patients were pooled and randomized to training, calibration, or validation sets using a 2:1:1 ratio. From baseline CT images, volume of tumor lesions was semiautomatically segmented, and 38 radiomic variables depicting tumor phenotype were extracted. Association between the radiomic signature and OS was assessed in the nivolumab-treated (validation set) and chemotherapy-treated (test set) patients in these studies. RESULTS: A baseline radiomic signature was identified using CT images obtained from 758 patients. The radiomic signature used a combination of imaging variables (spatial correlation, tumor volume in the liver, and tumor volume in the mediastinal lymph nodes) to output a continuous value, ranging from 0 to 1 (from most to least favorable estimated OS). Given a threshold of 0.55, the sensitivity and specificity of the radiomic signature for predicting 3-month OS were 86% and 77.8%, respectively. The signature was identified in the training set of patients treated with nivolumab and was significantly associated (p < 0.0001) with OS in patients treated with nivolumab or chemotherapy. CONCLUSIONS: The radiomic signature provides an early readout of the anticipated OS in patients with NSCLC treated with nivolumab or chemotherapy. This could provide important prognostic information and may support risk stratification in clinical trials.


Asunto(s)
Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Humanos , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/tratamiento farmacológico , Nivolumab/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Pronóstico , Tomografía Computarizada por Rayos X/métodos , Estudios Retrospectivos
9.
Vaccines (Basel) ; 10(11)2022 Nov 01.
Artículo en Inglés | MEDLINE | ID: mdl-36366412

RESUMEN

The journal retracts the article "Expression of SARS-CoV-2 Spike Protein Receptor Binding Domain on Recombinant B. subtilis on Spore Surface: A Potential COVID-19 Oral Vaccine Candidate"[...].

10.
3 Biotech ; 12(9): 179, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-35865258

RESUMEN

The toxic effects of diesel fuel on whole plants have been reported before, but little is known about the toxic effect of diesel fuel on callus cultures. This knowledge is a pre-requisite for exploring the possibility of using a sub-lethal diesel concentration as an agent for in vitro cell line selection to obtain novel somaclonal variants resistant to diesel toxicity. These novel variants could be useful for the phytoremediation of diesel-contaminated soil. Here, a callus induction medium [Murashige and Skoog medium supplemented with 1.8 µM of naphthlene-1-acetic acid (NAA) and 6.6 µM of 6-benzyladenine (BA)] was found to induce 85% of Petunia grandiflora leaf explants to form light green calli. Since it was not possible to include diesel in aseptic culture, the P. grandiflora calli were exposed to diesel under non-aseptic conditions. It was found that the calli did not exhibit any sign of necrosis immediately after up to 9 min of diesel exposure. The diesel-treated calli were subsequently subcultured successfully on the callus induction medium using the proliferating, non-necrotic cells. Transverse sections of the control and diesel-treated calli after 2 weeks of culture revealed that the control calli exhibited more small meristematic cells while diesel-treated calli exhibited larger, empty-looking parenchyma cells. Moreover, it was possible to induce, though at a low frequency (< 15%), shoot formation in the control calli and those derived from the diesel treatment on the Murashige and Skoog medium supplemented with 1.1 µM of indole-3-acetic acid (IAA) and 13.3 µM of BA. Under glasshouse conditions, the shoots regenerated from the calli derived from the diesel treatment exhibited higher biomass than those from the control calli and P. grandiflora seedlings when grown in a potting mix spiked with 0%, 2% and 7% diesel. Taken together, these results suggest that up to 9 min of diesel exposure of P. grandiflora calli was sub-lethal.

11.
Neuro Oncol ; 24(11): 1935-1949, 2022 11 02.
Artículo en Inglés | MEDLINE | ID: mdl-35511454

RESUMEN

BACKGROUND: Nearly all patients with newly diagnosed glioblastoma experience recurrence following standard-of-care radiotherapy (RT) + temozolomide (TMZ). The purpose of the phase III randomized CheckMate 548 study was to evaluate RT + TMZ combined with the immune checkpoint inhibitor nivolumab (NIVO) or placebo (PBO) in patients with newly diagnosed glioblastoma with methylated MGMT promoter (NCT02667587). METHODS: Patients (N = 716) were randomized 1:1 to NIVO [(240 mg every 2 weeks × 8, then 480 mg every 4 weeks) + RT (60 Gy over 6 weeks) + TMZ (75 mg/m2 once daily during RT, then 150-200 mg/m2 once daily on days 1-5 of every 28-day cycle × 6)] or PBO + RT + TMZ following the same regimen. The primary endpoints were progression-free survival (PFS) and overall survival (OS) in patients without baseline corticosteroids and in all randomized patients. RESULTS: As of December 22, 2020, median (m)PFS (blinded independent central review) was 10.6 months (95% CI, 8.9-11.8) with NIVO + RT + TMZ vs 10.3 months (95% CI, 9.7-12.5) with PBO + RT + TMZ (HR, 1.1; 95% CI, 0.9-1.3) and mOS was 28.9 months (95% CI, 24.4-31.6) vs 32.1 months (95% CI, 29.4-33.8), respectively (HR, 1.1; 95% CI, 0.9-1.3). In patients without baseline corticosteroids, mOS was 31.3 months (95% CI, 28.6-34.8) with NIVO + RT + TMZ vs 33.0 months (95% CI, 31.0-35.1) with PBO + RT + TMZ (HR, 1.1; 95% CI, 0.9-1.4). Grade 3/4 treatment-related adverse event rates were 52.4% vs 33.6%, respectively. CONCLUSIONS: NIVO added to RT + TMZ did not improve survival in patients with newly diagnosed glioblastoma with methylated or indeterminate MGMT promoter. No new safety signals were observed.


Asunto(s)
Neoplasias Encefálicas , Glioblastoma , Humanos , Temozolomida , Glioblastoma/tratamiento farmacológico , Nivolumab/uso terapéutico , Neoplasias Encefálicas/tratamiento farmacológico , Quimioradioterapia , Corticoesteroides/uso terapéutico , Antineoplásicos Alquilantes/uso terapéutico , Metilasas de Modificación del ADN , Proteínas Supresoras de Tumor , Enzimas Reparadoras del ADN
12.
Neuro Oncol ; 24(8): 1219-1229, 2022 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-35380705

RESUMEN

Imaging response assessment is a cornerstone of patient care and drug development in oncology. Clinicians/clinical researchers rely on tumor imaging to estimate the impact of new treatments and guide decision making for patients and candidate therapies. This is important in brain cancer, where associations between tumor size/growth and emerging neurological deficits are strong. Accurately measuring the impact of a new therapy on tumor growth early in clinical development, where patient numbers are small, would be valuable for decision making regarding late-stage development activation. Current attempts to measure the impact of a new therapy have limited influence on clinical development, as determination of progression, stability or response does not currently account for individual tumor growth kinetics prior to the initiation of experimental therapies. Therefore, we posit that imaging-based response assessment, often used as a tool for estimating clinical effect, is incomplete as it does not adequately account for growth trajectories or biological characteristics of tumors prior to the introduction of an investigational agent. Here, we propose modifications to the existing framework for evaluating imaging assessment in primary brain tumors that will provide a more reliable understanding of treatment effects. Measuring tumor growth trajectories prior to a given intervention may allow us to more confidently conclude whether there is an anti-tumor effect. This updated approach to imaging-based tumor response assessment is intended to improve our ability to select candidate therapies for later-stage development, including those that may not meet currently sought thresholds for "response" and ultimately lead to identification of effective treatments.


Asunto(s)
Neoplasias Encefálicas , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/tratamiento farmacológico , Ensayos Clínicos como Asunto , Diagnóstico por Imagen , Humanos , Resultado del Tratamiento
13.
Plants (Basel) ; 11(2)2022 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-35050072

RESUMEN

Microshoots have been widely used for micropropagation. It may be necessary to store microshoots for a short period of time, for example in germplasm exchange needing transport to other research groups. Here, we investigated the short-term storability of alginate-encapsulated Persian violet (Exacum affine Balf. f. ex Regel) microshoots at 4 °C and 25 °C. After storage, the encapsulated microshoots were sown on basal Murashige and Skoog medium for germination and viability determination using tetrazolium chloride staining. The results showed that one or five microshoots encapsulated with a single alginate layer could be stored at 4 °C for up to 30 days, while the percentages of germination and viability of the microshoots encapsulated with two layers of alginate were greatly reduced upon storage. This is the first report on the storability of alginate-encapsulated multiple microshoots, which could be a more efficient way to encapsulate microshoots used for short-term cold storage.

14.
Psychiatry Res ; 308: 114340, 2022 02.
Artículo en Inglés | MEDLINE | ID: mdl-34983010

RESUMEN

Co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common and particularly associated with elevation of hyperarousal compared to PTSD alone. Treatment options are limited. Oxytocin regulates physiological stress response. Intranasal oxytocin administration has demonstrated potential in reducing symptoms of both PTSD and AUD. This study addresses a gap in the literature by investigating effects of intranasal oxytocin on startle reactivity, an important potential marker of both PTSD and AUD symptomatology. This is a randomized, double-blind, placebo-controlled, within- and between-participant, crossover, dose-ranging study examining the effects of a single administration of oxytocin 20 IU versus 40 IU versus placebo on psychophysiological responses to a common laboratory fear-potentiated acoustic startle paradigm in participants with PTSD-AUD (n = 47) and controls (n = 37) under three different levels of threat. Contrary to our hypothesis, for the PTSD-AUD group, oxytocin 20 IU had no effect on startle reactivity, while oxytocin 40 IU increased measures of startle reactivity. Additionally, for PTSD-AUD only, ambiguous versus low threat was associated with an elevated skin conductance response. For controls only, oxytocin 20 IU versus placebo was associated with reduced startle reactivity.


Asunto(s)
Alcoholismo , Trastornos por Estrés Postraumático , Acústica , Alcoholismo/complicaciones , Alcoholismo/diagnóstico , Alcoholismo/tratamiento farmacológico , Miedo , Humanos , Oxitocina/farmacología , Oxitocina/uso terapéutico , Reflejo de Sobresalto , Trastornos por Estrés Postraumático/complicaciones , Trastornos por Estrés Postraumático/diagnóstico , Trastornos por Estrés Postraumático/tratamiento farmacológico
15.
J Nucl Med ; 63(6): 899-905, 2022 06.
Artículo en Inglés | MEDLINE | ID: mdl-34503964

RESUMEN

Immune checkpoint inhibitors (ICIs) targeting programmed cell death protein-1 (PD-1)/programmed cell death ligand-1 (PD-L1) frequently induces tumor response in metastatic melanoma patients. However, tumor response often takes months and may be heterogeneous. Consequently, additional local treatment for nonresponsive metastases may be needed, especially in the case of brain metastases. Noninvasive imaging may allow the characterization of (brain) metastases to predict response. This pilot study uses 18F-BMS986192 PET for PD-L1 expression to explore the variability in metastatic tracer uptake and its relation to tumor response, with a special focus on brain metastases. Methods: Metastatic melanoma patients underwent whole-body 18F-BMS986192 PET/CT scanning before and 6 wk after starting ICI therapy. 18F-BMS986192 uptake was measured in healthy tissues, organs, and tumor lesions. Tumor response was evaluated at 12 wk using CT of the thorax/abdomen and MRI of the brain. RECIST, version 1.1, was used to define therapy response per patient. Response per lesion was measured by the percentage change in lesion diameter. Toxicity was assessed according to Common Terminology Criteria for Adverse Events, version 4.0. Results: Baseline 18F-BMS986192 PET/CT was performed in 8 patients, with follow-up scans in 4 patients. The highest tracer uptake was observed in the spleen, bone marrow, kidneys, and liver. Tracer uptake in tumor lesions was heterogeneous. In total, 42 tumor lesions were identified at baseline, with most lesions in the lungs (n = 21) and brain (n = 14). Tracer uptake was similar between tumor locations. 18F-BMS986192 uptake in lesions at baseline, corrected for blood-pool activity, was negatively correlated with the change lesion diameter at response evaluation (r = -0.49, P = 0.005), both in intra- and extracerebral lesions. Receiver-operating-characteristic analysis demonstrated that 18F-BMS986192 uptake can discriminate between responding and nonresponding lesions with an area under the curve of 0.82. At the follow-up scan, an increased 18F-BMS986192 uptake compared with baseline scan was correlated with an increased lesion diameter at response evaluation. In the follow-up 18F-BMS986192 PET scan of 2 patients, ICI-related toxicity (thyroiditis and colitis) was detected. Conclusion: In this pilot study, 18F-BMS986192 PET showed heterogeneous uptake in intra- and extracerebral metastatic lesions in melanoma patients. Baseline 18F-BMS986192 uptake was able to predict an ICI treatment-induced reduction in lesion volume, whereas the follow-up PET scan allowed the detection of treatment-induced toxicity.


Asunto(s)
Neoplasias Encefálicas , Melanoma , Neoplasias Primarias Secundarias , Antígeno B7-H1 , Neoplasias Encefálicas/diagnóstico por imagen , Neoplasias Encefálicas/tratamiento farmacológico , Fluorodesoxiglucosa F18/uso terapéutico , Humanos , Inhibidores de Puntos de Control Inmunológico , Melanoma/diagnóstico por imagen , Melanoma/tratamiento farmacológico , Proyectos Piloto , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Tomografía de Emisión de Positrones
16.
Cancer ; 128(5): 966-974, 2022 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-34784056

RESUMEN

BACKGROUND: Nivolumab plus ipilimumab (NIVO + IPI) has demonstrated long-term efficacy and safety in patients with previously untreated, advanced renal cell carcinoma (aRCC). Although most phase 3 clinical trials exclude patients with brain metastases, the ongoing, multicohort phase 3b/4 CheckMate 920 trial (ClincalTrials.gov identifier NCT02982954) evaluated the safety and efficacy of NIVO + IPI in a cohort that included patients with aRCC and brain metastases, as reported here. METHODS: Patients with previously untreated aRCC and asymptomatic brain metastases received NIVO 3 mg/kg plus IPI 1 mg/kg every 3 weeks × 4 followed by NIVO 480 mg every 4 weeks. The primary end point was the incidence of grade ≥3 immune-mediated adverse events (imAEs) within 100 days of the last dose of study drug. Key secondary end points were progression-free survival and the objective response rate according to Response Evaluation Criteria in Solid Tumors, version 1.1 (both determined by the investigator). Exploratory end points included overall survival, among others. RESULTS: After a minimum follow-up of 24.5 months (N = 28), no grade 5 imAEs occurred. The most common grade 3 and 4 imAEs were diarrhea/colitis (n = 2; 7%) and hypophysitis, rash, hepatitis, and diabetes mellitus (n = 1 each; 4%). The objective response rate was 32% (95% CI, 14.9%-53.5%) with a median duration of response of 24.0 months; 4 of 8 responders remained without reported progression. Seven patients (25%) had intracranial progression. The median progression-free survival was 9.0 months (95% CI, 2.9-12.0 months), and the median overall survival was not reached (95% CI, 14.1 months to not estimable). CONCLUSIONS: In patients who had previously untreated aRCC and brain metastases-a population with a high unmet medical need that often is underrepresented in clinical trials-the approved regimen of NIVO + IPI followed by NIVO showed encouraging antitumor activity and no new safety signals.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica , Neoplasias Encefálicas , Carcinoma de Células Renales , Neoplasias Renales , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Neoplasias Encefálicas/tratamiento farmacológico , Neoplasias Encefálicas/secundario , Carcinoma de Células Renales/tratamiento farmacológico , Carcinoma de Células Renales/patología , Estudios de Cohortes , Humanos , Ipilimumab/efectos adversos , Neoplasias Renales/tratamiento farmacológico , Neoplasias Renales/patología , Nivolumab/efectos adversos
17.
Eur Urol ; 81(3): 266-271, 2022 03.
Artículo en Inglés | MEDLINE | ID: mdl-34750035

RESUMEN

We present an exploratory post hoc analysis from the phase 3 CheckMate 214 trial of first-line nivolumab plus ipilimumab (NIVO+IPI) versus sunitinib in a subgroup of 108 patients with advanced renal cell carcinoma (aRCC) without prior nephrectomy and with an evaluable primary tumor, a population under-represented in clinical trials. Patients with clear cell aRCC were randomized to NIVO+IPI every 3 wk for four doses followed by NIVO monotherapy, or sunitinib every day for 4 wk (6-wk cycle). Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and primary tumor shrinkage were assessed. PFS and ORR were assessed per independent radiology review committee using RECIST version 1.1. With minimum study follow-up of 4 yr for intent-to-treat patients, OS favored NIVO+IPI (n = 53) over sunitinib (n = 55; hazard ratio 0.63, 95% confidence interval 0.40-1.0) among patients without prior nephrectomy. ORR was higher (34% vs 15%; p = 0.0041) and median duration of response was longer with NIVO+IPI versus sunitinib (20.5 vs 14.1 mo); the best overall response was partial response in either arm. A ≥30% reduction in the diameter of intact target renal tumors was achieved in 35% of patients with NIVO+IPI versus 20% with sunitinib. Safety was consistent with the global study population. In conclusion, in patients with aRCC without prior nephrectomy and with an evaluable primary tumor, NIVO+IPI showed survival benefits and renal tumor reduction versus sunitinib. This trial is registered at ClinicalTrials.gov as NCT02231749. PATIENT SUMMARY: In an exploratory analysis of a large global trial (CheckMate 214), we observed positive outcomes (both survival and tumor response to treatment) with nivolumab plus ipilimumab over sunitinib in a subgroup of patients with advanced kidney cancer who did not undergo removal of their primary kidney tumor. This subset of patients represents a population that has not been studied in clinical trials and for whom outcomes with new immunotherapy combination regimens are not yet known. We conclude that treatment with nivolumab plus ipilimumab offers these patients a survival benefit versus sunitinib, consistent with that observed in the overall study, as well as a notable kidney tumor reduction.


Asunto(s)
Carcinoma de Células Renales , Neoplasias Renales , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Carcinoma de Células Renales/patología , Femenino , Humanos , Ipilimumab/efectos adversos , Neoplasias Renales/patología , Masculino , Nefrectomía , Nivolumab/efectos adversos , Sunitinib/uso terapéutico
18.
Eur Urol Focus ; 8(1): 200-209, 2022 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-33495133

RESUMEN

BACKGROUND: Kidney cancer is a major urological disease globally, with more than 400 000 new cases diagnosed every year. OBJECTIVE: To investigate incidence and mortality trends for kidney cancer and their associations with modifiable risk factors for kidney cancer. DESIGN, SETTING, AND PARTICIPANTS: The most up-to-date figures on kidney cancer incidence and mortality were collected from the GLOBOCAN database and the Cancer Incidence in Five Continents (CI5). Data on total alcohol consumption and the prevalence of smoking, overweight, diabetes, and hypertension were extracted from the World Health Organization Global Health Observatory data repository. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Age-standardized rates (ASRs) for incidence and mortality and their correlations with potential risk factors for kidney cancer were investigated. Multivariable linear regression analysis was also conducted. The 10-yr temporal patterns for incidence are presented as the average annual percent change with 95% confidence interval using joinpoint regression analysis. RESULTS AND LIMITATIONS: Globally, there is wide variation in kidney cancer incidence and mortality. There were positive correlations between rates of smoking, alcohol consumption, and overweight and ASRs of kidney cancer incidence and mortality. Multivariable regression analysis revealed that alcohol consumption and overweight were significant risk factors for kidney cancer incidence, while smoking and alcohol consumption were significant risk factors for kidney cancer mortality. There was an increasing trend for the incidence of kidney cancer globally, with a particularly prominent trend for European countries. Of note, increasing incidence of kidney cancer is evident even for younger individuals aged <50 yr. However, cancer registries vary by country and period and there is a lack of data regarding the severity of risk factors and disease characteristics such as the distribution of histological groups, tumor grading, and staging. CONCLUSIONS: There is an increasing trend for kidney cancer incidence globally, particularly in European countries and the younger population. Modifiable risk factors for kidney cancer incidence and mortality have been identified. The increasing incidence of kidney cancer among younger individuals is worrying and warrants early action on possible preventive measures. PATIENT SUMMARY: The incidence of kidney cancer has been increasing globally, particularly in European countries and the younger population. Risk factors include smoking, alcohol consumption, overweight, and hypertension, and these factors are all modifiable.


Asunto(s)
Hipertensión , Neoplasias Renales , Síndrome Metabólico , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Humanos , Incidencia , Neoplasias Renales/epidemiología , Síndrome Metabólico/epidemiología , Sobrepeso , Fumar/efectos adversos , Fumar/epidemiología
19.
Toxics ; 9(11)2021 Oct 21.
Artículo en Inglés | MEDLINE | ID: mdl-34822667

RESUMEN

The public is already aware that nitrate pollution caused by nutrient runoff from farms is harmful to aquatic life and human health, and there is an urgent need for a product/technology to solve this problem. A biochar adsorbent was synthesized and used to remove nitrate ions from aqueous media based on spent mushroom compost (SMC), pre-treated with iron (III) chloride hexahydrate and pyrolyzed at 600 °C. The surface properties and morphology of SMCB/Fe were investigated using Fourier transform-infrared spectroscopy (FT-IR), X-ray diffraction (XRD), and scanning electron microscopy (SEM). The effect of main parameters such as the adsorbent dosages, pH of the solutions, contact times, and ion concentrations on the efficiency of nitrate removal was investigated. The validity of the experimental method was examined by the isothermal adsorption and kinetic adsorption models. The nitrate sorption kinetics were found to follow the pseudo-second-order model, with a higher determination coefficient (0.99) than the pseudo-first-order (0.86). The results showed that the maximum percentage of nitrate adsorption was achieved at equilibrium pH 5-7, after 120 min of contact time, and with an adsorbent dose of 2 g L-1. The highest nitrate adsorption capacity of the modified adsorbent was 19.88 mg g-1.

20.
Front Oncol ; 11: 698425, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34497758

RESUMEN

Programmed death-1 (PD-1) and programmed death ligand 1 (PD-L1) inhibitors target the important molecular interplay between PD-1 and PD-L1, a key pathway contributing to immune evasion in the tumor microenvironment (TME). Long-term clinical benefit has been observed in patients receiving PD-(L)1 inhibitors, alone and in combination with other treatments, across multiple tumor types. PD-L1 expression has been associated with response to immune checkpoint inhibitors, and treatment strategies are often guided by immunohistochemistry-based diagnostic tests assessing expression of PD-L1. However, challenges related to the implementation, interpretation, and clinical utility of PD-L1 diagnostic tests have led to an increasing number of preclinical and clinical studies exploring interrogation of the TME by real-time imaging of PD-(L)1 expression by positron emission tomography (PET). PET imaging utilizes radiolabeled molecules to non-invasively assess PD-(L)1 expression spatially and temporally. Several PD-(L)1 PET tracers have been tested in preclinical and clinical studies, with clinical trials in progress to assess their use in a number of cancer types. This review will showcase the development of PD-(L)1 PET tracers from preclinical studies through to clinical use, and will explore the opportunities in drug development and possible future clinical implementation.

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