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1.
Nat Commun ; 12(1): 769, 2021 02 03.
Artículo en Inglés | MEDLINE | ID: mdl-33536445

RESUMEN

Some breast tumors metastasize aggressively whereas others remain dormant for years. The mechanism governing metastatic dormancy remains largely unknown. Through high-parametric single-cell mapping in mice, we identify a discrete population of CD39+PD-1+CD8+ T cells in primary tumors and in dormant metastasis, which is hardly found in aggressively metastasizing tumors. Using blocking antibodies, we find that dormancy depends on TNFα and IFNγ. Immunotherapy reduces the number of dormant cancer cells in the lungs. Adoptive transfer of purified CD39+PD-1+CD8+ T cells prevents metastatic outgrowth. In human breast cancer, the frequency of CD39+PD-1+CD8+ but not total CD8+ T cells correlates with delayed metastatic relapse after resection (disease-free survival), thus underlining the biological relevance of CD39+PD-1+CD8+ T cells for controlling experimental and human breast cancer. Thus, we suggest that a primary breast tumor could prime a systemic, CD39+PD-1+CD8+ T cell response that favors metastatic dormancy in the lungs.


Asunto(s)
Antígenos CD/inmunología , Apirasa/inmunología , Neoplasias de la Mama/inmunología , Linfocitos T CD8-positivos/inmunología , Neoplasias Mamarias Experimentales/inmunología , Receptor de Muerte Celular Programada 1/inmunología , Animales , Antígenos CD/metabolismo , Apirasa/metabolismo , Neoplasias de la Mama/patología , Neoplasias de la Mama/terapia , Linfocitos T CD8-positivos/metabolismo , Línea Celular Tumoral , Humanos , Inmunoterapia , Pulmón/inmunología , Pulmón/patología , Neoplasias Mamarias Experimentales/patología , Neoplasias Mamarias Experimentales/terapia , Ratones Endogámicos BALB C , Ratones Endogámicos NOD , Ratones Noqueados , Metástasis de la Neoplasia , Receptor de Muerte Celular Programada 1/metabolismo
2.
Allergol Immunopathol (Madr) ; 49(1): 150-152, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33528943

RESUMEN

Food allergy immunotherapy is a promising allergen-specific approach to manage food allergy in children, although it is not exempt from adverse events, even severe. The adverse events are not predictable and furthermore cofactors can play a role in triggering them. During the COVID-19 pandemic, patients on food allergy immunotherapy should be provided with suggestions on how to proceed in the event of COVID-19 infection occurring or is suspected. These recommendations would be of support to clinical practitioners dealing with patients on food allergy immunotherapy since there is little data in the literature on the topic.


Asunto(s)
Hipersensibilidad a los Alimentos/complicaciones , Hipersensibilidad a los Alimentos/terapia , Inmunoterapia/efectos adversos , /complicaciones , Niño , Protocolos Clínicos , Hipersensibilidad a los Alimentos/inmunología , Humanos , Cuerpo Médico/educación
3.
Adv Exp Med Biol ; 1295: 135-162, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33543459

RESUMEN

During the last 20+ years, research into the biomedical application of nanotechnology has helped in reshaping cancer treatment. The clinical use of several passively targeted nanosystems resulted in improved quality of care for patients. However, the therapeutic efficacy of these systems is not superior to the original drugs. Moreover, despite extensive investigations into actively targeted nanocarriers, numerous barriers still remain before their successful clinical translation, including sufficient bloodstream circulation time and efficient tumor targeting. The combination of synthetic nanomaterials with biological elements (e.g., cells, cell membranes, and macromolecules) is presently the cutting-edge research in cancer nanotechnology. The features provided by the biological moieties render the particles with prolonged bloodstream circulation time and homotopic targeting to the tumor site. Moreover, cancer cell membranes serve as sources of neoantigens, useful in the formulation of nanovaccines. In this chapter, we will discuss the advantages of biohybrid nanosystems in cancer chemotherapy, immunotherapy, and combined therapy, as well as highlight their preparation methods and clinical translatability.


Asunto(s)
Nanoestructuras , Neoplasias , Sistemas de Liberación de Medicamentos , Humanos , Inmunoterapia , Nanotecnología , Neoplasias/tratamiento farmacológico
4.
Adv Exp Med Biol ; 1295: 303-315, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33543465

RESUMEN

Up until now, surgery, radiation, and chemotherapy remain the conventional methods used in cancer treatment. However, these treatments are widely associated with severe side effects due to toxicity on normal cells. Consequently, there is an urgent need for novel therapeutic approaches that are able to effectively and selectively target tumor cells without any adverse effects on normal cells. Among the new approaches, cancer immunotherapy seems promising in the fight against tumors thanks to its prolonged efficacy and lower toxicity compared to the traditional treatments.Research studies suggested that both adjuvants and antigens are essential to induce optimal anti-tumor immunity. Among the different delivery strategies, nanotechnology offers several advantages for the design of cancer vaccines. Indeed, nanocarriers can protect the encapsulated antigens and/or adjuvant from enzymatic degradation, sustain and control the release for the entrapped cargo, and enhance the immune responses.Several studies reported that different physical characteristics of nanoparticles affect their uptake in cells and the potential to induce cellular responses. Among them, particle size and surface chemistry resulted the most influent.Clinical trials and recent research papers on the use of nanotechnology in cancer immunotherapy support the idea that this strategy could be successful as weapon against cancer in the near future.


Asunto(s)
Vacunas contra el Cáncer , Nanopartículas , Neoplasias , Humanos , Inmunoterapia , Nanotecnología , Neoplasias/terapia
5.
Adv Exp Med Biol ; 1295: 327-347, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33543467

RESUMEN

Immunotherapy has revolutionised oncology and represents a fast-growing area of new drug products in anti-cancer therapy. Patients can now benefit from an expanded landscape of treatment options for several tumour types. The value of cancer immunotherapy is well-established thanks to the clinical success following regulatory approval of several immunomodulators and cellular immunotherapies, and both the private and the public sector are investing to provide patients with improved immune-based agents and to extend the indications of already marketed products. Although recent achievements offer the best promise for successful treatment, innovators in the field of cancer immunotherapy still face many challenges toward commercialisation that could be mitigated by a smart drug development strategy.


Asunto(s)
Neoplasias , Desarrollo de Medicamentos , Humanos , Factores Inmunológicos , Inmunoterapia , Neoplasias/terapia
6.
Adv Exp Med Biol ; 1290: 67-80, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33559855

RESUMEN

The great hopes raised by the discovery of the immunoregulatory cytokine interleukin 12 (IL-12) as an anticancer agent were marred during early clinical experimentation because of severe adverse effects, which prompted a search for alternative formulations and routes of administration. Onco-immunotherapeutic viruses (OIVs) are wild-type or genetically engineered viruses that exert antitumor activity by causing death of the tumor cells they infect and by overcoming a variety of immunosuppressive mechanisms put in place by the tumors. OIVs have renewed the interest in IL-12, as they offer the opportunity to encode the cytokine transgenically from the viral genome and to produce it at high concentrations in the tumor bed. A large body of evidence indicates that IL-12 serves as a potent adjuvant for the immunotherapeutic response elicited by OIVs in murine tumor models. The list of OIVs includes onco-immunotherapeutic herpes simplex, adeno, measles, Newcastle disease, and Maraba viruses, among others. The large increase in IL-12-mediated adjuvanticity was invariably observed for all the OIVs analyzed. Indirect evidence suggests that locally delivered IL-12 may also increase tumor antigenicity. Importantly, the OIV/IL-12 treatment was not accompanied by adverse effects and elicited a long-lasting immune response capable of halting the growth of distant tumors. Thus, OIVs provide an avenue for reducing the clinical toxicity associated with systemic IL-12 therapy, by concentrating the cytokine at the site of disease. The changes to the tumor microenvironment induced by the IL-12-armed OIVs primed the tumors to an improved response to the checkpoint blockade therapy, suggesting that the triple combination is worth pursuing in the future. The highly encouraging results in preclinical models have prompted translation to the clinic. How well the IL-12-OIV-checkpoint inhibitors' combination will perform in humans remains to be fully investigated.


Asunto(s)
Viroterapia Oncolítica , Virus Oncolíticos , Animales , Humanos , Inmunoterapia , Interleucina-12/genética , Ratones , Virus Oncolíticos/genética , Microambiente Tumoral
7.
Adv Exp Med Biol ; 1278: 229-256, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33523451

RESUMEN

Regulatory T cells (Tregs) are critical in maintaining immune homeostasis under various pathophysiological conditions. A growing body of evidence demonstrates that Tregs play an important role in cancer progression and that they do so by suppressing cancer-directed immune responses. Tregs have been targeted for destruction by exploiting antibodies against and small-molecule inhibitors of several molecules that are highly expressed in Tregs-including immune checkpoint molecules, chemokine receptors, and metabolites. To date, these strategies have had only limited antitumor efficacy, yet they have also created significant risk of autoimmunity because most of them do not differentiate Tregs in tumors from those in normal tissues. Currently, immune checkpoint inhibitor (ICI)-based cancer immunotherapies have revolutionized cancer treatment, but the resistance to ICI is common and the elevation of Tregs is one of the most important mechanisms. Therapeutic strategies that can selectively eliminate Tregs in the tumor (i.e. therapies that do not run the risk of causing autoimmunity by affecting normal tissue), are urgently needed for the development of cancer immunotherapies. This chapter discusses specific properties of human Tregs under the context of cancer and the various ways to target Treg for cancer immunotherapy.


Asunto(s)
Neoplasias , Linfocitos T Reguladores , Autoinmunidad , Homeostasis , Humanos , Inmunoterapia , Neoplasias/tratamiento farmacológico
9.
J Immunother Cancer ; 9(2)2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33574054

RESUMEN

By the beginning of the global pandemic, SARS-CoV-2 infection has dramatically impacted on oncology daily practice. In the current oncological landscape, where immunotherapy has revolutionized the treatment of several malignancies, distinguishing between COVID-19 and immune-mediated pneumonitis can be hard because of shared clinical, radiological and pathological features. Indeed, their common mechanism of aberrant inflammation could lead to a mutual and amplifying interaction.We describe the case of a 65-year-old patient affected by metastatic squamous head and neck cancer and candidate to an experimental therapy including an anti-PD-L1 agent. COVID-19 ground-glass opacities under resolution were an incidental finding during screening procedures and worsened after starting immunotherapy. The diagnostic work-up was consistent with ICIs-related pneumonia and it is conceivable that lung injury by SARS-CoV-2 has acted as an inflammatory primer for the development of the immune-related adverse event.Patients recovered from COVID-19 starting ICIs could be at greater risk of recall immune-mediated pneumonitis. Nasopharyngeal swab and chest CT scan are recommended before starting immunotherapy. The awareness of the phenomenon could allow an easier interpretation of radiological changes under treatment and a faster diagnostic work-up to resume ICIs. In the presence of clinical benefit, for asymptomatic ICIs-related pneumonia a watchful-waiting approach and immunotherapy prosecution are suggested.


Asunto(s)
/diagnóstico , Neoplasias Pulmonares/diagnóstico , Neumonía/diagnóstico , Carcinoma de Células Escamosas de Cabeza y Cuello/diagnóstico , Anciano , Antígeno B7-H1/antagonistas & inhibidores , Antígeno B7-H1/inmunología , /inmunología , Diagnóstico Diferencial , Humanos , /efectos adversos , Inmunoterapia/efectos adversos , Lesión Pulmonar/diagnóstico , Lesión Pulmonar/diagnóstico por imagen , Lesión Pulmonar/patología , Lesión Pulmonar/virología , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/secundario , Neoplasias Pulmonares/virología , Masculino , Nasofaringe/metabolismo , Nasofaringe/patología , Metástasis de la Neoplasia , Pandemias , Neumonía/tratamiento farmacológico , Neumonía/inmunología , Neumonía/virología , Carcinoma de Células Escamosas de Cabeza y Cuello/tratamiento farmacológico , Carcinoma de Células Escamosas de Cabeza y Cuello/inmunología , Carcinoma de Células Escamosas de Cabeza y Cuello/virología
10.
Medicine (Baltimore) ; 100(3): e23802, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545943

RESUMEN

BACKGROUND: Thymic carcinoma is a rare malignancy, and platinum-based chemotherapy has not previously been established as a standard treatment for advanced or metastatic thymic carcinoma. With the breakthrough and progress of immunotherapy, the possibility of curing thymic carcinoma has greatly increased. Some clinical trials have reported that compared with traditional platinum-based chemotherapy, the use of programmed death 1 and programmed death ligand 1 inhibitors alone can benefit patients and effectively prolong their overall survival. We compare the efficacy of single immunotherapy with traditional platinum-based chemotherapy in a systematic review and meta-analysis to provide a reliable basis for clinicians. METHODS: Pubmed (Medline), Web of Science, Embase, Cochrane Central Register of Controlled Trials, and Google Scholar will be searched for relevant randomised controlled trials, quasi- randomised controlled trials, and Hi-Q(high quality) prospective cohort trials published or unpublished in any language before March 1, 2021. Subgroup analysis will be performed in tumor pathological stage and ethnicity. INPLASY registration number: INPLASY2020110060. RESULTS: The results of this study will be published in a peer-reviewed journal. CONCLUSION: The results of this systematic review and meta-analysis will provide a basis for clinicians to formulate the best chemotherapy regimen for patients, as well as a research clue for clinical researchers in this field. The results of this study will expand the treatment options for thymic carcinoma, but due to the nature of the disease and intervention, large sample clinical trials are not abundant, so we will include some high-quality small sample trials, which may cause high heterogeneity. INPLASY REGISTRATION NUMBER: INPLASY2020110060.


Asunto(s)
Antineoplásicos/uso terapéutico , Inmunoterapia , Platino (Metal)/uso terapéutico , Timoma/terapia , Neoplasias del Timo/terapia , Humanos , Metaanálisis como Asunto , Metástasis de la Neoplasia , Ensayos Clínicos Controlados Aleatorios como Asunto , Revisiones Sistemáticas como Asunto , Timoma/secundario , Neoplasias del Timo/patología
12.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 29(1): 288-292, 2021 Feb.
Artículo en Chino | MEDLINE | ID: mdl-33554836

RESUMEN

T lymphoid malignancy is a group of highly heterogeneous hematological tumors. Disease recurrence and resistance to therapy are the common causes of failed treatment. Traditional therapy is radiotherapy and chemotherapy, although it has achieved great success. However, many patients still failed to survive following the treatment. With the introduction of monoclonal antibodies, immunotherapy and cellular therapy into clinical practice, the outcome of hematologic malignancies has been significantly improved. In particular, chimeric antigen receptor T cells (CAR-T) showed high efficacy in treating B-cell lymphoma and acute B lymphocytic leukemia and surpassed any previous therapeutic strategies. However, this treatment seldom succeeded in treating T cell malignancies. In this review, the history of CAR-T cells treating T cell malignancies, and the clinical trials, adverse events of previously reported were summarized briefly.


Asunto(s)
Receptores Quiméricos de Antígenos , Humanos , Inmunoterapia , Inmunoterapia Adoptiva , Receptores de Antígenos de Linfocitos T , Linfocitos T
13.
Nat Commun ; 12(1): 832, 2021 02 05.
Artículo en Inglés | MEDLINE | ID: mdl-33547304

RESUMEN

The two T cell inhibitory receptors PD-1 and TIM-3 are co-expressed during exhausted T cell differentiation, and recent evidence suggests that their crosstalk regulates T cell exhaustion and immunotherapy efficacy; however, the molecular mechanism is unclear. Here we show that PD-1 contributes to the persistence of PD-1+TIM-3+ T cells by binding to the TIM-3 ligand galectin-9 (Gal-9) and attenuates Gal-9/TIM-3-induced cell death. Anti-Gal-9 therapy selectively expands intratumoral TIM-3+ cytotoxic CD8 T cells and immunosuppressive regulatory T cells (Treg cells). The combination of anti-Gal-9 and an agonistic antibody to the co-stimulatory receptor GITR (glucocorticoid-induced tumor necrosis factor receptor-related protein) that depletes Treg cells induces synergistic antitumor activity. Gal-9 expression and secretion are promoted by interferon ß and γ, and high Gal-9 expression correlates with poor prognosis in multiple human cancers. Our work uncovers a function for PD-1 in exhausted T cell survival and suggests Gal-9 as a promising target for immunotherapy.


Asunto(s)
Adenocarcinoma/terapia , Neoplasias del Colon/terapia , Galectinas/inmunología , Regulación Neoplásica de la Expresión Génica/inmunología , Proteína Relacionada con TNFR Inducida por Glucocorticoide/inmunología , Receptor 2 Celular del Virus de la Hepatitis A/inmunología , Receptor de Muerte Celular Programada 1/inmunología , Adenocarcinoma/genética , Adenocarcinoma/inmunología , Adenocarcinoma/mortalidad , Animales , Anticuerpos/farmacología , Antineoplásicos Inmunológicos/farmacología , Neoplasias del Colon/genética , Neoplasias del Colon/inmunología , Neoplasias del Colon/mortalidad , Galectinas/antagonistas & inhibidores , Galectinas/genética , Proteína Relacionada con TNFR Inducida por Glucocorticoide/agonistas , Proteína Relacionada con TNFR Inducida por Glucocorticoide/genética , Receptor 2 Celular del Virus de la Hepatitis A/genética , Humanos , Inmunoterapia/métodos , Células Jurkat , Melanoma Experimental/genética , Melanoma Experimental/inmunología , Melanoma Experimental/mortalidad , Melanoma Experimental/terapia , Ratones , Ratones Endogámicos BALB C , Receptor de Muerte Celular Programada 1/genética , Unión Proteica , Transducción de Señal , Neoplasias Cutáneas/genética , Neoplasias Cutáneas/inmunología , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/terapia , Análisis de Supervivencia , Linfocitos T Citotóxicos/efectos de los fármacos , Linfocitos T Citotóxicos/inmunología , Linfocitos T Citotóxicos/patología , Linfocitos T Reguladores/efectos de los fármacos , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/patología
14.
Brain Nerve ; 73(2): 161-169, 2021 Feb.
Artículo en Japonés | MEDLINE | ID: mdl-33561830

RESUMEN

Inflammatory myopathies are heterogeneous disorders characterized by muscle inflammation. They are frequently accompanied by extra-muscular manifestations that affect the skin, lungs, heart, and joints. Owing to its low prevalence, wide phenotypic heterogeneity, and variable disease course, it is difficult to make clear recommendations for the treatment of inflammatory myopathies. Corticosteroids are administered as first-line treatment based on clinical experience rather than controlled trial findings. Empirically, addition of an immunosuppressive drug might offer a steroid-sparing effect or an additional benefit. Administration of intravenous immunoglobulins has been shown to be effective as second-line treatment. Recently, there has been a growing interest in assessing the potential of several biological agents in the treatment of inflammatory myopathies. There are multiple ongoing clinical trials that will lead to more treatment options for inflammatory myopathies.


Asunto(s)
Miositis , Corticoesteroides , Humanos , Inmunoglobulinas Intravenosas/uso terapéutico , Inmunosupresores/uso terapéutico , Inmunoterapia , Miositis/tratamiento farmacológico
15.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artículo en Inglés | MEDLINE | ID: mdl-33431450

RESUMEN

An 83-year-old woman was referred to hospital with a 2-week history of short-lived episodic unpleasant sensations in her head and running down her body. This was accompanied by new short-term memory impairment and arm spasms. Initial investigations including blood tests and brain imaging did not reveal the diagnosis. The patient developed an increasing frequency of abnormal movements of her face and arm. These were clinically recognised as faciobrachial dystonic seizures (FBDS). FBDS are pathognomonic of an autoimmune encephalitis caused by an antibody directed against leucine-rich glioma-inactivated 1 (LGI1). The clinical diagnosis resulted in treatment with immunotherapy, leading to cessation of seizures and rapid cognitive recovery. Later, the predicted serology was confirmed. This reversible and under-recognised cause of cognitive impairment, typically affecting elderly patients, can be diagnosed clinically to enable early and effective treatment.


Asunto(s)
Autoanticuerpos/sangre , Disfunción Cognitiva/inmunología , Inmunoterapia/métodos , Encefalitis Límbica/diagnóstico , Convulsiones/inmunología , Administración Intravenosa , Anciano de 80 o más Años , Autoanticuerpos/inmunología , Disfunción Cognitiva/terapia , Femenino , Glucocorticoides/administración & dosificación , Humanos , Péptidos y Proteínas de Señalización Intracelular/inmunología , Encefalitis Límbica/complicaciones , Encefalitis Límbica/inmunología , Encefalitis Límbica/terapia , Sistema Límbico/diagnóstico por imagen , Sistema Límbico/inmunología , Metilprednisolona/administración & dosificación , Intercambio Plasmático , Tomografía de Emisión de Positrones , Convulsiones/terapia , Resultado del Tratamiento
16.
Nat Commun ; 12(1): 653, 2021 01 28.
Artículo en Inglés | MEDLINE | ID: mdl-33510147

RESUMEN

Only a subpopulation of non-small cell lung cancer (NSCLC) patients responds to immunotherapies, highlighting the urgent need to develop therapeutic strategies to improve patient outcome. We develop a chemical positive modulator (HEI3090) of the purinergic P2RX7 receptor that potentiates αPD-1 treatment to effectively control the growth of lung tumors in transplantable and oncogene-induced mouse models and triggers long lasting antitumor immune responses. Mechanistically, the molecule stimulates dendritic P2RX7-expressing cells to generate IL-18 which leads to the production of IFN-γ by Natural Killer and CD4+ T cells within tumors. Combined with immune checkpoint inhibitor, the molecule induces a complete tumor regression in 80% of LLC tumor-bearing mice. Cured mice are also protected against tumor re-challenge due to a CD8-dependent protective response. Hence, combination treatment of small-molecule P2RX7 activator followed by immune checkpoint inhibitor represents a strategy that may be active against NSCLC.


Asunto(s)
Carcinoma Pulmonar de Lewis/terapia , Inmunoterapia/métodos , Receptores Purinérgicos P2X7/inmunología , Bibliotecas de Moléculas Pequeñas/farmacología , Animales , Carcinoma Pulmonar de Lewis/genética , Carcinoma Pulmonar de Lewis/inmunología , Línea Celular Tumoral , Terapia Combinada , Femenino , Células HEK293 , Humanos , Interferón gamma/inmunología , Interferón gamma/metabolismo , Interleucina-18/genética , Interleucina-18/inmunología , Interleucina-18/metabolismo , Ratones Endogámicos C57BL , Ratones Noqueados , Ratones Transgénicos , Estructura Molecular , Receptores Purinérgicos P2X7/genética , Receptores Purinérgicos P2X7/metabolismo , Bibliotecas de Moléculas Pequeñas/química , Análisis de Supervivencia , Carga Tumoral/efectos de los fármacos , Carga Tumoral/inmunología
17.
Anticancer Res ; 41(2): 869-876, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517292

RESUMEN

BACKGROUND/AIM: Treatment options for advanced non-small cell lung cancer (NSCLC) include immunotherapy. Elevated carcinoembryonic antigen (CEA) and cancer antigen 125 (Ca-125) levels are associated with poorer prognoses of resected NSCLC, but currently no predictive biomarkers exist for immunotherapy response. This study evaluated CEA and Ca-125 as predictive biomarkers for immunotherapy efficiency in patients with metastatic NSCLC. PATIENTS AND METHODS: The single-centre observational retrospective study includes NSCLC stage III/IV patients treated with programmed death-ligand 1 (PD-L1) inhibitors nivolumab or pembrolizumab. The primary study endpoint was treatment response assessed by CT-scan following RECIST-criteria 1.1. CEA/Ca-125 serum values were determined at initiation of treatment and repeated every 2 weeks. Values closest to the day of CT-scan were compared to baseline values. RESULTS: A total of 136 patients were treated with mono-immunotherapy. Of these, 73 patients were included in the CEA group and 53 patients were included in the Ca-125 group. Baseline CEA and Ca-125 ranged from 8.14 to 5,909 and 1.1 to 4,238 respectively. The sensitivity for Ca-125 as predictor for tumor response was 62.9% (95% CI=61.8%-63.6%), specificity 61.1% (95% CI=60.2%-62.0%), with a positive predictive value (PPV) of 75.9% (95% CI=75.2%-76.7%). For CEA, the sensitivity was 72.0% (95% CI=71.5%-72.5%), specificity 47.1% (95% CI 46.4%-47.8%), with a PPV of 80.0% (95% CI=79.6%-80.4%). CONCLUSION: Increased serum CEA might predict tumor progression in NSCLC patients treated with PD-L1 inhibitors. Unconfirmed progression accompanied by increased CEA would support discontinuation of the immunotherapy, while continuation would be advised when serum CEA is not increased.


Asunto(s)
Antineoplásicos Inmunológicos/uso terapéutico , Antígeno Ca-125/sangre , Antígeno Carcinoembrionario/sangre , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Neoplasias Pulmonares/tratamiento farmacológico , Anciano , Anciano de 80 o más Años , Anticuerpos Monoclonales Humanizados/uso terapéutico , Biomarcadores/sangre , Carcinoma de Pulmón de Células no Pequeñas/diagnóstico por imagen , Carcinoma de Pulmón de Células no Pequeñas/patología , Femenino , Humanos , Inmunoterapia , Neoplasias Pulmonares/diagnóstico por imagen , Neoplasias Pulmonares/patología , Masculino , Persona de Mediana Edad , Metástasis de la Neoplasia , Estadificación de Neoplasias , Nivolumab/uso terapéutico , Pronóstico , Estudios Retrospectivos , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
18.
Anticancer Res ; 41(2): 999-1004, 2021 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-33517307

RESUMEN

BACKGROUND/AIM: Identification of predictors of survival of patients with lower genital tract melanoma (LGTM) and evaluation of the effectiveness of immunotherapy. PATIENTS AND METHODS: Data of twenty women with LGTM were retrospectively collected. Survival outcomes were evaluated using the Kaplan-Meier method. Survival distributions were analyzed using the Log rank test. RESULTS: Twenty patients with LGTM (6 vaginal/14 vulvar) were evaluated. Factors significantly affecting Five-year OS was the stage of the American Joint Committee on Cancer (AJCC 2017) (I+II: 55.6% vs. III+IV: 25.9%; p=0.030) and the T-Stage (I+II: 100% vs. III+IV: 7.5%; p=0.280). Factors negatively affecting Five-year PFS was T-Stage >II (p=0.005), AJCC stage >II (p<0.001), depth of tumor infiltration >3 mm (p=0.008), nodal involvement (p=0.013), distant disease (p=0.002), and resection margins <10 mm (p=0.024). Nine patients received immunotherapy [median duration of response (DOR)=4 months]. Three patients received immuno- and radiation therapy (median DOR of 5 months). Two patients received T-VEC, only one responded. CONCLUSION: Surgery has a therapeutic effect in early stage LGTM. Advanced stages may be treated with immunotherapy, radiation therapy, a combination of both, and oncolytic viral immunotherapy.


Asunto(s)
Terapia Combinada/métodos , Melanoma/terapia , Neoplasias Vaginales/terapia , Neoplasias de la Vulva/terapia , Anciano , Anciano de 80 o más Años , Antineoplásicos Inmunológicos/uso terapéutico , Terapia Combinada/mortalidad , Femenino , Procedimientos Quirúrgicos Ginecológicos , Humanos , Inmunoterapia , Estimación de Kaplan-Meier , Márgenes de Escisión , Melanoma/mortalidad , Melanoma/patología , Persona de Mediana Edad , Estadificación de Neoplasias , Virus Oncolíticos/fisiología , Radioterapia , Estudios Retrospectivos , Resultado del Tratamiento , Neoplasias Vaginales/mortalidad , Neoplasias Vaginales/patología , Neoplasias de la Vulva/mortalidad , Neoplasias de la Vulva/patología
19.
Zhonghua Zhong Liu Za Zhi ; 43(1): 39-59, 2021 Jan 23.
Artículo en Chino | MEDLINE | ID: mdl-33472316

RESUMEN

Primary lung cancer is the most common malignancy and the leading cause of cancer death in China, with an estimated 787 thousands incident cases and 631 thousands deaths in 2015. Due to its aggressive behavior and the absence of effective early screening methods, most patients with lung cancer in China are in stage Ⅳ when diagnosed. Chemotherapy is the cornerstone of stage Ⅳ lung cancer, but its efficacy is unsatisfactory. In recent years, with the rapid development of molecular targeted therapy and immunotherapy, the treatment concept has continuously changed and survival for patients has also been greatly improved. In order to update the progress in the treatment of stage Ⅳ lung cancer worldwide timely, and further improve the level of standardized diagnosis and treatment of stage Ⅳ lung cancer in China, Chinese Association for Clinical Oncologists and Medical Oncology Branch of Chinese International Exchange and Promotion Association for Medical and Healthcare organized experts to formulate "Clinical Practice Guideline for Stage Ⅳ Primary Lung Cancer in China(2021 version)" .


Asunto(s)
Neoplasias Pulmonares , China , Humanos , Inmunoterapia , Neoplasias Pulmonares/tratamiento farmacológico , Neoplasias Pulmonares/terapia , Oncología Médica , Terapia Molecular Dirigida
20.
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