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1.
Nat Hum Behav ; 2024 Mar 04.
Artigo em Inglês | MEDLINE | ID: mdl-38438651

RESUMO

People who take on challenges and persevere longer are more likely to succeed in life. But individuals often avoid exerting effort, and there is limited experimental research investigating whether we can learn to value effort. We developed a paradigm to test the hypothesis that people can learn to value effort and will seek effortful challenges if directly incentivized to do so. We also dissociate the effects of rewarding people for choosing effortful challenges and performing well. The results provide limited evidence that rewarding effort increased people's willingness to choose harder tasks when rewards were no longer offered (near transfer). There was also mixed evidence that rewarding effort increased willingness to choose harder tasks in another unrelated and unrewarded task (far transfer). These heterogeneous results highlight the need for further research to understand when this paradigm may be the most effective for increasing and generalizing the value of effort.

2.
Disabil Rehabil Assist Technol ; : 1-8, 2023 Nov 16.
Artigo em Inglês | MEDLINE | ID: mdl-37971205

RESUMO

PURPOSE: Rehabilitation professionals prescribe patients with suitable powered mobility aids (PMAs) based on patient characteristics, e.g., age and mobility. However, there is paucity of literature examining patient characteristics associated with PMA types in Asian contexts. This research aims to study (i) characteristics of Singapore PMA users and (ii) correlations between characteristics and two PMA types - motorised wheelchairs and powered scooters. It is hypothesised that patients' age, mobility status and medical conditions have correlations with PMA types. METHODOLOGY: A cross-sectional, retrospective study design was used to investigate characteristics of patients (age ≥ 21 years) at Tan Tock Seng Hospital Occupational Therapy Seating Clinic between 2017 and 2019. Comparisons of proportions of motorised wheelchair users versus powered scooter users based on characteristics were analysed using Chi-square test. Subsequently, statistically significant patient characteristics were selected for a multiple logistic regression. RESULTS: Among 352 patients, 21% and 79% were prescribed motorised wheelchairs and powered scooters, respectively. Patients aged 61-90 years were twice those aged 21-60 years. Males were double of females. Patients of (i) an older age, (ii) more ambulant, (iii) independent in transfers and (iv) in activities of daily living (ADLs), were more likely powered scooter users. Conversely, patients of (i) a younger age, (ii) less ambulant, (iii) require assistance in transfers and (iv) in ADLs were more likely motorised wheelchair users. Patients' gender and caregiver status showed no statistically significant correlations with PMA types. CONCLUSIONS: Rehabilitation professionals could consider patients' age, mobility status, transfer status and ADL status when prescribing PMA for Asian populations.Implications for rehabilitationGuide rehabilitation professionals in making clinical decisions on the type of powered mobility aid (PMA) to prescribe based on patients' characteristics.Aid in the development of future guidelines for rehabilitation professionals in prescription of PMAs.

3.
Tumour Biol ; 45(1): 73-80, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37694331

RESUMO

Proprotein convertase subtilisin/kexin type 9 (PCSK9) binds to low-density lipoprotein (LDL) receptor and fatty acid translocase CD36, inducing lysosomal degradation of these two receptors in the liver cells. Both monoclonal antibody (mAb) and small-interfering RNA (siRNA) targeting PCSK9 have been designed for treatment of familial hypercholesterolemia recently, with elevating LDL receptors on the liver cell surface and increasing LDL uptake as the main beneficial mechanism. However, given that the binding domains of PCSK9 for LDL receptor and CD36 are different, and PCSK9 mAb only attacks the domain for LDL receptor, CD36 expression remains partially controlled under PCSK9 mAb treatment. In contrast, PCSK9 siRNA brings on complete loss of PCSK9, resulting in overexpression of CD36. Based on the fact that CD36 is a key factor in the pathogenesis of non-alcoholic fatty liver disease (NAFLD) and subsequent hepatocellular carcinoma (HCC), the risk of developing NAFLD and HCC on long-term use of PCSK9 siRNA is thus raised as a hypothesis. Additionally, because CD36 is also involved in the promotion of malignant diseases other than HCC, such as acute myeloid leukemia, gastric cancer, breast cancer, and colorectal cancer, the speculative danger of flourishing these malignancies by PCSK9 siRNA is discussed as well.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Hepatopatia Gordurosa não Alcoólica , Humanos , Regulação para Cima , RNA Interferente Pequeno/genética , Carcinoma Hepatocelular/genética , Pró-Proteína Convertase 9/genética , Neoplasias Hepáticas/genética , Receptores de LDL , Anticorpos Monoclonais , Subtilisinas
4.
J Immunother ; 46(3): 96-106, 2023 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-36809225

RESUMO

T-cell immunotherapies are promising strategies to generate T-cell responses towards tumor-derived or pathogen-derived antigens. Adoptive transfer of T cells genetically modified to express antigen receptor transgenes has shown promise for the treatment of cancer. However, the development of T-cell redirecting therapies relies on the use of primary immune cells and is hampered by the lack of easy-to-use model systems and sensitive readouts to facilitate candidate screening and development. Particularly, testing T-cell receptor (TCR)-specific responses in primary T cells and immortalized T cells is confounded by the presence of endogenous TCR expression which results in mixed alpha/beta TCR pairings and compresses assay readouts. Herein, we describe the development of a novel cell-based TCR knockout (TCR-KO) reporter assay platform for the development and characterization of T-cell redirecting therapies. CRISPR/Cas9 was used to knockout the endogenous TCR chains in Jurkat cells stably expressing a human interleukin-2 promoter-driven luciferase reporter gene to measure TCR signaling. Reintroduction of a transgenic TCR into the TCR-KO reporter cells results in robust antigen-specific reporter activation compared with parental reporter cells. The further development of CD4/CD8 double-positive and double-negative versions enabled low-avidity and high-avidity TCR screening with or without major histocompatibility complex bias. Furthermore, stable TCR-expressing reporter cells generated from TCR-KO reporter cells exhibit sufficient sensitivity to probe in vitro T-cell immunogenicity of protein and nucleic acid-based vaccines. Therefore, our data demonstrated that TCR-KO reporter cells can be a useful tool for the discovery, characterization, and deployment of T-cell immunotherapy.


Assuntos
Receptores de Antígenos de Linfócitos T alfa-beta , Receptores de Antígenos de Linfócitos T , Humanos , Receptores de Antígenos de Linfócitos T/genética , Receptores de Antígenos de Linfócitos T/metabolismo , Receptores de Antígenos de Linfócitos T alfa-beta/genética , Transferência Adotiva , Luciferases , Desenvolvimento de Vacinas
5.
Nutr Health ; 29(2): 171-174, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36266952

RESUMO

Background: Substance misuse brings tremendous harm to global health. Strategies for the treatment and prevention of drug addiction are in urgent need. Aim: Trace amine-associated receptor 1 (TAAR1) widely distributed in the central nervous system has been identified as a hopeful target in the management of certain substance abuse. Discovery of food ingredients that act on TAAR1 might help health care providers develop chemoprevention for substance misuse disorders. Methods: Animal experiments clearly demonstrated the capability of TAAR1 agonists in attenuating addictive behavior regarding cocaine, nicotine, methamphetamine, and morphine. Ractopamine, a livestock feed additive used in the United States for over 20 years, has proven to be a full TAAR1 agonist. Literature review and internet web database survey were performed to see if ractopamine residues in meat could affect substance addiction behavior. Results: Integrating all available epidemiologic studies revealed that the prevalence of cocaine, nicotine, methamphetamine, and opioid misuse showed steadily downward or stable trends coincidently during the same time period of ractopamine use in the United States. Conclusion: A hypothesis is thus raised here that ractopamine residues in meat might have contributed secretly to the smoothened prevalence curves of cocaine, nicotine, methamphetamine, and opioids addiction.


Assuntos
Cocaína , Metanfetamina , Transtornos Relacionados ao Uso de Substâncias , Animais , Humanos , Estados Unidos , Metanfetamina/efeitos adversos , Nicotina/efeitos adversos , Morfina , Carne , Ração Animal
6.
Nutr Health ; 29(1): 5-7, 2023 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-35702043

RESUMO

Background: The overall prevalence of diabetes in the world has risen substantially in the past several decades, so have complications and mortalities associated with it. Aim: Prevention strategies for diabetes thus become an urgent public health need for reducing the burden of diabetes. Methods: Ractopamine, a ß1/2-adrenergic receptor agonist, has been approved for use in finishing swine, cattle, and turkey in countries where meat exporting brings tremendous economic benefits. This leanness enhancer is recently found to be a full agonist at trace amine-associated receptor 1 also. A thorough literature review was performed to assess possible effects of ractopamine on glucose metabolism. Results: Activating ß-adrenoceptor could lead to glucose-lowering effects independent of insulin while activation on trace amine-associated receptor 1 induces an incretin-like signaling on insulin-secreting pancreatic ß-cells. Conclusion: Accordingly, it is hypothesized that long-term consuming meat containing ractopamine might lower the risk of type 2 diabetes.


Assuntos
Diabetes Mellitus Tipo 2 , Insulinas , Humanos , Animais , Suínos , Bovinos , Agonistas Adrenérgicos beta/uso terapêutico , Agonistas Adrenérgicos beta/farmacologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/prevenção & controle , Fenetilaminas/uso terapêutico , Fenetilaminas/farmacologia , Carne
7.
J Med Case Rep ; 16(1): 459, 2022 Dec 11.
Artigo em Inglês | MEDLINE | ID: mdl-36496425

RESUMO

BACKGROUND: Multiple myeloma remains incurable despite treatment advancements over the last 20 years. LCAR-B38M Cells in Treating Relapsed/Refractory Multiple Myeloma was a phase 1, first-in-human, investigator-initiated study in relapsed/refractory multiple myeloma conducted at four sites in China. The study used LCAR-B38M chimeric antigen receptor-T cells expressing two B-cell maturation antigen-targeting single-domain antibodies designed to confer avidity, and a CD3ζ signaling domain with a 4-1BB costimulatory domain to optimize T-cell activation and proliferation. This chimeric antigen receptor construct is identical to ciltacabtagene autoleucel. In the LEGEND-2 study (n = 57, Xi'an site), overall response rate was 88%; median (95% CI) progression-free survival and overall survival were 19.9 (9.6-31.0) and 36.1 (26.4-not evaluable) months, respectively; and median follow-up was 25 months. This case study reports on a patient with relapsed/refractory multiple myeloma (λ light chain type) who was treated with LCAR-B38M chimeric antigen receptor T cells in the LEGEND-2 study (Xi'an site); he had received five prior lines of treatment and had extensive extramedullary lesions. CASE PRESENTATION: The patient, a 56-year-old Asian male, received cyclophosphamide (500 mg daily × 3 days) as lymphodepletion therapy and a total dose of 0.5 × 106 chimeric antigen receptor + T cells/kg split into three infusions (days 1, 24, and 84 from June to August 2016). He experienced grade 2 cytokine release syndrome after the first infusion; all symptoms resolved with treatment. No cytokine release syndrome occurred following the second and third infusions. His λ light chain levels decreased and normalized 20 days after the first infusion, and extramedullary lesions were healed as of January 2018. He has sustained remission for 5 years and received no other multiple myeloma treatments after LCAR-B38M chimeric antigen receptor T cell infusion. As of 30 October 2020, the patient is still progression-free and has maintained minimal residual disease-negative (10-4) complete response status for 52 months. CONCLUSIONS: This case provides support that treatment with LCAR-B38M chimeric antigen receptor T cells can result in long-term disease remission of 5 or more years without disease progression in a heavily pretreated patient with extensive extramedullary disease and no other treatment options.


Assuntos
Mieloma Múltiplo , Receptores de Antígenos Quiméricos , Masculino , Humanos , Pessoa de Meia-Idade , Receptores de Antígenos Quiméricos/uso terapêutico , Mieloma Múltiplo/tratamento farmacológico , Antígeno de Maturação de Linfócitos B , Linfócitos T/patologia , Progressão da Doença
10.
Int J Mol Sci ; 23(16)2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-36012532

RESUMO

Anthracycline-induced cardiomyopathy has been noted as a non-neglectable issue in the field of clinical oncology. Remarkable progress has been achieved in searching for inherited susceptible genetic deficits underlying anthracycline cardiotoxicity in the past several years. In this case report, we present the preliminary results of a genetic study in a young male patient who was treated with standard dose anthracycline-based chemotherapy for his acute myeloid leukemia and attacked by acute congestive heart failure after just two courses of therapy. After a survey of 76 target genes, an in-frame deletion of the titin gene was recognized as the most possible genetic defect responsible for his cardiomyopathy caused by anthracycline. This defect proved to pass down from the patient's mother and did not exist in seven unrelated chemotherapy-treated cancer patients without chemotherapy-induced cardiomyopathy and four other healthy volunteer DNA donors.


Assuntos
Antraciclinas , Cardiomiopatias , Antraciclinas/efeitos adversos , Antibióticos Antineoplásicos/efeitos adversos , Cardiomiopatias/induzido quimicamente , Cardiomiopatias/complicações , Cardiomiopatias/genética , Cardiotoxicidade/etiologia , Causalidade , Conectina/genética , Humanos , Masculino
11.
Cureus ; 14(4): e24193, 2022 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35592216

RESUMO

A 39-year-old man with a history of intravenous drug use was diagnosed to have a sudden onset of immune thrombocytopenia (ITP) in the background of a chronic hepatitis C infection with genotype 3a. Two courses of high-dose pulse dexamethasone therapy (40 mg daily for consecutive four days) failed to raise the platelet counts, but a combination direct-acting antiviral (DAA) regimen of sofosbuvir and velpatasvir, which had been proved to be effective for all hepatitis C virus (HCV) genotypes, successfully restored the platelets number to normal ranges after hepatitis C virus ribonucleic acid (RNA) was totally eliminated. Molecular mimicry of hepatitis C virus envelope proteins with platelet surface antigens is proposed to be the underlying cause of immune thrombocytopenia. An adequate direct-acting antiviral regimen is considered to be the most reliable therapy for hepatitis C-related immune thrombocytopenia.

12.
Am J Epidemiol ; 191(6): 1140-1151, 2022 05 20.
Artigo em Inglês | MEDLINE | ID: mdl-35238335

RESUMO

The inverse probability of treatment weighting (IPTW) approach is popular for evaluating causal effects in observational studies, but extreme propensity scores could bias the estimator and induce excessive variance. Recently, the overlap weighting approach has been proposed to alleviate this problem, which smoothly down-weights the subjects with extreme propensity scores. Although advantages of overlap weighting have been extensively demonstrated in literature with continuous and binary outcomes, research on its performance with time-to-event or survival outcomes is limited. In this article, we propose estimators that combine propensity score weighting and inverse probability of censoring weighting to estimate the counterfactual survival functions. These estimators are applicable to the general class of balancing weights, which includes IPTW, trimming, and overlap weighting as special cases. We conduct simulations to examine the empirical performance of these estimators with different propensity score weighting schemes in terms of bias, variance, and 95% confidence interval coverage, under various degrees of covariate overlap between treatment groups and censoring rates. We demonstrate that overlap weighting consistently outperforms IPTW and associated trimming methods in bias, variance, and coverage for time-to-event outcomes, and the advantages increase as the degree of covariate overlap between the treatment groups decreases.


Assuntos
Pontuação de Propensão , Viés , Causalidade , Simulação por Computador , Humanos
13.
Eur J Cancer Prev ; 31(1): 82-84, 2022 01 01.
Artigo em Inglês | MEDLINE | ID: mdl-33369951

RESUMO

There is currently no evidence of the carcinogenic effect of the ß-adrenergic agonist ractopamine added in finishing swine and cattle feed for promoting leanness. Nonetheless, it has the capability of stimulating expression of asparagine synthetase (ASNS) through activating transcription factor 5, and many other genes involved in the stress reaction in the skeletal muscle of pigs according to published scientific articles. Because overexpression of ASNS has been detected as a key player in amino acid response and unfolded protein response during the development of not a few malignant diseases, especially those with KRAS mutations, and found to be closely related to tumor proliferation, invasion and metastasis, it seems reasonable to hypothesize that intake of ractopamine residue in meat might bring negative effects to cancer patients.


Assuntos
Aspartato-Amônia Ligase , Neoplasias , Animais , Aspartato-Amônia Ligase/genética , Aspartato-Amônia Ligase/metabolismo , Bovinos , Humanos , Carne , Neoplasias/genética , Fenetilaminas/farmacologia , Suínos
14.
Curr Protoc ; 1(11): e296, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34787960

RESUMO

Antibody Fc effector function is one of the main mechanisms of action (MoA) for therapeutic monoclonal antibodies. Measurement of antibody-dependent cellular cytotoxicity (ADCC) is critical for understanding the Fc effector function during monoclonal antibody development. This article covers two cell-based ADCC bioassays which can quantitatively measure the antibody potency in ADCC. Basic Protocol 1 describes the ADCC reporter bioassay using engineered ADCC effector cells which measures the FcγRIIIa-mediated luciferase reporter activation upon the binding of antibody-coated target cells. Basic Protocol 2 describes the PBMC ADCC bioassay using primary peripheral blood mononuclear cells (PBMC) as effector cells and engineered HiBiT target cells in an assay that measures the release of HiBiT from target cells upon antibody-mediated target lysis. Optimization of several key assay parameters including cell handling, effector:target (E:T) ratios, assay plate, and plate reader requirement, and how these parameters impact assay performance are discussed. © 2021 Promega Corporation. Current Protocols published by Wiley Periodicals LLC. Basic Protocol 1: ADCC reporter bioassay using engineered ADCC bioassay effector cells Basic Protocol 2: PBMC ADCC bioassay using primary PBMC and engineered HiBiT target cells.


Assuntos
Citotoxicidade Celular Dependente de Anticorpos , Leucócitos Mononucleares , Anticorpos Monoclonais , Bioensaio , Células Matadoras Naturais
15.
JTO Clin Res Rep ; 2(1): 100108, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34589973

RESUMO

INTRODUCTION: Taletrectinib (AB-106/DS-6051b) is an oral, potent selective ROS1 and pan-NTRK tyrosine kinase inhibitor (TKI). Preclinically, taletrectinib has activity against ROS1 G2032R solvent-front mutation. METHODS: Patients with ROS1+ NSCLC enrolled into two phase 1 studies conducted in United States (U101, NCT02279433) and Japan (J102, NCT02675491) were analyzed for objective response rate (ORR) by the Response Evaluation Criteria in Solid Tumors version 1.1, progression-free survival, and safety. RESULTS: A total of 22 patients with ROS1+ NSCLC out of the total 61 patients enrolled were analyzed. Taletrectinib was given at the oral dose of 400 mg, 600 mg, 800 mg, and 1200 mg once daily and 400 mg twice daily as part of the dose-escalation schema. Data cutoff was August 19, 2020. Median follow-up time for all 22 patients was 14.9 months (95% confidence interval [CI]: 4.1-33.8). A total of 18 patients with ROS1+ were assessable for response. The confirmed ORR for ROS1 TKI-naive patients (N = 9) was 66.7% (95% CI: 35.4-87.9) with a disease control rate of 100% (70.1-100). The confirmed ORR for crizotinib pretreated patients (N = 6) was 33.3% (95% CI: 9.7-70.0) with a disease control rate of 88.3% (95% CI: 443.6-97.0). The median progression-free survival for ROS1 TKI-naive patients (N = 11) was 29.1 months (95% CI: 2.6-not reached) and 14.2 months (95% CI: 1.5-not reached) for crizotinib-refractory only patients (N = 8). The most common treatment-related adverse events were alanine transaminase elevations (72.7%), aspartate transaminase elevations (72.7%), nausea (50.0%), and diarrhea (50.0%). Grade 3 or higher adverse events were alanine transaminase elevations (18.2%), aspartate transaminase (9.1%), and diarrhea (4.5%). CONCLUSIONS: Taletrectinib (AB106/DS6051b) has a meaningful clinical activity in patients with advanced ROS1+ NSCLC who are ROS1 TKI-naive or crizotinib-refractory and a manageable safety profile.

16.
Dement Geriatr Cogn Dis Extra ; 11(2): 110-113, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34178014

RESUMO

The feed additive ractopamine, a ß-adrenergic agonist, has been approved for use in livestock for nearly 2 decades. Studies of its possible adverse effects in humans have concentrated exclusively on cardiovascular disease and cardiovascular functional disorders in the past. In this article, whether and how ractopamine may affect neurodegeneration, either to promote or to reduce the incidence of Alz-heimer disease, will be discussed based on the recent controversial findings that ß-adrenoreceptor activation not only can stimulate Alzheimer-pathogenic amyloid-ß accumulation but also are able to enhance hippocampal neurogenesis and ameliorate mouse memory deficits in independent laboratory studies. Furthermore, environmental enrichment has been found to prevent impairment of memory-related hippocampal long-term potentiation and microglia-mediated neuroinflammation induced by amyloid-ß. These beneficial effects are achieved mainly through enhanced ß-adrenergic signaling and can be imitated by ß agonist isoprotenerol. Finally, it has been demonstrated that the ß-adrenergic agonist salbutamol could bind directly to tau protein and interfere with the tau filament formation seen in the prodromal phase of Alzheimer disease. These complex but interesting issues lead to contradictory speculations of possible effects of ractopamine residue in meat on Alzheimer disease. Hypotheses derived from this review surely deserve carefully designed laboratory investigations and clinical studies in the future.

17.
Lancet ; 398(10297): 314-324, 2021 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-34175021

RESUMO

BACKGROUND: CARTITUDE-1 aimed to assess the safety and clinical activity of ciltacabtagene autoleucel (cilta-cel), a chimeric antigen receptor T-cell therapy with two B-cell maturation antigen-targeting single-domain antibodies, in patients with relapsed or refractory multiple myeloma with poor prognosis. METHODS: This single-arm, open-label, phase 1b/2 study done at 16 centres in the USA enrolled patients aged 18 years or older with a diagnosis of multiple myeloma and an Eastern Cooperative Oncology Group performance status score of 0 or 1, who received 3 or more previous lines of therapy or were double-refractory to a proteasome inhibitor and an immunomodulatory drug, and had received a proteasome inhibitor, immunomodulatory drug, and anti-CD38 antibody. A single cilta-cel infusion (target dose 0·75 × 106 CAR-positive viable T cells per kg) was administered 5-7 days after start of lymphodepletion. The primary endpoints were safety and confirmation of the recommended phase 2 dose (phase 1b), and overall response rate (phase 2) in all patients who received treatment. Key secondary endpoints were duration of response and progression-free survival. This trial is registered with ClinicalTrials.gov, NCT03548207. FINDINGS: Between July 16, 2018, and Oct 7, 2019, 113 patients were enrolled. 97 patients (29 in phase 1b and 68 in phase 2) received a cilta-cel infusion at the recommended phase 2 dose of 0·75 × 106 CAR-positive viable T cells per kg. As of the Sept 1, 2020 clinical cutoff, median follow-up was 12·4 months (IQR 10·6-15·2). 97 patients with a median of six previous therapies received cilta-cel. Overall response rate was 97% (95% CI 91·2-99·4; 94 of 97 patients); 65 (67%) achieved stringent complete response; time to first response was 1 month (IQR 0·9-1·0). Responses deepened over time. Median duration of response was not reached (95% CI 15·9-not estimable), neither was progression-free survival (16·8-not estimable). The 12-month progression-free rate was 77% (95% CI 66·0-84·3) and overall survival rate was 89% (80·2-93·5). Haematological adverse events were common; grade 3-4 haematological adverse events were neutropenia (92 [95%] of 97 patients), anaemia (66 [68%]), leukopenia (59 [61%]), thrombocytopenia (58 [60%]), and lymphopenia (48 [50%]). Cytokine release syndrome occurred in 92 (95%) of 97 patients (4% were grade 3 or 4); with median time to onset of 7·0 days (IQR 5-8) and median duration of 4·0 days (IQR 3-6). Cytokine release syndrome resolved in all except one with grade 5 cytokine release syndrome and haemophagocytic lymphohistiocytosis. CAR T-cell neurotoxicity occurred in 20 (21%) patients (9% were grade 3 or 4). 14 deaths occurred in the study; six due to treatment-related adverse events, five due to progressive disease, and three due to treatment-unrelated adverse events. INTERPRETATION: A single cilta-cel infusion at the target dose of 0·75 × 106 CAR-positive viable T cells per kg led to early, deep, and durable responses in heavily pretreated patients with multiple myeloma with a manageable safety profile. The data from this study formed the basis for recent regulatory submissions. FUNDING: Janssen Research & Development and Legend Biotech.


Assuntos
Antígeno de Maturação de Linfócitos B/administração & dosagem , Imunoterapia Adotiva/métodos , Mieloma Múltiplo/tratamento farmacológico , Receptores de Antígenos Quiméricos/administração & dosagem , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Intervalo Livre de Progressão , Estados Unidos
18.
Med Dosim ; 46(4): 356-359, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33934976

RESUMO

The purpose of this case study is to describe an external beam radiation therapy planning technique for carcinoma of the left breast. A female patient on protocol NSABP B-51/RTOG 1304 presented with unusual anatomy and large habitus. Deep inspiration breath-hold (DIBH) IMRT was used in conjunction a DIBH-3D conformal radiotherapy (3DCRT) tangential boost plan to meet the dose criteria for protocol compliance. Traditionally 3DCRT planning using a DIBH technique would be used for both billing authorization and as DIBH-IMRT involves a longer treatment time and more difficulty in terms of patient compliance; however, the patient tolerated the treatment very well. The subsequent treatment plan met all criteria per protocol with the exception of the ipsilateral lung, which passed with acceptable variation.


Assuntos
Neoplasias da Mama , Neoplasias , Radioterapia de Intensidade Modulada , Neoplasias Unilaterais da Mama , Neoplasias da Mama/radioterapia , Suspensão da Respiração , Feminino , Coração , Humanos , Órgãos em Risco , Dosagem Radioterapêutica , Planejamento da Radioterapia Assistida por Computador
19.
Cureus ; 13(3): e13793, 2021 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-33959428

RESUMO

A 60-year-old male patient whose nasopharyngeal carcinoma was brought to complete remission with induction chemotherapy composing of cisplatin plus fluorouracil and subsequent radiotherapy with intent of cure eight years ago presented with dyspnea due to left side massive pleural effusion with pleural seedings, left lower lobe huge space occupying lesion, and left atrial tumor extending from the intrapulmonary lesion through left inferior pulmonary veins. Pleural biopsy revealed a picture of nonkeratinizing squamous cell carcinoma positive for Epstein-Barr virus-encoded small RNAs in situ hybridization, leading to a diagnosis of late pulmonary metastases from the antecedent nasopharyngeal carcinoma. Systemic chemotherapy with initial cisplatin plus paclitaxel and subsequent cisplatin plus gemcitabine brought remarkable resolution to the malignant cardiac and intrathoracic lesions. So far as we know, this is the first case report of left atrial invasion from pulmonary metastasis of a nasopharyngeal carcinoma origin in the English literature.

20.
Plast Reconstr Surg Glob Open ; 9(2): e3420, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33680668

RESUMO

Human acellular dermal matrices (hADMs) are applied in various soft tissue reconstructive surgeries as scaffolds to support tissue remodeling and regeneration. To evaluate the clinical efficacy of hADM implants, it is integral that the hADM does not induce a host chronic inflammatory response leading to fibrotic encapsulation of the implant. In this study, we characterized the inflammatory and fibrosis-related tissue remodeling response of 2 commercial hADM products (SimpliDerm and AlloDerm RTU) in a nonhuman primate model using histology and gene expression profiling. METHODS: Eighteen African green monkeys with abdominal wall defects were applied to evaluate the performance of SimpliDerm and AlloDerm RTU implants (N = 3) at 2, 4, and 12-weeks post-implantation. Using histology and gene expression profiling, tissue responses such as implant integration, degradation, cell infiltration, immune response, neovascularization, and pro-fibrotic responses over time were evaluated. RESULTS: SimpliDerm showed a lower initial inflammatory response and slower implant degradation rate than AlloDerm RTU evidenced by histomorphological analysis. These factors led to a more anti-inflammatory and pro-remodeling microenvironment within SimpliDerm, demonstrated by lower TNFα levels and lower expression levels of pro-fibrotic markers, and promoted tissue repair and regeneration by 3-months post-implantation. CONCLUSIONS: Overall, histology and gene expression profiling analyses shown in this study demonstrated an effective model for analyzing hADM performance in terms of host inflammatory and fibrotic response. Further studies are warranted to fully evaluate the utility of this novel hADM in the clinical setting and verify the prognosis of our pre-clinical analysis model.

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