RESUMO
BACKGROUND: Immunotherapy can activate the recognition of tumor antigen, build immune memory, and more and more clinical trials have taken the scheme of immunochemotherapy or immunoradiotherapy as a treatment strategy for esophageal squamous cell carcinoma (ESCC). Our objective was to compare the efficacy and safety between pembrolizumab combined with the chemotherapy group and simple chemotherapy in neoadjuvant therapy of ESCC. METHODS: Fifty-four ESCC patients with stage II-IVa were enrolled at the Fifth Affiliated Hospital of Sun Yat-sen University between January 2018 and December 2020, including 23 in the pembrolizumab combined with chemotherapy group (combined group), and 31 in the simple chemotherapy group. All patients received radical surgical treatment after two cycles of neoadjuvant therapy. RESULTS: The pathological complete response (pCR) and objective response rate (ORR) in the combined group were significantly higher than that of the simple chemotherapy group (30.4% vs. 9.7%, P=0.048; 86.9% vs. 95.7%, P=0.017) as well as the score of tumor regression ≥2 (80.7% vs. 50.0%, P=0.013). And the complete rate of esophagectomy and R0 /R1 resection rate in the two groups were not statistically significant. Otherwise, the incidence of adverse events in the combined group was similar compared with the simple chemotherapy group. CONCLUSIONS: Pembrolizumab combined with chemotherapy showed promising activity with a manageable safety profile. And it could offer a potential new neoadjuvant treatment approach for patients with ESCC.
RESUMO
Melanoma is a rare malignancy that invades the skin and the mucosa. Research has been conducted on melanoma incidence and the survival of patients with melanoma; however, no studies in melanoma incidence and the survival spanning 40 years and based on a large population have thus far been reported. We obtained data on patients with melanoma for each decade from 1974 to 2013 from the Surveillance, Epidemiology, and End Results (SEER) database. Disparities in survival by decade, age group, gender, race, site, and socioeconomic status (SES) within the aforementioned period were analyzed by comparison of Kaplan-Meier curves. We collected data on 133,996 melanoma patients in 18 SEER registry regions for the period 1974-2013. Our study found that the melanoma incidence increased continuously for the total population as well as for most age groups. The survival of patients with melanoma (except mucosal melanoma) also increased. This study showed increases in incidence and survival in melanoma across four decades in a large sample; meanwhile, the survival rates for mucosal melanoma decreased in the latter three decades, suggesting the need to improve melanoma diagnosis, broaden melanoma awareness among health care providers, and initiate the development of more effective treatments than the existing ones.