RESUMO
To investigate whether cytokine genetic polymorphisms influence the outcome of diffuse large B cell lymphoma (DLBCL), we tested 337 consecutive DLBCL treated with CHOP or rituximab-CHOP (R-CHOP) from interleukin 10 (IL10), Bcl-2, and tumor necrosis factor (TNF)-α polymorphisms. Patients who carried the IL10 rs1800871 TT or rs1800872 AA genotype showed higher complete response (CR) and overall response rate (ORR) significantly. A longer progression-free survival (PFS) was observed in patients with IL10 rs1800871 TT (P = 0.017) or rs1800872 AA (P = 0.017) genotype after rituximab-based chemotherapy, and better PFS was also noted with Bcl-2 rs1801018 AA genotype in the CHOP group (P = 0.048). Furthermore, the R-CHOP group patients who carried the IL10 non-CCA haplotype had longer PFS (P = 0.030). Cox proportional hazards analyses demonstrated that the genotype TT of IL10 rs1800871 and AA plus AC of rs1800872 were predictive of longer PFS and event-free survival (EFS) in DLBCL patients treated with R-CHOP. And the Bcl-2 rs2279115 AA plus AC genotypes and rs1801018 GG genotype were risk factors for EFS in DLBCL patients treated with CHOP. In conclusion, the results reminded us those DLBCL patients with IL10 rs1800871 TT, rs1800872 AA, or IL10 non-CCA haplotype are likely to benefit from the therapy of rituximab-based chemotherapy.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Biomarcadores Tumorais/genética , Citocinas/genética , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Linfoma Difuso de Grandes Células B/genética , Polimorfismo de Nucleotídeo Único/genética , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Murinos/uso terapêutico , Ciclofosfamida/uso terapêutico , Doxorrubicina/uso terapêutico , Feminino , Haplótipos/genética , Humanos , Linfoma Difuso de Grandes Células B/diagnóstico , Masculino , Pessoa de Meia-Idade , Prednisona/uso terapêutico , Rituximab , Resultado do Tratamento , Vincristina/uso terapêutico , Adulto JovemRESUMO
The aim of this study was to assess the cost-effectiveness of pembrolizumab versus chemotherapy for metastatic colorectal cancer (mCRC) patients with mismatch-repair deficiency or microsatellite instability-high (dMMR/MSI-H) in China. A partitioned survival model was constructed to determine the costs and effects of pembrolizumab and chemotherapy based on KEYNOTE-177 trial outcomes data. Health outcomes were measured in quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). The Chinese health service system perspective was considered. A willing-to-pay threshold was set at 35,832 USD/QALY, which was three times the gross domestic product (GDP) per capita of China in 2021. We examined the robustness of the model in the one-way and probabilistic sensitivity analysis. Pembrolizumab was associated with better health outcomes than chemotherapy (5.30 vs 3.37 QALYs). Compared with chemotherapy, the pembrolizumab strategy yielded an incremental cost of $16 032.57, which resulted in an ICER of $8285 per QALY. The cost of pembrolizumab and chemotherapy had the largest impact on the ICER. The parameters with less influence on the ICER were utility values of the Post-PFS state. Compared to chemotherapy, pembrolizumab had the economic advantage as the first-line treatment of mCRC patients with dMMR/MSI-H in China.
Assuntos
Anticorpos Monoclonais Humanizados , Carcinoma Pulmonar de Células não Pequenas , Neoplasias do Colo , Neoplasias Colorretais , Neoplasias Pulmonares , Humanos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias do Colo/tratamento farmacológico , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/genética , Análise Custo-Benefício , Análise de Custo-Efetividade , Reparo de Erro de Pareamento de DNA , Neoplasias Pulmonares/tratamento farmacológico , Instabilidade de Microssatélites , Anticorpos Monoclonais Humanizados/uso terapêuticoRESUMO
AIM: MicroRNA-21 is an oncogenic miRNA that modulates the expression of multiple cancer-related target genes. We conducted this meta-analysis to assess diagnostic role of circulating miR-21 in CRC, hoping to choose the best biomarker in CRC diagnosis. METHODS: We searched the PubMed, CNKI and WanFang database to identify records related to diagnostic role of circulating miR-21 in CRC. The search words were "microRNA-21", "miRNA-21", "colorectal cancer", "colorectal carcinoma" and "diagnosis". The searched articles were published before 14th July 2020. RESULTS: We got 18 studies to conduct this meta-analysis including 1129 blood specimens of CRC patients and 951 control specimens. The meta-analysis showed that the pooled sensitivity and specificity of circulating miR-21 for CRC diagnosis were 77% (95% CI, 70-82) and 83% (95% CI, 78-88). The combined positive likelihood ratio (PLR) was 4.20 (95% CI, 3.12-5.66) and the combined negative likelihood ratio(NLR) was 0.30 (95% CI, 0.23-0.38). The diagnostic odds ratio (DOR) was 16.48 (95% CI 10.09-26.91) and the area under the summary receiver operating characteristic curve (SROC) for the included studies was 0.87(95%CI, 0.84-0.90). CONCLUSION: Our meta-analysis results suggest that circulating miR-21 has a potential diagnostic value with moderate sensitivity and good specificity for CRC.