Search Results for: Terapia sistemica del carcinoma epatocellulare

Stabilizza vista e può ridurre necessità iniezioni intravitreali

Da biopsia liquida a studio cellule epatiche, per malattie rare

Efficace nel 30% dei pazienti che non risponde alle altre cure

Introduction
Treatment combination of pembrolizumab plus platinum and 5-fluorouracil (PF) has increased the survival of recurrent or metastatic (R/M) head and neck squamous cell carcinoma (HNSCC). The combination of platinum and gemcitabine (PG) has been shown to be superior to PF in the treatment of R/M nasopharyngeal carcinoma patients. Therefore, we hypothesise that the combination of pembrolizumab with PG would be comparable to pembrolizumab with PF as a first-line treatment in R/M HNSCC.

Methods and analysis
This is an open-label, multicentre, single-arm, phase 2 study of pembrolizumab plus PG for first-line treatment in subjects with R/M HNSCC in Malaysia. The study is conducted using the Optional Simon optimal 2-stage design. At the initial stage, 26 subjects will be enrolled and if seven or more patients achieve an objective response rate (ORR), then 63 patients will be enrolled. Subjects will be given pembrolizumab 200 mg3 every 3 weeks up to 35 cycles in combination with chemotherapy for up to six cycles of platinum (either cisplatin at 35 mg/m2 intravenous on day 1 and day 8 or carboplatin at area under the curve 5 intravenous on day 1 of each 3-week cycle) and gemcitabine at 1250 mg/m2 intravenous on days 1 and 8 of a 3-week cycle. The primary end point is the ORR as per Response Evaluation Criteria in Solid Tumors 1.1. Secondary end points include the overall survival, progression free survival, response duration and safety. The exploratory objectives include relationships of microbiome profiles, prognostic and predictive biomarkers with the clinical responses.

Ethics and dissemination
The study was approved by the ethics committee of the University Malaya Medical Centre (202213–10884). Findings will be disseminated through conference presentations and peer review publications.

Trial registration number
ClinicalTrials.gov (www.clinicaltrial.gov); NCT05286619.

This phase 2 nonrandomized clinical trial assesses the efficacy and safety of dual immune checkpoint inhibition in patients with aggressive thyroid carcinoma.

This nonrandomized clinical trial examines whether matched-targeted therapy based on tumor mutation status with a PD-L1 inhibitor is associated with improved overall survival among patients with anaplastic thyroid carcinoma.

Over the last several years, the prognosis for patients with nasopharyngeal cancer has improved due to therapeutic advances. As a result, the staging system has lagged behind, creating a discrepancy between expected and actual treatment outcomes. Given this incongruence, an updated staging system is warranted to accurately capture the successful change in patient survival. In JAMA Oncology, Pan et al present the American Joint Committee on Cancer (AJCC) version 9 TNM Staging System for nasopharyngeal carcinoma (NPC). They retrospectively analyzed tumor biological features and overall survival of 4914 patients from an international cohort diagnosed with NPC. Based on their results, they propose reclassification of stage I to III for localized disease, stage IV distant metastatic disease, while also adding radiological extranodal extension (ENE) as a criterion for N3.

Immunotherapy has represented a novel and cutting-edge approach to treating patients with many types of metastatic cancers in recent years, transforming outcomes for patients who previously had limited options. Immunotherapy enhances the body’s natural defenses to target and eliminate cancer cells. The agents used are immune checkpoint inhibitors that target specific sites within the immune system, particularly focusing on T cells and their interactions with cancer cells or antigen-presenting cells. The primary sites at T cells of action include the programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) axis and cytotoxic T-lymphocyte–associated protein 4 (CTLA-4). The US Food and Drug Administration (FDA) has approved several immunotherapy agents, and each could have different modes of action targeting these sites in various cancers. In 2020, pembrolizumab, a PD-1 inhibitor, was approved for the treatment of patients with anaplastic thyroid carcinoma. In 2 nonrandomized phase 2 clinical trials in this issue of JAMA Oncology, Sehgal et al and Cabanillas et al explored the applications of immunotherapy in treating patients with aggressive thyroid cancer.

Currently, patients with hepatocellular carcinoma (HCC) in the United States are assigned a uniform score relative to the median MELD at transplant (MMaT-3) after a minimum 6-month waiting period. Here, we develop a risk stratification model for patients with HCC, using the available and objective variables at time of listing.

New England Journal of Medicine, Volume 391, Issue 21, Page 2061-2063, November 28, 2024.