This randomized clinical trial examines if radiotherapy is noninferior to chemoradiotherapy after induction chemotherapy for locoregionally advanced nasopharyngeal carcinoma.
Risultati per: Carcinoma della prostata
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Clinical variables associated with immune checkpoint inhibitor outcomes in patients with metastatic urothelial carcinoma: a multicentre retrospective cohort study
Objectives
Immune checkpoint inhibitors (ICIs) are indicated for metastatic urothelial cancer (mUC), but predictive and prognostic factors are lacking. We investigated clinical variables associated with ICI outcomes.
Methods
We performed a multicentre retrospective cohort study of 135 patients who received ICI for mUC, 2016–2021, at three Canadian centres. Clinical characteristics, body mass index (BMI), metastatic sites, neutrophil-to-lymphocyte ratio (NLR), response and survival were abstracted from chart review.
Results
We identified 135 patients and 62% had received ICI as a second-line or later treatment for mUC. A BMI ≥25 was significantly correlated to a higher overall response rate (ORR) (45.4% vs 16.3%, p value=0.020). Patients with BMI ≥30 experienced longer median overall survival (OS) of 24.8 vs 14.4 for 25≤BMI
Tumore alla prostata, passi avanti nelle cure di prima linea
Aifa approva darolutamide nella forma metastatica ormonosensibile
Endoscopic variceal ligation versus propranolol for the primary prevention of oesophageal variceal bleeding in patients with hepatocellular carcinoma: an open-label, two-centre, randomised controlled trial
Objective
This randomised trial aimed to address whether endoscopic variceal ligation (EVL) or propranolol (PPL) is more effective at preventing initial oesophageal variceal bleeding (EVB) in patients with hepatocellular carcinoma (HCC).
Design
Patients with HCC and medium-to-large oesophageal varices (EVs) but without previous EVB were randomised to receive EVL (every 3–4 weeks until variceal eradication) or PPL (up to 320 mg daily) at a 1:1 ratio. Long-term follow-up data on EVB, other upper gastrointestinal bleeding (UGIB), non-bleeding liver decompensation, overall survival (OS) and adverse events (AEs) were analysed using competing risk regression.
Results
Between June 2011 and April 2021, 144 patients were randomised to receive EVL (n=72) or PPL (n=72). In the EVL group, 7 patients experienced EVB, and 30 died; in the PPL group, 19 patients had EVB, and 40 died. The EVL group had a lower cumulative incidence of EVB (Gray’s test, p=0.009) than its counterpart, with no mortality difference (Gray’s test, p=0.085). For patients with Barcelona Clinic Liver Cancer (BCLC) stage A/B, EVL was better than PPL in reducing EVB (p
Non-linear association of baseline viral load with on-treatment hepatocellular carcinoma risk in chronic hepatitis B
Objective
The association between baseline pretreatment serum HBV DNA levels and on-treatment hepatocellular carcinoma (HCC) risk remains controversial in patients with chronic hepatitis B (CHB). We aimed to investigate the association between baseline HBV viral load and on-treatment HCC risk in CHB patients without cirrhosis.
Design
Using a multicentre historical cohort study including 4693 hepatitis B e antigen (HBeAg)-negative and HBeAg-positive, adult CHB patients without cirrhosis who initiated antiviral treatment, HCC risk was estimated by baseline HBV viral load as a categorical variable.
Results
During a median of 7.6 years of antiviral treatment, 193 patients developed HCC (0.53 per 100 person- years). Baseline HBV DNA level was independently associated with on-treatment HCC risk in a non-linear, parabolic pattern. Patients with moderate baseline viral loads (5.00–7.99 log10 IU/mL) exhibited the highest HCC risk (HR, 2.60; p
La 'senescenza' cellulare può arrestare il tumore alla prostata
Il trattamento va affiancato al farmaco specifico
Camrelizumab in combination with chemotherapy versus concurrent chemoradiotherapy for the conversion of locally advanced unresectable oesophageal squamous carcinoma: protocol for a two-arm, open-label phase II trial
Introduction
Oesophageal cancer (OC) has higher morbidity and mortality rate than most other malignancies. The standard treatment for unresectable locally advanced oesophageal squamous cell carcinoma (OSCC) is concurrent chemoradiotherapy, with tumour regression observed in a proportion of patients after treatment, but prognostic improvement remains limited. Immunotherapy in combination with chemotherapy (CT) has been shown to be efficacious as the first-line treatment of advanced OC and neoadjuvant therapy. Therefore, we conducted a prospective, two-arm, randomised, unblinded phase II study to explore the efficacy of camrelizumab in combination with CT versus chemoradiotherapy for the conversion of unresectable advanced OSCC.
Methods and analysis
All participants meeting the inclusion criteria will be enrolled after signing an informed consent form. Patients with clinically cT4b or spread to at least one group of lymph nodes with possible invasion of surrounding organs and unresectable locally advanced squamous carcinoma of the thoracic segment of the oesophagus will be included in the study. Patients with suspected distant metastases on the preoperative examination will be excluded from this study. Patients eligible for enrolment will be grouped by centre randomisation according to the study plan. Patients will undergo radical surgery after completion of two cycles of chemotherapy (CT) combined with camrelizumab induction therapy or concurrent chemoradiotherapy if assessed to be operable. Patients evaluated as inoperable will be scheduled for a multidisciplinary consultation to determine the next treatment option. The primary endpoint is the R0 resection rate in patients undergoing surgery after treatment. Secondary endpoints are the rate of major pathological remission, pathological complete response rate, overall survival, progression-free survival and adverse events for all patients.
Ethics and dissemination
Ethical approval was obtained from the ethics committees of Fujian Medical University Union Hospital (No. 2022YF039-02). The findings will be disseminated in peer-reviewed publications.
Trial registration number
NCT05821452.
TGF-β1 Induced SOX18 Elevation Promotes Hepatocellular Carcinoma Progression and Metastasis through Transcriptionally Upregulating PD-L1 and CXCL12
Hepatocellular carcinoma (HCC) is characterized by an immune-suppressive microenvironment, which contributes to tumor progression, metastasis and immunotherapy resistance. Identification of HCC-intrinsic factors regulating immunosuppressive microenvironment is urgently needed. Here, we aimed to elucidate the role of SYR-Related High-Mobility Group Box 18 (SOX18) in inducing immunosuppression and to validate novel combination strategies for SOX18-mediated HCC progression and metastasis.
Allo studio gli screening contro i tumori di polmone e prostata
I test per la prevenzione sono tornati al livello pre-Covid ma le adesioni restano ancora insufficienti
Tumore della prostata, la sopravvivenza migliora anche nei casi più gravi
+14% di diagnosi l’anno. Al via la nuova campagna d’informazione degli oncologi
Immune Checkpoint Inhibitor Therapy Before Nephrectomy for Renal Cell Carcinoma
This narrative review considers the current evidence and ongoing trials of neoadjuvant or prenephrectomy immune checkpoint inhibitor therapy in patients with locally advanced and metastatic renal cell carcinoma.
Genetic Risk Factors for Early-Onset Merkel Cell Carcinoma
This case-control study examines genetic risk factors associated with early-onset Merkel cell carcinoma.
Messo in discussione il ruolo dell’esame rettale nello screening del cancro alla prostata
Assessing Response for Nivolumab Plus Ipilimumab in Squamous Cell Carcinoma of the Head and Neck—Reply
In Reply We thank Parast et al for commenting on our article reporting the phase 2 CheckMate 714 study outcomes. The study did not meet its primary end point of objective response rate (ORR) benefit with first-line nivolumab and ipilimumab vs nivolumab alone in patients with platinum-refractory recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN). Median duration of response (mDOR) was not reached for nivolumab plus ipilimumab vs 11.1 months for nivolumab. Although survival benefits are considered gold-standard end points for cancer clinical trials, ORR and mDOR among responders are clinically relevant and widely accepted by clinicians and regulatory agencies. While addressing comments from Parast et al, we bring your attention to similar correspondence on this issue concerning the CheckMate 143 study.
Assessing Response for Nivolumab Plus Ipilimumab in Squamous Cell Carcinoma of the Head and Neck
To the Editor In a recent issue of JAMA Oncology, Harrington et al reported on the outcome of the CheckMate 714 randomized clinical trial, which compared combination immunotherapy using the anti–programmed death 1 (PD-1) antibody nivolumab and the anti–cytotoxic T-lymphocyte antigen 4 (CTLA-4) antibody ipilimumab vs nivolumab monotherapy in patients with advanced head and neck cancer. The trial failed to show superiority of the combination, and as the authors briefly acknowledge, the chosen ipilimumab dosing may have contributed to the negative outcome of the study.
Assessing Response for Nivolumab Plus Ipilimumab in Squamous Cell Carcinoma of the Head and Neck
To the Editor In their randomized clinical trial published recently in JAMA Oncology, Harrington and colleagues evaluated the efficacy of nivolumab/ipilimumab vs nivolumab alone for treating recurrent or metastatic squamous cell carcinoma of the head and neck. The primary end points were the patient’s objective response and duration of response (DOR). The objective response rates were 13.2% and 18.3% with nivolumab/ipilimumab and nivolumab, respectively. The median DOR was not reached for nivolumab/ipilimumab vs 11.1 months for nivolumab. Although these results are not encouraging for the combination therapy, there are several lessons we may learn from this well-intended study, which would be helpful for conducting future oncology trials in a similar setting.