Search Results for: Immunoterapia e terapia mirata per il carcinoma gastroesofageo avanzato

Objective
This study aimed to investigate the cost-effectiveness of adding Chinese-developed anti-PD-1 antibody camrelizumab to first-line platinum-doublet chemotherapy in patients with recurrent or metastatic nasopharyngeal carcinoma (L/M NPC) from the perspective of Chinese healthcare system.

Design
A Markov model consisting of four health states, progression-free survival, first progression survival, second progression survival and death, was built to simulate 3-week patient transitions over a 20-year horizon. A direct comparison between first-line camrelizumab in combination with gemcitabine plus cisplatin and gemcitabine plus cisplatin was performed by calculating transition probabilities from the CAPTAIN-1st trial. Costs and utilities were collected from the local public database and literature. One-way and probabilistic sensitivity analyses were employed to evaluate the robustness of the model.

Setting
The Chinese healthcare system perspective.

Participants
A hypothetical cohort of Chinese patients with pathologically diagnosed L/M NPC who had an Eastern Cooperative Oncology Group performance status of 0 or 1.

Interventions
First-line camrelizumab in combination with camrelizumab and gemcitabine plus cisplatin (CGP) versus gemcitabine plus cisplatin (GP).

Primary outcome measure
Cost, quality-adjusted life-years (QALYs), incremental cost-effectiveness ratio (ICER).

Results
The baseline analysis demonstrated that, compared with first-line GP, first-line CGP yields an effectiveness increase of 0.26 QALY, accompanied by an increment of US$6137.59 in healthcare cost. This results in an ICER of US$23 482.32/QALY. With the willingness-to-pay (WTP) threshold for a QALY set at US$37 654.50, first-line CGP proves to be cost-effective in 97.20% of the iterations. Deterministic sensitivity analyses indicated that the uncertainty in model parameters had no substantial effect on our results. Probability sensitivity analysis indicated that CGP was cost-effective at the assumed WTP threshold.

Conclusion
For Chinese patients with L/M NPC, adding Chinese-developed anti-PD-1 antibody camrelizumab to the first-line GP chemotherapy may be cost-effective.

Objective
The purpose of this study was to describe the clinicopathological characteristics and prognosis of primary small cell carcinoma of the breast (PSCCB) and compare PSCCB with breast invasive ductal carcinoma (IDC).

Design
A retrospective cohort study.

Setting
Data of patients with PSCCB and breast IDC were identified from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016.

Participants
Eighty-three patients with PSCCB and 410 699 patients with breast IDC were enrolled in the present cohort study.

Materials and methods
Patients with PSCCB and breast IDC were identified from the SEER database between 2004 and 2016. The clinicopathological characteristics and survival of patients with PSCCB and IDC were compared. Propensity score matching (PSM) analysis was performed to adjust for differences in baseline characteristics when comparing overall survival (OS) and cancer-specific survival (CSS). Moreover, OS-/CSS-specific nomograms were established to predict the prognosis of PSCCB.

Results
Compared with IDC, PSCCB was significantly correlated with older age, male, higher pathological grade, higher TNM (tumour, node, metastases) stage, a higher proportion of triple-negative breast cancer, a lower proportion of ER/PR positivity and significantly worse clinical outcome. The median OS and CSS of patients with PSCCB were 23.0 m (95%CI 13.0 to 56.0) and 28.0 m (95%CI 18.0 to 66.0), respectively. The 5-year OS and CSS rates in the PSCCB group were 36.1% and 42.4%, respectively. In the matched cohort after PSM analysis, patients with PSCCB had significantly worse OS and CSS than IDC patients. Multivariate Cox regression analysis demonstrated that T stage and administration of chemotherapy were independent prognostic factors for both OS and CSS in patients with PSCCB. The C-index for OS-/CSS-specific nomogram was 0.75 (95%CI 0.66 to 0.85)/0.79 (95%CI 0.69 to 0.89), respectively. The calibration curve in the ROC analysis indicated that the predicted value was consistent with the actual observation value. Decision curve analysis suggested that the nomogram model has a significant positive net benefit from the risk of death and are better than the traditional TNM staging system.

Conclusion
PSCCB has distinct clinicopathological characteristics, and patients with PSCCB have significantly worse clinical outcomes than those with IDC.

Alomari MAM, Wakabayashi T, Colella M, et al. Comparing the accuracy of positive and negative indocyanine green staining in guiding laparoscopic anatomical liver resection: protocol for a randomised controlled trial. BMJ Open 2023;13:e072926. doi:10.1136/bmjopen-2023-072926 This article was previously published with some errors. Author name ‘Kohei Mishima’ has been spelled correctly. The unit in figure 1 has been corrected to mg. Figure 2 and figure 3 have been swapped. The images in figure 2 show positive staining, while the images in figure 3 demonstrate negative staining. Figure 1Summary of practical doses and timing of injection. *Passed on experience, florescence technology and patient conditions. CRLM, colorectal liver metastasis; HCC, hepatocellular carcinoma; ICGR15, indocyanine green retention test after 15 min. Figure 2Indocyanine green (ICG) negative staining for colorectal liver metastasis in segment 5 and 6. (A) dissection…

Prevengono il tumore e potenziano l’effetto dell’immunoterapia

Objective
The ASTRUM-007 study confirmed the significant efficacy and safety of serplulimab plus chemotherapy for patients with locally advanced/metastatic, programmed cell death-ligand 1 positive oesophageal squamous cell carcinoma (OSCC). The economics of this regimen, however, is unclear. Therefore, this study aimed to evaluate the cost-effectiveness of adding serplulimab to chemotherapy for the treatment of advanced OSCC from the perspective of the Chinese healthcare system.

Design
A partitioned survival model was established to simulate the costs and outcomes of chemotherapy versus serplulimab plus chemotherapy. The survival data came from the ASTRUM-007 study. Only direct medical costs were considered, and utility values were referred to the literature. Sensitivity analysis was performed to assess the effect of parameter uncertainty on the model.

Outcome measures
Total costs, incremental costs, life years, quality-adjusted life years (QALYs), incremental QALYs and incremental cost-effectiveness ratio (ICER).

Results
The base case analysis showed that the cost of serplulimab plus chemotherapy (US$69 356) was US$41 607 higher than that of chemotherapy (US$27 749), but it also gained 0.38 QALYs more (1.38 vs 1 QALYs), with an ICER of US$110 744.36/QALY, which was higher than the willingness to pay. The factors that most influenced the ICER were the price of serplulimab, weight and utility value of the progression-free survival stage. The subgroup analysis and scenario analysis also demonstrated that serplulimab plus chemotherapy was not economical.

Conclusions
Compared with chemotherapy, serplulimab coupled with chemotherapy was not cost-effective for the treatment of advanced OSCC in China.

This cohort study compares prognostic assessments of perineural invasion in cutaneous squamous cell carcinoma and their associations with poor outcomes and implications for staging system revision.

A woman in her 60s with previous breast carcinoma, currently in remission, presented with pruritic lesions on her chest, arms, and back. What is your diagnosis?

This case report describes a patient in their 60s who developed apparent abnormal Q waves and severe hypomagnesemia while receiving chemotherapy for metastatic rectal carcinoma.

This narrative review investigates the use of circulating tumor human papillomavirus (HPV) DNA for surveillance of HPV-positive oropharyngeal squamous cell carcinoma.

This phase 3 randomized clinical trial evaluates the efficacy and safety of tislelizumab vs sorafenib as first-line treatment in patients with unresectable hepatocellular carcinoma.

Per le forme con mutazione dei geni Brca. Cala del 42% il rischio recidiva

Aiuta ciascuno a capire la terapia da usare 

Due to a unique immune substrate consisting of abundant lymphocytic infiltration, high programmed death–ligand 1 (PD-L1) expression, and the presence of several immune targets (CD40, CD70, CD80, and CD86), there is a strong biological rationale for incorporating immunotherapy in the treatment of nasopharyngeal carcinoma (NPC). Nonkeratinizing histological subtypes encompass more than 95% of NPC cases in endemic areas, and NPC is largely linked to Epstein-Barr virus (EBV) infection, providing an additional immune-prone factor through the expression of EBV antigens and CD4+/CD8+ T-cell target proteins. In this issue of JAMA, Mai and colleagues report the prespecified definitive overall survival analysis of the phase 3 JUPITER-02 trial. The addition of the anti–PD-1 antibody toripalimab to platinum-gemcitabine as a first-line treatment for recurrent or metastatic NPC (RM-NPC) proved to reduce by 37% the risk of death at 3 years of follow-up.

This multicenter, double-blind, randomized trial conducted in nasopharyngeal cancer (NPC)–endemic regions assesses whether toripalimab in combination with gemcitabine-cisplatin as first-line treatment for recurrent or metastatic NPC, compared with gemcitabine-cisplatin alone, will significantly improve progression-free survival and overall survival among chemotherapy-naive patients with recurrent or metastatic NPC.