scholarly journals INTERNATIONAL MULTICENTER EXPERIENCE IN THE TREATMENT OF INVASIVE ASPERGILLOSIS IN IMMUNOCOMPROMISED CANCER PATIENTS

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
R. Hachem ◽  
Marjorie Batista ◽  
Souha S Kanj ◽  
Saaed El Zein ◽  
Sara Haddad ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Cancer Patients ◽  
Amphotericin B ◽  
Multivariate Logistic Regression Analysis ◽  
Poor Response ◽  
Primary Treatment ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Primary Therapy ◽  
American University

BACKGROUND: Invasive aspergillosis (IA) is a life-threatening infection in immunocompromised patients. In this study, we compared the efficacy of voriconazole containing regimen vs non-voriconazole containing regimen in patients with IA. METHODS: In this retrospective study, we reviewed the medical records of all immunocompromised cancer patients diagnosed with proven or probable IA between February 2012 and March 2018. This trial included 26 patients from the American University of Beirut,  Lebanon, 20 patients from  Hospital das Clinicas da Faculdade de Medicina, Universidade de  São Paulo, Brazil, and 10 patients from St. Luke's International Hospital Tokyo, Japan. RESULTS:  A total of 56 patients were analyzed. They were divided into 2 groups voriconazole containing regimen and non-voriconazole containing regimen (90% Amphotericin B  based regimen) . Both groups had similar characteristic, age, gender, and immunocompromised status. The majority of patients had underlying leukemia 53%, lymphoma 18%, myeloma 15% and solid tumor 13%. Antifungal primary therapy with voriconazole-containing regimen was associated with better response to treatment (P = 0.003). Survival analysis showed that primary therapy with a voriconazole containing regimen was significantly associated with improved survival (p =0.006). By multivariate logistic regression analysis, mechanical ventilation was predictor of worse outcome (poor response to therapy and increased mortality at 6 weeks), whereas primary treatment with voriconazole containing regimen was associated with improved outcome (OR=0.14; 95% CI 0.03-0.64, P=0.01). CONCLUSIONS: Based on international experience in immunocompromised cancer patients with IA, primary therapy with voriconazole-containing regimen is associated with improved response and survival compared with non-voriconazole amphotericin B based regimen.

Cost Advantage of Voriconazole over Amphotericin B Deoxycholate for Primary Treatment of Invasive Aspergillosis

2005 ◽  
Vol 25 (6) ◽  
pp. 839-846 ◽  
Author(s):  
James S. Lewis ◽  
Helen W. Boucher ◽  
Teresa J. Lubowski ◽  
Ambarish J. Ambegaonkar ◽  
David L. Day ◽  
...  
Keyword(s):  
Invasive Aspergillosis ◽  
Amphotericin B ◽  
Primary Treatment ◽  
Cost Advantage ◽  
Amphotericin B Deoxycholate

scholarly journals Primary Biliary Cholangitis: Predictors of Poor Response to Ursodeoxycholic Acid after 1 Year of Treatment in Moroccan Patients

2021 ◽  
pp. 990-995
Author(s):  
Hakima Abid ◽  
Inssaf Akoch ◽  
Maria Lahlali ◽  
Nada Lahmidani ◽  
Mounia El Yousfi ◽  
...  
Keyword(s):  
Ursodeoxycholic Acid ◽  
Biological Response ◽  
Poor Response ◽  
Overlap Syndrome ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Decompensated Cirrhosis ◽  
Primary Biliary Cholangitis ◽  
Biliary Cirrhosis ◽  
Average Value

Introduction: Primary biliary cholangitis (PBC), the new dominance of primary biliary cirrhosis, is a cholestatic disease of autoimmune etiology and represents the leading cause of intra-hepatic cholestasis. Treatment is mainly based on ursodeoxycholic acid. The biological response to treatment is the main predictor of survival without liver transplantation. The Globe-score has been recently validated as the main prognostic factor. Materials and methods: This is a retrospective study carried out in our department collating all cases of PBC followed in consultation. The aim of our work is to research the predictors of poor response to UDCA. Results: 46 patients were collected. The mean age of the patients was 58.82 years, with a predominance of women (n = 43, 93.5%). 34.78% of patients were in the stage of cirrhosis. Anti-M2 mitochondria antibodies were positive in 44 patients (95.65%). An overlap syndrome was found in 11 patients (23.9%). Treatment was based on UDCA combined with corticosteroid therapy and immunosuppressant for overlap syndrome. A biochemical response at 1 year of treatment according to the Paris II criteria was found in 47.8%. The average value of the globe score was 1.35. A score greater than 0.30 was objectified in 20 cases (43.47%). Nineteen cirrhotic patients (41.30%) had a globe score> 0.30. Factors associated with poor response to therapy were: stage of decompensated cirrhosis, elevated pre-therapy total bilirubin greater than 30 g / l and hypoalbunemia less than 35 g / l. The study of the correlation between Globe score and Paris II showed a strong and significant association with a correlation coefficient estimated at 67%. The Paris II score was significantly correlated with the response to treatment (p = 0.001). Conclusion: In accordance with the data in the literature, the globe-score and Paris II are two similar predictive means for evaluating the response at 1 year of treatment in Moroccan context. Keywords: Morocco, Predictors of response, Primary biliary cholangitis, Ursodeoxycholic acid

Expression of mEGFR, pEGFRThr654, and pPKN1Thr774 to predict response to chemoradiation and prognosis in patients with cervical cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e16531-e16531
Author(s):  
Jin Yi Lang ◽  
Jianming Huang ◽  
Xin Lai
Keyword(s):  
Cervical Cancer ◽  
Protein Expression ◽  
Cancer Patients ◽  
Concurrent Chemoradiotherapy ◽  
Nuclear Translocation ◽  
Poor Response ◽  
Response To Therapy ◽  
Nuclear Staining ◽  
Poor Overall Survival ◽  
Cytoplasmic Staining

e16531 Background: The aim of this study was to determine the relation between proteins involved in phosphorylation of EGFRThr654 and response to chemoradiation and survival in a well-documented series of cervical cancer patients. Methods: Pre-treatment tissue samples of 90 consecutive FIGO stage IIA-IIIB cervical cancer patients treated with concurrent chemoradiotherapy between January 2007 and December 2009 were collected. Clinicopathologic and follow-up data were collected by a retrospective chart review. Protein expression of membranous EGFR (mEGFR), pEGFRThr654 and pPKN1Thr774 were examined by immunohistochemistry on FFPE tumor specimens. The correlations between protein expression and clinicopathological factors and outcomes were analyzed. Results: mEGFR staining was present in 67.78%, pEGFRThr654 in 91.11%, pPKN1Thr774 in 56.67% of tumors. pEGFRThr654 staining was positively correlated to pPKN1Thr774 (p = 0.04) and to mEGFR staining (p = 0.015). In multivariate analysis, nuclear staining of pEGFRThr654 [hazard ratio(HR)= 4.833; 95%CI=1.959-11.922, P=0.001)] and cytoplasmic staining of pPKN1Thr774 (HR=3.095; 95%CI=1.019-9.406; P=0.046) were prognostic factors for poor overall survival (OS) and also were independent predictors of poor response to (chemo)radiation for progress-free survival (PFS) (HR=2.921, 95%CI=1.360-6.274, P=0.006; HR=2.963, 95% CI=1.187-7.394, P=0.020), and mEGFR staining was an independent prognostic factor for poor PFS (HR=5.934, 95% CI=1.378-25.555, p=0.017). The high expression of pEGFRthr654 is related to poor local control rate (p = 0.000) and to poor short-term efficacy (p = 0.009). Conclusions: mEGFR and pEGFRThr654 immunostaining are frequently observed and independently associated with poor response to therapy and poor PFS and OS in cervical cancer patients primarily treated by concurrent chemoradiotherapy. Our data presents the pEGFRThr654 nuclear translocation as a promising target in Integrated therapies of chemoradiotherapy combined with targeting inhibition of pEGFRThr654 and its nuclear import for cervical cancer.

scholarly journals Translational Potential of MicroRNAs for Preoperative Staging and Prediction of Chemoradiotherapy Response in Rectal Cancer

Cancers ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 1545 ◽  
Author(s):  
Machackova ◽  
Prochazka ◽  
Kala ◽  
Slaby
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Cancer Patients ◽  
Current Knowledge ◽  
Preoperative Staging ◽  
Operative Therapy ◽  
Tnm Staging ◽  
Response To Therapy ◽  
Response To Treatment ◽  
Circulating Mirnas

Abstract: Colorectal cancer is the third most common cancer and the second cause of cancer-related deaths. Rectal cancer presents roughly one-third of all colorectal cancer cases and differs from it on both anatomical and molecular levels. While standard treatment of colon cancer patients is radical surgery, rectal cancer is usually treated with pre-operative chemoradiotherapy followed by total mesorectal excision, which requires precise estimation of TNM staging. Unfortunately, stage evaluation is based solely on imaging modalities, and they often do not correlate with postoperative pathological findings. Moreover, approximately half of rectal cancer patients do not respond to such pre-operative therapy, so they are exposed to its toxic effects without any clinical benefit. Thus, biomarkers that could precisely predict pre-operative TNM staging, and especially response to therapy, would significantly advance rectal cancer treatment—but till now, no such biomarker has been identified. In cancer research, microRNAs are emerging biomarkers due to their connection with carcinogenesis and exceptional stability. Circulating miRNAs are promising non-invasive biomarkers that could allow monitoring of a patient throughout the whole therapeutic process. This mini-review aims to summarize the current knowledge on miRNAs and circulating miRNAs involved in the prediction of response to treatment and pre-operative staging in rectal cancer patients.

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