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- MeSH
- biologické markery analýza MeSH
- bronchoalveolární laváž MeSH
- dospělí MeSH
- laryngofaryngeální reflux * diagnóza MeSH
- lidé MeSH
- pepsin A analýza MeSH
- prospektivní studie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- Publikační typ
- kazuistiky MeSH
- MeSH
- bronchoskopie metody MeSH
- kongresy jako téma MeSH
- nemalobuněčný karcinom plic * terapie MeSH
- neoadjuvantní terapie MeSH
- Publikační typ
- zprávy MeSH
The significance of extraesophageal reflux as a risk factor in lung adenocarcinoma has been understudied. In this study, we investigated whether extraesophageal reflux leads to higher pepsin concentrations in bronchoalveolar lavage (BAL) in patients with lung adenocarcinoma compared to controls. Subjects were recruited from non-smoker patients (lifelong non-smokers and ex-smokers with more than 5 years of non-smoking history) who had undergone bronchoscopy due to pulmonary abnormalities on a CT scan and met the inclusion criteria. Based on histological verification of the lung process, the patients were divided into three groups: (1) lung adenocarcinoma, (2) pulmonary metastases, and (3) lung sarcoidosis. Lung adenocarcinoma cases were further categorized as central or peripheral. BAL samples collected during bronchoscopy were quantitatively analyzed by enzyme-linked immunosorbent assay (ELISA) to measure pepsin levels. No statistically significant difference in pepsin concentration was observed between the lung adenocarcinoma group and control groups (p = 0.135). After excluding hemorrhagic BAL samples, the pepsin concentration was significantly the lowest in patients with lung adenocarcinoma (p = 0.023) compared to the control groups. The results of the study do not support the hypothesis of a higher occurrence of extraesophageal reflux (evaluated as the amount of pepsin in BAL) in non-smoker patients with lung adenocarcinoma.
- Publikační typ
- časopisecké články MeSH
Mutace genu KRAS patří k nejčastějším genovým aberacím u solidních nádorů. U nemalobuněčného plicního adenokarcinomu se vyskytuje s frekvencí 30 %. Sotorasib a adagrasib jsou ireverzibilní inhibitory KRAS G12C, uplatňující se v léčbě nemalobuněčného karcinomu plic s touto prokázanou mutací.
Mutations in KRAS gene are among the most common gene aberrations in solid tumors. It occurs with a frequency in 30% of non-smaii cell lung adenocarcinoma. Sotorasib and adagrasib are irreversible KRAS G12C inhibitors used in the treatment of non-small cell lung cancer with this proven mutation.
Cemiplimab, anti-PD-1 protilátka, byl začleněn do 1. linie léčby lokálně pokročilého a generalizovaného nemalobuněčného plicního karcinomu v monoterapii nebo v kombinaci s chemoterapií na základě výsledků klinických studií EMPOWER-Lung 1 a EMPOWER-Lung 3.
Cemiplimab, an anti-PD-1 antibody, was incorporated into the first-line therapy of locally advanced and metastatic non-small cell lung cancer as monotherapy or in combination with chemotherapy based on the results of the EMPOWER-Lung 1 and EMPOWER-Lung 3 clinical trials.
PURPOSE: Immune checkpoint inhibitors (ICIs) dramatically changed the prognosis of patients with NSCLC. Unfortunately, a reliable predictive biomarker is still missing. Commonly used biomarkers, such as PD-L1, MSI, or TMB, are not quite accurate in predicting ICI efficacy. METHODS: In this prospective observational cohort study, we investigated the predictive role of erythrocytes, thrombocytes, innate and adaptive immune cells, complement proteins (C3, C4), and cytokines from peripheral blood of 224 patients with stage III/IV NSCLC treated with ICI alone (pembrolizumab, nivolumab, and atezolizumab) or in combination (nivolumab + ipilimumab) with chemotherapy. These values were analyzed for associations with the response to the treatment and survival endpoints. RESULTS: Higher baseline Tregs, MPV, hemoglobin, and lower monocyte levels were associated with favorable PFS and OS. Moreover, increased baseline basophils and lower levels of C3 predicted significantly improved PFS. The levels of the baseline immature granulocytes, C3, and monocytes were significantly associated with the occurrence of partial regression at the first restaging. Multiple studied parameters (n = 9) were related to PFS benefit at the time of first restaging as compared to baseline values. In addition, PFS nonbenefit group showed a decrease in lymphocyte count after three months of therapy. The OS benefit was associated with higher levels of lymphocytes, erythrocytes, hemoglobin, MCV, and MPV, and a lower value of NLR after three months of treatment. CONCLUSION: Our work suggests that parameters from peripheral venous blood may be potential biomarkers in NSCLC patients on ICI. The baseline values of Tregs, C3, monocytes, and MPV are especially recommended for further investigation.
- MeSH
- antigeny CD274 MeSH
- biologické markery MeSH
- hemoglobiny terapeutické užití MeSH
- imunofenotypizace MeSH
- inhibitory kontrolních bodů terapeutické užití MeSH
- lidé MeSH
- nádory plic * MeSH
- nemalobuněčný karcinom plic * MeSH
- nivolumab terapeutické užití MeSH
- prospektivní studie MeSH
- protinádorové látky imunologicky aktivní * terapeutické užití MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Nemalobuněčný karcinom plic (non-smaii cell lung cancer, NSCLC) tvoří 85 % všech plicních nádorů a nadále zaujímá čelní příčky v příčinách úmrtí na nádorová onemocnění. V posledních dvou dekádách do terapie lokálně pokročilého nebo metastazujícího NSCLC vstoupila cílená léčba, která významně změnila léčebné paradigma tohoto nádorového onemocnění. Molekulárně cílená léčba vede k významnému prodloužení celkového přežití pacientů s diagnózou pokročilého NSCLC. Terapeuticky cílených přípravků rychle přibývá a jeden z nich již figuruje v indikaci adjuvantní léčby po operaci plicního karcinomu se senzitivní mutací EGFR.
Non-smaii cell lung cancer (NSCLC) accounts for 85% of all lung cancers and continues to be the leading cause of cancer deaths. In the last two decades, targeted therapies have entered the treatment of iocaiiy advanced or metastatic NSCLC, significantly changing the treatment paradigm for this cancer. Moiecuiariy targeted therapies have ied to significant proiongation of overaii survivai in patients diagnosed with advanced NSCLC. Therapeuticaiiy targeted agents are rapidiy increasing in number and one of them is aiready inciuded in the indication for adjuvant therapy after surgery for EGFR-sensitive iung cancer.
- MeSH
- anaplastická lymfomová kináza antagonisté a inhibitory genetika MeSH
- cílená molekulární terapie * klasifikace MeSH
- geny erbB-1 genetika účinky léků MeSH
- geny erbB-2 genetika účinky léků MeSH
- lidé MeSH
- mutace genetika MeSH
- nemalobuněčný karcinom plic * diagnóza farmakoterapie genetika MeSH
- protoonkogenní proteiny B-Raf antagonisté a inhibitory genetika klasifikace MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- přehledy MeSH
Kazuistika popisuje případ 59letého pacienta, který je léčen imunoterapií pro inoperabilní recidivu maligního pleurálního mezoteliomu. Následná diskuse shrnuje výsledky klinických studií, které se zabývají využitím imunoterapie v léčbě neresekabilního maligního pleurálního mezoteliomu.
The case report outlines the treatment of a 59-year-old patient undergoing immunotherapy for an inoperable recurrence of malignant pleural mesothelioma. The subsequent discussion provides an overview of clinical trial findings on the application of immunotherapy in treating unresectable malignant pleural mesothelioma.
- MeSH
- farmakoterapie klasifikace metody MeSH
- imunoterapie klasifikace metody MeSH
- inhibitory kontrolních bodů farmakologie klasifikace terapeutické užití MeSH
- ipilimumab farmakologie terapeutické užití MeSH
- klinická studie jako téma MeSH
- lidé středního věku MeSH
- lidé MeSH
- maligní mezoteliom * diagnóza farmakoterapie MeSH
- nádory pleury * diagnóza farmakoterapie klasifikace MeSH
- nivolumab farmakologie terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
BACKGROUND/AIM: The aim of this study was to investigate possible association between adverse events of nivolumab therapy and the effectiveness of treatment in patients with non-small cell lung cancer (NSCLC). Focusing on serious adverse events (i.e., those of grade ≥3), we evaluated overall survival (OS), progression-free survival (PFS), as well as objective response rate (ORR) to treatment. PATIENTS AND METHODS: We retrospectively analyzed a set of patients from the TULUNG database of NSCLC treated with nivolumab in eight oncology centers. We evaluated OS data based upon this set. To reduce possible bias, we further evaluated a subgroup of patients treated at the University Hospital in Pilsen, where the occurrence of adverse events, PFS, and ORR were independently examined by two experienced physicians. Survival statistics were evaluated using the Kaplan-Meier method and Cox analysis. RESULTS: We observed significantly greater OS, PFS, and ORR in the group of patients experiencing adverse events upon nivolumab treatment versus in those patients without such events. Although the univariable model analyzing the data set of all patients demonstrated higher OS in patients with serious adverse events, only a nonsignificant trend was observed in the Cox multivariable model. In a subgroup of patients with PFS and ORR evaluation, we did observe significant, favorable effects for patients having had serious adverse effects. CONCLUSION: Patients experiencing severe adverse events show a tendency toward better OS, PFS, and ORR compared to patients without or having only mild adverse events with nivolumab treatment.
- Publikační typ
- časopisecké články MeSH
