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Včasné pridanie alirokumabu k intenzívnej statínovej liečbe u pacienta s infarktom myokardu má okrem zlepšenia lipidového spektra za následok aj významnú regresiu aterosklerotického postihnutia dokumentovanú tromi intrakoronárnymi zobrazovacími metódami.

Timely addition of alirocumab to high-intensity statin therapy in patients with myocardial infarction resulted in lipid profile improvement and significantly greater percent atheroma volume regression, assessed by combination of three intracoronary imaging modalities.

Klíčová slova
studie PACMAN-AMI, alirokumab,
MeSH
akutní koronární syndrom * farmakoterapie patologie MeSH
LDL-cholesterol účinky léků MeSH
lidé MeSH
multicentrické studie jako téma MeSH
PCSK9 inhibitory aplikace a dávkování terapeutické užití MeSH
placeba aplikace a dávkování terapeutické užití MeSH
randomizované kontrolované studie jako téma MeSH
statiny terapeutické užití MeSH
Check Tag
lidé MeSH
mužské pohlaví MeSH
ženské pohlaví MeSH

Článek

Adjuvant Nivolumab versus Placebo in Muscle-Invasive Urothelial Carcinoma

The New England journal of medicine. 2021 ; 384 (22) : 2102-2114. [pub] 20210603

N Engl J Med
ISSN 1533-4406
Medvik
Zdroj

BACKGROUND: The role of adjuvant treatment in high-risk muscle-invasive urothelial carcinoma after radical surgery is not clear. METHODS: In a phase 3, multicenter, double-blind, randomized, controlled trial, we assigned patients with muscle-invasive urothelial carcinoma who had undergone radical surgery to receive, in a 1:1 ratio, either nivolumab (240 mg intravenously) or placebo every 2 weeks for up to 1 year. Neoadjuvant cisplatin-based chemotherapy before trial entry was allowed. The primary end points were disease-free survival among all the patients (intention-to-treat population) and among patients with a tumor programmed death ligand 1 (PD-L1) expression level of 1% or more. Survival free from recurrence outside the urothelial tract was a secondary end point. RESULTS: A total of 353 patients were assigned to receive nivolumab and 356 to receive placebo. The median disease-free survival in the intention-to-treat population was 20.8 months (95% confidence interval [CI], 16.5 to 27.6) with nivolumab and 10.8 months (95% CI, 8.3 to 13.9) with placebo. The percentage of patients who were alive and disease-free at 6 months was 74.9% with nivolumab and 60.3% with placebo (hazard ratio for disease recurrence or death, 0.70; 98.22% CI, 0.55 to 0.90; P<0.001). Among patients with a PD-L1 expression level of 1% or more, the percentage of patients was 74.5% and 55.7%, respectively (hazard ratio, 0.55; 98.72% CI, 0.35 to 0.85; P<0.001). The median survival free from recurrence outside the urothelial tract in the intention-to-treat population was 22.9 months (95% CI, 19.2 to 33.4) with nivolumab and 13.7 months (95% CI, 8.4 to 20.3) with placebo. The percentage of patients who were alive and free from recurrence outside the urothelial tract at 6 months was 77.0% with nivolumab and 62.7% with placebo (hazard ratio for recurrence outside the urothelial tract or death, 0.72; 95% CI, 0.59 to 0.89). Among patients with a PD-L1 expression level of 1% or more, the percentage of patients was 75.3% and 56.7%, respectively (hazard ratio, 0.55; 95% CI, 0.39 to 0.79). Treatment-related adverse events of grade 3 or higher occurred in 17.9% of the nivolumab group and 7.2% of the placebo group. Two treatment-related deaths due to pneumonitis were noted in the nivolumab group. CONCLUSIONS: In this trial involving patients with high-risk muscle-invasive urothelial carcinoma who had undergone radical surgery, disease-free survival was longer with adjuvant nivolumab than with placebo in the intention-to-treat population and among patients with a PD-L1 expression level of 1% or more. (Funded by Bristol Myers Squibb and Ono Pharmaceutical; CheckMate 274 ClinicalTrials.gov number, NCT02632409.).

Článek

Léčba nemetastatického kastračně rezistentního karcinomu prostaty
[Treatment of non-metastatic castration-resistant prostate cancer]

Kocák, Ivo
Autor Autorita Masarykův onkologický ústav a LF MU Brno

Onkologie (Olomouc, Print). 2021 ; 15 (1) : 35-39.

ISSN 1802-4475
Medvik
Zdroj

Muži s nemetastatickým kastračně rezistentním karcinomem prostaty s krátkým doubling time PSA jsou ohroženi časnou progresí onemocnění. Výsledky nových klinických studií s antiandrogeny II. generace, jako apalutamid, enzalutamid, darolutamid, prokazují u těchto pacientů oddálení vzniku metastatického onemocnění a i prodloužení přežití.

Men with non-metastatic castration-resistant prostate cancer with short doubling time PSA are at risk for early disease progression. Results of new clinical studies with antiandrogens II. generations such as apalutamide, enzalutamide, darolutamide have been shown to delay the onset of metastatic disease and prolong survival in these patients.