6 research outputs found
Evidence of pseudoprogression in patients treated with PD1/ PDL1 antibodies across tumor types
Background: PD(L)1 antibodies (anti-PD(L)-1) have been a major breakthrough
in several types of cancer. Novel patterns of response and progression have been
described with anti-PD(L)-1. We aimed at characterizing pseudoprogression (PSPD)
among patients with various solid tumor types treated by anti-PD(L)-1.
Methods: All consecutive patients (pts) enrolled in phase 1 trials with advanced
solid tumors and lymphomas treated in phase I clinical trials evaluating monotherapy
by anti-PD(L)-1 at Gustave Roussy were analyzed. We aimed to assess prevalence
and outcome of PSPD across tumor types. We also intended to describe potential
clinical and pathological factors associated with PSPD.
Results: A total of 169 patients treated with anti-PD(L)-1 were included in the study.
Most frequent tumor types included melanoma (n = 57) and non-small cell lung cancer (n = 19). At first tumor evaluation 77 patients (46%) presented with immune unconfirmed progressive disease. Six patients (8%) experienced PSPD: 2 patients with
partial response; 4 patients with stable disease. Increase in target lesions in the first
CT-scan was more frequently associated to PSPD (67% vs 33%; P = .04). Patients
with a PSPD had a superior survival when compared to patients progressing (median
OS: 10.7 months vs 8.7 months; P = .07).
Conclusions: A small subset of PSPD patients may experience response after an
initial progression. Assessment of the current strategy for immune-related response
evaluations may require further attention
Evidence of pseudoprogression in patients treated with PD1/ PDL1 antibodies across tumor types
Background: PD(L)1 antibodies (anti-PD(L)-1) have been a major breakthrough
in several types of cancer. Novel patterns of response and progression have been
described with anti-PD(L)-1. We aimed at characterizing pseudoprogression (PSPD)
among patients with various solid tumor types treated by anti-PD(L)-1.
Methods: All consecutive patients (pts) enrolled in phase 1 trials with advanced
solid tumors and lymphomas treated in phase I clinical trials evaluating monotherapy
by anti-PD(L)-1 at Gustave Roussy were analyzed. We aimed to assess prevalence
and outcome of PSPD across tumor types. We also intended to describe potential
clinical and pathological factors associated with PSPD.
Results: A total of 169 patients treated with anti-PD(L)-1 were included in the study.
Most frequent tumor types included melanoma (n = 57) and non-small cell lung cancer (n = 19). At first tumor evaluation 77 patients (46%) presented with immune unconfirmed progressive disease. Six patients (8%) experienced PSPD: 2 patients with
partial response; 4 patients with stable disease. Increase in target lesions in the first
CT-scan was more frequently associated to PSPD (67% vs 33%; P = .04). Patients
with a PSPD had a superior survival when compared to patients progressing (median
OS: 10.7 months vs 8.7 months; P = .07).
Conclusions: A small subset of PSPD patients may experience response after an
initial progression. Assessment of the current strategy for immune-related response
evaluations may require further attention
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Impact of the International Nosocomial Infection Control Consortium (INICC)’s multidimensional approach on rates of ventilator-associated pneumonia in intensive care units in 22 hospitals of 14 cities of the Kingdom of Saudi Arabia
To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and use of INICC Surveillance Online System (ISOS) on ventilator-associated pneumonia (VAP) rates in Saudi Arabia from September 2013 to February 2017.
A multicenter, prospective, before–after surveillance study on 14,961 patients in 37 intensive care units (ICUs) of 22 hospitals. During baseline, we performed outcome surveillance of VAP applying the definitions of the CDC/NHSN. During intervention, we implemented the IMA and the ISOS, which included: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on VAP rates and consequences and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using generalized linear mixed models to estimate the effect of intervention.
The baseline rate of 7.84 VAPs per 1000 mechanical-ventilator (MV)-days―with 20,927 MV-days and 164 VAPs―, was reduced to 4.74 VAPs per 1000 MV-days―with 118,929 MV-days and 771 VAPs―, accounting for a 39% rate reduction (IDR 0.61; 95% CI 0.5–0.7; P 0.001).
Implementing the IMA was associated with significant reductions in VAP rates in ICUs of Saudi Arabia