Nivolumab as first-line treatment in non-small cell lung cancer patients-key factors: Tumor mutation burden and PD-L1 ≥50%

[No abstract available

Second-line afatinib administration in an elderly patient with squamous cell carcinoma

Wolfgang Hohenforst-Schmidt,1 Paul Zarogoulidis,2 Michael Steinheimer,1 Naim Benhassen,3 Chrysanthi Sardeli,4 Nikos Stalikas,2 Melpomeni Toitou,2 Haidong Huang5 1Sana Clinic Group Franken, Department of Cardiology/Pulmonology/Intensive Care/Nephrology, “Hof” Clinics, University of Erlangen, Hof, Germany; 2Pulmonary Department – Oncology Unit, “G Papanikolaou” General Hospital, Thessaloniki, Greece; 3Medical Clinic I, “Fuerth” Hospital, University of Erlangen, Fuerth, Germany; 4Department of Pharmacology & Clinical Pharmacology, School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; 5Department of Respiratory and Critical Care Medicine, Changhai Hospital/First Affiliated Hospital of the Secondary Military Medical University, Shanghai, China Introduction: The majority of cases of lung cancer are still diagnosed at a late stage. At this stage, palliative therapeutic options including nonspecific cytotoxic drugs, targeted therapy, or immunotherapy can be utilized. In 2016, immunotherapy was approved in Europe for squamous cell carcinoma and adenocarcinoma. Moreover, afatinib was also approved as second-line therapy for squamous cell carcinoma. Case report: This article presents a case of a 76-year-old male with squamous cell carcinoma who received nab-paclitaxel as first-line therapy, and his treatment was switched to the tyrosine kinase inhibitor afatinib (40 mg) after disease progression with left lung atelectasis. After receiving afatinib for only 28 days, the atelectasis resolved. No adverse effects were observed from the afatinib therapy. Discussion: In this case, afatinib 40 mg proved to be an effective alternative treatment for an elderly patient. Treatment choice should be based on the performance status of the patient, cost-effectiveness, and drug treatment guidelines. Keywords: lung cancer, EGFR, afatini

Carotid intima-media thickness is associated with media rather than intima thickness

CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO ETECNOLOGICOsem informação261169171CNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO ETECNOLOGICOCNPQ - CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO ETECNOLOGICOsem informaçã

Antidepressants on Multiple Sclerosis: A Review of In Vitro and In Vivo Models

Background: Increased prevalence of depression has been observed among patients with multiple sclerosis (MS) and correlated with the elevated levels of proinflammatory cytokines and the overall deregulation of monoaminergic neurotransmitters that these patients exhibit. Antidepressants have proved effective not only in treating depression comorbid to MS, but also in alleviating numerous MS symptoms and even minimizing stress-related relapses. Therefore, these agents could prospectively prove beneficial as a complementary MS therapy. Objective: This review aims at illustrating the underlying mechanisms involved in the beneficial clinical effects of antidepressants observed in MS patients. Methods: Through a literature search we screened and comparatively assessed papers on the effects of antidepressant use both in vitro and in vivo MS models, taking into account a number of inclusion and exclusion criteria. Results: In vitro studies indicated that antidepressants promote neural and glial cell viability and differentiation, reduce proinflammatory cytokines and exert neuroprotective activity by eliminating axonal loss. In vivo studies confirmed that antidepressants delayed disease onset and alleviated symptoms in Experimental Autoimmune Encephalomyelitis (EAE), the most prevalent animal model of MS. Further, antidepressant agents suppressed inflammation and restrained demyelination by decreasing immune cell infiltration of the CNS. Conclusion: Antidepressants were efficient in tackling numerous aspects of disease pathophysiology both in vitro and in vivo models. Given that several antidepressants have already proved effective in clinical trials on MS patients, the inclusion of such agents in the therapeutic arsenal of MS should be seriously considered, following an individualized approach to minimize the adverse events of antidepressants in MS patients. © Copyright © 2021 Stamoula, Siafis, Dardalas, Ainatzoglou, Matsas, Athanasiadis, Sardeli, Stamoulas and Papazisis

Acute effect of aerobic exercise on arterial stiffness in breast cancer survivors: preliminary results

Breast cancer survivors (BCS) who underwent chemotherapy treatment have increased risk of cardiovascular disease (CVD). Chemotherapy contributes to increased arterial stiffness. Acute aerobic exercise has been demonstrated to be effective in improving arterial stiffness in healthy individuals, however, it is unknown if BCS have a similar response to aerobic exercise. To determine if arterial stiffness is different between BCS and healthy controls following acute aerobic exercise. Seven BCS (48 ± 4 yrs; 26.0 ± 2.8 kg/m2) and seven female controls (43 ± 9 yrs; 22.7 ± 3.5 kg/m2) completed a 30-min bout of aerobic cycling exercise at 65% of their maximal aerobic capacity. Central arterial stiffness was evaluated by pulse wave velocity (PWV) via applanation tonometry at baseline, 5 and 30-min post exercise. Hemodynamic variables [cardiac output (Q), heart rate (HR), and mean arterial blood pressure (MAP)] were acquired with an automated ambulatory blood pressure monitor. Carotid arterial stiffness was determined using ultrasonography [β-stiffness index, pressure-strain elasticity modulus (Ep) and arterial compliance (AC)]. See Table. Both groups had similar increases in AC at 30-min compared to 5 min post-exercise (p<0.05). HR increased in both groups post exercise (p<0.05); however, BCS had an overall higher HR compared to the control group (p<0.05). There were no differences in PWV, β-stiffness, Ep and AC responses following exercise between the groups. These results suggest that BCS have similar arterial stiffness responses compared to a healthy control group. Interestingly, PWV decreased (approached significance), while AC decreased following exercise, showing a possible differential response between the aorta and carotid artery, suggesting more investigation in this area51243244Annual Meeting of the American-College-of-Sports-Medicine (ACSM

Re-biopsy after relapse of targeted therapy. T790M after epidermal growth factor mutation, where and why based on a case series

Guidelines for the treatment of non-small cell lung cancer adenocarcinoma positive in epidermal growth factor mutations indicate tyrosine kinase inhibitors. There are currently three tyrosine kinase inhibitors that can be used as first line treatment: gefitinib, erlotinib and afatinib. Regarding erlotinib and afatinib dosage can be modified in the case of severe adverse effects. In the case of disease relapse investigation for T790M mutation has to be made either with re-biopsy or liquid biopsy and osimertinib has to be administered when T790M is diagnosed. Based on a case series we indicate which is the best approach for T790M mutation. © 2017 The Author

Immunotherapy “Shock” with vitiligo due to nivolumab administration as third line therapy in lung adenocarcinoma

Non-small cell lung cancer is still diagnosed at late stage due to the lack of early symptoms and methods of diagnostic prevention. In the past ten years several targeted therapies have been introduced or explored. Tyrosine kinase inhibitors and immunotherapy are currently considered the most effective and safe therapies in comparison to the non-specific cytotoxic agents. Regarding tyrosine kinase inhibitors the adverse effects have been fully explored, however; on the other hand for immunotherapy there are still several issues to be clarified. We report a rare case of a patient with lung cancer adenocarcinoma who developed vitiligo throughout his body after nivolumab administration. © 201

Possible adverse effects of immunotherapy in non-small cell lung cancer; treatment and follow-up of three cases

In the past decade novel agents are on the market for non-small cell lung cancer adenocarcinoma based on pharmacogenomics. The epidermal growth factor receptor mutation, anaplastic lymphoma kinase and programmed death-ligand 1 investigation is necessary in the everyday clinical practice for the oncologic patient. Immunotherapy is nowadays the novel therapy for advanced stage non-small cell lung cancer with two agents nivolumab and pembrolizumab. In the current case series we will present adverse effects from our centers and comment on the treatment and follow-up of the patients. © 2017 The Author

Genes’ interactions: A major contributor to the malignant transformation of endometriosis

The genetic and epigenetic factors that contribute to the malignant transformation of endometriosis are still under investigation. The objective of the present study was to investigate the genetic link between endometriosis and cancer by examining and correlating the latest clinical observations with biological experimental data. We collected updated evidence about the genetic relationship between endometriosis and cancers by conducting a comprehensive search of PubMed and Scopus databases, focusing on the papers published between January 2018 and January 2019. New insights into the mechanism of the malignant transformation of endometriosis have been published recently. The use of state-of-the-art techniques and methods, such as the genome-wide association study analysis and the weighted gene co-expression analysis, have significantly altered our understanding of the association between endometriosis and endometriosis-associated cancer development. Interestingly, the interactions formed between genes seem to play a pivotal role in the phenotypic expression of mutations. Therefore, the effect of single nucleotide polymorphisms and the function of the expression quantitative trait loci on genes’ expression have been the subject of many recent works. In addition, it has been discovered that genes, the mutations of which have been related to the development of endometriosis, play a role as hub genes. This may lead to new areas of research for understanding the mechanism of malignant transformation of the disease. Significant steps forward have been made towards the identification of factors that control the malignant transformation of endometriosis. Still, due to rarity of the event, a better-organized scheme for sampling on a global level should be adopted. © 2019 by the authors. Licensee MDPI, Basel, Switzerland