Oncological outcome of peripartum colorectal carcinoma-a single-center experience.

This study aimed to analyze disease presentation, management, and oncological outcomes of patients diagnosed with peripartum colorectal cancer (CRC). Retrospective cohort study of all consecutive women of childbearing age (18-45 years) between 2002 and 2014 diagnosed with CRC adenocarcinoma at a tertiary academic institution. Patients who experienced pregnancy within 12 months of their diagnosis (peripartum period, group 1) were compared to the remaining patients of the cohort (group 2). Overall survival (OS) was compared between the two groups through Kaplan-Meier estimates. Out of 555 consecutive women with a mean age of 37.8 + 6 years, 31 (5.6%) were diagnosed with CRC in the peripartum period. Of these, all patients were symptomatic during pregnancy due to bleeding, abdominal pain, or constipation; however, only 11 CRC (35.5%) were diagnosed during pregnancy, 1 (3.2%) during C section, and the remaining (61.3%) postpartum. TNM stage at presentation was I in 6 patients (19.4%), II in 4 patients (13.9%), III in 8 patients (25.8%), and IV in 13 patients (41.9%). Surgical resection was performed in 23 patients (74.2%): 2 while pregnant, 2 at the time of C section, and the remainder postpartum. Across all stages, OS was 95% at 1 year and 62% at 5 years and did not differ between the two comparative groups (p = 0.16). A suspicious attitude towards cancer-related symptoms during pregnancy is crucial to prevent delayed evaluation for CRC

Variability within Kabatiella caulivora Race 1 and Race 2 revealed by cultural and molecular analyses

Kabatiella caulivora is the causal agent of clover scorch, a fungal disease of clover (Trifolium) species. Variability within and between K. caulivora Race 1 and Race 2 was determined by cultural characteristics, isozymes, and amplified fragment length polymorphisms (AFLP). Cultural studies indicated isolates from both races were highly variable. No differences were identified within or between races by isozyme analysis. Similarity coefficients, determined from AFLP analysis, indicated that isolates from different races were often more similar than isolates from the same race. Comparison of single representative isolates from Race 1 and Race 2, collected at a Denmark (Western Australia) disease site, with isolates collected from another site of clover scorch outbreak at Esperance, 300 km east of Denmark, indicated most of the isolates causing the second outbreak were similar to Race 2, confirming previously conducted pathogenicity tests. It is hypothesised that Race 2 may have evolved from Race 1, and that the level of variability in the pathogen indicates the potential for development of further new races of K. caulivora. The requirement for improved selection strategies, including the screening of new cultivars and breeding lines with multiple isolates of the pathogen, is discussed in relation to these findings

OARSI Clinical Trials Recommendations: Design and conduct of clinical trials for primary prevention of osteoarthritis by joint injury prevention in sport and recreation

SummaryThe risk of post-traumatic osteoarthritis (PTOA) substantially increases following joint injury. Research efforts should focus on investigating the efficacy of preventative strategies in high quality randomized controlled trials (RCT). The objective of these OARSI RCT recommendations is to inform the design, conduct and analytical approaches to RCTs evaluating the preventative effect of joint injury prevention strategies.Recommendations regarding the design, conduct, and reporting of RCTs evaluating injury prevention interventions were established based on the consensus of nine researchers internationally with expertise in epidemiology, injury prevention and/or osteoarthritis (OA). Input and resultant consensus was established through teleconference, face to face and email correspondence over a 1 year period.Recommendations for injury prevention RCTs include context specific considerations regarding the research question, research design, study participants, randomization, baseline characteristics, intervention, outcome measurement, analysis, implementation, cost evaluation, reporting and future considerations including the impact on development of PTOA.Methodological recommendations for injury prevention RCTs are critical to informing evidence-based practice and policy decisions in health care, public health and the community. Recommendations regarding the interpretation and conduct of injury prevention RCTs will inform the highest level of evidence in the field. These recommendations will facilitate between study comparisons to inform best practice in injury prevention that will have the greatest public health impact

A phase II study of retifanlimab (INCMGA00012) in patients with squamous carcinoma of the anal canal who have progressed following platinum-based chemotherapy (POD1UM-202)

Background: Locally advanced or metastatic squamous carcinoma of the anal canal (SCAC) has poor prognosis following platinum-based chemotherapy. Retifanlimab (INCMGA00012), a humanized monoclonal antibody targeting programmed death protein-1 (PD-1), demonstrated clinical activity across a range of solid tumors in clinical trials. We present results from POD1UM-202 (NCT03597295), an open-label, single-arm, multicenter, phase II study evaluating retifanlimab in patients with previously treated advanced or metastatic SCAC. Patients and methods: Patients ≥18 years of age had measurable disease and had progressed following, or were ineligible for, platinum-based therapy. Retifanlimab 500 mg was administered intravenously every 4 weeks. The primary endpoint was overall response rate (ORR) by independent central review. Secondary endpoints were duration of response (DOR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and safety. Results: Overall, 94 patients were enrolled. At a median follow-up of 7.1 months (range, 0.9-19.4 months), ORR was 13.8% [95% confidence interval (CI) 7.6% to 22.5%], with one complete response (1.1%) and 12 partial responses (12.8%). Responses were observed regardless of human immunodeficiency virus or human papillomavirus status, programmed death ligand 1 (PD-L1) expression, or liver metastases. Stable disease was observed in 33 patients (35.1%) for a DCR of 48.9% (95% CI 38.5% to 59.5%). Median DOR was 9.5 months (range, 5.6 months-not estimable). Median (95% CI) PFS and OS were 2.3 (1.9-3.6) and 10.1 (7.9-not estimable) months, respectively. Retifanlimab safety in this population was consistent with previous experience for the PD-(L)1 inhibitor class. Conclusions: Retifanlimab demonstrated clinically meaningful and durable antitumor activity, and an acceptable safety profile in patients with previously treated locally advanced or metastatic SCAC who have progressed on or are intolerant to platinum-based chemotherapy.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Prognostic value of serum soluble Fas in patients with locally advanced unresectable rectal cancer receiving concurrent chemoradiotherapy

Objective: This study was designed to detect the changes of serum soluble Fas (sFas) levels in patients with locally advanced unresectable rectal cancer (LAURC), and to explore its prognostic value of response. Methods: Soluble samples were obtained from LAURC subjects, treated by concurrent chemoradiotherapy, before treatment and one month after treatment. Healthy donor serum samples were used as controls. sFas concentration was measured by enzyme-linked immunosorbent assay (ELISA). Results: The sFas levels before treatment and one month after treatment were both significantly higher in LAURC subjects than in healthy controls [(8.79±1.39) and (7.74±1.32) vs. (5.53±1.13) ng/L, P<0.01]. The sFas levels before treatment and one month after treatment were significantly lower in the response group (complete and partial responses) than in the non-response group (stable and progressive diseases) [(8.50±1.25) vs. (10.17±1.26) ng/L, P<0.01 and (7.50±1.24) vs. (8.90±1.13) ng/L, P<0.01, respectively]. The one-year survival rate was 54.2% and 82.6% in those with sFas levels >8.79 ng/L and <8.79 ng/L before treatment (P<0.02), respectively, 50.0% and 87.0% in those with sFas levels >7.74 ng/L and <7.74 ng/L one month after treatment (P<0.01), respectively. Conclusions: The sFas level is higher in LAURC subjects than in healthy controls. Concurrent chemoradiotherapy can reduce sFas levels in LAURC patients. The monitoring of sFas may provide prognostic information for LAURC patients