8 research outputs found

    Graphic satire and the rise and fall of the First British Empire: political prints from the Seven Years' War to the Treaty of Paris, c. 1756-1783

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    This thesis examines the early stages of the transformation of emblematic political prints into political caricature from the beginning of the Seven Years' War (1756) to the Treaty of Paris, which ended the American Revolutionary War (1783). Both contextual and iconographical issues are investigated in relation to the debates occasioned by Britain's imperial project, which marked a period of dramatic expansion during the Seven Years' War, and ended with the loss of the American colonies, consequently framing this thesis as a study of political prints during the rise and fall of the so-called 'First British Empire'. Previous studies of eighteenth-century political prints have largely ignored the complex and lengthy evolutionary process by which the emblematic mode amalgamated with caricatural representation, and have consequently concluded that political prints excluded emblems entirely by the end of the 1770s. However, this study emphasizes the significance of the Wilkite movement for the promotion and preservation of emblems, and investigates how pictorial political argument was perceived and received in eighteenth-century British society, arguing that wider tastes and opinions regarding the utilization of political prints gradually shifted to accept both modes of representation. Moreover, the marketplace, legal status, topicality, and manufacturing methods of political prints are analyzed in terms of understanding the precarious nature of their consumption and those that endeavoured to engage in political printmaking. The evolution, establishment, and subsequent appropriation of pictorial tropes is discussed from the early modern period to the beginning of the so-called Golden Age of caricature, while tracing the adaptation of representational models in American colonial prints that employed emblems already entrenched in British pictorial political debate. Political prints from the two largest print collections, the British Museum and the Lewis Walpole Library at Yale are consulted, along with a number of eighteenth-century newspapers and periodicals, to develop the earlier research by M. Dorothy George, Charles Press, Herbert Atherton, Diana Donald, Amelia Rauser, and Eirwen Nicholson

    Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events

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    Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p < 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p < 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p < 0.001, respectively). Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers.Peer reviewe

    Keliakia : Ravintolahenkilökunnan tietÀmys keliakiasta

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    TĂ€mĂ€n tutkimuksen tarkoituksena oli selvittÀÀ tutkimuksen toimeksiantajan, Osuuskauppa PeeÄssĂ€n ravintoloiden henkilökunnan tietĂ€mys keliakiasta. Kyselymme antaa tietoa, kuinka hyvin ravintoloissa tiedetÀÀn keliakiasta sairautena ja kuinka se huomioidaan ravintolan toiminnassa. KyseessĂ€ oli kvantitatiivinen tutkimus. MÀÀrĂ€llistĂ€ menetelmÀÀ kĂ€yttĂ€mĂ€llĂ€ tutkimus kuvaa ja tulkitsee ilmiöitĂ€ mittausmenetelmillĂ€ ja analysoi numeraalisia tutkimusaineistoja. KyselyssĂ€ kĂ€ytettiin sekĂ€ monivalintakysymyksiĂ€, ettĂ€ avoimia kysymyksiĂ€. MÀÀrĂ€llinen tutkimus perustuu mittaamiseen, jonka tuloksena syntyy lukuarvoja sisĂ€ltĂ€vĂ€ havaintoaineisto, jota analysoidaan tilastollisin analyysimenetelmin. Tutkimus toteutettiin Webropol-ohjelmalla, jonka kautta jaoimme linkin kyselyyn ravintoloihin sĂ€hköpostilla. Kysely oli avoinna vastaamiseen 12.2.2018- 28.2.2018. Tutkimustuloksia analysoitiin Webropol sovelluksella yhdessĂ€ kĂ€yttĂ€en ExceliĂ€, jonka kautta pystyimme tulkitsemaan lukuja ja vastauksia ristiin verraten. Keliakia on yksi vaativimmista autoimmuunisairauksista, jonka vuoksi oikean ruokavalion noudattaminen on erityisen tĂ€rkeÀÀ sairauden kannalta. Gluteenittoman ruokavalion noudattaminen on lisÀÀntynyt nykypĂ€ivĂ€nĂ€ suuresti. Moni noudattaa ruokavaliota, vaikkei siihen ole lÀÀketieteellistĂ€ syytĂ€. Tutkimuksissa kĂ€vi ilmi, ettĂ€ keliakia mielletÀÀn allergiaksi, eikĂ€ autoimmuunisairaudeksi. On tĂ€rkeÀÀ osata erottaa nĂ€mĂ€ kaksi toisistaan. Allergiaa voidaan hoitaa lÀÀkkeillĂ€ ja siedĂ€tyshoidolla, mutta keliakian hoitona on ainoastaan elinikĂ€inen gluteeniton ruokavalio. Tutkimustulokset osoittivat, ettĂ€ ravintoloissa ruoan valmistaminen ja tarjoilu ovat kiitettĂ€vĂ€llĂ€ tasolla. Ravintoloissa osataan valmistaa ruokaa turvallisesti keliaakikoille ja tuotetuntemus sekĂ€ raaka-aine tuntemus ovat hyvĂ€llĂ€ tasolla. Gluteenittoman ruokavalion noudattaminen ja sen lisÀÀntyminen on tuonut haasteita ravintoloille ja heidĂ€n toiminnalleen. Ravintoloissa on tĂ€rkeÀÀ osata erottaa asiakkaat, joilla on terveydellinen syy ruokavalioon ja pystyĂ€ tarjoamaan heille turvallista ruokaa, sekĂ€ osata ottaa heidĂ€n sairautensa tarvittavalla vakavuudella huomioon tarjoilussa.The purpose of this research was to investigate the restaurant staff’s knowledge of celiac disease. Our survey gives information on how well restaurants know about celiac disease and how the disease is taken into consideration in restaurant operations. The client organisation of this research was Osuuskauppa PeeÄssĂ€. Quantitative method was used in this research. The research describes and interprets phenomena by measurement methods and analyzes numerical research data. The used inquiry included both multiple-choice and open questions. Quantitative research is based on measurement, resulting in observation data containing numerical values that are analyzed by statistical analysis methods. The research was carried out with the Webropol program through which we distributed a link by e-mail to the res-taurants. The survey was open for reply from February 12 2018 to February 28 2018. The research results were analyzed using the Webropol application and Microsoft Excel, which enable the cross comparison in the figures and answers. Celiac disease is one of the most demanding autoimmune diseases which is why the proper diet is particularly im-portant for the disease. The number of persons following a gluten- free diet has increased greatly today, many will follow the diet, even without a medical reason for it. The research showed that celiac disease is mistakenly thought to be an allergy, and not an autoimmune disorder as it is. It is important to know how to separate these two. Allergy can be treated with medications and suppressive care, but the only treatment for celiac disease is a lifelong gluten-free diet. The results showed that in restaurants, food preparation and serving are at an excellent level. The restaurants know how to make food safely to persons who have celiac disease. Product knowledge and raw material knowledge are at a good level. In restaurants, it is important that restaurant staff members know how to separate customers who have a healthy cause for diet and can provide food safely for them. It is also important to know how to take the severity of the illness needed for serving

    Implied crash risk in foreign exchange options - Analysis of EUR-USD volatility curves

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    AALTO UNIVERSITY SCHOOL OF ECONOMICS ABSTRACT Department of Economics December 2012 Henna KarhapÀÀ IMPLIED CRASH RISK IN FOREIGN EXCHANGE OPTIONS - ANALYSIS OF EUR-USD VOLATILITY CURVES Objective of the study Objective of the study is to examine foreign exchange options and market expectations embedded in option prices about the possibility of currency crashes. The thesis describes a procedure for estimating the market assessment of currency crash risk from option implied volatility curves with jump-diffusion option pricing model for exchange rates. This method is used to construct time series of option-implied crash risk measures. Additionally, the study examines economic determinants of implied crash risk over the period from January 5, 2006 to December 30, 2011. Data Data set consists of dollar-euro foreign exchange option daily quotes of 1 month, 3 month, 6 month and 1 year at-the-money volatilities, 25-delta and 10-delta risk reversals and 25-delta and 10-delta butterfly spreads from January 5, 2006 to December 30, 2011. Each series contain 1562 observations for a total of 31 240 observations. Results Results show that shorter maturity options are pricing in higher frequency of jumps but lower magnitude jumps, and the longer maturity options are pricing less frequent, higher magnitude jumps. Jump volatility is increasing with maturity and jumps are found to contribute the most to the prices of the longer options. The implied parameters are used to construct time-series of three crash risk measures: expected jumps per year, risk-neutral skewness and crash probability. Expected jumps per year, that indicates the frequency and the magnitude of jumps, is highest for the shortest options and decreases as the time to maturity increases. During the sample period this crash risk measure ranges from 9 percent to -27 percent. The risk-neutral skewness measure indicates asymmetry of the left and right tails of the risk-neutral distribution. The yearly skewness estimations range from 0,14 to -1,0. Crash probability indicates the option-implied probability that the exchange rate would depreciate more than a certain level during a time interval. Probability estimates are calculated for three crash levels: -15 %, -20% and -25%. The empirical section of this thesis shows that sovereign long-term bond yield, stock market and the spot exchange rate are the best performing determinants of option implied crash risk. Crash risk increases when the spread between US sovereign bond yields and euro area sovereign bond yields increases. Higher crash risk is associated with relative underperformance of European stock market compared to the US stock market. Weekly changes of the spot exchange rate are the best variable explaining weekly changes of crash risk. Keywords Foreign exchange options, implied volatility curve, currency crash, option pricing models, jumpdiffusion mode

    Kanalle lÀhitoukkaa

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    The need for animal-derived additional protein from one's own farm or nearby areas is significant due to the increased prices, usage restrictions, and availability difficulties of fishmeal and organic soybeans commonly used in poultry and pig feed. These challenges are particularly significant in organic production. Currently, insects cannot be certified as organic, but legislation enabling certification is being prepared. In addition to protein self-sufficiency, insect production can also improve fertilizer self-sufficiency, as the by-product of production, known as frass, is a first-rate fertilizer. Research indicates that the larvae of the black soldier fly (Hermetia illucens) are excellent for poultry feed. For example, the growth of young chickens can be improved by adding 3–10% Hermetia to their feed. In laying hens, soybeans have been entirely replaced by black soldier fly protein and fat, and in broiler feed, fishmeal has been replaced with black soldier fly up to 15% without compromising consumption and growth. Feed containing insects provides health benefits to animals. The abundant lauric acid in the black soldier fly's fat reduces enterobacteria in the intestine, such as coliform bacteria. Chitin and its breakdown products improve gut microbiota. The black soldier fly also contains bacteria-killing peptides, and its proteins and chitin enhance the animals' natural immune system. In experimental infections, a 3–10% insect addition has reduced morbidity and mortality. The immune-boosting and morbidity-reducing effect of insect feed may decrease the need for antibiotics and reduce the risk of developing new antibiotic-resistant bacterial strains in connection with livestock production. In organic production, where animals spend part of their time outdoors and antibiotics are not used, strengthening disease resistance is particularly necessary. The goal of the "Farm maggot for chicken" project is to improve protein self-sufficiency, security of supply, and resilience to crises on poultry and pig farms by replacing imported protein with insect protein. The project produces and pilots a farm-scale, scalable, and generalizable operational model for insect larvae and their protein concentrate production. The operational model includes information on equipment and methods for producing black soldier fly protein and generalizable calculation tools for preparing farm-specific profitability calculations for insect production. The project utilizes the farm's own vegetable by-products as feed for the larvae. Preliminary results indicate that the by-product of grain sorting is suitable as feed for Hermetia larvae. The project tests the best way to compose the growing mass, as the structure of the growing substrate is crucial for optimizing larval growth. The "Farm maggot for chicken" project is funded by the Rural Development Programme for Mainland Finland 2014–2020 as the European Innovation Partnerships -project (EIP). It is implemented by the Natural Resources Institute Finland (Luke), Jamk University of Applied Sciences, and Kaistin Tila Oy. &nbsp; &nbsp;Tarve elĂ€inperĂ€isen lisĂ€valkuaisen saannille omalta tilalta tai lĂ€hialueelta on suuri siipikarjan ja sian rehuissa yleisesti kĂ€ytettĂ€vien kalajauhon ja luomusoijan kohonneiden hintojen, kĂ€yttörajoitusten sekĂ€ saantivaikeuksien takia. Haasteet ovat erityisen suuret luomutuotannossa. HyönteisiĂ€ ei tĂ€llĂ€ hetkellĂ€ voi sertifioida luomuksi, mutta sertifioinnin mahdollistava lainsÀÀdĂ€ntö on valmisteilla.&nbsp;Valkuaisomavaraisuuden lisĂ€ksi hyönteistuotannon avulla voidaan parantaa myös lannoiteomavaraisuutta, sillĂ€ tuotannon sivuvirtana syntyvĂ€ toukanpuru eli frassi on ensiluokkaista lannoitetta. Tutkimusten mukaan mustasotilaskĂ€rpĂ€sen (Hermetia illucens) toukka sopii erinomaisen hyvin siipikarjan rehuksi. Esimerkiksi kananpoikien varhaisen vaiheen kasvua voidaan parantaa lisÀÀmĂ€llĂ€ niiden rehuun 3–10% Hermetiaa. Munituskanoilla soija on voitu korvata kokonaan mustasotilaskĂ€rpĂ€sen proteiinilla ja rasvalla ja broilerin rehusta on korvattu kalajauhoa mustasotilaskĂ€rpĂ€sellĂ€ aina 15%:iin asti ilman syönnin ja kasvun heikkenemistĂ€. HyönteistĂ€ sisĂ€ltĂ€vĂ€ rehu tuottaa elĂ€imelle terveyshyötyjĂ€. MustasotilaskĂ€rpĂ€sen rasvan runsas lauriinihappo vĂ€hentÀÀ suoliston enterobakteereja, kuten kolibakteereja. Kitiini ja sen pilkkoutumistuotteet parantavat suoliston mikrobistoa. MustasotilaskĂ€rpĂ€nen sisĂ€ltÀÀ myös bakteereja tappavia peptidejĂ€ ja sen proteiinit ja kitiini voimistavat elĂ€inten luontaista immuunijĂ€rjestelmÀÀ. Kokeellisissa infektioissa 3–10%:n hyönteislisĂ€ on vĂ€hentĂ€nyt sairastavuutta ja kuolleisuutta. Hyönteisrehun immuniteettia voimistava ja sairastavuutta vĂ€hentĂ€vĂ€ vaikutus voi vĂ€hentÀÀ antibioottien tarvetta ja pienentÀÀ riskiĂ€ uusien antibioottiresistenssien bakteerikantojen kehittymiseen kotielĂ€intuotannon yhteydessĂ€. Luomutuotannossa, jossa elĂ€imet ovat osan ajastaan ulkona eikĂ€ antibiootteja kĂ€ytetĂ€, taudinvastustuskyvyn vahvistaminen on erityisen tarpeen. Kanalle lĂ€hitoukkaa -hankkeen tavoitteena on parantaa siipikarja- ja sikatilojen valkuaisomavaraisuutta, huoltovarmuutta ja kriisinkestĂ€vyyttĂ€ korvaamalla tuontivalkuaista hyönteisproteiinilla. Hankkeessa tuotetaan ja pilotoidaan maatilamittakaavaan sopiva, skaalattava ja yleistettĂ€vĂ€ toimintamalli hyönteistoukan ja sen proteiinirikasteen tuotantoon. Toimintamalli kattaa tiedon laitteista ja menetelmistĂ€ mustasotilaskĂ€rpĂ€sen proteiinin tuottamiseen sekĂ€ yleistettĂ€vissĂ€ olevat laskentatyökalut hyönteistuotannon tilakohtaisten kannattavuuslaskelmien laatimiseen. Hankkeessa hyödynnetÀÀn maatilan omia kasvisivuvirtoja toukkien rehuina. Alustavien tulosten mukaan viljojen lajittelun sivuvirta sopii Hermetian toukkien rehuiksi. Hankkeessa testataan parasta tapaa koostaa kasvatusmassa, sillĂ€ kasvatusalustan rakenne on olennaisen tĂ€rkeĂ€ toukkien kasvun optimoinnin kannalta. Kanalle lĂ€hitoukkaa -hanke on Manner-Suomen maaseudun kehittĂ€misohjelman 2014–2020 rahoittama maaseudun innovaatioryhmĂ€ (EIP) hanke. Sen toteuttavat Luonnonvarakeskus (Luke), JyvĂ€skylĂ€n ammattikorkeakoulu Oy (Jamk) ja Kaistin tila Oy.Behovet av ytterligare animaliskt protein frĂ„n den egna gĂ„rden eller nĂ€rliggande omrĂ„den Ă€r betydande pĂ„ grund av de höjda priserna, anvĂ€ndningsbegrĂ€nsningarna och tillgĂ€nglighetsproblemen för fiskmjöl och ekologiska sojabönor som vanligtvis anvĂ€nds i fjĂ€derfĂ€- och grisfoder. Dessa utmaningar Ă€r sĂ€rskilt betydande inom ekologisk produktion. För nĂ€rvarande kan insekter inte certifieras som ekologiska, men lagstiftning som möjliggör certifiering Ă€r under förberedelse. Förutom protein sjĂ€lvförsörjning kan insektproduktion ocksĂ„ förbĂ€ttra gödsel sjĂ€lvförsörjning, eftersom biprodukten av produktionen, kĂ€nd som frass, Ă€r en förstklassig gödsel. Forskning visar att larverna av den svarta soldatflugan (Hermetia illucens) Ă€r utmĂ€rkta för fjĂ€derfĂ€foder. Till exempel kan tillvĂ€xten hos unga kycklingar förbĂ€ttras genom att tillsĂ€tta 3–10% Hermetia till deras foder. Hos vĂ€rphöns har sojabönor helt ersatts av svart soldatflugsprotein och fett, och i slaktkycklingfoder har fiskmjöl ersatts med svart soldatflug upp till 15% utan att konsumtion och tillvĂ€xt komprometteras. Foder som innehĂ„ller insekter ger hĂ€lsofördelar för djur. Den rikliga laurinsyran i den svarta soldatflugans fett minskar enterobakterier i tarmen, sĂ„som koliforma bakterier. Kitin och dess nedbrytningsprodukter förbĂ€ttrar tarmens mikrobiota. Den svarta soldatflugan innehĂ„ller ocksĂ„ bakteriedödande peptider, och dess proteiner och kitin förstĂ€rker djurens naturliga immunsystem. I experimentella infektioner har ett 3–10% insekttillskott minskat morbiditet och mortalitet. Den immunstĂ€rkande och morbiditetsreducerande effekten av insektsfoder kan minska behovet av antibiotika och minska risken för att utveckla nya antibiotikaresistenta bakteriestammar i samband med boskapsproduktion. I ekologisk produktion, dĂ€r djur tillbringar en del av sin tid utomhus och antibiotika inte anvĂ€nds, Ă€r det sĂ€rskilt nödvĂ€ndigt att stĂ€rka sjukdomsresistensen. MĂ„let med projektet "NĂ€rbildslarver för kycklingen" Ă€r att förbĂ€ttra protein sjĂ€lvförsörjning, försörjningstrygghet och krisresilience pĂ„ fjĂ€derfĂ€- och grisgĂ„rdar genom att ersĂ€tta importerat protein med insektsprotein. Projektet producerar och piloterar en gĂ„rdsanpassad, skalbar och generaliserbar driftsmodell för insektslarver och deras proteinberikning. Driftsmodellen inkluderar information om utrustning och metoder för att producera svart soldatflugans protein och generaliserbara berĂ€kningsverktyg för att upprĂ€tta gĂ„rdspecifika lönsamhetsberĂ€kningar för insektproduktion. Projektet utnyttjar gĂ„rdens egna vegetabiliska biprodukter som foder till larverna. PreliminĂ€ra resultat tyder pĂ„ att biprodukten av spannmĂ„lsortering Ă€r lĂ€mplig som foder för Hermetia-larver. Projektet testar det bĂ€sta sĂ€ttet att komponera den vĂ€xande massan, eftersom strukturen pĂ„ odlingssubstratet Ă€r avgörande för att optimera larvernas tillvĂ€xt. Projektet "NĂ€rbildslarver för kycklingen" finansieras av Landsbygdsutvecklingsprogrammet för Fastlandsfinland 2014–2020 som ett landsbygds innovations grupp (EIP) projekt. Det genomförs av Naturresursinstitutet Finland (Luke), Jamk University of Applied Sciences och Kaistin Tila Oy

    Viral molecular mimicry influences the antitumor immune response in murine and human melanoma

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    Molecular mimicry is one of the leading mechanisms by which infectious agents can induce autoimmunity. Whether a similar mechanism triggers an antitumor immune response is unexplored, and the role of antiviral T cells infiltrating the tumor has remained anecdotal. To address these questions, we first developed a bioinformatic tool to identify tumor peptides with high similarity to viral epitopes. Using peptides identified by this tool, we demonstrated that, in mice, preexisting immunity toward specific viral epitopes enhanced the efficacy of cancer immunotherapy via molecular mimicry in different settings. To understand whether this mechanism could partly explain immunotherapy responsiveness in humans, we analyzed a cohort of patients with melanoma undergoing anti-PD1 treatment who had a high IgG titer for cytomegalovirus (CMV). In this cohort of patients, we showed that high levels of CMV-specific antibodies were associated with prolonged progression-free survival and found that, in some cases, peripheral blood mononuclear cells (PBMC) could cross-react with both melanoma and CMV homologous peptides. Finally, T-cell receptor sequencing revealed expansion of the same CD8ĂŸ T-cell clones when PBMCs were expanded with tumor or homologous viral peptides. In conclusion, we have demonstrated that preexisting immunity and molecular mimicry could influence the response to immunotherapies. In addition, we have developed a free online tool that can identify tumor antigens and neoantigens highly similar to pathogen antigens to exploit molecular mimicry and cross-reactive T cells in cancer vaccine development.publishedVersionPeer reviewe

    FITeens Toolkit: promoting health-related behaviors in the educational context

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    Children and adolescents acquire different habits as they grow up. Some of these habits are closely related to health, so acquiring healthy habits can greatly help them lead a healthy and peaceful life in the future, while bad habits can be detrimental to them. For that reason, it is necessary that from the different educational institutions, we help these young people in the acquisition of these habits. The aim of FITeens (Promoting physical activity and healthy habits in sedentary teenagers) project is to pilot an entertaining and engaging educational intervention targeted at teenagers to promote physical activity and healthy habits This first result of the project consists of a comprehensive set of ideas, resources, practices and some examples for Physical Education teachers that will cover the different key behaviors that increase the risk of chronic diseases (physical activity, sufficient sleep, moderate screen time, alcohol and tobacco consumption, and healthy food intake) that can be incorporated into their teaching practice. This toolkit consists of 3 different modules: 1. High schools as effective settings to promote healthy lifestyles. This module covers the importance of schools in the acquisition of healthy habits by adolescents. 2. Motivation as a key to physical activity promotion. This module focuses on the importance of motivation in the acquisition of healthy habits. 3. Health-related behaviors in young people. This module will focus on the key health-related behaviors mentioned above (physical activity, sufficient sleep, moderate screen time, alcohol and tobacco use, and healthy food intake), describing each of them in depth. All of these modules are dedicated to the different health-related behaviors mentioned above. Each of them will have a theoretical explanation, explanatory videos, infographics and learning situations that will support Physical Education teachers in acquiring a broad knowledge of how to get their students motivated to engage in physical activity and acquire healthy habits, making them aware of their importance.info:eu-repo/semantics/publishedVersio

    Previous radiotherapy improves treatment responses and causes a trend toward longer time to progression among patients with immune checkpoint inhibitor-related adverse events

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    Abstract Background: Immune-related adverse events (irAEs) are frequently encountered by patients during immune checkpoint inhibitor (ICI) treatment and are associated with better treatment outcomes. The sequencing of radiotherapy (RT) and ICIs is widely used in current clinical practice, but its effect on survival has remained unclear. Methods: In a real-world multicenter study including 521 patients who received ICI treatment for metastatic or locally advanced cancer, RT schedules and timing, irAEs, time to progression, overall survival, and treatment responses were retrospectively reviewed. Results: Patients who received previous RT and developed irAE (RT +/AE +) had the best overall response rate (ORR 44.0%). The ORR was 40.1% in the RT −/AE + group, 26.7% in the RT −/AE − group and 18.3% in the RT + /AE − group (p &lt; 0.001). There was a significantly longer time to progression (TTP) in the RT + /AE + group compared to the RT −/AE − and RT + /AE − groups (log rank p = 0.001 and p &lt; 0.001, respectively), but the trend toward longer TTP in the RT + /AE + group did not reach statistical significance in pairwise comparison to that in the RT −/AE + group. Preceding RT timing and intent had no statistically significant effect on TTP. In a multivariate model, ECOG = 0 and occurrence of irAEs remained independent positive prognostic factors for TTP (HR 0.737; 95% CI 0.582–0.935; p = 0.012, and HR 0.620; 95% CI 0.499–0.769; p &lt; 0.001, respectively). Conclusions: Better ORR and a trend toward longer TTP were demonstrated for patients with RT preceding ICI treatment and development of irAEs, which suggests that RT may boost the therapeutic effect of immunotherapy in patients with metastatic cancers
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