Carcinoma of the cervix – risk factors, prevention, diagnosis and treatment

O câncer de colo uterino é o segundo tipo de câncer mais frequente entre as mulheresde todo o mundo e também no Brasil. Sua maior incidência se dá em mulheres entre45 e 49 anos de idade e estima-se que o rastreamento sistemático e o tratamento de lesõesprecursoras possam reduzir a mortalidade pela doença em até 80%. O principal fator de riscoé a infecção pelo Papiloma Vírus Humano (HPV) e já foram desenvolvidas vacinas contra osprincipais tipos oncogênicos do vírus. A redução da mortalidade decorrente dessa doençadepende da adoção de medidas de prevenção primária, de diagnóstico e tratamento de lesõesprecursoras bem como do diagnóstico e tratamento adequados das lesões invasivas.The cervical cancer is the second leading cause of cancer between womenaround the world, as in Brazil. The highest incidence is in women aged 45-49 years and themortality can be reduced by 80% with the systematic screening and treatment of precursorlesions. Human papillomavirus is the major risk factor and vaccines were recent developed.Strategies to reduction of cervical cancer mortality include prevention measures, diagnosis andtreatment of early and invasive lesions

Patterns of immune-related adverse events in patients treated with immune checkpoint inhibitors: a Brazilian real-world analysis

Objectives: To report real-world data of a cohort of patients treated with immune-checkpoint inhibitors in Brazil, with focus in immune-related adverse events. Material and Methods: In this retrospective study, we analyzed a cohort of patients with metastatic solid tumors treated at an oncology reference center with at least one dose of immune-checkpoint inhibitors (given as monotherapy or in combination with other agents). The safety profile was characterized through the incidence of adverse events, management and hospitalization. Results: We included 185 patients. Immune-related adverse events were observed in 92 of the 185 study patients (49.7%), including 16 patients (8.6%) with such events of grade 3 or 4, and 28 patients (15.1%) requiring systemic corticosteroid therapy. Thyroid disorders (20%), rash (17.8%), pruritus (11.4%) and colitis (11.4%) were the most frequent immune-related adverse events. Five (2.7%) patients discontinued immune-checkpoint inhibitors and 15 (7.0%) were hospitalized due to immune-related adverse events. Development of immune-related adverse events and immune-checkpoint inhibitors used in the firstline setting were associated with prolonged progression-free survival and overall survival in the multivariate analysis. Moreover, age <75 years old and ECOG score 0 or 1 were positively associated with overall survival in the multivariate analysis. Conclusion: This study based upon a Brazilian “real-world” data confirms the toxicity profile of immune-checkpoint inhibitors seen in clinical trials. In accordance with previous retrospective analyses, development of immune-related adverse events was associated with survival outcome of immune-checkpoint inhibitors treatment in patients with metastatic solid cancers