Metachronous primary uterine cancer surgically resected during crizotinib treatment in a ALK-rearranged advanced lung adenocarcinoma

Rearrangements of the anaplastic lymphoma kinase (ALK) gene are present in 3% to 7% of nonsmall-cell lung cancers (NSCLCs). Patients harboring ALK rearrangements show very favourable outcomes if treated with targeted agents, among which crizotinib is the first and best studied. Crizotinib, an oral smallmolecule tyrosine kinase inhibitor of ALK, MET, and ROS1 kinases, is a very active and well tolerated drug. Nevertheless, the optimal therapy management with this new drug is still partially unknown, especially with regard to the safety of combined treatments. Recently, the integration of locoregional treatments has been proposed as a feasible multimodality strategy in selected patients with good clinical conditions and slowgrowing or oligoprogressive disease. In this report, a case of advanced lung adenocarcinoma, progressed after first line chemotherapy and re-biopsied detecting ALK rearrangement, is described. During crizotinib treatment the primary lung tumor showed an excellent regression; meanwhile a major surgery for a metachronous uterine cancer was safely and successfully carried out

Impact of Proton Pump Inhibitors and Histamine-2-Receptor Antagonists on Non-Small Cell Lung Cancer Immunotherapy: A Systematic Review and Meta-Analysis

(1) Background: In recent years, immunotherapy has revolutionized the treatment landscape of non-small cell lung cancer (NSCLC), representing a therapeutic breakthrough in this field. Antacid agents such as proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H2RAs) are commonly prescribed for extended periods in NSCLC patients, and these drugs have the potential to modify the efficacy of immune checkpoint inhibitors (ICIs). (2) Materials and Methods: Herein, we conducted a systematic review and meta-analysis to investigate the impact of PPIs and H2RAs on progression-free survival (PFS) and overall survival (OS) among patients receiving immunotherapy for metastatic NSCLC. Effect measures for OS were Hazard Ratios (HRs) and 95% Confidence Intervals (CIs), which were extracted from available studies. Forest plots were used to assess HRs to describe the relationship between treatment and OS in the specified cohorts of patients. (3) Results: Six studies were included in the analysis, involving 2267 patients. The pooled HRs for OS and PFS were 1.4 (95% CI, 1.25–1.58) and 1.29 (95% CI, 1.17–1.43), respectively, suggesting that PPIs and H2RAs administration was negatively associated with PFS and OS. (4) Conclusion: Concomitant antacid use could modify the activity of ICIs in NSCLC patients

Dexamethasone-Sparing Regimens with Oral Netupitant and Palonosetron for the Prevention of Emesis Caused by High-Dose Cisplatin: A Randomized Noninferiority Study

To reduce the overall exposure to dexamethasone (DEX) in patients receiving cisplatin-based chemotherapy, we evaluated the noninferiority of DEX on day 1, with or without low-dose DEX on days 2 and 3, combined with an oral fixed-dose combination of netupitant and palonosetron (NEPA), compared with the guideline-consistent use of 4-day DEX

Evaluating the impact of chemotherapy-induced nausea and vomiting on daily functioning in patients receiving dexamethasone-sparing antiemetic regimens with NEPA (netupitant/palonosetron) in the cisplatin setting: results from a randomized phase 3 study

Background: The non-inferiority of dexamethasone (DEX) on day 1, with or without low-dose DEX on days 2 and 3, combined with oral NEPA (netupitant/palonosetron), compared with the guideline-consistent use of DEX was demonstrated in cisplatin. Here, we complete the analysis by assessing the impact of emesis on daily lives of patients receiving DEX-sparing regimens using the Functional Living Index-Emesis (FLIE).Methods: Chemotherapy-naive patients undergoing cisplatin (>= 70 mg/m(2)), were given NEPA and DEX (12 mg) on day 1 and randomized to receive either 1) no further DEX (DEX1), 2) oral DEX (4 mg daily) on days 2-3 (DEX3), or 3) DEX (4 mg twice daily) on days 2-4 (DEX4; control). Patients completed the FLIE questionnaire on day 6 of cycle 1. Endpoints included the FLIE nausea domain, vomiting domain, and overall combined domain scores, as well as the proportion of patients with no impact on daily life (NIDL; overall score > 108). This was a protocol-planned analysis.Results: In the DEX1 group, no significant differences were observed in the FLIE nausea score (48.9 [+/- 1.8; SE] vs. 53.7 [+/- 1.5]), vomiting score (56.6 [+/- 1.4] vs. 58.7 [+/- 0.8]) and overall score (105.6 [+/- 2.8] vs.1 12.4 [+/- 1.9]) versus DEX4 control; similar results were observed in the DEX3 group for nausea score (49.6 [+/- 1.7]), vomiting score (58.2 [+/- 1]) and overall score (107.8 [+/- 2.4]) versus control. There were no significant between-group differences in the proportion of patients reporting NIDL.Conclusion: Reducing DEX, when administered with NEPA, does not seem to adversely impact the daily functioning in patients undergoing cisplatin

Exploratory analysis of the effect of a dexamethasone-sparing regimen for prophylaxis of cisplatin-induced emesis on food intake (LUNG-NEPA study)

We demonstrated the non-inferiority of a dexamethasone (DEX)-sparing (single-dose) regimen with NEPA, a netupitant/palonosetron fixed combination, for preventing chemotherapy-induced nausea and vomiting (CINV) caused by cisplatin. This pre-planned exploratory analysis assessed the effect of the DEX-sparing regimen on a patient's food intake. Chemotherapy-naive patients undergoing cisplatin (>= 70 mg/m(2)) were given NEPA and DEX (12 mg) on day 1 and randomized to receive either no further DEX (DEX1), or oral DEX (4 mg BID) on days 2-4 (DEX4). Patient-reported endpoint maintenance of usual daily food intake was assessed during the 5-days post-chemotherapy. The relationship between usual daily food intake and CINV control, pre-chemotherapy self-rated food intake and BMI-adjusted weight loss (WL) were evaluated. One-hundred fifty-two patients (76/group) were assessable. The proportion of patients reporting maintenance of usual daily food intake was similar in both groups: 69.7% (95% CI, 58.6-78.9) for DEX1 vs. 72.4% (95% CI, 61.4-81.2) for DEX4. Only CINV control was significantly associated with maintenance of usual daily food intake (P <= 0.001) during the overall phase. The DEX-sparing regimen does not adversely affect patient-reported daily food intake post-chemotherapy. The current analysis adds further insights into antiemetic efficacy of DEX sparing beyond day 1 in the challenging setting of cisplatin.Trial registration: The parent study was registered on ClinicalTrials.gov (NCT04201769)

Relationship in Electronic Negotiations: Tracking Behaviour Over Time

Immer öfter sind Praktiker damit konfrontiert, Konflikte mittels elektronischer Kommunikation wie beispielsweise E-Mail zu lösen. Um zu verstehen, wie Konflikte in computervermittelter Kommunikation bewältigt werden, wurde ein Laborexperiment durchgeführt, in dem die Interaktion zwischen den Verhandlern analysiert wurde. Inhaltsanalyse sowie Phasenanalyse wurde für die Transkripte der Verhandlungen angewendet, und es konnten deutlich verschiedene Phasen identifiziert werden. Die erste Phase, Differenzierung, besteht darin, dass ein offener Konflikt diskutiert wird. Die darauf folgende Integrationsphase beabsichtigt die Schaffung eines positiven Klimas, in dem mögliche Lösungen besprochen werden. Eine Verlagerung von Informationsbereitstellung in der Differenzierungsphase hin zur Verwendung von Taktiken und dem Austausch von Angeboten in der Integrationsphase wird beobachtet. Ein spezieller Schwerpunkt wurde auf den Effekt von persönlicher Beziehung der Verhandler gelegt. Verhandler, die einander kennen, lösen Konflikte mit hoher Intensität besser und kommen auch öfter zu einer Einigung. Wir folgern, dass Praktiker Konflikte besser bewältigen wenn sie sich der unterschiedlichen Phasen im Verhandlungsprozess bewusst sind. Darüber hinaus werden Vorab-Treffen empfohlen, um die interpersonale Beziehung zwischen Verhandlern zu verstärken

Manual of Cardio-oncology Cardiovascular Care in the Cancer Patient

This concise and handy manual provides straightforward, up-to-date guidance for cardiologists and other practitioners on the management of cancer patients with cardiac problems, whether they be due to the cancer itself or to antineoplastic treatment. Detailed attention is devoted to the various forms of cardiotoxicity associated with chemotherapy and radiotherapy. The drugs commonly responsible for each toxicity are identified and clear advice is offered on monitoring techniques and treatment approaches. In addition, the issue of cardiotoxicity due to cancer treatment in particular patient groups \u2013 children, the elderly, and those with pre-existing cardiac disease \u2013 is addressed separately, with guidance on when and how antineoplastic (and/or cardiological) treatments should be modified. Further sections describe the correct responses to cardiac problems secondary to the cancer itself, including thromboembolic disorders and electrolyte imbalances, and the diagnosis, treatment, and follow-up of cardiac tumors. A closing section considers how to improve cooperation between oncologists, cardiologists, and general practitioners to ensure that cancer patients\u2019 cardiovascular needs are met in a multidisciplinary approach