6 research outputs found
Immunotherapy of Cancer: Developments and Reference Points, an Unorthodox Approach.
Oncology is currently a sector of medical science with accelerated progress due to rapid technological development, the advancement in molecular biology, and the invention of many innovative therapies. Immunotherapy partially accounts for this advance, since it is increasingly playing an important role in the treatment of cancer patients, bringing on a sense of hope and optimism through a series of clinical studies and cases with spectacular results. Immunotherapy, after the initial successes it experienced in the early 20th century, was forgotten after chemotherapy and radiotherapy prevailed and developed slowly in the background. Today, it is the new hope for cancer treatment, despite the unorthodox path it has followed. In this article, we study the course and key points of the discovery of immune-oncology from the oncologist's point of view. We also record the questions that have been posed about immunotherapy that sometimes lead to confusion or stalemate
Immunotherapy of Cancer: Developments and Reference Points, an Unorthodox Approach
Oncology is currently a sector of medical science with accelerated progress due to rapid technological development, the advancement in molecular biology, and the invention of many innovative therapies. Immunotherapy partially accounts for this advance, since it is increasingly playing an important role in the treatment of cancer patients, bringing on a sense of hope and optimism through a series of clinical studies and cases with spectacular results. Immunotherapy, after the initial successes it experienced in the early 20th century, was forgotten after chemotherapy and radiotherapy prevailed and developed slowly in the background. Today, it is the new hope for cancer treatment, despite the unorthodox path it has followed. In this article, we study the course and key points of the discovery of immune-oncology from the oncologist’s point of view. We also record the questions that have been posed about immunotherapy that sometimes lead to confusion or stalemate. © The Author(s) 2019
The Greek response to COVID-19: A true success story from an IBD perspective
Background: After the first case of infection with the novel coronavirus, SARS-CoV-2, in China, an outbreak rapidly spread, finally evolving into a global pandemic. The new disease was named coronavirus disease 2019 (COVID-19) and by May 10, 2020, it has affected more than 4 million people worldwide and caused more than 270,000 deaths. Methods: We describe the Greek experience regarding the response to COVID-19, with particular focus on 2 COVID-19 reference hospitals in the metropolitan area of Athens, the capital of Greece. Results: The first case of SARS-CoV-2 infection in Greece was reported on February 26, 2020, and prompted a decisive response from the Greek government. The primary focus was containment of virus spread, considering shortage of ICU beds. A general lockdown was implemented early on, and the national Health Care System underwent massive re-structuring. Our 2 gastrointestinal (GI) centers, which provide care for more than 1500 inflammatory bowel disease (IBD) patients, are located in hospitals that were transformed to COVID-19 reference centers. To maintain sufficient care for our patients, while also contributing to the fight against COVID-19, we undertook specific measures. These included provision of telemedicine services, electronic prescriptions and home delivery of medications, isolation of infusion units and IBD clinics in COVID-free zones of the hospitals, in addition to limiting endoscopies to emergencies only. Such practices allowed us to avoid interruption of appropriate therapies for IBD patients. In fact, within the SECURE-IBD database, there have been only 4 Greek IBD patients, to date, who have been reported as positive for SARS-CoV-2. Conclusion: Timely application of preventive measures and strict compliance to guidelines limited the spread of COVID-19 in Greece and minimally impacted our IBD community, without interfering with therapeutic management. © 2020 Crohn's & Colitis Foundatio
Efficacy of switching from infliximab to golimumab in ulcerative colitis patients on deep remission
Efficacy of switching from infliximab to golimumab in patients with ulcerative colitis in deep remission
Background-Aim: Intravenously administered biologicals are associated
with a huge pressure to Infusion Units and increased cost. We aimed to
assess the impact of switching infliximab to golimumab in ulcerative
colitis (UC) patients in deep remission.
Patients and method: In a prospective, single-centre pilot study UC
patients on infliximab mono-therapy for >= 2 years, whowere in deep
remission, consented to switch to golimumab and were followed for 1 year
with clinical assessment, serum and faecal biomarkers, work
productivity, satisfaction with treatment and quality of life
parameters. Endoscopic remission was assessed by colonoscopy at 1 year.
Patients fulfilling the same inclusion criteria, who did not consent to
switch to golimumab and continued to receive infliximab mono-therapy,
for the same period, served as controls.
Results: Between October 2015 and October 2017, 20 patients were
recruited; however one patient stopped therapy because of pregnancy. All
19 patients who were switched to golimumab were still in clinical,
biomarker and endoscopic remission at 1 year and maintained excellent
quality of life without any complications. In the control group, 18 of
19 patients were also in deep remission, since only one patient had a
flare which was managed with IFX dose intensification. During a median 3
years extension treatment with golimumab only 2 patients experienced a
flare of colitis.
Conclusions: This pilot study indicates that switching from in-fliximab
to golimumab in UC patients in deep remission does not compromise
treatment effectiveness or the course of disease; golimumab offers a
valid alternative to intravenous infliximab infusions during the
COVID-19 pandemic
Cold snare polypectomy vs. hot snare polypectomy vs. argon plasma coagulation for small (5-9mm) left-sided colorectal polyps: a prospective randomized trial
OBJECTIVE: To compare recurrence rates among three endoscopic treatment modalities for 5-9 mm left-sided colorectal polyps. METHODS: Consecutive adults referred for elective colonoscopy (1/2015-1/2018) with at least one polyp of eligible size (5-9 mm) located distally to the splenic flexure were randomly assigned (1:1:1) to one of three treatment modalities: (1) cold snare polypectomy (CSP), (2) hot snare polypectomy (HSP) and (3) argon plasma coagulation (APC) ablation (50-60 W, flow: 2 l/min). The polyp site was marked with an endoscopic tattoo, and a follow-up colonoscopy with scar biopsies was performed >6 months after the index procedure. Outcomes were polyp recurrence rate and occurrence of complications. RESULTS: One hundred nineteen patients were enrolled, of whom 112 (62.5% males, mean age 61.1 ± 9.9 years) with 121 polyps (CSP, 39; HSP, 45; APC, 37) returned for follow-up colonoscopy. Mean polyp size was 6.7 ± 0.91 mm, 58% were located in the sigmoid, 33% in the rectum and 8% in the descending colon. The majority of polyps resected by CSP or HSP were neoplastic (tubular adenomas: 25.9%, tubulovillous adenomas: 11.1% and sessile serrate adenomas/polyps: 17.5%). No cases of delayed bleeding or perforation occurred. Scar biopsies at follow-up colonoscopy (performed after a mean interval of 13.4 ± 3.8 months) revealed 7 (5.8%) cases of polyp recurrence, showing no significant difference among the three treatment groups [CSP, 3/39 (7.7%); HSP, 1/45 (2.2%); APC, 2/37 (5.4%); P = 0.51). CONCLUSIONS: CSP, HSP and APC-ablation are effective and well-tolerated treatment modalities for 5-9 mm left-sided colorectal polyps. The present randomized study did not detect any difference in polyp recurrence rate among the three endoscopic techniques. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved