Pseudoprogression and hyperprogression secondary to immunotherapy in lung cancer

BACKGROUND: The treatment of non-small cell lung cancer (NSCLC) has undergone changes that have improved the prognosis of patients. With the advent of immunotherapy, it has been possible to prolong significantly the overall and progression-free survival as well as quality of life. Nevertheless, its use represents clinical challenges which may turn into adverse events, such as progression and pseudo-progression, which are uncontrolled and often deleterious immune responses that simulate tumoral progression, generate worsening of symptoms and performance status of patients and even may lead to non-cancer related death of patients. MATERIALS AND METHODS: We assessed 128 records (clinical trials, reports, meta-analyses) in order to provide an updated review of the treatment of NSCLC, current definitions proposed for pseudo and hyperprogression (which are not homogeneous so far), incidence, theories about their physiopathogenesis, importance of making a judicious diagnostic workup, imaging criteria as well as biochemical markers in order to predict their appearance, concluding with a brief discussion about the topic addressed. CONCLUSIONS: Since there is no definition or standardized diagnostic and imaging criteria, these entities are a topic of major interest in the area of oncologic immunotherapy, for which the following review has been generated

Study protocol for the multicentre cohorts of Zika virus infection in pregnant women, infants, and acute clinical cases in Latin America and the Caribbean: The ZIKAlliance consortium

Background: The European Commission (EC) Horizon 2020 (H2020)-funded ZIKAlliance Consortium designed a multicentre study including pregnant women (PW), children (CH) and natural history (NH) cohorts. Clinical sites were selected over a wide geographic range within Latin America and the Caribbean, taking into account the dynamic course of the ZIKV epidemic. Methods: Recruitment to the PW cohort will take place in antenatal care clinics. PW will be enrolled regardless of symptoms and followed over the course of pregnancy, approximately every 4 weeks. PW will be revisited at delivery (or after miscarriage/abortion) to assess birth outcomes, including microcephaly and other congenital abnormalities according to the evolving definition of congenital Zika syndrome (CZS). After birth, children will be followed for 2 years in the CH cohort. Follow-up visits are scheduled at ages 1-3, 4-6, 12, and 24 months to assess neurocognitive and developmental milestones. In addition, a NH cohort for the characterization of symptomatic rash/fever illness was designed, including follow-up to capture persisting health problems. Blood, urine, and other biological materials will be collected, and tested for ZIKV and other relevant arboviral diseases (dengue, chikungunya, yellow fever) using RT-PCR or serological methods. A virtual, decentralized biobank will be created. Reciprocal clinical monitoring has been established between partner sites. Substudies of ZIKV seroprevalence, transmissio