Recent therapeutic advances in urothelial carcinoma : A paradigm shift in disease management

Altres ajuts: Pfizer.Management of first-line advanced urothelial carcinoma (UC) has consisted during the past three decades in the administration of platinum-based chemotherapy followed by observation. Despite moderate to high response rates to first-line treatment, most patients will relapse shortly after and the outcomes with subsequent therapies are poor with 5-year overall survival rates of 5% in the pre-immunotherapy era. Nonetheless, recent therapeutic developments including the paradigm shift of first-line maintenance therapy with avelumab after response or stabilization on platinum-based chemotherapy, along with the incorporation of new drug classes in further lines of treatment such as antibody drug-conjugates and fibroblast growth factor receptor inhibitors have reshaped the field leading to better outcomes in this patient population. This article reviews the current state of the art with an overview on UC management, recent advances, and the upcoming strategies currently in development in advanced UC with an insight into the biology of this disease

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Adjuvant Nivolumab versus Placebo in Muscle-Invasive Urothelial Carcinoma

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Spontaneous rupture of chemotherapy catheter diagnosed using chest X-ray oblique projections: An interventional radiology approach

5 páginasTotally implanted central venous port systems are widely used to access central veins for patients needing long-term therapy. These devices have low rates of complications and are commonly used to administer medications like chemotherapeutic agents. Spontaneous rupture of a catheter segment is a rare mechanical complication, usually belatedly diagnosed and presenting with complications. We present a case of a spontaneously ruptured chemotherapy catheter diagnosed using a novel approach via oblique projections on chest X-rays and successfully removed using an endovascular approach. © 202

Recent therapeutic advances in urothelial carcinoma: A paradigm shift in disease management

Management of first-line advanced urothelial carcinoma (UC) has consisted during the past three decades in the administration of platinum-based chemotherapy followed by observation. Despite moderate to high response rates to first-line treatment, most patients will relapse shortly after and the outcomes with subsequent therapies are poor with 5-year overall survival rates of 5% in the pre-immunotherapy era. Nonetheless, recent therapeutic developments including the paradigm shift of first-line maintenance therapy with avelumab after response or stabilization on platinum-based chemotherapy, along with the incorporation of new drug classes in further lines of treatment such as antibody drug-conjugates and fibroblast growth factor receptor inhibitors have reshaped the field leading to better outcomes in this patient population. This article reviews the current state of the art with an overview on UC management, recent advances, and the upcoming strategies currently in development in advanced UC with an insight into the biology of this disease

Bladder cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up

Disclosure TP has received research funding from Merck Serono, Merck, Sharp & Dohme (MSD), Roche, Bristol Myers Squibb (BMS), AstraZeneca, Astellas, Novartis, Johnson and Johnson, Seattle Genetics, Pfizer, Exelixis and Eisai and honoraria from Merck Serono, MSD, Roche, BMS, AstraZeneca, Astellas, Novartis, Johnson and Johnson, Seattle Genetics, Pfizer, Exelixis and Eisai; JB has received honoraria for participation in advisory boards from Pfizer, AstraZeneca, Merck and BMS, invited speaker fees from Merck, Genentech and MSD, royalties from UpToDate, institutional research funding as principal investigator (PI) for MSD and Pfizer, research funding from Takeda and non-remunerated activities as steering committee member of the IMvigor 011 study; EC has received honoraria from Jansen for invited speaker and non-remunerated activities in an advisory role for the EAU guidelines; MDS has received honoraria for participation in advisory boards and as an invited speaker for 4D, AAA, Amgen, Astellas, AstraZeneca, Basilea, Bayer, Bioclin, BMS, EISAI, Ferring, Immunomedics, Ipsen, Janssen, MSD, Merck Serono, Novartis, Pfizer, Pierre Fabre Oncology, Roche, Sandoz, Sanofi, SeaGen and Amgen and institutional research as PI and steering committee member for Basilea, AstraZeneca, MSD, Merck, EISAI, Astellas, SeaGen, Exelixis, Ipsen, Roche, Immunomedics, Janssen and Calithera; RH has received honoraria for participation in advisory boards for Roche, Nektar, BMS, MSD and Astellas, expert testimony for National Institute of Clinical Excellence and partnership in the Cancer Centre London, institutional royalties received from Janssen, research grants from MSD and Roche, local PI for Roche, MSD, Basilea and Cancer Research UK; patient funding from Astellas and steering committee member with Cancer Research UK; YL has received honoraria for lectures, presentations, speaker’s bureau, manuscript writing or educational events from BMS, Pfizer, Merck KGaA, MSD, AstraZeneca, Roche, Jansen, Astellas, Seattle Genetics and Immunomedics and support for attending meetings and/or travel grants from BMS, Roche, AstraZeneca, MSD and Pfizer; AN has received institutional research grants from Merck, AstraZeneca, Ipsen and BMS and has undertaken personal research as a steering committee member for Roche, Janssen, Bayer, Astellas, AstraZeneca, Merck and Clovis Oncology; BPV has received honoraria for advisory boards for Pfizer, Astellas Pharma, BMS, Ipsen, EUSA Pharma, Sanofi-Aventis and Merck and has been an invited speaker for Janssen, Pfizer, BMS, Roche, Bayer, EUSA Pharma, MSD and Merck; AR has received honoraria for advisory boards for Pfizer, Merck GA, BMS, Ipsen, MSD and AstraZeneca and has been an invited speaker for Pfizer, Merck GA, BMS, Ipsen and MSD and has received institutional grants from Pfizer, Merck GA and Ipsen; SFS has received honoraria for participation in advisory boards for Astellas, Janssen, MSD, AstraZeneca, Bayer, BMS, Cepheid, Ferring Pharmaceuticals, Ipsen, Lilly, Olympus, Pfizer, Pierre Fabre, Richard Wolf, Roche, Sanochemia, Sanofi, Takeda and UroGen; BS has received honoraria from Ellipses, Ipsen, Merck, Pfizer and Roche and has received travel and research funding from BMS, Genentech, MSD, Pfizer and Roche; MSvdH has received honoraria (paid to institute) for participation in advisory boards for BMS, Roche, Seagen, AstraZeneca, Janssen, Pfizer and MSD, stock ownership with Gilead; and institutional research funding from BMS, Roche, AstraZeneca and 4SC; SG has received personal honoraria for participation in advisory boards for Sanofi, Orion, Roche, Amgen, MSD and Aranda; other honoraria from RSI Televisione Svizzera Italiana); has been an invited speaker for ESMO, SAKK, SAMO, Orikata and CACA-GU, speaker’s bureau for Janssen Cilag; travel grant from ProteoMEdiX, institutional honoraria for advisory boards for Bayer, Janssen Cilag, Roche and AAA International including Independent Data Monitoring Committee; steering committee for Amgen, Menarini Silicon Biosystems, Astellas Pharma, Tolero Pharmaceuticals, MSD, Pfizer, Telixpharma, BMS and Orion and has received a patent, royalties and other intellectual property from Method for Biomarker WO2009138392

Consenso colombiano de atención, diagnóstico y manejo de la infección por SARS-COV-2/COVID-19 en establecimientos de atención de la salud Recomendaciones basadas en consenso de expertos e informadas en la evidencia

The “Asociación Colombiana de Infectología” (ACIN) and the “Instituto de Evaluación de Nuevas Tecnologías de la Salud” (IETS) created a task force to develop recommendations for Covid 19 health care diagnosis, management and treatment informed, and based, on evidence. Theses reccomendations are addressed to the health personnel on the Colombian context of health services. © 2020 Asociacion Colombiana de Infectologia. All rights reserved

Body mass index and complications following major gastrointestinal surgery: A prospective, international cohort study and meta-analysis

Aim Previous studies reported conflicting evidence on the effects of obesity on outcomes after gastrointestinal surgery. The aims of this study were to explore the relationship of obesity with major postoperative complications in an international cohort and to present a metaanalysis of all available prospective data. Methods This prospective, multicentre study included adults undergoing both elective and emergency gastrointestinal resection, reversal of stoma or formation of stoma. The primary end-point was 30-day major complications (Clavien–Dindo Grades III–V). A systematic search was undertaken for studies assessing the relationship between obesity and major complications after gastrointestinal surgery. Individual patient meta-analysis was used to analyse pooled results. Results This study included 2519 patients across 127 centres, of whom 560 (22.2%) were obese. Unadjusted major complication rates were lower in obese vs normal weight patients (13.0% vs 16.2%, respectively), but this did not reach statistical significance (P = 0.863) on multivariate analysis for patients having surgery for either malignant or benign conditions. Individual patient meta-analysis demonstrated that obese patients undergoing surgery formalignancy were at increased risk of major complications (OR 2.10, 95% CI 1.49–2.96, P < 0.001), whereas obese patients undergoing surgery for benign indications were at decreased risk (OR 0.59, 95% CI 0.46–0.75, P < 0.001) compared to normal weight patients. Conclusions In our international data, obesity was not found to be associated with major complications following gastrointestinal surgery. Meta-analysis of available prospective data made a novel finding of obesity being associated with different outcomes depending on whether patients were undergoing surgery for benign or malignant disease