Estudios con fitoderivados en patología experimental: tendencias y recomendaciones

The university is an entity that allows the generation of knowledge through research, which responds to regional and global needs help making decisions and establishment of policies (1). To do this, universities are organized by research centers, which have lines of research; research thus become sustainable and contextual.La universidad es un ente que permite la generación de conocimientos a través de la investigación, la cual responde a necesidades regionales y globales que ayudarán a la toma de decisiones e instauración de políticas (1). Para ello, las universidades se organizan mediante centros de investigación, los cuales tienen líneas de investigación definidas; de este modo las investigaciones se hacen sostenibles y contextuales

Perfil epidemiológico y molecular de pacientes con cáncer de pulmón en un centro oncológico referencial de Lima, Perú.

Background: According to GLOBOCAN estimates, in 2020, lung cancer was the second most frequent cancer and epidemiological information is needed in Latin American countries. The objective was to describe the epidemiological and molecular characteristics of lung cancer patients from a referral clinic in Lima, Peru. Material and methods: A retrospective cohort study was conducted to characterize the epidemiological and molecular profile of lung cancer patients attended at a referral cancer center in Peru during 2018 to 2021. Variables such as age, sex, histology, staging and mutation were reported. In the descriptive analysis, frequencies and percentages were shown for categorical variables. For numerical variables, the best measure of central tendency and dispersion was reported. Results: A total of 225 patients with a diagnosis of lung cancer were observed. EGFR gene mutation was the most frequently detected (45.3%); and within them exon 19 deletion (55.7%). The most frequent histological type was adenocarcinoma with 180 patients (85.7%). Of the total number of patients with EGFR mutation, 77.8% received treatment with a tyrosine kinase inhibitor (osimertinib, erlotinib, afatinib) and 15.9% received immunotherapy (pembrolizumab, atezolizumab, nivolumab). Conclusions: The predominant mutation was EGFR, the most frequent histologic type was adenocarcinoma and most patients received treatment with a tyrosine kinase inhibitor.Introducción: Según estimaciones del GLOBOCAN, en 2020, el cáncer de pulmón fue el segundo más frecuente y se necesita información epidemiológica en países latinoamericanos. El objetivo fue describir las características epidemiológicas y moleculares de pacientes con cáncer de pulmón de una clínica referencial de Lima, Perú. Material y métodos: Se realizó un estudio cohorte retrospectiva para caracterizar el perfil epidemiológico y molecular de los pacientes con cáncer pulmón atendidos en un centro oncológico referencial del Perú durante 2018 al 2021. Se reportaron variables como edad, sexo, histología, estadiaje y mutación. En el análisis descriptivo, se mostraron frecuencias y porcentajes para las variables categóricas. En el caso de las variables numéricas, se reportó la mejor medida de tendencia central y de dispersión. Resultados: Se observó un total de 225 pacientes con diagnóstico de cáncer de pulmón. La mutación del gen EGFR fue la más frecuentemente detectada (45.3%); y dentro de ellas la deleción del exón 19 (55.7%). El tipo histológico más frecuente fue de Adenocarcinoma con 180 pacientes (85.7%). Del total de paciente con mutación en el EGFR, el 77.8% recibió tratamiento con algún inhibidor de tirosin kinasa (osimertinib, erlotinib, afatinib) y un 15.9% recibieron inmunoterapia (pembrolizumab, atezolizumab, nivolumab). Conclusiones: La mutación predominante fue el EGFR, el tipo histológico más frecuente fue el adenocarcinoma y la mayoría de pacientes recibió tratamiento con un inhibidor de tirosin kinasa

Effectiveness and safety of the bevacizumab and erlotinib combination versus erlotinib alone in EGFR mutant metastatic non-small-cell lung cancer: systematic review and meta-analysis

BackgroundThe EGFR gene encodes a protein that stimulates molecular pathways that allow the growth and development of the tumor microenvironment. The current preferred tyrosine kinase inhibitor (TKI) for the first-line treatment of EGFRm metastatic non-small cell lung cancer (NSCLC) is osimertinib. However, the combination of angiogenesis inhibitors and TKI has produced discordant results. We aimed to assess the effects of the bevacizumab and erlotinib combination in EGFRm metastatic NSCLC.MethodsUsing eligibility criteria focused on patients with EGFRm metastatic NSCLC treated with bevacizumab and erlotinib, we searched databases including clinical trial randomized studies and reviews published until April 15, 2023 in Medline (PubMed), Scopus, and Embase. Eight clinical trials (1,052 patients) were selected from 1,343 articles for quantitative and qualitative assessment. The risk of bias was assessed using the Cochrane Risk of Bias tool. Data were synthesized through random-effects meta-analysis.ResultsThe bevacizumab and erlotinib combination significantly improved the progression-free survival (PFS) (log(HR) = 0.63; 95% CI: 0.54–0.73, p < 0.001) and overall response ratio (ORR) (RR = 0.79; 95% CI, 0.64–0.97, p = 0.03). However, it did not improve the overall survival (log(HR) = 0.93; 95% CI, 0.78–1.10, p = 0.38) and was associated with higher serious adverse events (SAEs) (OR = 3.48; 95% CI, 1.76–6.88, p = 0.005). A subgroup analysis suggested similar benefits in different mutation subtypes and brain metastasis condition. The evidence is limited by a moderate risk of bias across studies and heterogeneity in the reporting of SAEs.ConclusionsThe bevacizumab and erlotinib combination significantly improved PFS and ORR in EGFRm metastatic NSCLC but were also associated with higher-grade (≥3) adverse events. These results suggest that while the combination therapy may enhance progression-free survival and overall response, it does not improve the overall survival and is associated with higher toxicity. Thus, the treatment should be personalized based on individual patient comorbidities. Further prospective trials are needed to validate these results.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/#searchadvanced, identifier CDR 42022364692