Blur-specific image quality assessment of microscopic hyperspectral images

Hyperspectral (HS) imaging (HSI) expands the number of channels captured within the electromagnetic spectrum with respect to regular imaging. Thus, microscopic HSI can improve cancer diagnosis by automatic classification of cells. However, homogeneous focus is difficult to achieve in such images, being the aim of this work to automatically quantify their focus for further image correction. A HS image database for focus assessment was captured. Subjective scores of image focus were obtained from 24 subjects and then correlated to state-of-the-art methods. Maximum Local Variation, Fast Image Sharpness block-based Method and Local Phase Coherence algorithms provided the best correlation results. With respect to execution time, LPC was the fastestBlur-specific image quality assessment of microscopic hyperspectral imagespublishedVersio

EPI.14-15 Real World Clinical Experience of the Galician Lung Cancer Group: Afatinib in Patients with EGFR Positive Mutation

Background Treatment with tyrosine kinasa inhibitors has been a revolution for the patients with non-small cell lung cancer and EGFR positive mutation, especially in patients with exon 19 deletions. Afatinib seems one of the best options of treatment. Method Retrospective study on patients from different hospitals in Galicia (Spain) diagnosed of metastasic lung adenocarcinoma with EGFR positive mutation who have received first line treatment with afatinib between July 2015 and September 2018 were included. Main objective was to compare our clinical experience concerning response rate, progression free survival and toxicity with published data. Result 45 Caucasians patients were included in our analysis (33 women, 12 men). Median age was 71.2 years (range 39-91 years) and 29 patients had never smoked. Exon 19 deletion was the most common mutation (41 patients, 91.1%). The objective overall response was 68.9% (95% CI: 82.4-55.3), complete responses were observed in 6 patients (13.3%) and partial responses were found in 25 patients (55.6%). Stable disease was observed in 8 patients (17.8%) and disease progression in 1 patient (2.2%), 5 patients have not been reevaluated (11.1%). Median progression free survival (PFS) was 27 months (95% CI: 14.8-39.1) and overall survival was not reached. Common adverse events grade 3/4 were mucositis and skin toxicity in 11 patients (24.4%) and diarrhea in 6 patients (13.3%), respectively. The dose was reduced in 28 patients (62.2%) and treatment was discontinued in 8 patients (17.8%) owing to adverse events. Conclusion Median PFS in our patients is 15 months longer than the information retrieved from differents studies with similar response rates and toxicity. This might be due to a majority of population with exon 19 deletion which, according to published data, seems to benefit more from afatinib than from other EGFR mutations

PD-(L)1 Inhibitors in Combination with Chemotherapy as First-Line Treatment for Non-Small-Cell Lung Cancer: A Pairwise Meta-Analysis

The combination of programmed cell death-1 (PD-1)/programmed death ligand-1 (PD-L1) inhibitors with chemotherapy has emerged as a promising therapeutic option for advanced non-small-cell lung cancer (NSCLC). The aim of this meta-analysis was to evaluate the efficacy of the combined strategy in this setting. For this purpose, we performed a literature search of randomized controlled trials comparing PD-(L)1 inhibitors plus platinum-based chemotherapy versus chemotherapy alone in stage IV NSCLC patients. Seven clinical trials with 4562 patients were included. In the intention-to-treat wildtype population, PD-(L)1 inhibitor plus chemotherapy was significantly associated with improved progression-free survival (PFS) (Hazard ratio (HR) = 0.61, 95% confidence interval (CI): 0.57–0.65, p < 0.001) and overall survival (OS) (HR = 0.76, 95% CI: 0.67–0.86; p < 0.001) compared to chemotherapy. A significantly higher overall response rate (ORR) was also observed with the combined strategy (Odds ratio (OR) = 2.12, 95% CI: 1.70–2.63, p < 0.001). Furthermore, in all the analyzed subgroups, addition of PD-(L)1 inhibitors to chemotherapy significantly improved efficacy endpoints. Specifically, stratification according to PD-L1 expression revealed a benefit across all patients, regardless of their PFS status. In conclusion, PD-(L)1 blockade added to standard platinum-based chemotherapy significantly improved PFS, OS, and ORR in the up-front treatment of advanced NSCLC

Experiencia cubana con el uso terapéutico de células madre adultas Cuban experience with the therapeutic use of adult stem cells

Las investigaciones básicas y clínicas realizadas en los últimos años sobre las células madre y sus posibilidades terapéuticas, son en la actualidad uno de los temas más excitantes de la medicina contemporánea. Ya se han obtenido importantes avances en el estudio y aplicación de las células madre adultas que muestran notables ventajas sobre las embrionarias, pues su manipulación resulta más simple, económica y se pueden obtener del propio individuo que va a ser tratado. Para la introducción en Cuba de la terapia celular regenerativa, en el Instituto de Hematología e Inmunología se seleccionaron como fuentes celulares las células madre adultas derivadas de la médula ósea y las movilizadas a la sangre periférica. Para facilitar la extensión del tratamiento a otros centros hospitalarios, se estandarizó una técnica para la movilización de las células madre hematopoyéticas a la sangre periférica, mediante un factor estimulador de colonias de granulocitos (Filgrastim, de producción nacional) y se desarrolló un método simple, económico y también más tolerable para los enfermos. De esta forma, se ha extendido la terapia celular a 6 provincias cubanas y hasta abril del año 2009 se habían tratado 563 casos con trasplante de células madre adultas autólogas, de los cuales el 81,7 % corresponde a pacientes con enfermedades angiológicas, en los que se ha logrado disminuir significativamente la indicación de amputaciones mayores. También los resultados han sido muy prometedores en las lesiones óseas y procesos periodontales, entre otras enfermedades tratadas. Los resultados obtenidos hasta el momento se pueden considerar como un nuevo logro de la ciencia revolucionaria y de nuestros sistemas nacionales de salud y de ciencia y técnica. El método empleado es un proceder económico y factible para instituciones con recursos limitados