Cancer investigation
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Cancer investigation · Mar 2020
Meta Analysis Comparative StudySafety of Combination Immune Checkpoint Inhibitors Compared to Monotherapy; A Systematic Review and Meta-Analysis.
Combination immune checkpoint inhibitors (ICIs) achieved higher efficacy than monotherapy in many types of cancers. We searched PubMed, Scopus, and Cochrane databases for randomized phase II/III trials in cancer patients receiving combination ICIs vs. Monotherapy. ⋯ Eight studies were found to be eligible for meta-analysis recruiting 2544 patients. Combined immunotherapy nivolumab plus ipilimumab was associated with statistically significant higher risk of all grade adverse events (AE), and discontinuation due to all grade AEs as compared to both ipilimumab or nivolumab. Although combination ICIs showed better oncological activity, it carried a higher risk of all grade irAEs.
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Cancer investigation · Feb 2020
Meta AnalysisFatal Adverse Events Associated with Pembrolizumab in Cancer Patients: A Meta-Analysis.
Background: Pembrolizumab as an immune checkpoint inhibitor (ICI) has emerged as an effective treatment for many cancers. It has unique immune-related adverse events (irAE) and little is known about its risk of fatal adverse events (FAEs). We conducted a meta-analysis of clinical trials to determine the incidence and risk of FAEs with pembrolizumab. ⋯ There was no significant difference in the risk of FAEs when pembrolizumab was compared with chemotherapy with RR = 1.24 (95% CI: 0.8-1.89; p = .31). The most common FAEs were due to infectious complication (26.5%), cardiac toxicity (14.7%) and pneumonitis (13.2%). Conclusions: The risk of FAEs with pembrolizumab may be similar to chemotherapy in cancer patients and may vary with tumor types and its combination with chemotherapy.
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Cancer investigation · Jan 2019
Radiotherapy in the treatment of primary or recurrent unresectable desmoid tumors of the neck.
Purpose: Desmoid tumors are locally aggressive nonmalignant soft tissue tumors, which frequently recur after therapy. The optimal treatment is still controversial because of the lack of large research. A few studies have reported the effects of other treatments in one lesion when surgery is not possible or would cause notable functional impairment. ⋯ The most common acute side effects of the radiation-related complication were grade 1-2 skin toxicities. Conclusion: Radiotherapy is a valuable option in the management of primary or recurrent unresectable DTs of the neck with good local control. Multi-institutional and prospective studies are warranted to further validate our findings.
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To the best of our knowledge, only two studies analyzed the relationship between HRV and carcinoembryonic antigen (CEA) in colon cancer patients. The aim of this study was to analyze changes in the autonomic activity of colon cancer patients using heart rate variability (HRV) and blood pressure variability (BPV) measures, and to verify if HRV and BPV parameters correlate with hemodynamic indices in this group and the plasma levels of CEA. Presence of colon cancer is associated with changes in autonomic activity, namely parasympathetic-sympathetic imbalance in form of sympathetic overdrive. Cancer-related autonomic dysfunction may contribute to impairment of gastrointestinal motility.