Checkpointinhibitoren beim nichtkleinzelligen Lungenkarzinom

Zusammenfassung

Hintergrund

Die moderne Immuntherapie mit Checkpointinhibitoren hat unaufhaltsam Einzug in die Behandlung des nichtkleinzelligen Lungenkarzinoms (NSCLC) gehalten.

Fragestellung

Studien zu Checkpointinhibitoren beim fortgeschrittenen NSCLC wurden auf ihre Ergebnisse hinsichtlich Effektivität und Toxizität analysiert und bewertet.

Material und Methode

Phase-I-, Phase-II- und Phase-III-Studienergebnisse zu neuen Checkpointinhibitoren beim fortgeschrittenen NSCLC wurden aus der Literatur (Pubmed) und aus Beiträgen auf großen internationalen Kongressen (ASCO, ESMO, WCLC) zusammengestellt.

Ergebnisse

Für die beiden PD-1-Antikörper Nivolumab und Pembrolizumab existieren bereits große Phase-III-Studien beim fortgeschrittenen NSCLC in der Second- und First-Line-Therapie. Zulassungen sind für Nivolumab (ohne Markerbezug, Zweitlinie) und Pembrolizumab (bei PD-L1-Expression ≥ 1 % „tumor proportion score", ​TPS; Zweit- und Drittlinie) beim fortgeschrittenen NSCLC und für Pembrolizumab in der Erstlinie bei Hochexpression des Immunmarkers PD-L1 (≥50 % TPS) von der EMA (European Medicines Agency) ausgesprochen worden. Erste Ergebnisse von Phase-III-Studien mit PD-L1-Antikörpern sind für das Atezolizumab bereits berichtet worden (OAK-Studie) oder werden für das Durvalumab aktuell noch erwartet (MYSTIC-Studie). Für Kombinationen mit konventioneller Chemotherapie und Kombinationen mit anderen Checkpointinhibitoren wie CTLA4-Antikörpern fehlen noch die abschließenden Ergebnisse von großen Phase-II- bzw. Phase-III-Studien.

Schlussfolgerungen

Die moderne Immuntherapie mit einem PD-1-Antikörper hat sich als integrale Behandlungsoption beim fortgeschrittenen NSCLC klar etabliert. In Zukunft wird die Suche nach besseren prädiktiven Faktoren und Markern für einen eher selektiven Einsatz dieser hochwirksamen, aber spezifischen Medikamente essenziell werden.

http://ift.tt/2xAKCDm

Efficacy and safety of ixekizumab for the treatment of moderate-to-severe plaque psoriasis: Results through 108 weeks of a randomized, controlled phase 3 clinical trial (UNCOVER-3)

Ixekizumab, a high-affinity monoclonal antibody that selectively targets interleukin 17A, is efficacious in treating moderate-to-severe plaque psoriasis through 60 weeks.

http://ift.tt/2x1wSyy

A new evidence-based risk stratification system for cutaneous squamous cell carcinoma into low, intermediate, and high risk groups with implications for management

Most primary cutaneous squamous cell carcinomas are cured with surgery. A subset, however, may develop local and nodal metastasis that may eventuate in disease-specific; death. This subset has been variably termed high risk. Herein, we review; an emerging body of data on the risks of these outcomes and propose an evidence-based; risk stratification for low-, intermediate-, and high-risk tumors that takes into; account both tumor and patient characteristics. Finally, we discuss a framework for; management of these tumors on the basis of data, when available, and our; recommendations when data are sparse.

http://ift.tt/2f7qgdw

Serious infections among a large cohort of subjects with systemically treated psoriasis

Biologic therapy is effective for treatment of moderate-to-severe psoriasis but may be associated with an increased risk for serious infection.

http://ift.tt/2x1wT5A

Uncovering burden disparity: A comparative analysis of the impact of moderate-to-severe psoriasis and hidradenitis suppurativa

Psoriasis and hidradenitis suppurativa (HS) exhibit distinct clinical features, but no studies have directly compared the health-related quality of life (HRQoL) in patients with moderate-to-severe manifestations of these conditions.

http://ift.tt/2wawnFd

Early mobilization programme improves functional capacity after major abdominal cancer surgery: a randomized controlled trial

Abstract

Background: Major abdominal oncology surgery is associated with substantial postoperative loss of functional capacity, and exercise may be an effective intervention to improve outcomes. The aim of this study was to assess efficacy, feasibility and safety of a supervised postoperative exercise programme.Methods: We performed a single-blind, parallel-arm, randomized trial in patients who underwent major abdominal oncology surgery in a tertiary university hospital. Patients were randomized to an early mobilization postoperative programme based on supervised aerobic exercise, resistance and flexibility training or to standard rehabilitation care. The primary outcome was inability to walk without human assistance at postoperative day 5 or hospital discharge.Results: A total of 108 patients were enrolled, 54 into the early mobilization programme group and 54 into the standard rehabilitation care group. The incidence of the primary outcome was nine (16.7%) and 21 (38.9%), respectively (P=0.01), with an absolute risk reduction of 22.2% [95% confidence interval (CI) 5.9–38.6] and a number needed to treat of 5 (95% CI 3–17). All patients in the intervention group were able to follow at least partially the exercise programme, although the performance among them was rather heterogeneous. There were no differences between groups regarding clinical outcomes or complications related to the exercises.Conclusions: An early postoperative mobilization programme based on supervised exercises seems to be safe and feasible and improves functional capacity in patients undergoing major elective abdominal oncology surgery. However, its impact on clinical outcomes is still unclear.Clinical trial registration: NCT01693172.

http://ift.tt/2x2VMj2

Racial and Insurer-Based Disparities of Care Exist Among Thyroid Cancer Patients in the United States

Clinical Thyroidology Sep 2017, Vol. 29, No. 9: 351-353.


http://ift.tt/2x2mLuY