Response to treatment

对治疗的反应
  • 文章类型: Journal Article
    为了开发准确和可访问的预测方法,以评估手术前NICT后的病理反应,我们进行了一项回顾性研究,纳入了我们中心的137例食管鳞状细胞癌(ESCC)患者,这些患者在2019年1月至2022年3月期间接受了两个周期的NICT手术.我们收集临床参数以评估原发肿瘤的动态变化。进行单变量和多变量分析以确定这些参数与原发性肿瘤的病理反应之间的相关性。随后,我们使用多元逻辑回归构建了pCR和MPR的预测模型。MPR预测模型2使用自举进行内部验证,并使用我们中心的独立队列进行外部验证。单变量逻辑分析显示,在具有不同病理反应的患者中,反映肿瘤消退的临床参数存在显着差异。基于这些评估的临床模型显示出出色的预测性能,训练队列的pCRC指数为0.879,MPRC指数为0.912,而测试队列的MPRC指数也达到了0.912。值得注意的是,阈值截止为0.74的MPR预测模型2表现出92.7%的特异性和大于70%的灵敏度,表明低估残留肿瘤的比率较低。总之,我们的研究证明了基于临床评估的模型在病理反应预测中的高准确性,在诱导免疫化疗后帮助做出有关器官保存和放疗调整的决策。
    To develop accurate and accessible prediction methods for assessing pathologic response following NICT prior to surgery, we conducted a retrospective study including 137 patients with esophageal squamous cell carcinoma (ESCC) who underwent surgery after two cycles of NICT between January 2019 and March 2022 at our center. We collected clinical parameters to evaluate the dynamic changes in the primary tumor. Univariate and multivariate analyses were performed to determine the correlations between these parameters and the pathologic response of the primary tumor. Subsequently, we constructed prediction models for pCR and MPR using multivariate logistic regression. The MPR prediction Model 2 was internally validated using bootstrapping and externally validated using an independent cohort from our center. The univariate logistic analysis revealed significant differences in clinical parameters reflecting tumor regression among patients with varying pathologic responses. The clinical models based on these assessments demonstrated excellent predictive performance, with the training cohort achieving a C-index of 0.879 for pCR and 0.912 for MPR, while the testing cohort also achieved a C-index of 0.912 for MPR. Notably, the MPR prediction Model 2, with a threshold cut-off of 0.74, exhibited 92.7% specificity and greater than 70% sensitivity, indicating a low rate of underestimating residual tumors. In conclusion, our study demonstrated the high accuracy of clinical assessment-based models in pathologic response prediction, aiding in decision-making regarding organ preservation and radiotherapy adjustments after induction immunochemotherapy.
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  • 文章类型: Journal Article
    最近的研究表明,MRI在评估骨肉瘤的化疗疗效方面取得了有希望的结果。本文就目前评价恶性骨肿瘤疗效的方法及MRI在该领域的应用作一综述。并强调每种模式的优点和局限性。证据水平:5技术效率:第2阶段。
    Recent studies have shown that MRI demonstrates promising results for evaluating the chemotherapy efficacy in bone sarcomas. This article reviews current methods for evaluating the efficacy of malignant bone tumors and the application of MRI in this area, and emphasizes the advantages and limitations of each modality. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 2.
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  • 文章类型: Journal Article
    Objective: Pembrolizumab and bevacizumab both have antitumor activity. According to NCCN updated guideline the benefit of pembrolizumab or bevacizumab as a first line in management of advanced nonsmall cell lung cancer (NSCLC) is documented in randomized controlled studies. The study aimed to evaluate the response and complications of patients with advanced NSCLC treated with pembrolizumab or bevacizumab plus chemotherapy. Methods: This study was a retrospective cohort study of patients with advanced nonsquamous NSCLC who received cisplatin with pemetrexed combined with pembrolizumab (A group) or bevacizumab (B group) from 07/02/2018 to 07/03/2021 at Peking University Cancer Hospital. Progression-free survival (PFS) was the primary outcome. The secondary outcomes included overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DoR), and adverse events (AEs). Results: This study included 66 patients, 34 in A group and 32 in B group. There were no differences in median PFS (7.6 vs 9.9 months, P = .601). There were no differences in median OS (23.1 vs 24.2 months, P = .782). There were no differences in ORR (57.6% vs 41.9%, P = .211) and DCR (93.9% vs 100.0%, P = .164) between 2 groups. The occurrence of AEs was similar. No new safety signals were observed. Grade 3 to 4 treatment-related AEs occurred in 17 (50.0%) patients of A group and in 12 (37.5%) of B group (P > .05). Conclusion: The addition of pembrolizumab or bevacizumab to pemetrexed plus cisplatin was well tolerated and resulted in a clinically meaningful treatment benefit in advanced nonsquamous NSCLC. When pembrolizumab is not suitable, bevacizumab plus chemotherapy may be an option.
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  • 文章类型: Journal Article
    Both specific and innate immune responses play important roles in autoimmune encephalitis (AE). We aimed to explore the predictive value of the systemic inflammation index (SII) at admission as a peripheral biomarker of treatment response of AE. A total of 146 patients diagnosed with AE in the First Affiliated Hospital of Zhengzhou University from January 1, 2018 to September 22, 2020 were retrospectively and consecutively analyzed as per the inclusion criteria and divided into two groups according to their response to immunotherapy after 30 days. The predictive value of the SII as a peripheral biomarker for AE treatment response was calculated using the receiver operating characteristic curve analysis, which showed that the best SII cut-off value for predicting poor response to AE treatment was 863.3; the area under the curve was 0.75, with 83.0% sensitivity and 72.0% specificity. The risk factors for poor response to AE treatment were analyzed; univariable analysis showed that the rate of decreased level of consciousness, rate of cognitive or mental behavior abnormality, cerebrospinal fluid pressure, blood neutrophils, platelets, time until treatment initiation, neutrophil to lymphocyte ratio, platelet to lymphocyte ratio, and SII were significantly higher in patients with poor response to AE immunotherapy after 30 days than in patients with good response. Meanwhile, the blood lymphocyte counts and Glasgow Coma Scale (GCS) scores in patients with poor response were significantly lower than those in patients with good response (all p < 0.05), and multivariable binary logistic regression with backward stepwise method showed that decreased levels of consciousness, time until treatment initiation and SII were associated with poor response to immunotherapy. Moreover, the SII ≤ 863.3 group had lower rates of decreased consciousness levels, admission to the intensive care unit, and mechanical ventilation; lower cerebrospinal fluid pressure, blood neutrophil count, and platelet count; and higher blood lymphocyte count and GCS scores. The SII was associated with worsened disease severity and poor response to treatment after 30 days of the initially diagnosed AE, and patients with an SII > 863.3 were more likely to have poor response to immunotherapy.
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  • 文章类型: Journal Article
    Background: The aim of this study is to evaluate the clinical efficacy of vitamin D (VitD) supplementation in terms of response to treatment and improvement of disease activity in rheumatoid arthritis (RA). Methods: This study analyzed 1180 RA patients\' records treated at Mianyang Central Hospital from February 2015 to July 2019. The patients were allocated into VitD group and control group based on their medical regimens. The outcome measures were primary efficacy, defined as treatment response-based EULAR response criteria in RA, and secondary efficacy, defined as improvement in disease activity indicators. Safety was evaluated according to the incidence of all-cause infections. Results: At month 6, the primary efficacy revealed that there were 22.8% good responders and 19.0% moderate responders in the VitD group, and 22.3% good responders and 22.3% moderate responders in the control group; there were no differences between the two groups (p = 0.754). The similar primary efficacy outcomes were observed at months 3, 12, and >12. The secondary efficacy indicated that there were no differences in most indexes between the two groups at months 1, 3, 6, 12, and >12. The subgroups (based on baseline DAS28 (CRP), glucocorticoids use and disease duration) analysis results suggested that VitD group didn\'t have the advantage for treating RA. The incidence of infections was similar in the two groups. Conclusion: VitD supplementation did not provide additional benefit for anti-rheumatic treatment. These data supported the need for prospective, randomized, controlled trials to evaluate the role of VitD supplementation in treating RA.
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  • 文章类型: Journal Article
    背景:MicroRNA-146b(miR-146b)是几种血液系统恶性肿瘤的关键调节因子和预后生物标志物,而其在多发性骨髓瘤(MM)中的作用尚不清楚。因此,本研究旨在探讨miR-146b在MM患者中的意义。
    方法:从180例有症状的MM患者(治疗前)和50例健康对照(HC)的骨髓样本中分离浆细胞,随后通过逆转录-定量聚合酶链反应检测miR-146b的表达。
    结果:与HCs相比,MM患者的MiR-146b升高(P<.001),并预测MM风险增加(曲线下面积(AUC):0.879,95%置信区间(CI):0.822-0.936)。对于临床参数,miR-146b与血清肌酐呈正相关(P=0.047)。β-2-微球蛋白(P<.001),乳酸脱氢酶(P<.001),骨损伤(P=.027),国际分期系统(ISS)阶段(P<.001),和t(4;14;P=.006),MM患者与白蛋白呈负相关(P=.004)。为了预后,与非CR患者相比,完全反应(CR)患者的miR-146b降低(P=0.025),以及总反应率(ORR)患者与非ORR患者相比(P=0.036),在MM患者中,将CR患者与非CR患者区分开(AUC:0.610,95%CI:0.523-0.698),将ORR患者与非ORR患者区分开(AUC:0.602,95%CI:0.501-0.703)。此外,miR-146b与MM患者无进展生存期(P=.007)和总生存期(P=.014)相关。
    结论:MiR-146b在MM患者中过度表达,预测MM风险增加;它与恶化的临床特性有关,增加国际空间站的舞台,cacethic染色体异常,MM患者预后较差。
    BACKGROUND: MicroRNA-146b (miR-146b) is a critical regulator and prognosis biomarker in several hematological malignancies, whereas its role in multiple myeloma (MM) was unclear. Therefore, this study aimed to investigate the significance of miR-146b in MM patients.
    METHODS: The plasma cells were separated from bone marrow samples of 180 symptomatic MM patients (before treatment) and 50 healthy controls (HCs), and subsequently detected by reverse transcription-quantitative polymerase chain reaction for miR-146b expression.
    RESULTS: MiR-146b was increased in MM patients compared with HCs (P < .001), and it predicted increased MM risk (area under curve (AUC): 0.879, 95% confidence interval (CI): 0.822-0.936). For clinical parameters, miR-146b was positively correlated with serum creatinine (P = .047), beta-2-microglobulin (P < .001), lactate dehydrogenase (P < .001), bone lesion (P = .027), International Staging System (ISS) stage (P < .001), and t (4; 14; P = .006), while negatively correlated with albumin (P = .004) in MM patients. For prognosis, miR-146b was decreased in complete response (CR) patients compared with non-CR patients (P = .025), as well as in overall response rate (ORR) patients compared with non-ORR patients (P = .036), and it discriminated CR patients from non-CR patients (AUC: 0.610, 95% CI: 0.523-0.698) and distinguished ORR patients from non-ORR patients (AUC: 0.602, 95% CI: 0.501-0.703) in MM patients. Moreover, miR-146b was correlated with worse progression-free survival (P = .007) and overall survival (P = .014) in MM patients.
    CONCLUSIONS: MiR-146b was overexpressed in MM patients and predicted increased MM risk; meanwhile, it correlated with deteriorated clinical properties, increased ISS stage, cacoethic chromosome abnormality, and worse prognosis in MM patients.
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  • 文章类型: Journal Article
    OBJECTIVE: To investigate the correlation between DKK1 polymorphisms with bone phenotypes and response to alendronate treatment.
    METHODS: Five tag single nucleotide polymorphisms of DKK1 were analyzed in 639 Chinese postmenopausal women with osteoporosis or osteopenia. Bone mineral density (BMD), β-CTX and ALP were measured before and after alendronate treatment.
    RESULTS: Genotypes at rs1896367, rs1528877 and rs2241529 correlated to baseline BMD (p < 0.05). rs1528877 and rs2241529 polymorphisms correlated to baseline β-CTX levels (p < 0.05). rs2241529 polymorphisms of DKK1 had a small influence on the skeletal response to alendronate treatment (p < 0.05).
    CONCLUSIONS: DKK1 polymorphisms may correlate to baseline BMD and serum β-CTX levels, but present a weak effect on the response to alendronate.
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  • 文章类型: Journal Article
    OBJECTIVE: To investigate the association between LRP5 gene polymorphisms and response to alendronate in Chinese osteoporotic women.
    METHODS: Six hundred and thirty nine Chinese postmenopausal women with osteopenia or osteoporosis were included and received alendronate treatment. The A1330V polymorphism of LRP5 was investigated. Bone mineral density (BMD) and bone turnover markers (ALP and β-isomerized carboxy-telopeptide of type I collagen [β-CTX]) were measured before and after treatment. The correlation of LRP5 polymorphisms with changes in BMD and bone turnover biomarkers were analyzed after treatment.
    RESULTS: After 12 months of treatment, participants with CC and CT genotypes had a larger increase in lumbar spine BMD and a larger decrease in serum β-CTX and ALP levels than those with TT genotype (all p < 0.001). No significant genotype-treatment interaction was found in hip BMD.
    CONCLUSIONS: The A1330V polymorphism of LRP5 is possibly correlated with response to alendronate treatment in Chinese women with osteoporosis, and the TT genotype could possibly predict a weak response to alendronate.
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