Vincristine

长春新碱
  • 文章类型: Journal Article
    软骨肉瘤(CS)是一种罕见的恶性骨肉瘤,主要影响股骨和骨盆的软骨细胞。虽然大多数亚型表现出缓慢的生长,预后非常好,一些侵袭性亚型的总体生存率较差.CS以其对化疗和放疗的抗性而闻名,离开手术作为唯一有效的治疗选择。冷物理血浆(CPP)已在体外作为一种潜在的治疗方法进行了探索,证明对CS细胞有积极的抗肿瘤作用。这项研究调查了CPP与细胞抑制剂组合对CS细胞的协同作用。化疗药物顺铂,阿霉素,将长春新碱应用于两种CS细胞系(CAL-78和SW1353)。在确定其IC20和IC50后,将其与CPP在两种细胞系中组合以评估其对细胞增殖的影响,生存能力,新陈代谢,和凋亡。与单独的细胞抑制疗法相比,这种组合方法显着降低了细胞增殖和活力,同时增加了凋亡信号。CPP和化疗药物的组合在靶向化学抗性CS细胞方面显示出希望,有可能改善临床患者的预后。
    Chondrosarcoma (CS) is a rare malignant bone sarcoma that primarily affects cartilage cells in the femur and pelvis. While most subtypes exhibit slow growth with a very good prognosis, some aggressive subtypes have a poorer overall survival. CS is known for its resistance to chemotherapy and radiotherapy, leaving surgery as the sole effective therapeutic option. Cold physical plasma (CPP) has been explored in vitro as a potential therapy, demonstrating positive anti-tumor effects on CS cells. This study investigated the synergistic effects of combining CPP with cytostatics on CS cells. The chemotherapeutic agents cisplatin, doxorubicin, and vincristine were applied to two CS cell lines (CAL-78 and SW1353). After determining their IC20 and IC50, they were combined with CPP in both cell lines to assess their impact on the cell proliferation, viability, metabolism, and apoptosis. This combined approach significantly reduced the cell proliferation and viability while increasing the apoptosis signals compared to cytostatic therapy alone. The combination of CPP and chemotherapeutic drugs shows promise in targeting chemoresistant CS cells, potentially improving the prognosis for patients in clinical settings.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Case Reports
    这是一例原发性弥漫性大B细胞淋巴瘤,累及子宫颈,表现为不规则阴道出血。在多次宫颈活检后证实了诊断。联合免疫疗法治疗,化疗(利妥昔单抗,环磷酰胺,阿霉素,长春新碱和泼尼松龙(R-CHOP)和放射疗法产生了良好的反应。
    This is a case of primary diffuse large B-cell lymphoma involving the uterine cervix which presented with irregular vaginal bleeding. The diagnosis was confirmed following multiple cervical biopsies. Treatment with a combination of immunotherapy, chemotherapy (rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP)) and radiotherapy produced a good response.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    前列腺癌是男性中普遍存在的癌症,和传统的治疗选择往往是有限的。细胞毒性化疗,尽管它有缺点,仍然是中流砥柱。我们提出了一种针对溶瘤麻疹病毒(OMV)和长春新碱(VC)的纳米级递送单位的靶向共递送方法,以增强治疗功效。HA包被的OMV+VC负载的TC纳米制剂被设计用于前列腺癌中的靶向溶瘤活性。前列腺癌细胞系中的CD44表达分析表明在PC3细胞中显著高表达。使用专家设计(DOE)进行纳米配方的优化,和HA包被的OMV+VC负载的TC纳米制剂的制备和表征被详细描述,显示平均粒度397.2±0.01nm和多分散指数0.122,ζ电位19.7±0.01mV。结果表明,成功的包封效率为2.4×106TCID50/Ml,并且从纳米制剂中持续释放OMV和VC长达72小时。分析显示,PC3细胞在10±0.71%的细胞活力下具有有效的抗癌活性,而在HPrEC中为73±0.66%,在剂量和时间依赖性方式为90µg/ml时具有显着的形态学变化。共制剂在PBS中50µgPI/ml时显示阳性细胞死亡49.5±0.02%,在G2/M期细胞周期停滞54.3%,8.1%G0/G1和5.7%在S阶段,具有50µg/ml的显着线粒体膜电位(MMP),通过流式细胞术(FACS)评估。表面整合配体方法增强溶瘤病毒和化疗药物的靶向递送,提出了前列腺癌治疗的潜在替代方案,并表明在纳米制剂中共同施用VC和OMV可以改善治疗结果,同时减少化疗药物剂量。
    Prostate cancer is a prevalent carcinoma among males, and conventional treatment options are often limited. Cytotoxic chemotherapy, despite its drawbacks, remains a mainstay. We propose a targeted co-delivery approach using nanoscale delivery units for Oncolytic measles virus (OMV) and vincristine (VC) to enhance treatment efficacy. The HA-coated OMV + VC-loaded TCs nanoformulation is designed for targeted oncolytic activity in prostate cancer. The CD44 expression analysis in prostate cancer cell lines indicates a significantly high expression in PC3 cells. The optimization of nanoformulations using Design of Expert (DOE) is performed, and the preparation and characterization of HA-coated OMV + VC-loaded TCs nanoformulations are detailed showing average particle size 397.2 ± 0.01 nm and polydispersity index 0.122 with zeta potential 19.7 + 0.01 mV. Results demonstrate successful encapsulation efficiency with 2.4 × 106 TCID50/Ml and sustained release of OMV and VC from the nanoformulation for up to 72 h. In vitro, assays reveal potent anticancer activity at 10 ± 0.71% cell viability in PC3 cells compared to 73 ± 0.66% in HPrEC and significant morphological changes at 90 µg/ml in dose and time-dependent manner. The co-formulation showed positive cell death 49.5 ± 0.02% at 50 µg PI/ml in PBS and 54.3% cell cycle arrest at the G2/M phase, 8.1% G0/G1 and 5.7% at S phase, with significant mitochondrial membrane potential (MMP) at 50 µg/ml, as assessed by flow cytometry (FACS). The surface-integrating ligand approach enhances the targeted delivery of the oncolytic virus and chemotherapeutic drug, presenting a potential alternative for prostate cancer treatment and suggested that co-administering VC and OMV in a nanoformulation could improve therapeutic outcomes while reducing chemotherapeutic drug doses.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    背景:和目的:化疗引起的周围神经病变(CIPN)由于患病率增加和缺乏治疗和预防疗法而构成了重大的健康问题。虽然对于常规癌症治疗至关重要,紫杉醇和长春新碱经常导致CIPN并影响癌症患者和幸存者的生活质量。这里,我们研究了CIPN的分子机制和药物转运。
    方法:人类感觉神经元来源于诱导多能干细胞(iPSC-SNs),使用流式细胞术和免疫标记进行表征。这些iPSC-SNs暴露于不同浓度的两种微管靶向剂,紫杉醇和长春新碱,有或没有预先暴露于外排转运蛋白的抑制剂和诱导剂。通过针对感觉神经元标记的荧光染色来量化神经元网络。使用定量聚合酶链反应(qPCR)检查化学疗法的转录作用。
    结果:紫杉醇暴露导致轴突收缩和增厚,而长春新碱引起轴突的破碎和消灭。两种药物都增加了疼痛受体的mRNA表达,瞬时受体电位香草酸(TRPV1),和高度诱导的神经元损伤,如通过激活转录因子3(ATF3)mRNA测量的。iPSC-SNs表达外排转运蛋白,P-糖蛋白(P-gp,由ABCB1编码)和多药耐药相关蛋白1(MPR1,由ABCC1编码)。外排转运蛋白的调节表明,在初步实验中,P-gp和MRP1在调节神经元积累和神经毒性中起作用。
    结论:和含义:iPSC-SNs是研究外排转运蛋白和其他机制靶标在CIPN中的作用的有价值且稳健的模型。外排转运蛋白可能在CIPN发病机制中发挥作用,因为它们调节化疗对周围神经系统的处置,它们可能为CIPN提供潜在的治疗靶点。
    BACKGROUND: and Purpose: Chemotherapy-induced peripheral neuropathy (CIPN) constitutes a significant health problem due to the increasing prevalence and lack of therapies for treatment and prevention. While pivotal for routine cancer treatment, paclitaxel and vincristine frequently cause CIPN and impact the quality of life among cancer patients and survivors. Here, we investigate molecular mechanisms and drug transport in CIPN.
    METHODS: Human sensory neurons were derived from induced pluripotent stem cells (iPSC-SNs), which were characterized using flow cytometry and immunolabeling. These iPSC-SNs were exposed to different concentrations of the two microtubule-targeting agents, paclitaxel and vincristine, with and without pre-exposure to inhibitors and inducers of efflux transporters. Neuronal networks were quantified via fluorescent staining against sensory neuron markers. Transcriptional effects of the chemotherapeutics were examined using quantitative polymerase chain reactions (qPCR).
    RESULTS: Paclitaxel exposure resulted in axonal retraction and thickening, while vincristine caused fragmentation and abolishment of axons. Both agents increased the mRNA expression of the pain receptor, transient receptor potential vanilloid (TRPV1), and highly induced neuronal damage, as measured by activating transcription factor 3 (ATF3) mRNA. iPSC-SNs express the efflux transporters, P-glycoprotein (P-gp, encoded by ABCB1) and multidrug resistance-associated protein 1 (MPR1, encoded by ABCC1). Modulation of efflux transporters indicate that P-gp and MRP1 play a role in modulating neuronal accumulation and neurotoxicity in preliminary experiments.
    CONCLUSIONS: and Implications: iPSC-SNs are a valuable and robust model to study the role of efflux transporters and other mechanistic targets in CIPN. Efflux transporters may play a role in CIPN pathogenesis as they regulate the disposition of chemotherapy to the peripheral nervous system, and they may present potential therapeutic targets for CIPN.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    在肯尼亚儿童中,长春新碱引起的周围神经病变(VIPN)的低发生率可能是由于长春新碱的低暴露所致。我们研究了肯尼亚儿童的长春新碱暴露,并在低长春新碱暴露的情况下增加了剂量(NCT05844670)。长春新碱平均暴露量高。用先前开发的列线图评估个体长春新碱暴露。对于低暴露和无VIPN的参与者,建议增加20%的剂量。高胆红素血症,或营养不良。15名参与者均未开发VIPN。在一名参与者中观察到低长春新碱暴露:实施剂量增加而无副作用。总之,尽管有较高的长春新碱暴露,但参与者没有发展为VIPN.
    The low incidence of vincristine-induced peripheral neuropathy (VIPN) in Kenyan children may result from low vincristine exposure. We studied vincristine exposure in Kenyan children and dose-escalated in case of low vincristine exposure (NCT05844670). Average vincristine exposure was high. Individual vincristine exposure was assessed with a previously developed nomogram. A 20% dose increase was recommended for participants with low exposure and no VIPN, hyperbilirubinemia, or malnutrition. None of the 15 participants developed VIPN. Low vincristine exposure was seen in one participant: a dose increase was implemented without side effects. In conclusion, the participants did not develop VIPN despite having high vincristine exposure.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • DOI:
    文章类型: Case Reports
    A 5-year-old spayed female mixed-breed dog was referred to the Atlantic Veterinary College (Charlottetown, Prince Edward Island) because of a 7-month history of intermittent pink, mucoid, vulvar discharge. The dog was imported from the Bahamas at 3.5 y of age and had a history of transmissible venereal tumor (TVT) of the vulva that was successfully treated with a course of vincristine chemotherapy. Complete remission was achieved with a disease-free interval of 6 mo before clinical signs recurred. Abdominal ultrasound and CT scan identified a large caudal abdominal mass thought to arise from the uterine stump. An exploratory laparotomy was performed and the mass grossly excised. Histopathology was consistent with a poorly differentiated round cell tumor, and immunohistochemical analysis confirmed TVT as the most likely diagnosis. No further treatment was carried out. Repeat abdominal ultrasound at 4 mo after surgery showed no evidence of mass recurrence. At 8 mo after surgery, the dog was reported to be doing well clinically. Key clinical message: Transmissible venereal tumor should be considered as a differential diagnosis for masses arising from the deep genital tissues of dogs in cases where there is a history of previous TVT. Transmissible venereal tumor should be considered even in dogs that have had complete resolution of a primary mass after chemotherapy.
    Tumeur vénérienne transmissible du moignon utérin à la suite d’une chimiothérapie réussie chez un chien croisé de 5 ans.Une chienne de race mixte de 5 ans, stérilisée, a été référée au Atlantic Veterinary College (Charlottetown, Île-du-Prince-Édouard) en raison d’antécédents de pertes vulvaires roses, mucoïdes et intermittentes depuis 7 mois. Le chien a été importé des Bahamas à l’âge de 3,5 ans et avait des antécédents de tumeur vénérienne transmissible (TVT) de la vulve qui a été traitée avec succès par une chimiothérapie à la vincristine. Une rémission complète a été obtenue avec un intervalle sans maladie de 6 mois avant la réapparition des signes cliniques. L’échographie abdominale et la tomodensitométrie ont identifié une grosse masse abdominale caudale qui proviendrait du moignon utérin. Une laparotomie exploratoire a été réalisée et la masse excisée. L’histopathologie était compatible avec une tumeur à cellules rondes peu différenciée et l’analyse immunohistochimique a confirmé la TVT comme le diagnostic le plus probable. Aucun autre traitement n’a été effectué. Une échographie abdominale répétée 4 mois après la chirurgie n’a montré aucun signe de récidive massive. Huit mois après l’opération, la chienne se portait bien cliniquement.Message clinique clé:Les tumeurs vénériennes transmissibles doivent être considérées comme un diagnostic différentiel pour les masses provenant des tissus génitaux profonds des chiens dans les cas où il existe des antécédents de TVT. Une tumeur vénérienne transmissible doit être envisagée même chez les chiens dont la masse primaire a complètement disparu après chimiothérapie.(Traduit par Dr Serge Messier).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    长春新碱(VCR)是治疗儿科癌症最广泛使用的化疗药物之一。尽管如此,已知它会引起剂量依赖性神经毒性,几乎可以影响每个器官系统。尽管它广泛使用,VCR对下尿路(LUT)的确切影响仍未充分阐明。我们的初步临床和转化研究表明,儿童VCR暴露对LUT功能的性别特异性影响。因此,本研究旨在探讨全身VCR暴露对LUT生理的后期影响及其潜在机制,关注剂量和男性,采用幼年CD-1小鼠作为模型。接受VCR的雄性小鼠在清醒膀胱测压期间表现出功能性膀胱容量增强,并伴有频繁的非空隙收缩,伴随着肥大细胞在膀胱内的积累,与盐水处理的对照组相比。在VCR组的膀胱条带中观察到值得注意的功能变化,包括神经介导的收缩减少,对胆碱能和嘌呤能激动剂的收缩反应增强,增强对组胺的反应性-主要通过组胺受体1(Hrh1)-和化合物48/80(肥大细胞脱粒剂)增强的松弛作用,相对于对照组。在VCR组的膀胱和腰s背根神经节(Ls-DRG)中均观察到与神经炎症和伤害感受相关的基因表达水平的显着变化。这些发现表明,儿童时期的VCR暴露,尤其是男性,触发膀胱和Ls-DRG的神经免疫反应,增强对膀胱神经递质的反应,从而导致以混合膀胱表型为特征的LUT功能障碍,这是存活期间的后期效应。
    Vincristine (VCR) is one of the most widely used chemotherapy agents in treating pediatric cancer. Nonetheless, it is known to cause dose-dependent neurotoxicity which can impact virtually every organ system. Despite its widespread use, the precise impact of VCR on the lower urinary tract (LUT) remains inadequately elucidated. Our initial clinical and translational investigations suggest a sex-specific influence of childhood VCR exposure on LUT function. Thus, the current study aimed to investigate the late effects of systemic VCR exposure on LUT physiology and the underlying mechanisms, focusing on dosage and male-sex, employing juvenile CD-1 mice as a model. Male mice subjected to VCR exhibited augmented functional bladder capacity accompanied by frequent non-void contractions during awake cystometry, alongside mast cell accumulation within the bladder, compared to the saline-treated control group. Noteworthy functional changes were observed in bladder strips from the VCR group, including decreased nerve-mediated contraction, heightened contractile responses to cholinergic and purinergic agonists, enhanced responsiveness to histamine-primarily via histamine receptor 1 (Hrh1)-and an augmented relaxation effect with compound 48/80 (a mast cell degranulator), relative to the control group. Significant changes in gene expression levels associated with neuroinflammation and nociception were observed in both the bladder and lumbosacral dorsal root ganglia (Ls-DRG) of the VCR group. These findings suggest that VCR exposure during childhood, particularly in males, triggers neuroimmune responses in the bladder and Ls-DRG, amplifying responsiveness to neurotransmitters in the bladder, thereby contributing to LUT dysfunction characterized by a mixed bladder phenotype as a late effect during survivorship.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Case Reports
    背景:绒毛膜癌是一种高度恶性的妊娠相关滋养细胞肿瘤,以早期转移到肺部为特征。因此,由于远处转移,患者可能会出现非神经系统症状。足月妊娠后绒毛膜癌的发生率非常罕见(1/160,000妊娠)。
    方法:我们报告一例20岁的伊朗妇女,gravida2para1活1流产1,她在分娩后第二天因突然发作的呼吸困难和左半胸疼痛而被转诊到我们的妇科。指数妊娠无任何并发症。在最初的检查之后,β-人绒毛膜促性腺激素(HCG)水平的升高(>1,000,000)以及远处转移的临床(阴道病变)和放射学证据(双侧肺结节)的鉴定指导我们对肺转移性绒毛膜癌的诊断。肿瘤学会诊后,依托泊苷,甲氨蝶呤,放线菌素D,环磷酰胺,并对患者开始长春新碱化疗方案。她对治疗反应良好,目前正在继续她的化疗过程。
    结论:如果按时开始治疗,绒毛膜癌的预后非常好。我们建议临床医生在产后并发症的鉴别诊断中应考虑妊娠滋养细胞瘤。尤其是在足月和非磨牙妊娠后。
    BACKGROUND: Choriocarcinoma is a highly malignant pregnancy-related trophoblastic neoplasm, characterized by early metastasis to the lungs. Therefore, patients may manifest nongynecological symptoms owing to distant metastases. The incidence of choriocarcinoma after a term pregnancy is really rare (1/160,000 pregnancies).
    METHODS: We report a case of a 20-year-old Iranian woman, gravida 2 para 1 live 1 abortion 1, who was referred to our gynecology department with sudden onset dyspnea and pain in the left hemithorax the day after her labor. The index pregnancy was without any complications. After the initial workup, the elevation of β-human chorionic gonadotropin (HCG) levels (> 1,000,000) along with the identification of clinical (vaginal lesions) and radiological evidence of distant metastases (bilateral pulmonary nodes) directed us toward pulmonary metastatic choriocarcinoma diagnosis. After the oncology consult, the etoposide, methotrexate, actinomycin D, cyclophosphamide, and vincristine chemotherapy regimen was started for the patient. She responded well to the treatment and is currently continuing her chemotherapy process.
    CONCLUSIONS: The prognosis of choriocarcinoma is very good if the treatment is started on time. We suggest that clinicians should consider gestational trophoblastic neoplasia in their differential diagnosis of the post-natal period complications, especially after a term and nonmolar pregnancy.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

       PDF(Pubmed)

  • 文章类型: Journal Article
    背景:儿童肿瘤学小组将中危横纹肌肉瘤定义为出现在不利部位的未切除FOXO1融合阴性疾病或非转移性FOXO1融合阳性疾病。坦西罗莫司联合化疗在复发性或难治性横纹肌肉瘤患者中显示出有希望的活性。我们旨在比较接受长春新碱治疗的中危横纹肌肉瘤患者的无事件生存率。放线菌素,环磷酰胺与长春新碱和伊立替康(VAC/VI)交替联合替西罗莫司,然后进行维持治疗,而VAC/VI单独进行维持治疗。
    方法:ARST1431是随机的,开放标签,在澳大利亚的210个机构中进行的第三阶段试验,加拿大,新西兰,和美国。符合条件的患者是年龄在40岁或以下,患有非转移性FOXO1阳性横纹肌肉瘤或来自不利部位的未切除FOXO1阴性横纹肌肉瘤疾病的患者。另外两组患者也符合资格:在未切除的有利部位(不包括眼眶)患有FOXO1阴性疾病的患者;以及年龄小于10岁的IV期FOXO1阴性疾病伴远处转移的患者。如果16岁或以下,符合条件的患者必须具有50或更高的Lansky表现状态评分,如果16岁以上,则Karnofsky表现状态评分必须为50或更高;所有患者先前均未接受治疗。患者被随机(1:1)分为4个组,并按组织学分层,舞台,和团体。患者接受静脉VAC/VI化疗,每个周期的环磷酰胺剂量为1·2g/m2,有或没有减少剂量的每周静脉坦西罗莫司,从15mg/m2或0·5mg/kg开始体重小于10kg。所有患者的治疗总持续时间为42周,然后口服环磷酰胺加静脉注射长春瑞滨维持治疗6个月。在放疗期间和任何重大外科手术前2周内,坦西罗莫司被停用。主要终点是3年无事件生存期。采用修订后的意向治疗方法分析数据。该研究已在ClinicalTrials.gov(NCT02567435)注册,并且已完成。
    结果:2016年5月23日至2022年1月1日,共纳入325例患者。在297名可评估患者中(148名仅接受VAC/VI治疗,149名接受替西罗莫司治疗的VAC/VI治疗),中位年龄为6·3岁(IQR3·0-11·3);33例(11%)患者年龄在18岁或以上;297人中有179例(60%)为男性.在VAC/VI组中,148例患者中有113例(77%)FOXO1阴性,在替罗莫司组的VAC/VI中,149例中的108例(73%)为FOXO1阴性。中位随访时间为3·6年(IQR2·8-4·5),两组之间的3年无事件生存率没有显着差异(VAC/VI组的64·8%[95%CI55·5-74·1]与66·8%[57·5-76·2]在VAC/VI加替西罗莫司组(风险比0·86[95%CI0·58-1·26];log-rankp=0·44)。最常见的3-4级不良事件是贫血(VAC/VI组148例患者中有62例发生[41%],VAC/VI组149例患者中有89例发生[58%],淋巴细胞减少(65例[44%]中的83例事件与71例[48%]中的99例事件),中性粒细胞减少症(99例[67%]中的160例事件与105例[70%]中的164例事件),和白细胞减少症(86例[58%]中121例,93例[62%]中132例)。VAC/VI与替西罗莫司组发生1例治疗相关死亡,归类为未指定。
    结论:在VAC/VI中添加替西罗莫司并不能改善由FOXO1易位状态和临床因素定义的中危横纹肌肉瘤患者的无事件生存率。需要新的基于生物学的策略来改善该人群的结果。
    背景:儿童肿瘤学小组(由美国国家癌症研究所支持,美国国立卫生研究院)。
    BACKGROUND: The Children\'s Oncology Group defines intermediate-risk rhabdomyosarcoma as unresected FOXO1 fusion-negative disease arising at an unfavourable site or non-metastatic FOXO1 fusion-positive disease. Temsirolimus in combination with chemotherapy has shown promising activity in patients with relapsed or refractory rhabdomyosarcoma. We aimed to compare event-free survival in patients with intermediate-risk rhabdomyosarcoma treated with vincristine, actinomycin, and cyclophosphamide alternating with vincristine and irinotecan (VAC/VI) combined with temsirolimus followed by maintenance therapy versus VAC/VI alone with maintenance therapy.
    METHODS: ARST1431 was a randomised, open-label, phase 3 trial conducted across 210 institutions in Australia, Canada, New Zealand, and the USA. Eligible patients were those aged 40 years or younger with non-metastatic FOXO1-positive rhabdomyosarcoma or unresected FOXO1-negative rhabdomyosarcoma disease from unfavourable sites. Two other groups of patients were also eligible: those who had FOXO1-negative disease at a favourable site (excluding orbit) that was unresected; and those who were aged younger than 10 years with stage IV FOXO1-negative disease with distant metastases. Eligible patients had to have a Lansky performance status score of 50 or higher if 16 years or younger and a Karnofsky performance status score of 50 or higher if older than 16 years; all patients were previously untreated. Patients were randomised (1:1) in blocks of four and stratified by histology, stage, and group. Patients received intravenous VAC/VI chemotherapy with a cyclophosphamide dose of 1·2 g/m2 per dose per cycle with or without a reducing dose of intravenous weekly temsirolimus starting at 15 mg/m2 or 0·5 mg/kg per dose for those who weighed less than 10 kg. The total duration of therapy was 42 weeks followed by 6 months of maintenance therapy with oral cyclophosphamide plus intravenous vinorelbine for all patients. Temsirolimus was withheld during radiotherapy and for 2 weeks before any major surgical procedure. The primary endpoint was 3-year event-free survival. Data were analysed with a revised intention-to-treat approach. The study is registered with ClinicalTrials.gov (NCT02567435) and is complete.
    RESULTS: Between May 23, 2016, and Jan 1, 2022, 325 patients were enrolled. In 297 evaluable patients (148 assigned to VAC/VI alone and 149 assigned to VAC/VI with temsirolimus), the median age was 6·3 years (IQR 3·0-11·3); 33 (11%) patients were aged 18 years or older; 179 (60%) of 297 were male. 113 (77%) of 148 patients were FOXO1 negative in the VAC/VI group, and 108 (73%) of 149 were FOXO1 negative in the VAC/VI with temsirolimus group. With a median follow-up of 3·6 years (IQR 2·8-4·5), 3-year event-free survival did not differ significantly between the two groups (64·8% [95% CI 55·5-74·1] in the VAC/VI group vs 66·8% [57·5-76·2] in the VAC/VI plus temsirolimus group (hazard ratio 0·86 [95% CI 0·58-1·26]; log-rank p=0·44). The most common grade 3-4 adverse events were anaemia (62 events in 60 [41%] of 148 patients in the VAC/VI group vs 89 events in 87 [58%] of 149 patients in the VAC/VI with temsirolimus group), lymphopenia (83 events in 65 [44%] vs 99 events in 71 [48%]), neutropenia (160 events in 99 [67%] vs 164 events in 105 [70%]), and leukopenia (121 events in 86 [58%] vs 132 events in 93 [62%]). There was one treatment-related death in the VAC/VI with temsirolimus group, categorised as not otherwise specified.
    CONCLUSIONS: Addition of temsirolimus to VAC/VI did not improve event-free survival in patients with intermediate-risk rhabdomyosarcoma defined by their FOXO1 translocation status and clinical factors. Novel biology-based strategies are needed to improve outcomes in this population.
    BACKGROUND: The Children\'s Oncology Group (supported by the US National Cancer Institute, US National Institutes of Health).
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

  • 文章类型: Journal Article
    OBJECTIVE: To compare the prognostic value of two predictive models based on C-reactive protein (CRP) and albumin (ALB), namely the CRP to ALB ratio (CAR) and the Glasgow prognostic score (GPS), in newly diagnosed patients with diffuse large B-cell lymphoma (DLBCL).
    METHODS: The data of newly diagnosed DLBCL patients admitted to our center from May 2014 to January 2022 were reviewed. A total of 111 patients who completed at least 4 cycles of R-CHOP or R-CHOP-like chemotherapy with detailed clinical, laboratory data and follow-up information were included. The receiver operating characteristic (ROC) curve was performed to evaluate the predictive value of pre-treatment CAR on disease progression and survival. Furthermore, the association between CAR and baseline clinical, laboratory characteristics of patients was evaluated, and progression-free survival (PFS) and overall survival (OS) were compared between different CAR and GPS subgroups. Finally, the univariate and multivariate COX propor-tional hazard regression models were used to analyze the factors affecting disease outcomes.
    RESULTS: ROC curve showed that the area under the curve (AUC) of CAR predicting PFS and OS in DLBCL patients was 0.687 (P =0.002) and 0.695 (P =0.005), respectively, with the optimal cut-off value of 0.11 for both predicting PFS and OS. Compared with the lower CAR (<0.11) group, the higher CAR (≥0.11) group had more clinical risk factors, including age >60 years (P =0.025), ECOG score ≥2 (P =0.004), Lugano stage III-IV (P < 0.001), non-germinal center B-cell-like (non-GCB) subtype (P =0.035), elevated lactate dehydrogenase (LDH) ( P < 0.001), extranodal involved site >1 (P =0.004) and IPI score >2 (P < 0.001). The interim response evaluation of patients showed that the overall response rate (ORR) and complete response rate (CRR) in the lower CAR group were both significantly better than those in the higher CAR group (ORR: 96.9% vs 80.0%, P =0.035; CRR: 63.6% vs 32.5%, P =0.008). With a median follow-up of 24 months, patients with lower CAR had significantly longer median PFS and OS than those with higher CAR (median PFS: not reached vs 67 months, P =0.0026; median OS: not reached vs 67 months, P =0.002), while there was no statistical difference in PFS (P =0.11) and OS (P =0.11) in patients with GPS of 0, 1, and 2. Multivariate Cox regression analysis indicated that only sex (male) and IPI score >2 were independent risk factors for both PFS and OS.
    CONCLUSIONS: CAR is significantly correlated with disease progression and survival in DLBCL patients; And compared with GPS, CAR has more advantages in predicting disease outcomes in DLBCL patients.
    UNASSIGNED: 比较C反应蛋白与白蛋白比值和格拉斯哥预后评分对弥漫大B细胞淋巴瘤患者预后判断的价值.
    UNASSIGNED: 探讨并比较基于C反应蛋白(CRP)和白蛋白(ALB)的两种预测模型——CRP与ALB比值(CAR)和格拉斯哥预后评分(GPS)——在新诊断弥漫大B细胞淋巴瘤(DLBCL)患者预后评估中的价值。.
    UNASSIGNED: 回顾性分析本院2014年5月至2022年1月收治的初诊DLBCL患者的资料,纳入至少完成4个周期R-CHOP或R-CHOP样方案化疗,且临床、实验室检查数据以及随访资料均完整的111例患者。根据患者治疗前CAR及随访截止时的生存状态绘制受试者工作特征曲线(ROC),初步判断CAR对疾病进展和生存结局的预测价值,进一步分析CAR与患者基线临床、实验室特征的关系,并比较不同CAR、GPS分组患者的无进展生存期(PFS)和总生存期(OS),采用单因素和多因素COX风险比例回归模型分析影响疾病预后的因素。.
    UNASSIGNED: ROC曲线分析结果显示,CAR预测DLBCL患者PFS、OS的曲线下面积(AUC)分别为0.687(P =0.002),0.695(P =0.005),最佳截断值均为0.11;相较于低CAR(<0.11)组,高CAR(≥0.11)组患者具有更多的临床高危因素,包括年龄>60岁(P =0.025)、ECOG评分≥2分(P =0.004)、Lugano分期III-IV期( P < 0.001)、non-GCB亚型(P =0.035)、乳酸脱氢酶升高( P < 0.001)、结外病变数>1处(P =0.004)及IPI评分>2分( P < 0.001)。对患者进行中期疗效评估,低CAR组患者的总有效率(ORR)及完全缓解率(CRR)均明显优于高CAR组(ORR: 96.9% vs 80.0%, P =0.035;CRR: 63.6% vs 32.5%, P =0.008)。中位随访24个月,低CAR组患者的中位PFS及OS均明显优于高CAR组(中位PFS:未达到 vs 67个月,P =0.0026;中位OS:未达到 vs 67个月,P =0.002),而GPS 0分、1分和2分3组患者的PFS(P =0.11)和OS(P =0.11)差异均不具有统计学意义。多因素分析显示,仅有性别为男性和IPI评分>2分是影响患者PFS和OS的独立危险因素。.
    UNASSIGNED: CAR与DLBCL患者的疾病进展和生存显著相关;与GPS相比,CAR对患者的预后判断价值更大。.
    导出

    更多引用

    收藏

    翻译标题摘要

    我要上传

    求助全文

公众号