nonmelanoma skin cancer (NMSC)

非黑色素瘤皮肤癌 (NMSC)
  • 文章类型: Journal Article
    背景:Cemiplimab,2018年批准的PD-1抑制剂用于不适合治愈性治疗的局部晚期或转移性皮肤鳞状细胞癌(cSCC)患者,尽管已知疗效,但仍缺乏最佳患者选择的清晰度。
    目的:这项回顾性研究旨在评估我们机构的cSCC患者的真实世界治疗模式和结果。
    方法:对cemiplimab连续治疗的cSCC患者进行回顾性分析。评估无进展生存期(PFS)和总生存期(OS)以及临床病理特征。
    结果:纳入45例患者,其中73.3%为男性,中位年龄为77岁。中位随访18个月后,中位PFS和OS未达到,平均21.3个月±2.2个月和25.3±2.1个月。分别。单变量和多变量分析显示,仅PFS与既往放疗之间存在显着相关性(p值分别为0.043和0.046)。
    结论:限制包括其回顾性性质,分析的患者数量少,以及潜在的固有偏见。
    结论:该研究揭示了cemiplimab治疗的cSCC中先前放疗与PFS改善之间的显著关联,提示放疗与cemiplimab相结合的可能性。有必要进一步探索这种组合方法。
    BACKGROUND: Cemiplimab, a programmed cell death-1 inhibitor approved in 2018 for patients with locally advanced or metastatic cutaneous squamous cell carcinoma (cSCC) who are ineligible for curative therapies, lacks clarity regarding the optimal patient selection despite its known efficacy.
    OBJECTIVE: This retrospective study aims to assess the real-world treatment patterns and outcomes in patients with cSCC at our institution.
    METHODS: A retrospective analysis of consecutively treated patients with cemiplimab for cSCC was conducted. Progression-free survival (PFS) and overall survival were evaluated alongside clinical-pathologic characteristics.
    RESULTS: Forty-five patients were included, of which 73.3% were male with a median age of 77 years. After 18 months of median follow-up median PFS and overall survival were not reached with a mean of 21.3 months ± 2.2 months and 25.3 ± 2.1 months, respectively. Univariate and multivariate analyses revealed significant correlations only between PFS and previous radiotherapy (P values: .043 and .046, respectively).
    CONCLUSIONS: Limitations include its retrospective nature, the low number of patients analyzed, and the potential for inherent biases.
    CONCLUSIONS: The study reveals a significant association between prior radiotherapy and improved PFS in cemiplimab-treated cSCC, suggesting the potential for combining radiotherapy with cemiplimab. Further exploration of this combined approach is warranted.
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  • 文章类型: Letter
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  • 文章类型: Journal Article
    非黑色素瘤皮肤癌(NMSC)是全球最常见的癌症,其中80%为基底细胞癌(BCC)。目前的疗法疗效低,副作用,高复发率凸显了替代疗法的需要。在这项工作中,使用我们实验室开发的部分还原纳米氧化石墨烯(p-rGon)。已通过经由UV-C照射的纳米石墨烯氧化物的受控还原来实现,其产生保持原始水稳定性的小纳米颗粒(低于200nm),同时获得高的光热转换效率。后者可以通过碳-氧单键(C-O)的损失和sp2碳键的重建来解释。将p-rGon与抗癌药物5-氟尿嘧啶(5-FU)一起掺入Carbopol水凝胶中以评估可能的PTT和化学治疗作用。Carbopol/p-rGon/5-FU水凝胶被认为对正常皮肤细胞(HFF-1)无细胞毒性。然而,当在Carbopol/p-rGon/5-FU水凝胶存在下将A-431皮肤癌细胞暴露于NIR照射30分钟时,72小时后几乎完全根除,在单次处理后,细胞数量减少90%,剩余细胞死亡80%。用发光二极管(LED)系统进行NIR照射,在我们的实验室开发,它允许调整施加的光剂量以实现安全和选择性的治疗,而不是与肿瘤周围健康组织损伤相关的标准激光系统。这些是第一个包含用于BCC光疗的药物制剂的基于石墨烯的材料。
    Nonmelanoma skin cancer (NMSC) is the most common cancer worldwide, among which 80% is basal cell carcinoma (BCC). Current therapies\' low efficacy, side effects, and high recurrence highlight the need for alternative treatments. In this work, a partially reduced nanographene oxide (p-rGOn) developed in our laboratory was used. It has been achieved through a controlled reduction of nanographene oxide via UV-C irradiation that yields small nanometric particles (below 200 nm) that preserve the original water stability while acquiring high light-to-heat conversion efficiency. The latter is explained by a loss of carbon-oxygen single bonds (C-O) and the re-establishment of sp2 carbon bonds. p-rGOn was incorporated into a Carbopol hydrogel together with the anticancer drug 5-fluorouracil (5-FU) to evaluate a possible combined PTT and chemotherapeutic effect. Carbopol/p-rGOn/5-FU hydrogels were considered noncytotoxic toward normal skin cells (HFF-1). However, when A-431 skin cancer cells were exposed to NIR irradiation for 30 min in the presence of Carbopol/p-rGOn/5-FU hydrogels, almost complete eradication was achieved after 72 h, with a 90% reduction in cell number and 80% cell death of the remaining cells after a single treatment. NIR irradiation was performed with a light-emitting diode (LED) system, developed in our laboratory, which allows adjustment of applied light doses to achieve a safe and selective treatment, instead of the standard laser systems that are associated with damages in the healthy tissues in the tumor surroundings. Those are the first graphene-based materials containing pharmaceutical formulations developed for BCC phototherapy.
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  • 文章类型: Journal Article
    背景:本文旨在描述类风湿关节炎(RA)患者的恶性肿瘤,银屑病关节炎(PsA),强直性脊柱炎(AS),或接受upadacitinib(UPA)或主动比较剂治疗的非影像学轴性脊柱关节炎(nr-axSpA)。
    方法:此综合安全性分析包括来自RA的11项3期UPA试验(6项试验)的数据,PsA(2次试验),AS(2个试验;一个2b/3阶段),和nr-axSpA(1次试验)。对RA的治疗引起的不良事件(TEAE)进行了总结(合并的UPA15mg[UPA15],合并的UPA30毫克[UPA30],阿达木单抗40毫克[ADA],甲氨蝶呤单一疗法[MTX]),PsA(合并UPA15,合并UPA30,ADA),AS(合并UPA15),和nr-axSpA(UPA15)。TEAE报告为暴露校正事件率(事件/100患者-年)。
    结果:中位治疗时间为1.0-4.0年(RA最长6.6年)。在治疗和适应症中,不包括非黑素瘤皮肤癌(NMSC)的恶性率范围为0.2~1.1,而NMSC范围为0.0~1.4.在RA中,不包括NMSC的恶性肿瘤发生率在UPA15、UPA30、ADA、和MTX(乳腺癌和肺癌最常见)。在RA和PsA中,Kaplan-Meier分析显示,随着时间的推移,UPA15与UPA30在排除NMSC的恶性肿瘤事件发作中没有差异。在RA中,UPA30的NMSC率高于UPA15;UPA15和UPA30均高于ADA和MTX。在PsA,UPA15,UPA30和ADA中不包括NMSC和NMSC的恶性肿瘤发生率大致相似.在AS和nr-axSpA中,恶性肿瘤很少被报道.在整个临床项目中很少报道淋巴瘤事件。
    结论:不包括NMSC的恶性肿瘤率在UPA15、UPA30、ADA、和MTX,并且在RA中一致,PsA,AS,还有nr-axSpA.在RA中,UPA观察到NMSC的剂量依赖性增加。
    背景:ClinicaTrials.gov标识符:NCT02706873、NCT02675426、NCT02629159、NCT02706951、NCT02706847、NCT03086343、NCT03104400、NCT03104374、NCT03178487和NCT04169373。
    BACKGROUND: This article aims to describe malignancies in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), or non-radiographic axial spondyloarthritis (nr-axSpA) treated with upadacitinib (UPA) or active comparators.
    METHODS: This integrated safety analysis includes data from 11 phase 3 UPA trials across RA (6 trials), PsA (2 trials), AS (2 trials; one phase 2b/3), and nr-axSpA (1 trial). Treatment-emergent adverse events (TEAEs) were summarized for RA (pooled UPA 15 mg [UPA15], pooled UPA 30 mg [UPA30], adalimumab 40 mg [ADA], methotrexate monotherapy [MTX]), PsA (pooled UPA15, pooled UPA30, ADA), AS (pooled UPA15), and nr-axSpA (UPA15). TEAEs were reported as exposure-adjusted event rates (events/100 patient-years).
    RESULTS: Median treatment duration ranged from 1.0 to 4.0 years (with a maximum of 6.6 years in RA). Across treatments and indications, rates of malignancy excluding nonmelanoma skin cancer (NMSC) ranged from 0.2 to 1.1, while NMSC ranged from 0.0 to 1.4. In RA, rates of malignancy excluding NMSC were generally similar between UPA15, UPA30, ADA, and MTX (breast and lung cancer were the most common). In RA and PsA, Kaplan-Meier analyses revealed no differences in event onset of malignancy excluding NMSC with UPA15 versus UPA30 over time. In RA, NMSC rates were higher with UPA30 than UPA15; both UPA15 and UPA30 were higher than ADA and MTX. In PsA, rates of malignancy excluding NMSC and NMSC were generally similar between UPA15, UPA30, and ADA. In AS and nr-axSpA, malignancies were reported infrequently. Few events of lymphoma were reported across the clinical programs.
    CONCLUSIONS: Rates of malignancy excluding NMSC were generally similar between UPA15, UPA30, ADA, and MTX and were consistent across RA, PsA, AS, and nr-axSpA. A dose-dependent increased rate of NMSC was observed with UPA in RA.
    BACKGROUND: ClinicaTrials.gov identifier: NCT02706873, NCT02675426, NCT02629159, NCT02706951, NCT02706847, NCT03086343, NCT03104400, NCT03104374, NCT03178487, and NCT04169373.
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  • 文章类型: Case Reports
    疱疹感染的不典型形态和解剖表现可能是诊断和治疗挑战。虽然单纯疱疹病毒2型(HSV-2)感染主要发生在口腔或生殖器区域,我们的患者表现为肩关节上的溃疡营养斑与非黑色素瘤皮肤癌(NMSC)具有共同的临床特征.根据临床表现和解剖部位,包括活组织检查在内的适当检查对于获得正确的诊断至关重要,因为病变可以模仿广谱的皮肤病,特别是如果病变发生在不典型的位置。皮肤科提供者在有异常溃疡或疣状病变时,应将HSV-2纳入鉴别诊断。
    Atypical morphologic and anatomic presentations of herpetic infection can be a diagnostic and therapeutic challenge. Although herpes simplex virus type 2 (HSV-2) infections primarily occur in the oral or anogenital region, our patient presented with ulcerated vegetative plaques on the shoulder sharing clinical features with nonmelanoma skin cancer (NMSC). Depending on the clinical appearance and anatomical site, proper workup including biopsy can be pivotal to arrive at a correct diagnosis as lesions can mimic a broad spectrum of cutaneous diseases, particularly if the lesion occurs in an atypical location. Dermatology providers should include HSV-2 in the differential diagnosis when challenged with unusual ulcerated or verrucous lesions.
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  • 文章类型: Journal Article
    皮肤病对全球生活质量有重大影响,心理健康,和收入损失。目前,亚洲皮肤病的负担及其与社会经济地位的关系尚不清楚。
    我们选择了全球疾病负担研究数据集来分析50个亚洲国家的残疾调整寿命年(DALYs),包括中亚,北亚,东亚,西亚,东南亚,南亚,1990年至2017年。我们使用一个国家的社会人口统计学指数和人均国内生产总值将DALY与社会经济地位进行了比较。采用Pearson相关性进行统计学分析。
    一些国家的皮肤病的年龄标准化DALY发病率高于或低于预期。亚洲国家,特别是高收入国家,有很高的炎症性皮肤病负担,包括痤疮,斑秃,特应性皮炎,接触性皮炎,褥疮溃疡,牛皮癣,瘙痒,和脂溢性皮炎.亚洲低收入国家感染性皮肤病的负担更大。亚洲皮肤癌的负担相对较低。
    皮肤病负担很高,尤其是炎症,在亚洲国家,但亚洲个别皮肤病的负担因国家和社会经济地位而异。DALYs可以作为一种有目的的措施,用于指导资源以改善亚洲皮肤病的负担。
    UNASSIGNED: Skin diseases have a significant global impact on quality of life, mental health, and loss of income. The burden of dermatologic conditions and its relationship with socioeconomic status in Asia is currently not well understood.
    UNASSIGNED: We selected Global Burden of Disease Study datasets to analyze disability-adjusted life years (DALYs) in 50 Asian countries, including Central Asia, northern Asia, eastern Asia, western Asia, southeastern Asia, and southern Asia, between 1990 and 2017. We compared DALYs to the socioeconomic status using the sociodemographic index and gross domestic product per capita of a country. Statistical analysis was performed using Pearson\'s correlation.
    UNASSIGNED: Some countries had higher or lower than expected age-standardized DALY rates of skin diseases. Asian countries, especially high-income countries, had a high burden of inflammatory dermatoses, including acne, alopecia areata, atopic dermatitis, contact dermatitis, decubitus ulcers, psoriasis, pruritus, and seborrheic dermatitis. The burden of infectious dermatoses was greater in low-income Asian countries. The burden of skin cancer in Asia was relatively low.
    UNASSIGNED: There is a high burden of skin disease, especially inflammatory conditions, in Asian countries, but the burden of individual dermatoses in Asia varies by country and socioeconomic status. DALYs can potentially serve as a purposeful measure for directing resources to improve the burden of skin disease in Asia.
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  • 文章类型: Journal Article
    UNASSIGNED: Dermatologic disease represents a significant burden worldwide, but the regional effect of skin disease in the Caribbean and how it relates to socioeconomic status remain unknown.
    UNASSIGNED: This study aims to measure the burden of skin disease in the Caribbean from epidemiologic and socioeconomic standpoints.
    UNASSIGNED: We selected Global Burden of Disease Study data sets to analyze disability-adjusted life-years (DALYs) and the annual rate of change of dermatoses between 1990 and 2017 in 18 Caribbean countries and the United States. The principal country-level economic factor used was gross domestic product per capita from the World Bank.
    UNASSIGNED: Countries with lower gross domestic product per capita had higher DALYs for dermatology-related infectious diseases, urticaria, asthma, and atopic dermatitis. Countries with higher gross domestic product per capita had higher DALYs of cutaneous neoplasms, contact dermatitis, psoriasis, and pruritus. Several Caribbean countries were among the top worldwide for annual increase in DALYs for melanoma, nonmelanoma skin cancers, bacterial skin disease, and total skin and subcutaneous diseases.
    UNASSIGNED: Despite promising ongoing interventions in skin disease, better support is needed in both resource-rich and -poor areas of the Caribbean. DALYs can serve as a purposeful measure for directing resources and care to improve the burden of skin disease in the Caribbean.
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