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Domenech P, Mariscal G, Marquina V, Bas P, Bas T. Efficacy and safety of halo-gravity traction in the treatment of spinal deformities: A systematic review of the literature. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:159-167. [PMID: 37230411 DOI: 10.1016/j.recot.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 05/16/2023] [Accepted: 05/17/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE To determine, through a systematic review, the effects of halo gravity traction in spinal deformity. METHODS Prospective studies or case series of patients with scoliosis or kyphosis treated with cranial halo gravity traction (HGT) were included. Radiological outcomes were measured in the sagittal and/or coronal planes. Pulmonary function was also assessed. Perioperative complications were also collected. RESULTS Thirteen studies were included. Congenital etiology was the most frequent etiology observed. Most studies provided clinically relevant curve correction values in the sagittal and coronal planes. Pulmonary values improved significantly after the use of HGT. Finally, there were a pool of 83 complications in 356 patients (23.3%). The most frequent complications were screw infection (38 cases). CONCLUSIONS Preoperative HGT appears to be a safe and effective intervention for deformity that allows correction prior to surgery. However, there is a lack of homogeneity in the published studies.
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Affiliation(s)
- P Domenech
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - G Mariscal
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, Spain.
| | - V Marquina
- Department of Orthopedic Surgery and Traumatology, Valencia General University Hospital, Valencia, Spain
| | - P Bas
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, Spain
| | - T Bas
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, Spain
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Domenech P, Mariscal G, Marquina V, Bas P, Bas T. Efficacy and safety of halo-gravity traction in the treatment of spinal deformities: A systematic review of the literature. Rev Esp Cir Ortop Traumatol (Engl Ed) 2024; 68:T159-T167. [PMID: 38000543 DOI: 10.1016/j.recot.2023.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 05/17/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVE To determine, through a systematic review, the effects of halo-gravity traction (HGT) in spinal deformity. METHODS Prospective studies or case series of patients with scoliosis or kyphosis treated with cranial HGT were included. Radiological outcomes were measured in the sagittal and/or coronal planes. Pulmonary function was also assessed. Perioperative complications were also collected. RESULTS Thirteen studies were included. Congenital etiology was the most frequent etiology observed. Most studies provided clinically relevant curve correction values in the sagittal and coronal planes. Pulmonary values improved significantly after the use of HGT. Finally, there were a pool of 83 complications in 356 patients (23.3%). The most frequent complications were screw infection (38 cases). CONCLUSIONS Preoperative HGT appears to be a safe and effective intervention for deformity that allows correction prior to surgery. However, there is a lack of homogeneity in the published studies.
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Affiliation(s)
- P Domenech
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, España
| | - G Mariscal
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, España.
| | - V Marquina
- Department of Orthopedic Surgery and Traumatology, Valencia General University Hospital, Valencia, España
| | - P Bas
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, España
| | - T Bas
- Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital, Valencia, España
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Pipola V, Pasini S, Ghermandi R, Girolami M, Falzetti L, Pérez S, Bas T, Gasbarrini A. Management of symptomatic spine metastases: A multidisciplinary approach based flow-chart. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:S552-S559. [PMID: 37774915 DOI: 10.1016/j.recot.2023.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 10/01/2023] Open
Abstract
We described an algorithm for the management of spinal metastases in which the importance of single parameters varies depending on when they are contemplated. Each patient follows his own «personal» sequential process which does not necessarily consider all the parameters each time as some may be irrelevant for the purpose of choosing the type of treatment for that single individual. For instance, a patient in general poor condition with a high ASA score is usually not a candidate for surgery, regardless of the primary tumor nature or the number of metastases. For this patient, the most important element would be the sensitivity of the tumor to adjuvant treatment. Similarly, a patient with acute and progressive spinal cord injury would undergo surgical decompression and stabilization without considering a more strenuous intervention.
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Affiliation(s)
- V Pipola
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia.
| | - S Pasini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia
| | - R Ghermandi
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia
| | - M Girolami
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia
| | - L Falzetti
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia
| | - S Pérez
- Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - T Bas
- Unidad de Columna, Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario y Politécnico La Fe, Valencia, España
| | - A Gasbarrini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italia
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Pipola V, Pasini S, Ghermandi R, Girolami M, Falzetti L, Pérez S, Bas T, Gasbarrini A. Management of symptomatic spine metastases: A multidisciplinary approach based flow-chart. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:552-559. [PMID: 37343934 DOI: 10.1016/j.recot.2023.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
We described an algorithm for the management of spinal metastases in which the importance of single parameters varies depending on when they are contemplated. Each patient follows his own "personal" sequential process which does not necessarily consider all the parameters each time as some may be irrelevant for the purpose of choosing the type of treatment for that single individual. For instance, a patient in general poor condition with a high "ASA" score is usually not a candidate for surgery, regardless of the primary tumor nature or the number of metastases. For this patient, the most important element would be the sensitivity of the tumor to adjuvant treatment. Similarly, a patient with acute and progressive spinal cord injury would undergo surgical decompression and stabilization without considering a more strenuous intervention.
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Affiliation(s)
- V Pipola
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
| | - S Pasini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - R Ghermandi
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - M Girolami
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - L Falzetti
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
| | - S Pérez
- Spine Unit, Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital of Valencia, Avinguda de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - T Bas
- Spine Unit, Department of Orthopedic Surgery and Traumatology, La Fe University and Polytechnic Hospital of Valencia, Avinguda de Fernando Abril Martorell, 106, 46026 Valencia, Spain
| | - A Gasbarrini
- Department of Spine Surgery, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy
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Weber JS, Schadendorf D, Del Vecchio M, Larkin J, Atkinson V, Schenker M, Pigozzo J, Gogas H, Dalle S, Meyer N, Ascierto PA, Sandhu S, Eigentler T, Gutzmer R, Hassel JC, Robert C, Carlino MS, Di Giacomo AM, Butler MO, Muñoz-Couselo E, Brown MP, Rutkowski P, Haydon A, Grob JJ, Schachter J, Queirolo P, de la Cruz-Merino L, van der Westhuizen A, Menzies AM, Re S, Bas T, de Pril V, Braverman J, Tenney DJ, Tang H, Long GV. Adjuvant Therapy of Nivolumab Combined With Ipilimumab Versus Nivolumab Alone in Patients With Resected Stage IIIB-D or Stage IV Melanoma (CheckMate 915). J Clin Oncol 2023; 41:517-527. [PMID: 36162037 PMCID: PMC9870220 DOI: 10.1200/jco.22.00533] [Citation(s) in RCA: 59] [Impact Index Per Article: 59.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 07/08/2022] [Accepted: 08/01/2022] [Indexed: 01/26/2023] Open
Abstract
PURPOSE Ipilimumab and nivolumab have each shown treatment benefit for high-risk resected melanoma. The phase III CheckMate 915 trial evaluated adjuvant nivolumab plus ipilimumab versus nivolumab alone in patients with resected stage IIIB-D or IV melanoma. PATIENTS AND METHODS In this randomized, double-blind, phase III trial, 1,833 patients received nivolumab 240 mg once every 2 weeks plus ipilimumab 1 mg/kg once every 6 weeks (916 patients) or nivolumab 480 mg once every 4 weeks (917 patients) for ≤ 1 year. After random assignment, patients were stratified by tumor programmed death ligand 1 (PD-L1) expression and stage. Dual primary end points were recurrence-free survival (RFS) in randomly assigned patients and in the tumor PD-L1 expression-level < 1% subgroup. RESULTS At a minimum follow-up of approximately 23.7 months, there was no significant difference between treatment groups for RFS in the all-randomly assigned patient population (hazard ratio, 0.92; 95% CI, 0.77 to 1.09; P = .269) or in patients with PD-L1 expression < 1% (hazard ratio, 0.91; 95% CI, 0.73 to 1.14). In all patients, 24-month RFS rates were 64.6% (combination) and 63.2% (nivolumab). Treatment-related grade 3 or 4 adverse events were reported in 32.6% of patients in the combination group and 12.8% in the nivolumab group. Treatment-related deaths were reported in 0.4% of patients in the combination group and in no nivolumab-treated patients. CONCLUSION Nivolumab 240 mg once every 2 weeks plus ipilimumab 1 mg/kg once every 6 weeks did not improve RFS versus nivolumab 480 mg once every 4 weeks in patients with stage IIIB-D or stage IV melanoma. Nivolumab showed efficacy consistent with previous adjuvant studies in a population resembling current practice using American Joint Committee on Cancer eighth edition, reaffirming nivolumab as a standard of care for melanoma adjuvant treatment.
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Affiliation(s)
- Jeffrey S. Weber
- Laura and Isaac Perlmutter Cancer Center, NYU Langone Health, New York, NY
| | - Dirk Schadendorf
- Department of Dermatology, University of Essen and the German Cancer Consortium, Partner Site, Essen, Germany
| | | | - James Larkin
- The Royal Marsden NHS Foundation Trust, London, United Kingdom
| | - Victoria Atkinson
- Division of Cancer Services, Gallipoli Medical Research Foundation and Princess Alexandra Hospital, University of Queensland, Brisbane, Queensland, Australia
| | | | | | - Helen Gogas
- National and Kapodistrian University of Athens, Athens, Greece
| | | | - Nicolas Meyer
- Institut Universitaire du Cancer and CHU, Toulouse, France
| | | | - Shahneen Sandhu
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Victoria, Australia
| | - Thomas Eigentler
- Universitätsklinikum und Medizinische Fakultät Tübingen, Tübingen, and Charité—Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt Universität zu Berlin, Department of Dermatology, Venerology and Allergology, Berlin, Germany
| | - Ralf Gutzmer
- Medizinische Hochschule Hannover, Hannover, and Mühlenkreiskliniken Minden, Ruhr-Universität Bochum, Bochum, Germany
| | - Jessica C. Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany
| | - Caroline Robert
- Gustave Roussy and Paris-Saclay University, Villejuif Cedex, France
| | - Matteo S. Carlino
- Westmead and Blacktown Hospitals, University of Sydney, Melanoma Institute Australia, Sydney, New South Wales, Australia
| | | | - Marcus O. Butler
- Medical Oncology and Hematology, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | | | - Michael P. Brown
- Cancer Trials Unit, Royal Adelaide Hospital, and School of Medicine, The University of Adelaide, Adelaide, Australia
| | - Piotr Rutkowski
- Maria Sklodowska-Curie National Institute of Oncology, Warsaw, Poland
| | - Andrew Haydon
- The Alfred Hospital, Monash University, Melbourne, Australia
| | - Jean-Jacques Grob
- Department of Dermatology, Aix-Marseille University, Hôpital de la Timone, Marseille, France
| | - Jacob Schachter
- Sheba Medical Center, IEO European Institute of Oncology, Tel-Hashomer, Israel
| | - Paola Queirolo
- IEO European Institute of Oncology, IRCCS, Milan, Italy
- IRCCS San Martino, Genova, Italy
| | | | - Andre van der Westhuizen
- Calvary Mater Newcastle Hospital and University of Newcastle. Waratah, New South Wales, Australia
| | - Alexander M. Menzies
- Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
| | - Sandra Re
- Bristol Myers Squibb Company, Princeton, NJ
| | - Tuba Bas
- Bristol Myers Squibb Company, Princeton, NJ
| | | | | | | | - Hao Tang
- Bristol Myers Squibb Company, Princeton, NJ
| | - Georgina V. Long
- Melanoma Institute Australia, University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, New South Wales, Australia
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Wolchok JD, Chiarion-Sileni V, Gonzalez R, Grob JJ, Rutkowski P, Lao CD, Cowey CL, Schadendorf D, Wagstaff J, Dummer R, Ferrucci PF, Smylie M, Butler MO, Hill A, Márquez-Rodas I, Haanen JBAG, Guidoboni M, Maio M, Schöffski P, Carlino MS, Lebbé C, McArthur G, Ascierto PA, Daniels GA, Long GV, Bas T, Ritchings C, Larkin J, Hodi FS. Long-Term Outcomes With Nivolumab Plus Ipilimumab or Nivolumab Alone Versus Ipilimumab in Patients With Advanced Melanoma. J Clin Oncol 2022; 40:127-137. [PMID: 34818112 PMCID: PMC8718224 DOI: 10.1200/jco.21.02229] [Citation(s) in RCA: 427] [Impact Index Per Article: 213.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
PURPOSE In the phase III CheckMate 067 trial, durable clinical benefit was demonstrated previously with nivolumab plus ipilimumab and nivolumab alone versus ipilimumab. Here, we report 6.5-year efficacy and safety outcomes. PATIENTS AND METHODS Patients with previously untreated unresectable stage III or stage IV melanoma were randomly assigned 1:1:1 to receive nivolumab 1 mg/kg plus ipilimumab 3 mg/kg once every 3 weeks (four doses) followed by nivolumab 3 mg/kg once every 2 weeks (n = 314), nivolumab 3 mg/kg once every 2 weeks (n = 316), or ipilimumab 3 mg/kg once every 3 weeks (four doses; n = 315). Coprimary end points were progression-free survival and overall survival (OS) with nivolumab plus ipilimumab or nivolumab versus ipilimumab. Secondary end points included objective response rate, descriptive efficacy assessments of nivolumab plus ipilimumab versus nivolumab alone, and safety. Melanoma-specific survival (MSS; descriptive analysis), which excludes deaths unrelated to melanoma, was also evaluated. RESULTS Median OS (minimum follow-up, 6.5 years) was 72.1, 36.9, and 19.9 months in the combination, nivolumab, and ipilimumab groups, respectively. Median MSS was not reached, 58.7, and 21.9 months, respectively; 6.5-year OS rates were 57%, 43%, and 25% in patients with BRAF-mutant tumors and 46%, 42%, and 22% in those with BRAF-wild-type tumors, respectively. In patients who discontinued treatment, the median treatment-free interval was 27.6, 2.3, and 1.9 months, respectively. Since the 5-year analysis, no new safety signals were observed. CONCLUSION These 6.5-year CheckMate 067 results, which include the longest median OS in a phase III melanoma trial reported to date and the first report of MSS, showed durable, improved clinical outcomes with nivolumab plus ipilimumab or nivolumab versus ipilimumab in patients with advanced melanoma and, in descriptive analyses, with the combination over nivolumab monotherapy.
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Affiliation(s)
- Jedd D. Wolchok
- Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY,Jedd D. Wolchok, MD, PhD, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, 1275 York Ave, Box 340, New York, NY 10065; e-mail:
| | | | | | | | - Piotr Rutkowski
- Maria Sklodowska-Curie National Institute of Oncology Center, Warsaw, Poland
| | | | - C. Lance Cowey
- Texas Oncology-Baylor Charles A. Sammons Cancer Center, Dallas, TX
| | - Dirk Schadendorf
- University of Essen, Essen, and German Cancer Consortium, Heidelberg, Germany
| | - John Wagstaff
- The College of Medicine, Swansea University, Swansea, United Kingdom
| | | | | | | | | | - Andrew Hill
- Tasman Oncology Research, Southport, Queensland, Australia
| | | | | | - Massimo Guidoboni
- Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori IRCCS, Meldola, Italy
| | - Michele Maio
- Center for Immuno-Oncology, University Hospital of Siena, Siena, Italy
| | - Patrick Schöffski
- University Hospitals Leuven, Department of General Medical Oncology, Leuven Cancer Institute, KU Leuven, Leuven, Belgium
| | - Matteo S. Carlino
- Westmead and Blacktown Hospitals, University of Sydney, Melanoma Institute Australia, Sydney, Australia
| | - Céleste Lebbé
- Université de Paris, Department of Dermatology and CIC, AP-HP Hôpital Saint Louis, INSERM U976, Paris, France
| | - Grant McArthur
- Peter MacCallum Cancer Centre, East Melbourne, Australia
| | - Paolo A. Ascierto
- Melanoma Cancer Immunotherapy and Innovative Therapy Unit, Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | | | - Georgina V. Long
- Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, Sydney, Australia
| | - Tuba Bas
- Bristol Myers Squibb, Princeton, NJ
| | | | - James Larkin
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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Tawbi H, Forsyth P, Hodi F, Algazi A, Hamid O, Lao C, Moschos S, Atkins M, Lewis K, Postow M, Thomas R, Khushalani N, Pavlick A, Ernstoff M, Reardon D, Chung C, Lee CW, Bas T, Askelson M, Margolin K. 1039MO CheckMate 204: 3-year outcomes of treatment with combination nivolumab (NIVO) plus ipilimumab (IPI) for patients (pts) with active melanoma brain metastases (MBM). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1424] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Wolchok JD, Chiarion-Sileni V, Gonzalez R, Grob JJ, Rutkowski P, Lao CD, Cowey CL, Schadendorf D, Wagstaff J, Dummer R, Ferrucci PF, Smylie M, Butler MO, Hill AG, Marquez-Rodas I, Haanen JBAG, Bas T, van Dijck W, Larkin J, Hodi FS. CheckMate 067: 6.5-year outcomes in patients (pts) with advanced melanoma. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.9506] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9506 Background: In the phase 3 CheckMate 067 trial, a durable and sustained clinical benefit was achieved with nivolumab (NIVO) + ipilimumab (IPI) and NIVO alone vs IPI at 5-y of follow-up (overall survival [OS] and progression-free survival [PFS] rates: 52%, 44%, 26% and 36%, 29%, 8%, respectively). Here we report 6.5-y efficacy and safety outcomes. Methods: Eligible pts with previously untreated unresectable stage III or IV melanoma were randomly assigned in a 1:1:1 ratio and stratified by PD-L1 status, BRAF mutation status, and metastasis stage. Pts received NIVO 1 mg/kg + IPI 3 mg/kg for 4 doses Q3W followed by NIVO 3 mg/kg Q2W (n = 314), NIVO 3 mg/kg Q2W + placebo (n = 316), or IPI 3 mg/kg Q3W for 4 doses + placebo (n = 315) until progression or unacceptable toxicity. Co-primary endpoints were PFS and OS with NIVO + IPI or NIVO vs IPI. Secondary endpoints included objective response rate (ORR), descriptive efficacy assessments of NIVO + IPI vs NIVO alone, and safety. Results: With a minimum follow-up of 6.5 y, median OS was 72.1 mo with NIVO + IPI, 36.9 mo with NIVO, and 19.9 mo with IPI (table). Median time from randomization to subsequent systemic therapy was not reached (NR; 95% CI, 59.6–NR) with NIVO + IPI, 25.2 mo (95% CI, 16.0–43.2) with NIVO, and 8.0 mo (95% CI, 6.5–8.7) with IPI; 36%, 49%, and 66% of pts, respectively, received any subsequent systemic therapy. Median treatment-free interval (which excluded pts who discontinued follow-up prior to initiation of subsequent systemic therapy) was 27.6 mo (range, 0–83.0), 2.3 mo (range, 0.2–81.6), and 1.9 mo (range, 0.1–81.9) with NIVO + IPI, NIVO, and IPI, respectively. Of the pts alive and in follow-up, 112/138 (81%; NIVO + IPI), 84/114 (74%; NIVO), and 27/63 (43%; IPI) were off treatment and never received subsequent systemic therapy; 7, 8, and 0 pts, respectively, were still on treatment. Grade 3/4 treatment-related adverse events were reported in 59% of NIVO + IPI-treated pts, 24% of NIVO-treated pts, and 28% of IPI-treated pts. Since the 5-y analysis, no new safety signals were observed and no additional treatment-related deaths occurred. Conclusions: This 6.5-y analysis represents the longest follow-up from a phase 3 melanoma trial in the modern checkpoint inhibitor combination therapy and targeted therapy era. The results show durable improved outcomes with NIVO + IPI and NIVO vs IPI in pts with advanced melanoma. We observed improvement in OS, PFS, and ORR with NIVO + IPI over NIVO alone. Clinical trial information: NCT01844505. [Table: see text]
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Affiliation(s)
- Jedd D. Wolchok
- Medical Oncology, Memorial Sloan Kettering Cancer Center, and Weill Cornell Medical College, New York, NY
| | | | | | | | - Piotr Rutkowski
- Maria Sklodowska-Curie Institute-Oncology Center, Warsaw, Poland
| | - Christopher D. Lao
- Michigan Medicine, Rogel Cancer Center, University of Michigan, Ann Arbor, MI
| | | | - Dirk Schadendorf
- Department of Dermatology, University of Essen, Essen, and German Cancer Consortium, Heidelberg, Germany
| | - John Wagstaff
- The College of Medicine, Swansea University, Swansea, United Kingdom
| | - Reinhard Dummer
- Skin Cancer Center, University Hospital of Zürich, Zürich, Switzerland
| | | | | | | | | | - Ivan Marquez-Rodas
- Medical Oncology, General University Hospital Gregorio Marañón & CIBERONC, Madrid, Spain
| | | | - Tuba Bas
- Bristol Myers Squibb, Princeton, NJ
| | | | - James Larkin
- The Royal Marsden Hospital NHS Foundation Trust, London, United Kingdom
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9
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Paz-Ares L, Vicente D, Tafreshi A, Robinson A, Soto Parra H, Mazières J, Hermes B, Cicin I, Medgyasszay B, Rodríguez-Cid J, Okamoto I, Lee S, Ramlau R, Vladimirov V, Cheng Y, Deng X, Zhang Y, Bas T, Piperdi B, Halmos B. A Randomized, Placebo-Controlled Trial of Pembrolizumab Plus Chemotherapy in Patients With Metastatic Squamous NSCLC: Protocol-Specified Final Analysis of KEYNOTE-407. J Thorac Oncol 2020; 15:1657-1669. [DOI: 10.1016/j.jtho.2020.06.015] [Citation(s) in RCA: 206] [Impact Index Per Article: 51.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 06/10/2020] [Accepted: 06/16/2020] [Indexed: 12/16/2022]
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Rodriguez-Abreu D, Powell SF, Hochmair M, Gadgeel SM, Esteban E, Felip E, Speranza G, Dómine Gomez M, Cheng SY, Bischoff H, Peled N, Reck M, Hui R, Garon EB, Boyer MJ, Kurata T, Yang J, Bas T, Souza FG, Garassino MC. Final analysis of KEYNOTE-189: Pemetrexed-platinum chemotherapy (chemo) with or without pembrolizumab (pembro) in patients (pts) with previously untreated metastatic nonsquamous non-small cell lung cancer (NSCLC). J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.9582] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9582 Background: The phase III KEYNOTE-189 study (NCT02578680), showed significant improvements in OS and PFS with pembro + chemo vs placebo + chemo in pts with previously untreated metastatic nonsquamous NSCLC without sensitizing EGFR/ALK mutations. We report the protocol-specified final analysis of KEYNOTE-189. Methods: Pts were randomized 2:1 to receive 35 cycles of pembro 200 mg Q3W (n = 410) or placebo Q3W (n = 206) plus 4 cycles of pemetrexed (pem) and carboplatin/cisplatin followed by maintenance pem. Pts in the placebo + chemo arm could crossover to pembro upon PD. PFS and OS were primary endpoints; ORR was a secondary endpoint. PFS2 (time from randomization to objective tumor progression on next-line treatment/death), was an exploratory endpoint. Results: At data cutoff (May 20, 2019), median (range) time from randomization to data cutoff was 31.0 (26.5–38.8) mo. 17 pts in the pembro + chemo arm and 1 pt in the placebo + chemo arm were receiving initially assigned treatment; 84 pts crossed over to pembro. Median (95% CI) OS (22.0 [19.5–24.5] vs 10.6 [8.7–13.6] mo; HR 0.56 [95% CI, 0.46–0.69]) and PFS (9.0 [8.1–10.4] vs 4.9 [4.7–5.5] mo; HR 0.49 [95% CI, 0.41–0.59]) were longer with pembro + chemo vs placebo + chemo (Table). The 2-y OS rate was 45.7% vs 27.3% and the 2-y PFS rate was 22.0% vs 3.4%. ORR was 48.3% with pembro + chemo vs 19.9% with placebo + chemo. 56 pts in the pembro + chemo arm completed 35 cycles of pembro among whom ORR was 85.7% (4 CR, 44 PR, 8 SD) and median OS was not reached. 292 (72.1%) pts in the pembro + chemo arm and 135 (66.8%) pts in the placebo + chemo arm had grade 3–5 AEs. Conclusions: Pembro + chemo continued to show improved outcomes in OS, PFS, ORR and PFS2 compared with placebo + chemo, with manageable toxicity. These findings support first-line pembro + chemo in pts with previously untreated metastatic nonsquamous NSCLC. Clinical trial information: NCT02578680 . [Table: see text]
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Affiliation(s)
- Delvys Rodriguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas De Gran Canaria, Spain
| | | | - Maximilian Hochmair
- Department of Respiratory and Critical Care Medicine and Ludwig Boltzmann Institute for COPD and Respiratory Epidemiology, Vienna, Austria
| | - Shirish M. Gadgeel
- Karmanos Cancer Institute (currently at University of Michigan, Ann Arbor), Detroit, MI
| | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Giovanna Speranza
- Centre Integré de Cancérologie de la Montérégie, Hôpital Charles-Le Moyne, Greenfield Park, QC, Canada
| | | | | | | | - Nir Peled
- Davidoff Cancer Center, Tel Aviv University, Petah Tikva (currently at Soroka Medical Center, Ben-Gurion University, Beer-Sheeva), Israel
| | - Martin Reck
- LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - Rina Hui
- Westmead Hospital and University of Sydney, Sydney, NSW, Australia
| | | | | | | | | | - Tuba Bas
- Merck & Co., Inc., Kenilworth, NJ
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11
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Gadgeel S, Rodríguez-Abreu D, Speranza G, Esteban E, Felip E, Dómine M, Hui R, Hochmair MJ, Clingan P, Powell SF, Cheng SYS, Bischoff HG, Peled N, Grossi F, Jennens RR, Reck M, Garon EB, Novello S, Rubio-Viqueira B, Boyer M, Kurata T, Gray JE, Yang J, Bas T, Pietanza MC, Garassino MC. Updated Analysis From KEYNOTE-189: Pembrolizumab or Placebo Plus Pemetrexed and Platinum for Previously Untreated Metastatic Nonsquamous Non–Small-Cell Lung Cancer. J Clin Oncol 2020; 38:1505-1517. [DOI: 10.1200/jco.19.03136] [Citation(s) in RCA: 410] [Impact Index Per Article: 102.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
PURPOSE In KEYNOTE-189, first-line pembrolizumab plus pemetrexed-platinum significantly improved overall survival (OS) and progression-free survival (PFS) compared with placebo plus pemetrexed-platinum in patients with metastatic nonsquamous non‒small-cell lung cancer (NSCLC), irrespective of tumor programmed death-ligand 1 (PD-L1) expression. We report an updated analysis from KEYNOTE-189 (ClinicalTrials.gov: NCT02578680 ). METHODS Patients were randomly assigned (2:1) to receive pemetrexed and platinum plus pembrolizumab (n = 410) or placebo (n = 206) every 3 weeks for 4 cycles, then pemetrexed maintenance plus pembrolizumab or placebo for up to a total of 35 cycles. Eligible patients with disease progression in the placebo-combination group could cross over to pembrolizumab monotherapy. Response was assessed per RECIST (version 1.1) by central review. No alpha was assigned to this updated analysis. RESULTS As of September 21, 2018 (median follow-up, 23.1 months), the updated median (95% CI) OS was 22.0 (19.5 to 25.2) months in the pembrolizumab-combination group versus 10.7 (8.7 to 13.6) months in the placebo-combination group (hazard ratio [HR], 0.56; 95% CI, 0.45 to 0.70]). Median (95% CI) PFS was 9.0 (8.1 to 9.9) months and 4.9 (4.7 to 5.5) months, respectively (HR, 0.48; 95% CI, 0.40 to 0.58). Median (95% CI) time from randomization to objective tumor progression on next-line treatment or death from any cause, whichever occurred first (progression-free-survival-2; PFS-2) was 17.0 (15.1 to 19.4) months and 9.0 (7.6 to 10.4) months, respectively (HR, 0.49; 95% CI, 0.40 to 0.59). OS and PFS benefits with pembrolizumab were observed regardless of PD-L1 expression or presence of liver/brain metastases. Incidence of grade 3-5 adverse events was similar in the pembrolizumab-combination (71.9%) and placebo-combination (66.8%) groups. CONCLUSION First-line pembrolizumab plus pemetrexed-platinum continued to demonstrate substantially improved OS and PFS in metastatic nonsquamous NSCLC, regardless of PD-L1 expression or liver/brain metastases, with manageable safety and tolerability.
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Affiliation(s)
| | - Delvys Rodríguez-Abreu
- Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Universidad de Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Spain
| | - Giovanna Speranza
- Centre Integré de Cancérologie de la Montérégie, Hôpital Charles-Le Moyne, Greenfield Park, Quebec, Canada
| | - Emilio Esteban
- Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Enriqueta Felip
- Vall d’Hebron University, Vall d’Hebron Institute of Oncology, Barcelona, Spain
| | - Manuel Dómine
- Hospital Universitario Fundación Jiménez Díaz, IIS-FJD, Madrid, Spain
| | - Rina Hui
- Westmead Hospital and University of Sydney, Sydney, New South Wales, Australia
| | - Maximilian J. Hochmair
- Department of Respiratory and Critical Care Medicine, Karl Landsteiner Institute of Lung Research and Pulmonary Oncology, Vienna, Austria
| | - Philip Clingan
- Southern Medical Day Care Centre, Wollongong, New South Wales, Australia
| | | | | | | | - Nir Peled
- Soroka Medical Center, Ben-Gurion University, Beer Sheva, Israel
| | - Francesco Grossi
- Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | - Martin Reck
- LungenClinic, Airway Research Center North, German Center for Lung Research, Grosshansdorf, Germany
| | - Edward B. Garon
- David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA
| | - Silvia Novello
- Department of Oncology, University of Turin, Azienda Ospedaliero-Universitaria San Luigi, Orbassano, Italy
| | | | - Michael Boyer
- Chris O’Brien Lifehouse, Camperdown, New South Wales, Australia
| | | | | | | | | | | | - Marina C. Garassino
- Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale dei Tumori, Milan, Italy
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12
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Paz-Ares L, Vicente D, Tafreshi A, Robinson A, Soto Parra H, Mazières J, Hermes B, Cicin I, Medgyasszay B, Beatrix B, Rodríguez Cid J, Okamoto I, Lee S, Ramlau R, Vladimirov V, Cheng Y, Deng X, Bas T, Piperdi B, Halmos B. Pembrolizumab (pembro) + chemotherapy (chemo) in metastatic squamous NSCLC: Final analysis and progression after the next line of therapy (PFS2) in KEYNOTE-407. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.080] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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13
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Jež M, Rožman P, Ivanović Z, Bas T. Concise Review: The Role of Oxygen in Hematopoietic Stem Cell Physiology. J Cell Physiol 2015; 230:1999-2005. [DOI: 10.1002/jcp.24953] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 01/29/2015] [Indexed: 12/13/2022]
Affiliation(s)
- Mojca Jež
- Department of Immunohematology; Blood Transfusion Centre of Slovenia; Šlajmerjeva 6, Ljubljana Slovenia
| | - Primož Rožman
- Department of Immunohematology; Blood Transfusion Centre of Slovenia; Šlajmerjeva 6, Ljubljana Slovenia
| | - Zoran Ivanović
- Aquitaine-Limousin Branch of French Blood Institute; CNRS/Bordeaux University UMR 5164; Bordeaux France
| | - Tuba Bas
- Department of Medicine; Albert Einstein College of Medicine; 1300 Morris Park Avenue, Bronx New York
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14
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Abstract
The small intestinal mucosa exhibits a repetitive architecture organized into two fundamental structures: villi, projecting into the intestinal lumen and composed of mature enterocytes, goblet cells and enteroendocrine cells; and crypts, residing proximal to the submucosa and the muscularis, harboring adult stem and progenitor cells and mature Paneth cells, as well as stromal and immune cells of the crypt microenvironment. Until the last few years, in vitro studies of small intestine was limited to cell lines derived from either benign or malignant tumors, and did not represent the physiology of normal intestinal epithelia and the influence of the microenvironment in which they reside. Here, we demonstrate a method adapted from Sato et al. (2009) for culturing primary mouse intestinal crypt organoids derived from C57BL/6 mice. In addition, we present the use of crypt organoid cultures to assay the crypt metabolic profile in real time by measurement of basal oxygen consumption, glycolytic rate, ATP production and respiratory capacity. Organoids maintain properties defined by their source and retain aspects of their metabolic adaptation reflected by oxygen consumption and extracellular acidification rates. Real time metabolic studies in this crypt organoid culture system are a powerful tool to study crypt organoid energy metabolism, and how it can be modulated by nutritional and pharmacological factors.
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Affiliation(s)
- Tuba Bas
- Department of Medicine, Albert Einstein College of Medicine;
| | - Leonard H Augenlicht
- Department of Medicine, Albert Einstein College of Medicine; Department of Cell Biology, Albert Einstein College of Medicine
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15
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Bas T, Gao GY, Lvov A, Chandrasekhar KD, Gilmore R, Kobertz WR. Post-translational N-glycosylation of type I transmembrane KCNE1 peptides: implications for membrane protein biogenesis and disease. J Biol Chem 2011; 286:28150-9. [PMID: 21676880 DOI: 10.1074/jbc.m111.235168] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
N-Glycosylation of membrane proteins is critical for their proper folding, co-assembly and subsequent matriculation through the secretory pathway. Here, we examine the kinetics of N-glycan addition to type I transmembrane KCNE1 K(+) channel β-subunits, where point mutations that prevent N-glycosylation at one consensus site give rise to disorders of the cardiac rhythm and congenital deafness. We show that KCNE1 has two distinct N-glycosylation sites: a typical co-translational site and a consensus site ∼20 residues away that unexpectedly acquires N-glycans after protein synthesis (post-translational). Mutations that ablate the co-translational site concomitantly reduce glycosylation at the post-translational site, resulting in unglycosylated KCNE1 subunits that cannot reach the cell surface with their cognate K(+) channel. This long range inhibition is highly specific for post-translational N-glycosylation because mutagenic conversion of the KCNE1 post-translational site into a co-translational site restored both monoglycosylation and anterograde trafficking. These results directly explain how a single point mutation can prevent N-glycan attachment at multiple sites, providing a new biogenic mechanism for human disease.
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Affiliation(s)
- Tuba Bas
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605-2324, USA
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16
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Chandrasekhar KD, Bas T, Kobertz WR. KCNE1 subunits require co-assembly with K+ channels for efficient trafficking and cell surface expression. J Biol Chem 2006; 281:40015-23. [PMID: 17065152 DOI: 10.1074/jbc.m604398200] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
KCNE peptides are a class of type I transmembrane beta subunits that assemble with and modulate the gating and ion conducting properties of a variety of voltage-gated K(+) channels. Accordingly, mutations that disrupt the assembly and trafficking of KCNE-K(+) channel complexes give rise to disease. The cellular mechanisms responsible for ensuring that KCNE peptides assemble with voltage-gated K(+) channels have yet to be elucidated. Using enzymatic deglycosylation, immunofluorescence, and quantitative cell surface labeling experiments, we show that KCNE1 peptides are retained in the early stages of the secretory pathway until they co-assemble with specific K(+) channel subunits; co-assembly mediates KCNE1 progression through the secretory pathway and results in cell surface expression. We also address an apparent discrepancy between our results and a previous study in human embryonic kidney cells, which showed wild type KCNE1 peptides can reach the plasma membrane without exogenously expressed K(+) channel subunits. By comparing KCNE1 trafficking in three cell lines, our data suggest that the errant KCNE1 trafficking observed in human embryonic kidney cells may be due, in part, to the presence of endogenous voltage-gated K(+) channels in these cells.
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Affiliation(s)
- Kshama D Chandrasekhar
- Department of Biochemistry and Molecular Pharmacology, University of Massachusetts Medical School, Worcester, Massachusetts 01605, USA
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17
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Abstract
STUDY DESIGN The clinical records and radiographs of 18 patients with vertebral hemangiomas treated with ethanol vertebroplasty were reviewed to evaluate the usefulness of this method. OBJECTIVES To assess, after a mean 2-year follow-up, the complication rate, results, and patient satisfaction with ethanol injection into vertebral hemangioma. SUMMARY OF BACKGROUND DATA There is controversy about the safety of ethanol injections in the treatment of vertebral hemangiomas. METHODS Twenty-four patients with vertebral hemangiomas were prepared for ethanol vertebroplasty. Eighteen patients were treated with ethanol vertebroplasty (average age, 49 years; range, 18-77 years) with a mean follow-up of 2 years (range, 1-4 years). The rest of the patients were not treated with ethanol vertebroplasty because in a pretreatment test injection the contrast medium was not retained by the hemangioma. RESULTS Intralesional injections of alcohol did not cause clinical complications in any of the cases. CONCLUSIONS This study shows that intralesional alcohol injections can be considered a safe technique for vertebral hemangiomas. However, a careful technique is required.
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Affiliation(s)
- T Bas
- Unidad de Raquis, Hospital de la Ribera, Alzira, Spain
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18
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Prieto-Rodríguez M, Camañas-Sanz A, Bas T, Cortés B, Vera-Sempere FJ. Psammomatous melanotic schwannoma localized in the mediastinum: diagnosis by fine-needle aspiration cytology. Diagn Cytopathol 1998; 19:298-302. [PMID: 9784997 DOI: 10.1002/(sici)1097-0339(199810)19:4<298::aid-dc15>3.0.co;2-i] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The cytological characteristics are presented in a case of psammomatous melanotic schwannoma localized in the mediastinum, diagnosed by fine-needle aspiration cytology (FNAC), with later histological confirmation. This lesion affected a 38-year-old male, with a tumor measuring 5 cm in diameter located in the posterior mediastinum in contact with the spinal cord, with erosion of the adjacent vertebra (T5), that caused constant pain localized in the right scapular region with an evolution of several weeks. The cytological characteristics of psammomatous melanotic schwannoma are discussed, along with the histological and immunohistochemical features of this infrequent neural tumor, which aid in establishing a differential diagnosis. The importance of a correct histological diagnosis of this tumor is of particular clinical relevance after having been identified as one of the possible components of Carney's complex. This possibility demands a meticulous patient exploration in search of any other components that make up this complex, given the aggressive character of some of them. These lesions could, if not detected early enough, produce fatal consequences for the patient, fundamentally in those patients with cardiac myxomas. In this case, following an exhaustive clinical examination there was no pathology associated with this complex. It is therefore considered to be an isolated psammomatous melanotic schwannoma, and not a part of Carney's complex.
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Affiliation(s)
- M Prieto-Rodríguez
- Department of Pathology, University Hospital La Fe, Valencia Medical School, Spain
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19
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Abstract
In a randomized controlled clinical trial, 14 patients requiring resection of tumors were divided in two groups: one group was anesthetized with nitrous oxide [67% N2O-33% O2 (vol/vol)] and the other with propofol. Two other groups of subjects were studied: a group of patients that was undergoing orthopedic procedures and was anesthetized with nitrous oxide [67% N2O-33% O2 (vol/vol)] and a control group (fasted for 10 hrs and no anesthesia). In patients requiring resection of tumors, the blood L-methionine concentration was significantly lower and the blood amino acid pattern was significantly affected after the administration of nitrous oxide (120-310 mins) compared with values after the induction of anesthesia and before surgery. The administration of propofol (120-240 mins) did not produce any of these changes. No patients required blood transfusion during surgery, and the patients had not previously been treated with cancer chemotherapeutic agents. The administration of nitrous oxide (60-150 mins) to patients undergoing orthopedic procedures did not affect blood L-methionine. It is concluded that the administration of nitrous oxide to cancer-bearing patients, but not to those undergoing orthopedic surgery, produced major changes in amino acid metabolism; therefore, consideration should be given to the avoidance of exposure of cancer patients to nitrous oxide.
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Affiliation(s)
- M L Crespo
- Departamento de Anestesia y Reanimación, Hospital Universitario La Fe, Valencia, Spain
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20
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21
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Abstract
Chordomas are rare skeletal tumors arising from the embryonic remains of the notochord [18, 30]. These tumors tend to appear in midline regions, particularly at the upper and lower extremities of the spinal column. We report the case of a 74-year-old woman with radicular compression associated with an L3 chordoma that was treated with a wide resection.
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Affiliation(s)
- T Bas
- Servicio de Cirugía Ortopédica y Traumatología B. Hospital Universitario La Fe, Valencia, Spain
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22
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Roux M, Bourseau JP, Bas T, Dumont T, de Graciansky PC, Lemoine M, Rudkiewicz JL. Bathymetric evolution of the Tethyan margin in the Western Alps (data from stalked crinoids); a reappraisal of eustatism problems during the Jurassic. ACTA ACUST UNITED AC 1988. [DOI: 10.2113/gssgfbull.iv.4.633] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- M. Roux
- Univ. Claude Bernard-Lyon I, Villeurbanne, France
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