Durable Remissions with Ivosidenib in IDH1-Mutated Relapsed or Refractory AML

Somatic mutations within the conserved active site of isocitrate dehydrogenase (IDH) 1 and 2 occur in multiple tumors, including glioma, acute myeloid leukemia (AML), cholangiocarcinoma, and chondrosarcoma. IDH1 and IDH2 mutations confer a neomorphic enzymatic activity, resulting in the reduction…

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Durable Remissions with Ivosidenib in IDH1-Mutated Relapsed or Refractory AML

Somatic mutations within the conserved active site of isocitrate dehydrogenase (IDH) 1 and 2 occur in multiple tumors, including glioma, acute myeloid leukemia (AML), cholangiocarcinoma, and chondrosarcoma. IDH1 and IDH2 mutations confer a neomorphic enzymatic activity, resulting in the reduction…

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Case 20-2018: A 64-Year-Old Man with Fever, Arthralgias, and Testicular Pain

Presentation of Case. Dr. Jaime L. Schneider (Medicine): A 64-year-old man was admitted to this hospital with a 2-week history of fever, chills, arthralgias, abdominal and testicular pain, and leukocytosis. Twenty-five years before the current admission, while the patient was living in China, he…

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Case 19-2018: A 15-Year-Old Girl with Acute Kidney Injury

Presentation of Case. Dr. Helen I. Healy (Pediatrics): A 15-year-old girl was admitted to this hospital during the summer because of acute kidney injury. The patient had been well until 8 days before admission, when painful cramping in the lower abdomen and bloody diarrhea developed. Bowel…

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Addition of targeted agents to chemotherapy for persistent or recurrent ovarian cancer: a meta-analysis of randomized controlled trials

Publication date: Available online 30 June 2018
Source:Critical Reviews in Oncology/Hematology
Author(s): Xiao Li, Yuchan Mao, Qiwen Wu, Yuanyuan Liu, Qianqian Wu, Binghuan Wen
AimThe majority of epithelial ovarian cancer patients who achieve a full remission following first-line chemotherapy would finally develop recurrent disease. However, the optimal management of recurrent ovarian cancer (ROC) remains undefined. The preset meta-analysis aims to evaluate the role of novel targeted agents (TAs) in the treatment of ROC in terms of response, overall survival and toxicities.Materials and methodsEligible studies were identified using Medline, Pubmed, and meeting abstracts. Searches were last updated on April 30, 2018. Eligible randomized controlled studies reported survival, toxicities and/or response data for ROC patients receiving novel TAs were included. Primary outcomes of interest were objective response rate (ORR), overall survival (OS), progression free survival (PFS) and adverse events (AEs).ResultsA total of 6,606 patients from 16 studies were eligible for analysis. The pooled results showed that the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.63, 95%CI: 1.33-2.00, p < 0.001), PFS (0.78, 95%CI: 0.68-0.89, p < 0.001) and OS (HR 0.92, 95%CI: 0.87-0.99, p = 0.016) in ROC patients when compared to controls. Similar results in terms of ORR (RR 2.23, p < 0.001), PFS (HR 0.65, p < 0.001), and OS (HR 0.89, p = 0.015) were observed in platinum-sensitive ROC who received TAs. While the addition of novel TAs to chemotherapy significantly improved ORR (RR 1.84, p = 0.002) in platinum-resistant or refractory ROC, it did not translate into PFS (HR 0.83, p = 0.067) and OS (HR 0.94, p = 0.19) benefits. Sub-group analysis according to specific targeted agents showed that combination angiogenesis inhibitors with chemotherapy significantly improved PFS (HR 0.67, p = 0.018), but not for OS (HR 0.93, p = 0.31). As for toxicities, the use of TAs in ROC significantly increased the risk of developing serious AEs (RR 1.27, 95%CI: 1.08-1.50, p = 0.005) and AEs leading to treatment discontinuation (RR 1.93, 95%CI: 1.31-2.84, p = 0.001), but not for fatal AEs (RR: 1.49, 95% CI: 0.89–2.48, p = 0.13). In addition, correlation analysis indicates that PFS (r=0.86, p < 0.001) and ORR (r=0.85, p < 0.001) was strongly correlated with OS for ROC patients received TAs.ConclusionCombination treatment with novel TAs and chemotherapy significantly improved ORR, PFS and OS in platinum-sensitive ROC with an increased risk of severe adverse events. Conversely, we detect no statistically significant survival benefit in platinum-resistant or refractory ROC received TAs. Further prospective randomized studies are needed to confirm our findings and investigate more efficient agents in platinum-resistant or refractory ROC.



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Agenesis of dorsal pancreas associated with pancreatic neuroendocrine tumor: a case report and review of the literature

Agenesis of the dorsal pancreas is very rare. Less than 70 cases have been reported to date. Some of these cases had an association with a tumor. The literature of agenesis of the dorsal pancreas and agenesis ...

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HBV infection and extra-hepatic cancers in adolescents and 20s: A retrospective study in China

Publication date: August 2018
Source:Cancer Epidemiology, Volume 55
Author(s): Tingna Lu, Qing Yang, Mei Li, Jiqing Zhang, Jing Zou, Lu Huang, Jianhua Lin, Haosheng Jin, Jiman He
BackgroundThe mean age at cancer diagnosis is younger in hepatitis B virus (HBV) infected than non-infected patients. It remains unknown whether this association reflects an increase in the incidence rates of extra-hepatic cancers in adolescents and younger.MethodsWe examined 10 common extra-hepatic cancers (lung, breast, gastric, prostate, esophageal, rectal, cervical, nasopharyngeal, lymphatic, and urinary bladder) among patients diagnosed at three Chinese hospitals during 2007–2016. We compared the percentage distribution (frequencies at each age point are shown as a percentage of the total frequency) of HBsAg+ with HBsAgˉ patients, and calculated the standardized incidence ratio for each age group.ResultsA total of 60,323 patients were identified. The mean age at cancer diagnosis was 1.5–5.5 years younger in hepatitis B surface antigen (HBsAg) positive patients compared to HBsAgˉ patients (p ≤ 0.001). Lymphoma patients had the highest prevalence rate of HBV infection (20.7%). Among the pooled HBsAg+ cancer patients, 14.8% (1138/7666) were aged ≤39 years; by contrast, 9.7% (5122/52657) of HBsAgˉ cancer patients were in the same age range, giving an odds ratio of 1.6 [95%CI1.509–1.733)]. The observations were similar when each cancer was considered individually. The odds ratio was greater in pooled male patients aged ≤39 years [1.9(95%CI1.705–2.085)] compared with females [1.6(95%CI1.382–1.83)]. The ratio of the observed to the expected number of HBsAg+ patients aged 15–19, 20–24, and 25–29 years were 3.3, 4.8 and 2.0, respectively, higher than 1.2–1.7 observed for older age-groups.ConclusionHBV infection is a risk factor for diverse extra-hepatic cancers in adolescents and 20s.



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