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Ključne besede: onkologija, imunoterapija, zaviralci imunskih kontrolnih točk
Objavljeno v DiRROS: 11.09.2025; Ogledov: 537; Prenosov: 122
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Ključne besede: rak pljuč, kemoterapija, durvalumab
Objavljeno v DiRROS: 03.09.2025; Ogledov: 390; Prenosov: 143
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Povzetek: Črevesni mikrobiom predstavlja genetsko zasnovo vseh mikrobov, ki obstajajo v človeškem prebavnem traktu in vsebuje okoli 38 bilijonov mikroorganizmov, ki kodira več kot tri milijone genov. Razvoj novih tehnik molekularnega sekvenciranja je omogočil poglobljeno raziskovanje človeškega mikrobioma, ki je vpleten v presnovo hranil, zdravil, vzdržuje celovito bariero črevesne sluznice, varuje pred patogenimi mikroorganizmi in lahko spreminja imunski odziv gostitelja. Vedno več je dokazov, da je črevesni mikrobiom vpleten v razvoj nekaterih malignih bolezni in vpliva na učinkovitost onkološkega zdravljenja, predvsem na imunoterapijo. Sedanje razumevanje številnih zapletenih interakcij med črevesnim mikrobiomom, gostiteljevim imunskim sistemom, prehrano, zdravili in malignimi celicami temelji na manjših retrospektivnih in opazovalnih raziskavah. Namen tega prispevka je pregled razpoložljivih podatkov o mikrobiomu in naše dosedanje razumevanje vloge črevesnega mikrobioma pri bolnikih z rakom.
Ključne besede: črevesni mikrobiom, kancerogeneza, imunoterapija, zaviralci imunskih nadzornih točk
Objavljeno v DiRROS: 21.05.2025; Ogledov: 542; Prenosov: 281
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Povzetek: Background. Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective treatments for EGFR mutation-positive (EGFRm) non-small cell lung cancer (NSCLC). However, routine clinical practice is different between countries/institutions. Patients and methods. The REFLECT study (NCT04031898) is a retrospective medical chart review that explored real-life treatment and outcomes of EGFRm NSCLC patients receiving first-line (1L) first-/second-generation (1G/2G) EGFR TKIs in 8 countries. This study included adult patients with documented advanced/metastatic EGFRm NSCLC with 1L 1G/2G EGFR TKIs initiated between Jan 2015 – Jun 2018. We reviewed data on clinical characteristics, treatments, EGFR/T790M testing patterns, and survival outcomes. Here, we report data from 120 medical charts in 3 study sites from Slovenia. Results. The Slovenian cohort (median age 70 years, 74% females) received 37% erlotinib, 32% afatinib, 31% gefitinib. At the time of data collection, 94 (78%) discontinuations of 1L TKI, and 89 (74%) progression events on 1L treatment were reported. Among patients progressing on 1L, 73 (82%) were tested for T790M mutation yielding 50 (68%) positive results, and 62 (85%) received 2L treatment. 82% of patients received osimertinib. Attrition rate between 1L and 2L was 10%. The median (95% CI) real-world progression free survival on 1L EGFR TKIs was 15.6 (12.6, 19.2) months; median overall survival (95% CI) was 28.9 (25.0, 34.3) months. Conclusions. This real-world study provides valuable information about 1G/2G EGFR TKIs treatment outcomes and attrition rates in Slovenian EGFRm NSCLC patients. The reduced attrition rate and improved survival outcomes empha-size the importance of 1L treatment decision.
Ključne besede: real-world study, non-small cell lung cancer, epidermal growth factor receptor, lung cancer
Objavljeno v DiRROS: 25.07.2024; Ogledov: 1034; Prenosov: 401
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Povzetek: Uncommon responses during immunotherapy is a new challenging issue in oncology practice. Recently, new criteria for evaluation of response to immunotherapy immune response evaluation criteria solid tumors (iRECIST) were accepted. According to iRECIST, worsening of performance status (PS) accompanied to pseudoprogression reflects most probably the true progression of the malignant disease. Methods. A systematic review of the literature was made by using several electronic database with the following search criteria: symptomatic pseudoprogression, atypical response, immunotherapy and lung cancer. Results. In the literature, we identified five reports of seven patients treated with immunotherapy that met the inclusion criteria. We also report our experience of patient with pseudoprogression and almost complete response after one dose of immunotherapy. Conclusions. As seen from our review, iRECIST criteria might be insufficient in distinguishing true progression from pseudoprogression in some patients with advanced NSCLC treated with immunotherapy. More precise assessment methods are urgently needed.
Ključne besede: symptomatic pseudoprogression, atypical response, immunotherapy, lung cancer
Objavljeno v DiRROS: 11.06.2024; Ogledov: 1094; Prenosov: 287
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