Metastatic urothelial carcinoma has been associated with poor prognosis and a median survival of approximately 12-14 months with standard therapy. Treatment options for decades have been limited to platinum based chemotherapy as first line with few therapeutic options available to the majority who will ultimately progress beyond platinum. Areas covered: This review focuses on the various targeted, antiangiogenic, chemotherapeutic and immunotherapeutic agents currently being developed for the treatment of urothelial carcinoma. Expert opinion: Incorporation of systemic immunotherapy into the treatment of urothelial carcinoma has already fundamentally changed the treatment of this disease. The landscape is rapidly changing and it is likely that immunotherapy will be incorporated into therapy in earlier disease states and in novel combinations. Outcomes in urothelial carcinoma have improved and likely to improve further with ongoing and future clinical research that is discussed in this review.
Summary
Amniotic fluid levels of alpha–fetoprotein were measured in 93 patients with normal uncomplicated pregnancies and in 10 patients with anencephalic fetuses. The amniotic fluid levels in normal pregnancies between 12 and 41 weeks' gestation are presented. In all the pregnancies with anencephaly the alpha‐fetoprotein levels were significantly raised above the normal range. Two patients who had previously had an anencephalic fetus are also reported.
BackgroundThere has been a dramatic increase in T cell receptor (TCR) sequencing spurred, in part, by the widespread adoption of this technology across academic medical centers and by the rapid commercialization of TCR sequencing. While the raw TCR sequencing data has increased, there has been little in the way of approaches to parse the data in a biologically meaningful fashion. The ability to parse this new type of 'big data' quickly and efficiently to understand the T cell repertoire in a structurally relevant manner has the potential to open the way to new discoveries about how the immune system is able to respond to insults such as cancer and infectious diseases.
Summary
The serum levels of seromucoid were examined in patients with a wide variety of benign and malignant gynaecological disorders. Seromucoid was unchanged from normal in most benign conditions, but it was raised in pelvic infection and tended to be low in infertility. Serum seromucoid was unchanged in patients with carcinoma in situ, but was increased substantially above normal with invasive cancer. The level of serum seromucoid in patients with cancer was related to the severity of the clinical lesion and returned to normal when the lesion was successfully treated. Cases of recurrent carcinoma had highly elevated serum seromucoid levels. The measurement of serum seromucoid levels may be a useful means of assessing the severity of cancer and monitoring the effectiveness of its treatment.
Summary
The perchloric acid‐soluble glycoproteins of serum (seromucoid), a serum protein sub‐fraction which increases dramatically, together with a fall in serum albumin, in a wide variety of clinical situations, including clinical stress, was examined in relation to the stress of parturition. The results indicated that while the clinical stress response is not necessarily absent during childbirth, the profound changes in the amount and distribution of body fluid which occur at this time effectively mask any stress response that may have been invoked. Cord serum was also examined in this context and contained higher levels of albumin and considerably lower levels of seromucoid than maternal serum.
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