Adding an immune checkpoint inhibitor to chemotherapy to treat extensive-stage small cell lung cancer is effective. However, there are no reports of an effective second-line treatment in patients previously treated with chemotherapy and immune checkpoint inhibitors as a first-line treatment. Here, we assessed the efficacy and safety of amrubicin as a second-line treatment for extensive-stage small cell lung cancer after chemotherapy and immune checkpoint inhibitor combination therapy. The study enrolled 150 patients with extensive-stage small cell lung cancer. The efficacy and the incidence of adverse events were compared between patients previously treated with immune checkpoint inhibitors and patients without previous immune checkpoint inhibitor treatment. One hundred and twenty-three patients were eligible. There was no difference in objective response rate, time-to-treatment failure, progression-free survival, and overall survival between both groups. The incidence of adverse events was similar in both treatment groups. Pretreatment with immune checkpoint inhibitors was not associated with an increase in amrubicin-related adverse events. This study shows that the efficacy of amrubicin in extensive-stage small cell lung cancer remains unchanged irrespective of previous treatment with immune checkpoint inhibitors. Amrubicin-related adverse events did not increase in patients previously treated with immune checkpoint inhibitors.
Background The nutritional status can potentially affect the efficacy of cancer therapy. We evaluated the relationships between the nutritional status and the efficacy of chemotherapy in patients with non-small-cell lung cancer (NSCLC). Methods The Geriatric Nutritional Risk Index (GNRI), calculated from body weight and serum albumin, was retrospectively evaluated in 148 patients with NSCLC who received first-line platinum-based chemotherapy and scored as low or high. Results Patients with a high GNRI had a significantly higher overall response rate (ORR; 61.8% [95% confidence interval {CI} = 52.5–70.3%] vs. 34.2% [95% CI = 21.2–50.1%, p < 0.004), longer median progression-free survival (PFS; 6.3 months [95% CI = 5.6–7.2 months] vs. 3.8 months [95% CI = 2.5–4.7 months], p < 0.001), and longer median overall survival (OS; 22.8 months [95% CI = 16.7–27.2 months] vs. 8.5 months [95% CI = 5.4–16.0 months], p < 0.001) than those with low GNRI. High GNRI was independently predictive of longer PFS and OS, but not ORR, in multivariate Cox proportional hazard analyses. In 71 patients who received second-line non-platinum chemotherapy, patients with high GNRI exhibited significantly longer PFS and OS than those with low GNRI (both p < 0.001). Conclusions GNRI was predictive of prolonged survival in patients with NSCLC who received first-line platinum-based chemotherapy and second-line non-platinum chemotherapy. Assessment of the nutritional status may be useful for predicting the efficacy of chemotherapy.
BackgroundIdiopathic pleuroparenchymal fibroelastosis (iPPFE) is characterised by upper lobe-dominant fibrosis involving the pleura and subpleural lung parenchyma, with advanced cases often complicated by progressive weight loss. Therefore, we hypothesized that nutritional status is associated with mortality in iPPFE.MethodsThis retrospective study assesses nutritional status at the time of diagnosis and one year after diagnosis in 131 patients with iPPFE. Malnutrition-related risk was evaluated using the Geriatric Nutritional Risk Index (GNRI).ResultsOf the 131 patients, 96 (76.3%) were at malnutrition-related risk at the time of diagnosis according to GNRI. Of these, 21 patients (16.0%) were classified as at major malnutrition-related risk (GNRI <82). Patients at major malnutrition-related risk were significantly older and had worse pulmonary function than patients at low (92≤ GNRI <98)- and moderate (82≤ GNRI <92)-malnutrition-related risk. GNRI scores decreased significantly from the time of diagnosis to one year after diagnosis. Patients with lower GNRI (<91.7) had significantly shorter survival than patients with a median GNRI or higher (≥91.8). Patients with declines in annual GNRI scores of 5 or greater had significantly shorter survival than patients with declines in GNRI scores of less than 5. In multivariate analysis, major malnutrition-related risk was significantly associated with increased mortality after adjustment for age, sex and forced vital capacity (hazard-ratio, 1.957). A composite scoring model including age, sex, and major malnutrition-related risk was able to separate mortality risk in iPPFE.ConclusionAssessment of nutritional status by GNRI provides useful information for managing patients with iPPFE by predicting mortality risk.
•Abstract IntroductionRecently, allergic diseases caused by dental metals have been increasing. Therefore, rapid and accurate analytical methods for the metal restorations in the oral cavities of patients are required.The purpose of this study was to develop a non-destructive extraction method for dental alloys, along with a subsequent, rapid and accurate elemental analysis. Materials and MethodsSamples were obtained by polishing the surfaces of metal restorations using a dental rotating tool with disposable buffs and polishing pastes. As materials for the analysis, three dental alloys were used. To compare the sampling and analysis efficiencies, two buffs and seven pastes were used. After polishing the surface of a metal restoration, the buff was analyzed using X-ray scanning analytical microscopy (XSAM). ResultsThe efficiency of the analysis was judged based on the sampling rate achieved and the absence of disturbing elements in the background in fluorescence X-ray spectra. The best results were obtained for the combination of TexMet as a buff with diamond as a paste. This combination produced a good collection efficiency and a plain background in the fluorescence X-ray spectra, resulting in a high precision of the analysis.•Keywords X-ray scanning analytical microscope; Elemental analysis; light-element sampling tools; Fluorescent X-ray analysis; metal restoration; allergic diseases IntroductionIn dentistry, more than 20 metallic elements are processed into various dental metal alloys. These alloys are then cast and processed for use as metal restorations. Recently, an increase in allergic diseases has been reported in Japan, and metal allergies have attracted attention in dentistry [10]. The removal of metal restorations in the oral cavities of patients has become widespread in Japan, and an improvement in allergic diseases has been reported [11].Patients with allergic diseases must be examined to determine whether a metal restoration contains the allergenic substance. The sampling method should be a non-destructive extraction from the metal restorations in the oral cavity along with a subsequent rapid and accurate elemental analysis.The conventional extraction method has been to scrape powder from a metal restoration using a
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