Thermotherapy is an effective, comparatively well-tolerated, and rapid treatment for CL, and it should be considered as an alternative to antimony treatment.
Background
This study aimed to evaluate the efficacy, side-effects and resistance mechanisms of first-line afatinib in a real-world setting.
Methods
This is a multicenter observational study of first-line afatinib in Malaysian patients with epidermal growth factor receptor (EGFR)-mutant advanced non-small cell lung cancer (NSCLC). Patients’ demographic, clinical and treatment data, as well as resistance mechanisms to afatinib were retrospectively captured. The statistical methods included Chi-squared test and independent t-test for variables, Kaplan-Meier curve and log-rank test for survival, and Cox regression model for multivariate analysis.
Results
Eighty-five patients on first-line afatinib from 1st October 2014 to 30th April 2018 were eligible for the study. EGFR mutations detected in tumors included exon 19 deletion in 80.0%, exon 21 L858R point mutation in 12.9%, and rare or complex EGFR mutations in 7.1% of patients. Among these patients, 18.8% had Eastern Cooperative Oncology Group performance status of 2–4, 29.4% had symptomatic brain metastases and 17.6% had abnormal organ function.
Afatinib 40 mg or 30 mg once daily were the most common starting and maintenance doses. Only one-tenth of patients experienced severe side-effects with none having grade 4 toxicities. The objective response rate was 76.5% while the disease control rate was 95.3%. At the time of analysis, 56 (65.9%) patients had progression of disease (PD) with a median progression-free survival (mPFS) of 14.2 months (95% CI, 11.85–16.55 months). Only 12.5% of the progressed patients developed new symptomatic brain metastases. The overall survival (OS) data was not mature. Thirty-three (38.8%) patients had died with a median OS of 28.9 months (95% CI, 19.82–37.99 months). The median follow-up period for the survivors was 20.0 months (95% CI, 17.49–22.51 months).
Of patients with PD while on afatinib, 55.3% were investigated for resistance mechanisms with exon 20 T790 M mutation detected in 42.0% of them.
Conclusions
Afatinib is an effective first-line treatment for patients with EGFR-mutant advanced NSCLC with a good response rate and long survival, even in patients with unfavorable clinical characteristics. The side-effects of afatinib were manageable and T790 M mutation was the most common resistance mechanism causing treatment failure.
Radical RT followed by adjuvant chemotherapy was effective in our patients with locoregionally advanced NPC. The long-term results appear encouraging, even for patients with Stage IV disease. This single institution experience deserves further investigation in prospective trials.
Background: Safety and efficacy concerns regarding coronavirus disease 2019 vaccines are common among the public and have a negative impact on their uptake. We aimed to report the adverse effects currently associated with the vaccine in Pakistan to build confidence among the population for its adoption.
Methods:A cross-sectional study was conducted in five districts of the Punjab province of Pakistan between January and March 2022. The participants were recruited using convenience sampling. All data were analyzed using SPSS 22.
Results:We recruited 1622 people with the majority aged between 25-45 years. Of these, 51% were female, including 27 pregnant women and 42 lactating mothers. Most participants had received the Sinopharm (62.6%) or Sinovac (17.8%) vaccines. The incidences of at least one side effect after the first (N = 1622), second (N = 1484), and booster doses (N = 219) of the COVID-19 vaccine were 16.5%, 20.1%, and 32%, respectively. Inflammation/erythema at the injection site, pain at the injection site, fever, and bone/muscle pain were common side effects of vaccination. No significant differences were observed in the adverse effect scores between all demographic variables except for pregnancy (P = 0.012) after the initial dose. No significant association was observed between any variable and the side effect scores of the second and booster doses of the vaccine.
Conclusions:Our study showed a 16-32% prevalence of self-reported side effects after the first, second, and booster COVID-19 vaccinations. Most adverse effects were mild and transient, indicating the safety of different COVID-19 vaccines.
S464to the extremes of ranges, and start date for length of survival: method 1. progression after second line therapy or three weeks post last dose of chemo for control group and start date of erlotinib for treatment group; method 2. last date of second line therapy for both groups. 75 control and 70 erlotinib patients were included in the analysis. Results are presented in the table. The Incremental Cost-Effectiveness Ratio (ICER) was $28,516 per life-year-gained under method 1, and $17,632 under method 2. The erlotinib group had similar one year OS compared to literature (36 vs. 31%). Method 1: Parameter Controls (N=75) Erlotinib (N=70) Area under curve (months) 3.86 7.91 p-value (log-rank test) <0.001 Median Survival months (95% CI) 2.56 (2.04-4.8) 4.73 (2.89-14.7) 1-year OS % (95% CI) 0.
Medical informatics is concerned with the application of computers in the medical and biological sciences and has been considered a field of research in its own right for more than twenty years. In Malaysia, however, there are very few published efforts in this area. To keep up with research activities carried out worldwide and to create expertise that will be in great demand once the Malaysian Multimedia Super Corridor (MSC) Telemedicine Flagship project is implemented, it is time that Malaysians involved themselves in medical informatics research activities. For this reason, we are proposing a project that will involve the application of an artificial neural network in the domain of cancer. As a prelude to our own research, we review current research in medical informatics. This paper subsequently proposes the use of an artificial neural networks as an alternative tool for investigating cancer survival.
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