This paper empirically determines the drivers of functional diversification decision for 365 banks set in selected Middle East and North Africa (MENA) countries over 1988–2015. For this purpose, we use a dynamic nonlinear panel data model. Our findings reveal that both market share and financial intermediation stratify the diversification decision for the whole MENA sample. Splitting the sample shows that the risk‐adjusted profitability and the loan loss provision ratio exert a major influence over the diversification indicator for Gulf Cooperation Council (GCC) banks, whereas the net interest margin ratio, the bank market share, and financial intermediation are the major drivers of the strategic decision for the remaining non‐GCC banks.
Cervical cancer is a major cause of morbidity and mortality in women. The presence of macrophages as well as other inflammatory cells has been noted in many of these tumors. Intratumoral macrophages/monocytes induce anergy to cytokine therapy and cause apoptosis in natural killer(NK) and T cells. The aim of this study was to better evaluate and quantify the presence of macrophages in these tumors. Twenty-four cases of squamous cell carcinoma of the cervix seen at our institution were evaluated. Sections were stained with CD68, a marker for macrophages. Staining was graded microscopically by two reviewers together on a scale of 0-4+, with 4+ representing the greatest number of positive cells. Image analysis was conducted to quantify the percent area stained in a given lesion. For each lesion, 10 fields were evaluated, and a mean percentage area stained was calculated. 4+ staining was observed in five cases, 3+ in zero cases, 2+ in three cases, 1+ in six cases, 1-2+ in one case, and nine cases were negative. Image analysis results correlated well with the light microscopic scoring. Presence of a prominent infiltrate of macrophages did not correlate with tumor grade or with histologic lymph node status, but showed a strong negative correlation with tumor stage. Some squamous cell carcinomas of the cervix show a prominent macrophage component in the tumor-associated inflammatory infiltrate. The presence of this prominent infiltration of macrophages did not correlate with tumor grade or lymph node status, but showed a strong negative correlation with tumor stage. The results suggest that immunotherapy may have a potential role in the treatment of cervical carcinoma. Computerized image analysis appears to be a valid measure to assess macrophage counts in such lesions.
supports the described concept. The present study is a single-arm, investigatorinitiated phase II study (Eudract no. 2019-002748-25). Here we report the first feasibility interim analyses.Methods: The primary end-point is disease-control rate in irinotecan-resistant mCRC patients when treated with a combination of irinotecan, disulfiram and copper. Main inclusion criteria are signed written informed consent, age 18 years, WHO performance status 0e1, histologically verified, non-resectable, irinotecan-resistant mCRC, and willingness to refrain from alcohol consumption during the trial. In the phase I part, we used escalating doses of disulfiram. The planned treatment schedule was irinotecan 250 mg/m2 every 3rd week with continuous disulfiram 200 (escalating to 400) mg/day + copper 2 mg/day in phase II. Using Simon's two-stage design, we calculated to include 25 patients in the phase II study.Results: The combination of irinotecan, disulfiram and copper showed more side effects than expected from reports on use of either irinotecan or disulfiram alone. Seven of the first eight patient experienced severe fatigue. Furthermore, some patients described headache and two patients experienced cerebral confusions. We therefore amended the protocol, and presently we use a tolerable 3 weeks schedule with disulfiram 400 mg/day, day -4 to 3 and 100 mg/day, day 4 to 10 + copper 2 mg/ day, day -4 to 10, and irinotecan 250 mg/m2, day 1. Two of 11 patients in phase II received 9 series of treatment before progression, and two patients received 6 series. Seven patients had progressive disease at the first scan after 3 cycles, and 5 patients are ongoing.
Conclusions:We are testing a repurposing strategy by introducing disulfiram to patients with mCRC and irinotecan-resistant disease. Due to unexpected side effects (severe fatigue) during therapy with continuous treatment of disulfiram and copper combined with irinotecan, we had to change treatment schedule to disulfiram and copper in two of three weeks.
angiogenic drugs, no significant effect of IL-8 expression was detected in either OS or PFS, using a random effect model, although with significant heterogeneity between studies.Conclusions: Our updated metanalysis confirms the role of circulating IL-8 assessment in predicting CRC prognosis, particularly in operated patients and patients undergoing anti-angiogenic treatment. These results suggest that IL-8 could be a putative target to overcome resistance to anti-angiogenesis in CRC.Legal entity responsible for the study: The authors.
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