Background: Although both inhaled and oral corticosteroids have anti-inflammatory effects causing improvement in clinical symptoms and spirometry in the treatment of asthma, the role of corticosteroids in the management of chronic obstructive pulmonary disease (COPD) is controversial. Objective: To evaluate the effects of inhaled corticosteroids on sputum neutrophilia in clinically stable COPD patients. Methods: In total, 18 patients were enrolled in the study. During 2 months, 9 patients in group A inhaled fluticasone propionate (FP) 500 μg 3 times daily. In group B 9 patients received placebo. All of the patients continued to inhale both salbutamol and ipratropium bromide. In 9 patients, sustained-released theophylline was also administered. Blood samples, spirometric tests, blood gas analyses, and either spontaneous or induced sputum cultures were evaluated on entry into the study, after a 2 months of treatment and following the 6-week washout period. Results: After the 2-month FP treatment, no significant changes in the number of peripheral blood neutrophils, blood gas and spirometry data were observed in both groups. In group A, the total cell number and the number of neutrophils decreased from a mean of 3.4 ± 1.3 × 10⁶ cells/g and 0.6 ± 0.3 × 10⁶ neutrophils/g on entry into study to 1.9 ± 0.6 × 10⁶ cells/g and 0.02 ± 0.01 × 10⁶ neutrophils/g after 8-week treatment with FP, returning to 3.3 ± 1.1 × 10⁶ cells/g and 0.5 ± 0.3 × 10⁶ neutrophils/g following the washout period. The percentages of neutrophils were 55.6 and 77.9% in groups A and B after 2 months of FP treatment. There was no significant change in group B values during the study. Conclusion: These data suggest that neutrophilic inflammation in sputum may be decreased by inhaled corticosteroids in clinically stable COPD patients.

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However, treatment response between CU subtypes did not significantly differ. Perhaps patients with CindU more often dislike to discontinue treatment due to long disease duration or more often relapse while attempting discontinuation. Also the existence of differences in pathomechanism between CU subtypes may play a role, as the pathophysiology of CU is not completely understood.A limitation of this study might be that drug survival can be influenced by physician and/or patient behaviour regarding prescription and stopping of omalizumab, 10 which is partly intercepted by protocols. Generalization of our results may be limited due to differences in local/national treatment protocols between hospitals/countries. Further multicentre studies from different countries are needed to provide insight into potential differences.In conclusion, in this daily practice study of 142 CU patients, with an observation period up to 6 years, overall drug survival rates for omalizumab were 77%, 61% and 55% after 1, 2 and 3 years, respectively, and mostly determined by well-controlled disease activity. CindU was an independent determinant for overall longer drug survival and decreased risk to discontinue omalizumab due to wellcontrolled disease activity. CONF LICTS OF INTERESTNone declared. O R C I D L. S. Spekhorsthttps://orcid.org/0000-0002-7537-765X H. RöckmannT A B L E 1 Characteristics of the patients with positive and negative diagnostic skin test results with proton pump inhibitors (PPIs) Patients with positive diagnostic skin test results Patients with negative diagnostic skin test results P value n 62 (75.6%) 20 (24.4%) -Gender (F/M) 53 (85.5%)/9 (14.5%) 18 (90.0%)/2 (10.0%) 0.606 Age, median (min-max) 46 (22-78) 42.5 (22-75) 0.749Time to onset of the reaction after last exposure, median (min-max) hours 1.0 (0.1-8.0) 0.5 (0.1-4.0) 0.823Interval between the reaction and the diagnostic tests, median (min-max) months 3 (0.5-36) 12 (1-60) 0.047

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Background There is no standard treatment recommended at category 1 level in international guidelines for subsequent therapy after cyclin-dependent kinase 4/6 inhibitor (CDK4/6) based therapy. We aimed to evaluate which subsequent treatment oncologists prefer in patients with disease progression under CDKi. In addition, we aimed to show the effectiveness of systemic treatments after CDKi and whether there is a survival difference between hormonal treatments (monotherapy vs. mTOR-based). Methods A total of 609 patients from 53 centers were included in the study. Progression-free-survivals (PFS) of subsequent treatments (chemotherapy (CT, n:434) or endocrine therapy (ET, n:175)) after CDKi were calculated. Patients were evaluated in three groups as those who received CDKi in first-line (group A, n:202), second-line (group B, n: 153) and ≥ 3rd-line (group C, n: 254). PFS was compared according to the use of ET and CT. In addition, ET was compared as monotherapy versus everolimus-based combination therapy. Results The median duration of CDKi in the ET arms of Group A, B, and C was 17.0, 11.0, and 8.5 months in respectively; it was 9.0, 7.0, and 5.0 months in the CT arm. Median PFS after CDKi was 9.5 (5.0–14.0) months in the ET arm of group A, and 5.3 (3.9–6.8) months in the CT arm (p = 0.073). It was 6.7 (5.8–7.7) months in the ET arm of group B, and 5.7 (4.6–6.7) months in the CT arm (p = 0.311). It was 5.3 (2.5–8.0) months in the ET arm of group C and 4.0 (3.5–4.6) months in the CT arm (p = 0.434). Patients who received ET after CDKi were compared as those who received everolimus-based combination therapy versus those who received monotherapy ET: the median PFS in group A, B, and C was 11.0 vs. 5.9 (p = 0.047), 6.7 vs. 5.0 (p = 0.164), 6.7 vs. 3.9 (p = 0.763) months. Conclusion Physicians preferred CT rather than ET in patients with early progression under CDKi. It has been shown that subsequent ET after CDKi can be as effective as CT. It was also observed that better PFS could be achieved with the subsequent everolimus-based treatments after first-line CDKi compared to monotherapy ET.

Benign cystic teratomas of the lung are extremely rare. Up to the present time, around 30 cases have been reported in the literature. We report an additional case, a 28-year-old woman, admitted with the complaint of expectoration of hair. Histopathological, clinical, and Ct features are presented.

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Introduction: Ado-trastuzumab emtansine (T-DM1) is an antibody–drug conjugate and its survival advantage has been shown in advanced human epidermal growth factor receptor 2 (HER2)–positive breast cancer. However, clinical trials underrepresent patients ⩾65 years of age, leading to a lack of information in this population. We analyzed the real-world outcomes of older women who were treated with T-DM1 therapy. Methods: We performed a multicenter, observational, retrospective analysis of patients aged ⩾65 years treated with T-DM1. A total of 93 patients from 10 cancer centers were involved in the study. Our goal was to determine the survival, response rates, and toxicity profile in T-DM1–treated patients, as well as the factors that influence survival. Results: Median follow-up was 12.2 months. Objective response rate was 29%. Median progression-free survival (PFS) and overall survival (OS) were 8.47 and 15.0 months, respectively. In multivariate analysis, Eastern Cooperative Oncology Group Performance Score 2 was found to be an independent prognostic factor for worse PFS (hazard ratio [HR] 1.81, p = 0.032) and OS (HR 2.33, p = 0.006). Any adverse event (AE) was seen in 92.5% of patients; grade 3 or 4 AEs were seen in 30.1%. Dose reduction or treatment discontinuation rates were 11.8% and 6.5%, respectively. Conclusion: The efficacy of T-DM1 was acceptable and it was generally well-tolerated among older patients with advanced HER2-positive breast cancer.