• Title/Summary/Keyword: second-line treatment

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Meta-analysis of Seven Randomized Control Trials to Assess the Efficacy and Toxicity of Combining EGFR-TKI with Chemotherapy for Patients with Advanced NSCLC who Failed First-Line Treatment

  • Xiao, Bing-Kun;Yang, Jian-Yun;Dong, Jun-Xing;Ji, Zhao-Shuai;Si, Hai-Yan;Wang, Wei-Lan;Huang, Rong-Qing
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.7
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    • pp.2915-2921
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    • 2015
  • Background: Some recent clinical trials have been conducted to evaluate a combination of EGFR- TKI with chemotherapy for advanced NSCLC patients as second-line therapy, but the results on the efficacy of such trials are inconsistent. The aim of this meta-analysis was to evaluate the efficacy and safety of combination of EGFR-TKI and chemotherapy for patients with advanced NSCLC who failed first-line treatment. Materials and Methods: We searched relative trials from PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, Cochrane Library and Clinical Trials.gov. Outcomes analyzed were overall response rate (ORR), progression- free survival (PFS), overall survival (OS) and major toxicity. Results: Seven trails eventually were included in this meta-analysis, covering 1,168 patients. The results showed that the combined regimen arm had a significant higher ORR (RR 1.76 [1.16, 2.66], p=0.007) and longer PFS (HR 0.75 [0.66-0.85], p<0.00001), but failed to show effects on OS (HR 0.88 [0.68-1.15], p=0.36). In terms of subgroup results, continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance confered no improvement in ORR (RR 0.95 [0.68, 1.33], p=0.75) and PFS (HR 0.89[0.69, 1.15], p=0.38), and OS was even shorter (HR1.52 [1.05-2.21], p=0.03). However, combination therapy with EGFR-TKI and chemotherapy after failure of first-line chemotherapy significantly improved the ORR (RR 2.06 [1.42, 2.99], p=0.0002), PFS (HR 0.71 [0.61, 0.82], p<0.00001) and OS (HR 0.74 [0.62-0.88], p=0.0008), clinical benefit being restricted to combining EGFR-TKI with pemetrexed, but not docetaxel. Grade 3-4 toxicity was found at significantly higher incidence in the combined regimen arm. Conclusions: Continuation of EGFR-TKI in addition to chemotherapy after first-line EGFR-TKI resistance should be avoided. Combination therapy of EGFR-TKI and pemetrexed for advanced NSCLC should be further investigated for prognostic and predictive factors to find the group with the highest benefit of the combination strategy.

Overview of Helicobacter pylori and Treatment Options (헬리코박터 파일로리(Helicobacter pylori) 감염 및 치료법 개요)

  • Song, Young Goo
    • Economic and Environmental Geology
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    • v.48 no.3
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    • pp.241-246
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    • 2015
  • Helicobacter pylori is an important transmissible human pathogen found on the luminal surface of the gastric epithelium. The organism can persist in the stomach indefinitely and causes gastroduodenal inflammation that may proceed to atrophic gastritis, peptic ulcer, gastric MALT lymphoma, and gastric cancer. Standard triple therapy which consists of proton pump inhibitor (PPI) plus two antibiotics (amoxicillin and clarithromycin) is now generally used in Korea, however, eradication rates of H. pylori has been decreasing due to increasing antibiotic resistance. In this review, current second-line treatment regimens, difficult problems on treatment, necessity of local target therapy, applicability of clay minerals as a drug delivery system (DDS), and a new therapeutic strategy and its study plans will be discussed.

The Analysis of Environmental Impact Load by Fibrous Raw Materials and Wet-end Additives in Papermaking Process (제지공정 섬유상 원재료 및 공정 첨가제의 환경오염 부하 분석)

  • Kim, Hyoung-Jin;Shin, Dong-Uk
    • Journal of Korea Technical Association of The Pulp and Paper Industry
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    • v.37 no.3
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    • pp.50-58
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    • 2005
  • It is generally known that paper industry is the second largest industry in the use of process water, and also have the highest environmental impact load in the contaminant sources. Paper is produced from the mixtures composed of 1% fibrous raw materials and 99% water. The optimum use of process water effects on the quality properties of paper and the environmental impact load of waste water treatment. In this research, the kinds of fibrous raw material & additives used in the paperboard production line were investigated, and the quantification of environmental loads and the environmental effects of process water on COD potential were evaluated. The NBDCODs were also analyzed from process water by the method of waste water treatment in paper mill and applied for the optimum use of recycling water, and zero effluent process. In the fibrous raw materials, KOCC caused the highest COD potentials, and sack paper & UKP was comparatively low. The NBDCOD of KOCC largely reduced after biological treatment because of easily biodegradable properties, but AOCC contained non-biodegradable materials. In chemical additives, COD was high in turns of rosin>starch>deaeration agent>dye, NBDCOD greatly reduced in starch and deaeration agent. In the case of 2 kinds of paperboard product, the COD potentials was mainly high in starch, AOCC and KOCC.

Schizophrenia and Healing Environment (조현병과 치유환경)

  • Lee, Hae Kyung;Lee, Myung Soo;Noh, Jai Sung
    • Korean Journal of Biological Psychiatry
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    • v.22 no.3
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    • pp.95-100
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    • 2015
  • Treatment of schizophrenia is one of the most challenging areas in the field of psychiatry. There has been much improvement in psycho-pharmacotherapy, and at present, psycho-pharmacotherapy along with milieu therapy and social rehabilitation is the standard first-line treatment for schizophrenia. Healing environment, a concept which has arisen from the architectural field, has similarities in meaning to milieu therapy in psychiatry. In other words, healing environment may be an encountering point between psychiatry and architecture. In this encountering, each field can understand each other and expand its concept to aid the treatment of schizophrenia and to plan the build-up of the entire environment considering its social and psychological effects. In this paper, we aim to establish the basic concept of healing environment to alleviate the psychopathologies in schizophrenic patients. We worked under the premise that physical setting affects human behavior and mind, and that physical setting should play a role as a medium with therapeutic potential for patients with medical problems. The aims of this paper are as follows. First, theoretical discussion of the concept and the constructs of healing environment : second, understanding of the schizophrenic symptoms that may be affected by supporting environment : and third, discussion of supporting environment that may alleviate the symptoms of schizophrenia.

A Study on the Interior Design Characteristic of Skin Clinic (피부과 의원의 실내디자인 특성에 관한 연구)

  • 윤갑근;김양지;문희정
    • Korean Institute of Interior Design Journal
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    • v.13 no.4
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    • pp.110-117
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    • 2004
  • Recently the hospitals or clinics tend to get out of the functional and technological aspect so as to gradually emphasize service for patients. While qualitative rather than quantitative alteration is noticeable, the scale of clinics is getting larger. Especially, the opulence resulted from economic, social and cultural development has enabled more people to visit dermatology or plastic surgery besides treatment for disease. Responding to this tendency, dermatology is focusing on skin beauty, plastic operation, controlling obesity, etc. for women rather than ordinary treatment. Thus, dermatology is in need of space for skin control as well as ordinary treatment, which raises the immediate necessity of new plan for space and interior environment. In order to meet such necessity of dermatology, it is required to fully study and consider the plan for interior space. First, the purpose, scope and method of research will be defined in the introduction. Second, the concept of clinic as well at the characteristic of dermatology will be studied by theoretical investigation. Third, the general concept of dermatology will be analyzed by examining the characteristic of each room in dermatology, the moving line of nurses and patients, the color of dermatology and the design factor of finishing materials through general investigation on dermatology. Fourth, in order to look into the general case of dermatology, the object of examination will be selected for examination through literature and visiting. After examining data, the result will be analyzed and evaluated to prepare the ground for interior plan of dermatology.

Efficacy of evogliptin and cenicriviroc against nonalcoholic steatohepatitis in mice: a comparative study

  • Wang, Zheng;Park, Hansu;Bae, Eun Ju
    • The Korean Journal of Physiology and Pharmacology
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    • v.23 no.6
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    • pp.459-466
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    • 2019
  • Dipeptidyl peptidase (DPP)-4 inhibitors, or gliptins, are a class of oral hypoglycemic drugs that have been widely used as a second-line treatment for type 2 diabetes. Gliptins, which were introduced for clinical use a decade ago, have been shown to be beneficial against nonalcoholic fatty liver disease/nonalcoholic steatohepatitis (NASH) in animals and humans. Cenicriviroc (CVC), a dual antagonist of C-C chemokine receptor type 2 and 5, is currently under investigation against NASH and fibrosis. It was previously discovered that evogliptin (EVO) reduces hepatic steatosis in diet-induced obese animals but the effectiveness of EVO on NASH remains unexplored. Here, we compared the effectiveness of EVO and CVC against NASH and fibrosis in mice fed a high-fat and high-fructose diet (HFHF). Biochemical and histological analyses showed that mice fed a HFHF for 20 weeks developed severe hepatic steatosis and inflammation with mild fibrosis. Administration of EVO (0.2% wt/wt) for the last 8 weeks of HFHF feeding significantly reduced hepatic triglyceride accumulation, inflammation, and fibrosis as well as restored insulin sensitivity, as evidenced by lowered plasma insulin levels and the improvement in insulin tolerance test curves. Treatment of mice with CVC (0.1% wt/wt) inhibited hepatic inflammation and fibrogenesis with similar efficacy to that of EVO, without affecting hepatic steatosis. CVC treatment also reduced plasma insulin concentrations, despite no improvement in insulin tolerance. In conclusion, EVO administration efficiently ameliorated the development of NASH and fibrosis in HFHF-fed mice, corroborating its therapeutic potential.

Transcriptome analysis of iBET-151, a BET inhibitor alone and in combination with paclitaxel in gastric cancer cells

  • Kang, Sun Kyoung;Bae, Hyun Joo;Kwon, Woo Sun;Che, Jingmin;Kim, Tae Soo;Chung, Hyun Cheol;Rha, Sun Young
    • Genomics & Informatics
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    • v.18 no.4
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    • pp.37.1-37.11
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    • 2020
  • BET inhibitor, as an epigenetic regulator inhibitor, reduces the expression of oncogenes such as Myc and Bcl-2, which affects cancer growth and development. However, it has modest activity because of the narrow therapeutic index. Therefore, combination therapy is necessary to increase the anti-tumor effect. Paclitaxel, an anti-mitotic inhibitor, is used as second-line therapy for gastric cancer (GC) as a monotherapy or combination. In this study, we performed RNA sequencing of GC cells treated with iBET-151 and/or paclitaxel to identify the differentially expressed genes associated with possible mechanisms of synergistic effect. We also performed Gene Ontology enrichment and Kyoto Encyclopedia of Genes and Genomes pathway analyses to determine the most enriched terms and pathways of upregulated and downregulated genes. We found 460 genes in which iBET-151 and paclitaxel combination treatment changed more than single-treatment or no-treatment. Thus, additional functional studies are needed, but our results provide the first evidence of the synergistic effect between iBET-151 and paclitaxel in regulating the transcriptome of GC cells.

A case report of tubulointerstitial nephritis and uveitis syndrome in children with an unfavorable outcome

  • Sang I Kong;Mun Hyang Park;Eun Jung Cheon
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.40-45
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    • 2023
  • Tubulointerstitial nephritis and uveitis (TINU) syndrome is defined as the occurrence of tubulointerstitial nephritis and uveitis in the absence of other systemic diseases. Three pediatric cases have been reported in the Republic of Korea, and we now report a fourth case. A 15-year-old girl presented to the ophthalmology department with a 1-week history of bilateral ocular discomfort that worsened on the day of presentation with redness and pain in both eyes. She was diagnosed with bilateral uveitis, and her baseline examination revealed moderate renal dysfunction and mild proteinuria. A renal biopsy was performed and confirmed the diagnosis of TINU syndrome. She was started on steroid eye drops and a 12-week course of oral steroids at a dose of 40 mg/m2/day, which completely resolved the proteinuria and mild renal function to an estimated glomerular filtration rate of 60 mL/min/1.73 m2. However, the uveitis did not improve, and despite the addition of oral methotrexate as a second-line treatment, the uveitis remains unresponsive to treatment over 21 months. Further evaluation and treatment are ongoing, and active therapeutic intervention is suggested even at a pediatric age, considering the lack of improvement in renal function and uveitis to date.

A case of Transverse Myelitis due to Multidrug-Resistant Tuberculosis (다제내성 결핵에 의한 횡단척수염 1예)

  • Lee, Kwang Ha;Ra, Seung Won;Park, I-Nae;Choi, Hye Sook;Jung, Hoon;Chon, Gyu Rak;Shim, Tae Sun
    • Tuberculosis and Respiratory Diseases
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    • v.60 no.3
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    • pp.353-356
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    • 2006
  • Acute transverse myelitis (TM) is a neurological syndrome caused by inflammation of the spinal cord. TM is rare but is frequently caused by viral or bacterial infections. TM caused by tuberculosis (TB) is extremely rare and there are no reports of TM caused by multidrug-resistant TB (MDR-TB). We report a case of acute TM due to MDR-TB in a 40-year-old man. The patient had been diagnosed with pulmonary TB and was started on the first-line anti-TB treatment. However, the chest radiographic findings were aggravated and neurological symptoms such as weakness in both lower extremities, sensory changes, and voiding difficulty were newly developed. The T2-weighted magnetic resonance image of the spine showed diffusely increased signal intensity in the spinal cord, particularly at the lower cervical and upper thoracic levels, without any definite evidence of myeloradicular compression, which is consistent with a diagnosis of TM. A drug susceptibility test revealed MDR and second-line anti-TB drugs were prescribed. The chest radiographic findings showed improvement after treatment, the mycobacterial culture converted to negative, the MRI findings improved, and there was partial improvement in the low extremity weakness. The patient has been prescribing second-line anti-TB medications for 14 months.

Effect of Hormone Therapy on Long-term Outcomes of Patients with Human Epidermal Growth Factor Receptor 2-and Hormone Receptor-Positive Metastatic Breast Cancer: Real World Experience in China

  • Du, Feng;Yuan, Peng;Wang, Jia-Yu;Ma, Fei;Fan, Ying;Luo, Yang;Xu, Bing-He
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.3
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    • pp.903-907
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    • 2015
  • Background: Among human epidermal growth factor receptor 2 (HER2)-positive breast cancer, more than half are also hormone receptor (HR)-positive. Although HR is a predictive factor for the efficacy of hormone therapy, there are still some uncertainties in regard to the effects on patients with HR-positive and HER2-positive metastatic breast cancers due to the potential resistance to hormone therapy caused by co-expression of HR and HER2. There are no clinical trials directly comparing the efficacy of hormonal therapy with chemotherapy. Materials and Methods: To examine the real-world effect of hormone therapy on patients with HR-positive and HER2-positive metastatic breast cancers, a cross-sectional study of a representative sample of the Chinese population was conducted. The study included 113 patients who received first-line and second-line palliative treatment between 2005 and 2010 in the Cancer Institute and Hospital, Chinese Academy of Medical Science. The effect of hormone therapy on overall survival (OS) was studied. Results: The patients who received hormone therapy (n=51) had better overall survival in contrast to those who received chemotherapy with anti-HER2 therapy (n=62) in first- or second-line treatment. The difference was of borderline statistical significance (51.8m vs 31.9m, p=0.065). In addition, the effect of hormone therapy did not differ significantly with other prognostic factors, including age (${\leq}50$ years or >50 years), disease free survival (${\geq}2$ years or < 2 years) and site of metastasis (visceral or bone/soft tissue). On multivariate analysis, administration of hormone therapy was associated with a trend toward a favorable prognosis (p=0.148, HR=0.693, 95%CI 0.422-1.139). Age more than 50 years was the sole independent harmful prognostic factor (p<0.001, HR=2.797, 95%CI 1.676-4.668). Conclusions: Our data suggest that hormonel therapy may improve outcomes of the patients with ER-positive and HER2-positive metastatic breast cancer.