Prolonged disease control with Nivolumab in metastatic lung adenocarcinoma during immunotherapy era

Immune checkpoint inhibitors have taken an important place in the field of oncologic immunotherapy, especially for patients in whom conventional treatment regimens have failed. Nivolumab prevents programmed cell death 1 [PD-1] and programmed cell death ligand-1 [PD-L1] binding, resulting in blockage of the inhibitory signal and thus facilitating an immunologic antitumor response. Nivolumab has been shown to be effective in thoracic malignancies, including non-small cell lung cancer [NSCLC]. Here is a case of 52-year male patient with metastatic lung adenocarcinoma progressing after 4 cycles of chemotherapy. We started Nivolumab q2 weeks therapy. Firstly, his dyspnea relieved, carcinoembryonic antigen [CEA] and C-reactive protein [CRP] levels regressed, and then their levels remained constant at a stable level. Radiologically stable response was seen. Progression was seen after about one and half year. Patient died in a short time after progression. In conclusion, this observation provides a strong indication of the potential value of immune checkpoint inhibitors for the management of metastatic lung cancers

Effectiveness of Recombinant Human Growth Hormone for Pharyngocutaneous Fistula Closure

OBJECTIVES: In laryngeal cancer, which comprises 25% of head and neck cancer, chemotherapy has come into prominence with the increase in organ-protective treatments. With such treatment, salvage surgery has increased following recurrence; the incidence of pharyngocutaneous fistula has also increased in both respiratory and digestive system surgery. We investigated the effects of recombinant human growth hormone on pharyngocutaneous fistula closure in Sprague-Dawley rats, based on an increase in amino acid uptake and protein synthesis for wound healing, an increase in mitogenesis, and enhancement of collagen formation by recombinant human growth hormone. METHODS: This study was experimental animal study. Forty Sprague-Dawley rats were separated into two groups, and pharyngoesophagotomy was performed. The pharyngoesophagotomy was sutured with vicryl in both groups. Rats in group 1 (control group) received no treatment, while those in group 2 were administered a subcutaneous injection of recombinant human growth hormone daily. On day 14, the pharynx, larynx, and upper oesophagus were excised and examined microscopically. RESULTS: Pharyngocutaneous fistula exhibited better closure macroscopically in the recombinant human growth hormone group. There was a significant difference in collagen formation and epithelisation in the recombinant human growth hormone group compared to the control group. CONCLUSION: This study is believed to be the first in which the effect of recombinant human growth hormone on pharyngocutaneous fistula closure was evaluated, and the findings suggest the potential of use of growth hormone for treatment of pharyngocutaneous fistula.