ABSTRACT
Tocilizumab has been reported to attenuate the "cytokine storm" in COVID-19 patients. We attempted to verify the effectiveness and safety of tocilizumab therapy in COVID-19 and identify patients most likely to benefit from this treatment. We conducted a randomized, controlled, open-label multicenter trial among COVID-19 patients. The patients were randomly assigned in a 1:1 ratio to receive either tocilizumab in addition to standard care or standard care alone. The cure rate, changes of oxygen saturation and interference, and inflammation biomarkers were observed. Thirty-three patients were randomized to the tocilizumab group, and 32 patients to the control group. The cure rate in the tocilizumab group was higher than that in the control group, but the difference was not statistically significant (94.12% vs. 87.10%, rate difference 95% CI-7.19%-21.23%, P = 0.4133). The improvement in hypoxia for the tocilizumab group was higher from day 4 onward and statistically significant from day 12 (P = 0.0359). In moderate disease patients with bilateral pulmonary lesions, the hypoxia ameliorated earlier after tocilizumab treatment, and less patients (1/12, 8.33%) needed an increase of inhaled oxygen concentration compared with the controls (4/6, 66.67%; rate difference 95% CI-99.17% to-17.50%, P = 0.0217). No severe adverse events occurred. More mild temporary adverse events were recorded in tocilizumab recipients (20/34, 58.82%) than the controls (4/31, 12.90%). Tocilizumab can improve hypoxia without unacceptable side effect profile and significant influences on the time virus load becomes negative. For patients with bilateral pulmonary lesions and elevated IL-6 levels, tocilizumab could be recommended to improve outcome.
Subject(s)
Humans , Antibodies, Monoclonal, Humanized , COVID-19/drug therapy , SARS-CoV-2 , Treatment OutcomeABSTRACT
Purpose:To explore the clinical significance of VEGF in the diagnosis, treatment and prognosis of common malignant tumors. Methods:The levels of serum VEGF were measured by sandwich enzyme linked immunosorbent assay (ELISA) in 544 patients with malignant tumors and 87 healthy subjects. At the same time,another 6 tumor markers including CEA and CA50 were measured by immunoradiometric assay (IRMA) in 544 malignant tumor patients. Sensitivity, specificity, positive predictive value and negative predictive value of VEGF detection were calculated respectively. The relationship between the pre-treatment levels of serum VEGF and their clinical effect, and between the positive expression number of five kinds tumor markers jointly and the therapeutic effect were analyzed respectively. Results:1. The serum VEGF levels in patients with all kinds of malignant tumors were higher than those of the controls, the mean serum VEGF were relatively higher in patients with gastric cancer, liver cancer and lung cancer. 2. According to the cutoff of medicine reference of VEGF (200.6ng/L), its sensitivity and specificity were 54.2% and 95.4% respectively. There was a significant difference between the sensitivity of serum VEGF in patients with tumor burden (74.9%) and that in patients without tumor burden (20.4%)(P
ABSTRACT
Purpose: To evaluate the therapeutic effect and toxicities of paclitaxel combined chemotherapy regimens in the treatment of advanced breast cancer. Methods: 30 cases with advanced breast cancer verified by pathology were given routinely standard anti-hypersensitive treatment before systematic chemotherapy. In combination regimens, Taxol was given 175 mg/m by intravenous( i. v.) infusion on dayl, cyclophosphamide 400mg/m i. v. on day 1, day 8, 5-fluouracil 500 mg/ m i. v. on day 1, day 8. Drugs were repeated every 28 days and one course consisted of 2 cycles. Results: 3 patients showed complete response and 16 patients showed partial response. The overall response rate was 63. 3%. The median duration of remission was 9 months. The major toxic effects including myelosuppression, myalgia/arthralgta and peripheral neuropathy, were mild or moderate. There was no hypersensitivity. The side-effects disappeared after stopping chemotherapy. Conclusions: Taxol combined with chemotherapy regimens are an effective treatment for patients with advanced breast cancer, The toxicity of the treatment are tolerated by the patients. These regimens are worthy of recommendation as second-line chemotherapy.