Cancer immunotherapy in clinical practice -- the past, present, and future / 癌症

Considerable progress has been made in the field of cancer immunotherapy in recent years. This has been made possible in large part by the identification of new immune-based cellular targets and the development of novel approaches aimed at stimulating the immune system. The role played by the immunosuppressive microenvironment in the development of tumors has been established. The success of checkpoint-inhibiting antibodies and cancer vaccines has marked the beginning of a new era in cancer treatment. This review highlights the clinically relevant principles of cancer immunology and various immunotherapeutic approaches that have either already entered mainstream oncologic practice or are currently in the process of being evaluated in clinical trials. Furthermore, the current barriers to the development of effective immunotherapies and the potential strategies of overcoming them are also discussed.

Influence of working conditions on job satisfaction in Indian anesthesiologists: a cross sectional survey

Studies related to job satisfaction in Indian anesthesiologists are very limited which prompted us to design this study to quantify the level of job satisfaction among Indian anesthesiologists and to identify the factors responsible for satisfaction/dissatisfaction. Cross-sectional study based upon a confidential survey. Pravara Institute of Medical Sciences, Loni [India]. One year. A set of questions was handed over personally to the anesthesiologists at National and state level anesthesiology conferences and CMEs, and filled proformas were collected. Confidentiality and anonymity of the participants was maintained. Main outcome measures were demographics, anesthesia practice, overall job satisfaction, anaesthetic assistance, surgeons' perceived attitude, attitude towards other colleague anesthesiologists, and patients' perceived attitude towards them. Response rate was 96%. Seventy eighty percent respondents reported full satisfaction. Female anesthesiologists and male anesthesiologists working in teaching hospitals were more satisfied. [P < 0.01]. Forty nine percent respondents were satisfied with the assistance in operating rooms; 51% felt they were duly respected by the surgeons; and 50% expressed satisfaction with recognition of their services by patients. Two main factors for the dissatisfaction were lack of resources/equipment and low recognition of anesthesia services by the patients. Although job satisfaction level in Indian anesthesiologists is quite high, still there is a need to set the standards related to number of working hours, number of night call duties per week, enforcing proper assistance, raising the profile of anesthesiologists among general public, improving funding and resources for OT, which would help reduce occupational stress and further improve efficiency and job satisfaction among anesthesiologists

Feasibility study of docetaxel, oxaliplatin and capecitabine combination regimen in advanced gastric or gastroesophageal adenocarcinoma

At present, there is no standard regimen for the treatment of gastroesophageal cancer. Docetaxel, cisplatin and fluorouracil [DCF] has been shown to be an effective regimen; however, toxicity is an area of concern in the palliative case setting. Capecitabine and oxaliplatin have been shown to be as effective as fluorouracil and cisplatin, respectively. To reduce the toxicity of DCF while maintaining efficacy, we conducted this study to evaluate the efficacy of docetaxel, oxaliplatin and capecitabine [DOX] combination in advanced gastroesophageal cancer. Patients with histologically confirmed metastatic or locally advanced adenocarcinoma of the stomach or gastroesophageal junction received docetaxel 25 mg/m2 and oxaliplatin 50 mg/m2 on days 1 and 8 with capecitabine 625 mg/m2 twice daily from day 1-14, in 21-day cycles. The primary endpoint was overall response rate [ORR]. Of 21 patients, there were 16 males and 5 females with a median age of 57 years, range 37-80 years. The primary tumor was located at the gastroesophageal junction in 7 patients and in other parts of the stomach in the remaining 14 patients. One patient had locally advanced tumor without distant metastases and 20 patients presented with metastatic disease. Grade 3/4 toxicities included diarrhea [24%], hand-foot syndrome [5%] and febrile neutropenia [5%]. The ORR was 29%. The median survival was 8.4 months. At the time of analysis, 5 of the 21 patients [24%] were alive. The DOX combination is tolerable, active and a promising day-care regimen for advanced gastroesophageal cancer