RESUMEN
Background: Ovarian cancer is the 8th most common cancer among women in Lebanon. Despite new advances in the treatment of these tumors, their prognosis remains very poor. The histology of ovarian tumors and their stage at the time of diagnosis are the two most relevant prognostic factors. Epithelial tumors, including serous, mucinous, endometrioid, clear-cell, Brenner and seromucinous tumors, account for the vast majority of ovarian tumors. Germ cell tumors and tumors of the sexual cord are respectively the second and third subgroups of ovarian tumors. In Lebanon, there are no data concerning borderline and malignant ovarian tumors
Aim: We report the epidemiological and histological characteristics of borderline and malignant ovarian tumors in a Lebanese tertiary hospital
Material and Methods: This is a retrospective study evaluating the characteristics of borderline and malignant ovarian tumors diagnosed in 19 years [from 1999 to 2017] at the pathology laboratory of Hotel-Dieu de France, Saint Joseph University Hospital in Beirut, Lebanon. The data were extracted from the computerized registers of the laboratory. Statistical analysis was performed using SPSS 24.0
Results: Atotal of 996 ovarian lesions were found. Of these, 529 [53.1percent] were epithelial [342 [64.7percent] serous, 107 [20.2percent] mucinous, 23 [4.3percent] endometrioid, 18 [3.4percent] undifferentiated carcinoma, 15 [2.8percent] seromucinous, 12 [2.3percent] clear cell and 12 [2.5percent] Brenner]; 285 [28.6percent] were germinal [including 245 [86.0percent] mature teratomas, 12 [4.9percent] dysgerminomas and 7 [2.5percent] immature teratomas]; 83 [8.3percent] were stromal tumors of the sexual cord. Of the 529 epithelial tumors, 261 [49.3percent] were benign [60percent were serous cystadenomas], 46 [8.7percent] were borderline [26 serous, 18 mucinous and 2 serous] and 222 [42.0percent] were malignant [of which 139 [62.6percent] were high grade serous carcinomas, 19 [8.6percent] endometrioid, 18 undifferentiated, 12 low-grade serous and 12 clear cell]. Mean age for malignant epithelial tumors and borderline epithelial tumors were 54.3 years and 39.7 years respectively
Conclusion: Our data are compatible with those published in Western countries. Many studies will be launched on the basis of this database, including the evaluation of somatic and germinal ovarian panel mutations in high-grade ovarian serous carcinoma and in those with borderline tumor sequencing
RESUMEN
Introduction: Lung cancer represents the leading cause of cancer death worldwide. At diagnosis, the majority of patients present an advanced or metastatic disease. Despite the improvement in diagnostic and therapeutic strategies, lung cancer prognosis remains poor with less than 15 percent of patients surviving beyond 5 years. Advanced non-small-cell lung cancer [NSCLC] has been always treated by platinum-based regimens with various toxicity profiles However, with the discovery of the PD-1/PD-L1 pathway, novel checkpoint inhibitors emerged as promising agents for treating patients with advanced disease. When evaluated in clinical trials, they showed promising results and durable responses in a subset of patients treated in the first and second lines or beyond. The aim of this study is to assess the efficacy and responses of these agents in real-life practice when used in second line or after
Material and Methods: Patients with advanced [stage III and IV] NSCLC treated with immunotherapy between June 2015 and August 2018 were included. Patients should have received anti-PD-1 or anti-PD-L1 agent in the second, third of fourth line after failure of a prior first line regimen. Each patient should have received a minimum of 3 cycles of treatment and evaluation thereafter
Results: A total of 85 patients were included. The median age of our population was 65 years, and the majority were men [sex ratio = 2.3:1]. Around 95 percent of patients were smokers. Adenocarcinoma was the most frequent histologic subtype in 59.1 percent of cases, followed by squamous cell carcinoma in 35.5 percent of cases. At presentation, 81.7 percent of patients had metastatic deposits mainly in the bone and adrenals in 34.4 percent and 28 percent respectively. PD-L1 expression ranged from 0 to 100 percent with a median value of 45 percent. PD-L1 expression was >/= 50 percent, between1 and 50 percent, and less than 1 percent in 43 percent, 40 percent and 17 percent of patients respectively. Around half of patients [54 percent] underwent radiotherapy, with a curative intent in 42.5 percent and palliative intent in 57.5 percent. Checkpoint inhibitors were used in second line in 74.7 percent, third line in 21.8 percent and fourth line in 3.5 percent, and were balanced between Pembrolizumab and Nivolumab. The majority of patients progressed despite immunotherapy treatment in 41 percent of cases, presented a stability of the disease, partial response and complete response in 29.7 percent, 25.6 percent and 2.7 percent. The median progression-free survival [PFS] was 4.1 months [1-20.7]. Immune-related adverse events were present in around 7 percent of patients, and were mainly grade 2-3 managed with steroids and supportive care, with hormone replacement therapy in the case of thyroiditis
Conclusion: Checkpoint inhibitors represent a new hope for patients with advanced lung cancer who have few available effective treatments beyond first or second line