Progress of poly (ADP-ribose) polymerase inhibitor in advanced ovarian cancer / 肿瘤研究与临床

At present, ovarian cancer is one of the main diseases threatening women's life and health. The mortality ranks first among female reproductive system malignant tumors. Due to the hidden onset, more than 75% of them are at advanced stage once diagnosed. Advanced ovarian cancer is characterized with the Federation International of Gynecology and Obstetrics (FIGO) stage Ⅲ-Ⅳ, very poor prognosis and the 5-year survival rate less than 50%. In recent years, the exploration of maintenance treatment of ovarian cancer is in full swing. A large number of studies show that poly (ADP-ribose) polymerase (PARP) inhibitors are effective in patients with advanced ovarian cancer. Therefore, PARP inhibitors have gradually become an important part for treatment of ovarian cancer, and the indications have also been concerned by clinicians. This paper reviews the application of PARP inhibitors in advanced ovarian cancer.

Maintenance therapy following allogeneic hematopoietic stem cell transplantation in myeloid neoplasms / 白血病·淋巴瘤

The acute myeloid leukemia and myelodysplastic syndromes are common myeloid neoplasms for which allogeneic hematopoietic stem cell transplantation is one of the main curative therapies. In high-risk patients, the relapse rate can be more than 40%, and patients with post-transplantation relapses have a very poor prognosis, so preventing relapse after transplantation is crucial. The maintenance therapy is a group of interventions to prevent relapse when morphological, molecular biological and cytogenetic results are constantly negative after transplantation. Currently, the commonly used maintenance therapy is the application of demethylating drugs, targeted drugs, etc., but their necessity, medicine plan, adverse effects, multi-drug combinations, and other aspects need to be studied urgently. This article will systematically describe the progress of post-transplantation maintenance therapy for high-risk myeloid neoplasms based on drug classification.

Pharmacoeconomic evaluation of 2 kinds of inhalation schemes of budesonide for mild asthma / 中国药房

OBJECTIVE To evaluate the cost-utility of as-needed inhaled budesonide/formoterol versus budesonide maintenance therapy combined with as-needed inhaled terbutaline （hereinafter referred to as budesonide maintenance therapy） in patients with mild asthma from the perspective of the Chinese health service system. METHODS A Markov model of mild asthma was established based on an international multicenter randomized controlled clinical study （SYGMA 2 study）； the model cycle was one week， and the model had a whole horizon of 60 years. The cost only included direct medical cost， and utility value was derived from the data of EuroQol 5-Dimension 5-Level in the SYGMA 2 study and published literature. The total cost and total output of the above two inhalation therapies for patients with mild asthma were calculated， with discount rate of 5%. The stability of the model was evaluated by sensitivity analysis. RESULTS The total cost of as-needed inhaled budesonide/formoterol and budesonide maintenance therapy were 25 884 yuan and 45 822 yuan， respectively， and the effectiveness were 30.51 quality- adjusted life years （QALYs） and 30.50 QALYs， respectively. The former scheme was an absolute advantage. One-way sensitivity analyses showed that the price of drug （terbutaline and budesonide/formoterol） and average number of inhalations per day were the main influencing parameters， but they had little influence on the results of basic analysis. Probabilistic sensitivity analysis showed that the probability of as-needed budesonide/formoterol being cost-effective was 100%. CONCLUSIONS Compared with budesonide maintenance therapy， as-needed inhalation of budesonide/formoterol in mild asthma patients is more cost-effective.

Efficacy of Tyrosine Kinase Inhibitor Combined with Decitabine, Homoharringtonine, Interferon in the Maintenance Therapy of Blast Phase Chronic Myeloid Leukemia / 中国实验血液学杂志

OBJECTIVE@#To explore the efficacy of tyrosine kinase inhibitor (TKI) combined with decitabine, homoharringtonine, and interferon regimen as maintenance therapy for blast phase chronic myeloid leukemia (CML-BP).@*METHODS@#The clinical data of CML-BP patients who received the first major hematological response after induction therapy at The Affiliated Cancer Hospital of Zhengzhou University from June 2015 to December 2021 were analyzed retrospectively. The event-free survival, duration of remission, and overall survival of patients in TKI combined with decitabine, homoharringtonine, interferon group(n=18) and TKI combined with conventional chemotherapy group(n=10) were compared by log-rank test.@*RESULTS@#A total of 28 patients were included, with a median age of 46 (24-58) years old. Kaplan-Meier survival analysis showed that patients in TKI combined with decitabine, homoharringtonine, interferon group had longer event-free survival (7.4 vs 4.3 months, P=0.043, HR＝0.44, 95% CI: 0.17-1.14), duration of overall remission (16.1 vs 6.6 months, P=0.005, HR＝0.32, 95% CI: 0.11-0.89), overall survival (34.3 vs 13.5 months, P=0.006, HR＝0.29, 95% CI: 0.10-0.82) compared with patients in TKI combined with conventional chemotherapy group.@*CONCLUSION@#The TKI combined with decitabine, homoharringtonine and interferon regimen can significantly prolong the survival of CML-BP patients who obtained the major hematological response compared with TKI combined with conventional chemotherapy regimen.

Exploration of Peritoneal Metastasis of Advanced Ovarian Cancer and Maintenance Treatment with Traditional Chinese Medicine Based on Theory of Membranous Sanjiao / 肿瘤防治研究

Ovarian cancer has the highest mortality among the three major gynecological malignancies. Peritoneal metastasis, intestinal obstruction and then death is the main outcome pattern of advanced ovarian cancer. Traditional Chinese medicine maintenance treatment of advanced ovarian cancer is effective, but the theoretical basis needs to be further improved. Under the guidance of the membranous Sanjiao theory and combined with clinical experience, this paper traces the origin, focuses the location of membranous Sanjiao of ovarian cancer peritoneal metastasis and the role of membranous Sanjiao dysfunction in the occurrence and metastasis of ovarian cancer. Besides, the paper puts forward that the main strategies for the maintenance treatment of traditional Chinese medicine on ovarian cancer are ordering the Qi movement of Sanjiao, regulating and harmonizing Qi and blood, and clearing away the latent toxin. From the perspective of membranous Sanjiao theory, the theory enriches the traditional Chinese medicine theory of ovarian cancer and provides new ideas for the treatment of ovarian cancer.

Prediction of Relapse Among Individuals Undergoing Methadone Maintenance Therapy in Johor Bahru Health District

@#Introduction: Increase in the number of opioids seized in the recent year may indicate increased opioid use in Malaysia. In counteracting opioid abuse, Methadone Maintenance Therapy (MMT) was introduced in Malaysia but relapse following MMT has become an important issue. This study aimed to determine the prevalence and patient factors that served as predictors of opioid relapse among MMT patients. Method: A cross-sectional study involving 159 MMT patients who have reached dose stabilization (eight weeks at a constant dose of methadone) was conducted in Johor Bahru Health District. The dependent variable was opioid relapse, while the independent variables include socio-demographic characteristics, MMT history, crime history, cognitive and interpersonal factors, and social-environment influence. Face-to-face interviews using structured questionnaires and secondary data collection using data collection sheets were done. Multiple logistic regression was used to determine the predictors. Significant level set at alpha less than 5%. Result: The response rate was 86.9% with majority of them were Malay, male, and Muslim. The prevalence of opioid relapse was 11.9%. Those who were non-polydrug users (AOR=3.701, 95%CI=1.182, 11.587, p=0.025), classified as having moderate (AOR=5.869, 95%CI=1.524, 22.595, p=0.010) and high (AOR=5.952, 95%CI=1.000, 35.445, p=0.050) relapse risk response after given hypothetical situation whether respondent been offered drug or not, were more likely to have relapsed. Respondents with higher cognitive and behavioral problem-solving response scores were less likely to have relapsed (AOR=0.949, 95%CI=0.909, 0.991, p=0.008). Conclusion: About 1 in 5 MMT clients had relapsed after they reach dose stabilization. The predictors of opioid relapse were non-polydrug users, having moderate to high relapse risk, and cognitive and behavioral problem-solving responses.

Analysis of the Efficacy of Pemetrexed Maintenance Therapy in Patients with Malignant Pleural Mesothelioma / 中国肺癌杂志

BACKGROUND@#Malignant pleural mesothelioma (MPM) is a highly aggressive disease arising from pleural mesothelial cells. Advanced pleural mesothelioma has a poor prognosis, with a median survival of no more than 15 months. First line standard chemotherapy regimen recommended is Pemetrexed based chemotherapy regimen, with or without bevacizumab. There is no consensus on whether patients who have received first-line standard chemotherapy can benefit from pemetrexed maintenance chemotherapy. The study aimed to investigate the efficacy and safety of pemetrexed maintenance therapy (PMT) after treatment with a pemetrexed and platinum regimen for patients with MPM.@*METHODS@#A total of 40 MPM patients were collected from Cancer Hospital Chinese Academy of Medical Sciences from January 2013 to January 2018, eligible patients were unresectable MPM, without disease progression following 4 to 6 cycles of pemetrexed and platinum, including pemetrexed maintenance therapy group (22 cases) and observation group (18 cases). The last follow-up was conducted in January 2020. The primary endpoint were progression free survival (PFS), and the secondary end points were overall survival (OS), the efficacy, adverse reactions of PMT.@*RESULTS@#The median PFS in the PMT arm was longer than that in the observation arm (8.5 mon vs 3 mon, P=0.008), but there was no significant difference in median OS (26.4 mon vs 15.7 mon, P=0.177). Objective response rate (ORR) of two group were 22.7% and 0%, respectively. The grade 3-4 toxicity in PMT group included grade 4 neutropenia in 1 patient (4.5%), grade 3 neutropenia in 1 patient (4.5%), grade 4 anemia in 1 patient (4.5%) and grade 3 nausea and anorexia in 1 patient (4.5%).@*CONCLUSIONS@#Pemetrexed maintenance therapy following initial pemetrexed and platinum chemotherapy improve PFS in patients with MPM, and is well tolerated.

The Proportion of Non-retention and Its Associated Factors Among Clients Receiving Methadone Maintenance Therapy in Kelantan, Malaysia

@#Introduction: Methadone maintenance therapy (MMT) requires a client to take a daily dose of methadone to reduce cravings for opioid and suppress withdrawal syndrome. Non-retention in the MMT will seriously expose more risk rather than the benefits of the program. Hence, determining the factors associated with non-retention to the MMT is essential. Thus, the present study was conducted to determine the proportion of non-retention and its associated factors among clients receiving MMT in Kelantan, Malaysia. Methods: By using a retrospective record review analysis, the required information of the clients was obtained from fourteen MMT clinics in Kelantan, Malaysia. A total of 155 clients were selected in this study using systematic random sampling. Multiple logistic regression analysis was performed to determine the factors associated with non-retention among clients receiving MMT. Results: It was found that the proportion of non-retention to the MMT in Kelantan, Malaysia was 21.9%. Clients with advanced age, taking daily direct observed therapy, and no underlying HIV were the predictors of non-retention among clients receiving MMT in Kelantan, Malaysia. Conclusion: The findings highlight a relatively high proportion of non-retention among the MMT clients. There is a need for an integrated, culturally relevant approach towards tackling the factors associated with non-retention in the future to keep this program sustainable and effective.

Individuals' quality of life in periodontal maintenance therapy - critical literature review

Abstract: oral health is an integral part of an individual's general health, interfering with all dimensions of life: functional, aesthetic, psychological, social, physical, nutritional, and even psychosocial. hence oral health is directly related to quality of life. periodontitis is one of the most prevalent oral diseases and one of the major causes of tooth loss, impacting negatively on self-reported individuals' quality of life. periodontal maintenance therapy aims to effectively minimize the recurrence of periodontal disease, as well as the incidence of tooth loss. in periodontal literature, studies associated with quality of life indicators, presented in the form of questionnaires aimed at measuring the impact of periodontitis and tooth loss on self-reported individual's quality of life, highlight the "oral impacts on daily performance" (OIDP) and "oral health impact profile" (OHIP). as such, this study presents a critical review of the literature and describes the impact of periodontal disease and tooth loss on the quality of life of patients undergoing periodontal maintenance therapy.

Efficacy and safety of etoposide for maintenance therapy of small-cell lung cancer / 医学研究生学报

Objective Small cell lung cancer(SCLC)is generally sensitive to first-line therapy,but it has poor long-term efficacy,short-term recurrence and low sensitivity of second-line therapy.The study aimed to investigate the impact of etoposide capsule for the maintenance therapy of extensive stage SCLC. Methods A retrospective analysis was made on 82 patients with extensive SCLC treated in Tumor Hospital affiliated to Zhengzhou University from January 2014 to September 2015.The patients were divided into etoposide group(n=45,oral etoposide treatment after first-line chemotherapy)and control group(n=45,regular review after first-line therapy). Comparison was conducted in progression-free survival(PFS),total survival time(OS)and adverse reactions between two groups. Results The median PFS of etoposide group was higher than that of control group(3.5months vs 2.8months,P=0.012). The one-year and two-year survival rates of etoposide group were significantly higher than those of control group(59.5% vs 43.9%, 12.6% vs 4.9%,P<0.05). The analysis of Cox proportional hazard model showed first-line therapy(RR=2.036,95%CI:1.127~3.676)and BMI≥25(RR=0.598,95%CI:0.359~0.997),<18(RR=4.607,95%CI:2.203~9.631)were the risk factors for survival. No significant difference was found as to the risk of adverse effects be-tween two groups. Conclusion Maintenance therapy with oral eto-poside may improve progression-free-survival(PFS)in patients with extensive SCLC,which is safe and practical for maintenance therapy.

Korean Medication Algorithm for Bipolar Disorder 2018 : Maintenance Therapy / 우울ㆍ조울병

OBJECTIVES: In this study, we evaluated the maintenance-treatment strategies of bipolar I and bipolar II disorders of KMAP-BP 2018.METHODS: The questionnaire used to survey experts for their opinions of medication used for the treatment of bipolar disorder was completed by the review committee consisting of 84 experienced psychiatrists. It is composed of 50 questions, and each question includes various sub-items. The questionnaire for maintenance treatments was composed of overall treatment strategies after acute mood episodes in bipolar I and II disorders, including the choice of antipsychotic and antidepressant drugs, duration of medication, and treatment strategies used to achieve a breakthrough in symptoms.RESULTS: In case of bipolar I disorder, mood stabilizer monotherapy, a combination of mood stabilizer and atypical antipsychotic drugs, and atypical antipsychotic drug monotherapy were the first-line treatments. In maintenance management for bipolar II disorder, combinations of mood stabilizer and mood stabilizer monotherapy or atypical antipsychotic monotherapy were preferred. Atypical antipsychotic drugs were favored as the maintenance treatment for bipolar I and II disorders in KMAP-BP 2018.CONCLUSION: There have been growing bodies of tendency that atypical antipsychotics are more preferred than previously in the KMAP-BP 2014.

Maintenance therapy of multiple myeloma: is there a best drug or combinations ? / 白血病·淋巴瘤

Multiple myeloma (MM) is a kind of common hematologic neoplasms. The application of new drugs and autologous hemopoietic stem cell transplantation can significantly improve the response rate of MM. However, as it is impossible to eradicate the minimal residual disease, recurrence is unavoidable. Maintenance therapy has the potential to increase remission degree, thus lengthening the progression-free survival and overall survival time of MM patients.

Efficacy comparison of capecitabine metronomic chemotherapy and conventional chemotherapy in the maintenance of elderly patients with metastatic breast cancer / 肿瘤研究与临床

Objective To investigate the clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer. Methods Fifty-six patients with metastatic breast cancer treated in Jiangsu Shengze Hospital from April 2014 to April 2017 were randomly divided into two groups according to random number table method: metronomic chemotherapy group (n = 28) and conventional chemotherapy group (n = 28). The patients in the metronomic chemotherapy group were treated with capecitabine 500 mg, 2 times/d and continuous oral administration. The conventional chemotherapy group received capecitabine 1 250 mg, 2 times/d for 14 days, rested for 7 days, 21 days was a course of treatment.After two courses,the clinical efficacy,toxicity and quality of life were evaluated. Results There were no significant differences in RR and DCR between the metronomic chemotherapy group and conventional chemotherapy group (RR: 39.3 % vs. 42.8 %, DCR: 89.3 % vs. 85.7 %, both P > 0.05). The median progression-free survival (PFS) time in the metronomic chemotherapy group was 5.8 months (95 % CI 3.23-7.44, P= 0.764) and median overall survival (OS) time was 7.9 months (95 % CI 4.15-7.95, P=0.519). The median PFS time in the conventional chemotherapy group was 7.2 months (95 % CI 3.32-6.33, P=0.835), median OS time was 10.3 months (95 % CI 4.08-7.37, P=0.463). There was no significant difference between the two groups (both P> 0.05). The incidences of hand-foot syndrome, myelosuppression and digestive tract reaction in conventional chemotherapy group were higher than those in metronomic chemotherapy group, there were significant differences between the two groups (all P < 0.05). No Ⅲ-Ⅳ level adverse reactions were found in the metronomic chemotherapy group. The overall rate of improvement of the quality of life in the metronomic chemotherapy group was significantly higher than that in the conventional chemotherapy group (92.9 % vs. 78.8 %, χ 2= 7.629, P < 0.05). Conclusion The clinical efficacy of capecitabine metronomic chemotherapy in the maintenance of elderly patients with metastatic breast cancer is similar to conventional dose maintenance therapy,but it can not only reduce the side effects, but also improve the quality of life of patients.

Clinical research progress on the efficacy and safety of bevacizumab in treating ad-vanced non-small cell lung cancer / 中国肿瘤临床

Antiangiogenesis therapy is one of the most common anticancer therapies. Bevacizumab is a monoclonal antibody that blocks the binding of the vascular endothelial growth factor to its high-affinity receptors. It is the only antiangiogenic agent approved for the first-line treatment of advanced non-small cell lung cancer (NSCLC). Many recent studies have attempted to determine the suit-able partners of bevacizumab in first-line treatment of NSCLC and evaluate its efficacy and safety as a second-line or beyond and con-tinuous treatment of beyond disease progression in patients with advanced NSCLC. This review summarizes current clinical research about the efficacy and safety of bevacizumab in the treatment of advanced NSCLC.

Supportive Periodontal Therapy- A Review

Research has provided evidence that chronic inflammatory periodontal diseases are treatable. As a result of advances in knowledge and therapy, the great majority of patients retain their dentition over their lifetime with proper treatment, reasonable plaque control, and continuing maintenance care. However, there are some situations when traditional therapy is not effective in arresting the disease. In these instances the progression of the disease may be slowed, but eventually the teeth may be lost. Numerous studies have indicated that periodontal therapy in the absence of a carefully designed maintenance program invariably results in the relapse of the disease condition. Accordingly, periodontal care provided without a maintenance program deal with significant patient management and disease management issues. Hence supportive periodontal treatment forms an integral part of periodontal therapy, with all treatment accomplishments channeled into achieving a healthy periodontal status that can be effectively maintained. In this regard, supportive periodontal therapy becomes the most decisive aspect of dental treatment. This article gives an overview of the significance of supportive periodontal therapy in maintaining the integrity of the periodontium.

Consolidation, maintenance and continuous therapy for multiple myeloma in the era of novel agents / 肿瘤研究与临床

With the application of novel agents and high-dose chemotherapy with autologous stem cell transplantation(ASCT),the survival time of multiple myeloma(MM) has been significantly prolonged.However,due to the biological characteristics of myeloma and minimal residual disease after initial treatment,the disease courses of most MM patients show a series of remissions and relapses.Hence,it is necessary to apply consolidation and maintenance therapy after ASCT and continuous therapy for transplant-ineligible patients.This paper reviews the advances in consolidation,maintenance and continuous therapy for MM in the era of novel agents.

Maintenance therapy for multiple myeloma in the era of novel agents:reports from the 57th American Society of Hematology annual meeting / 白血病·淋巴瘤

Despite many recent advances in the treatment of multiple myeloma (MM), the course of the disease is characterized by a repeating pattern of periods of remission and relapse as patients cycle through the available treatment options. Evidence is mounting that long-term maintenance therapy may help suppressing residual disease after definitive therapy, prolonging remission and delaying relapse. For patients undergoing autologous stem cell transplantation (ASCT), lenalidomide maintenance therapy has been shown to improve progression-free survival (PFS), however, it is still unclear whether this translates into extended overall survival (OS). For patients ineligible for ASCT, continuous therapy with lenalidomide and low-dose dexamethasone is shown to improve PFS and OS (interim analysis) compared with a standard, fixed-duration regimen of melphalan, prednisone, and thalidomide in a large phase Ⅲ trial. Other trials have also investigated thalidomide and bortezomib maintenance for ASCT patients, and both agents have been evaluated as continuous therapy for those who are ASCT ineligible. However, some important questions regarding the optimal regimen and duration of therapy must be answered by prospective clinical trials before maintenance therapy, and continuous therapy should be considered routine practice. This article reviewed the available data on the use of maintenance or continuous therapy strategies and highlights ongoing trials reported in the 57th American Society of Hematology (ASH) annual meeting that would help to further define the role of these strategies in the management of patients with newly diagnosed MM.

Thoughts of Group and Phased Treatment of TCM for Malignant Tumor / 浙江中医药大学学报

Objective]To explore the pathogenesis and rules of syndrome and treatment of different groups and stages of patients with malignant tumor,we hope to broden the clinical thinking and improve clinical therapeutic effect. [Methods]Starting from the theory of Chinese medicine,combined with the author's clinical experience,according to patients’selection treatment,we summarize the syndrome patterns, treatment principle and prognosis of different groups and different treatment stages.We divided it into two categories: pure Chinese medicine treatment and traditional Chinese and western medicine treatment. [Outcome]There were many types of malignant tumors,whose pathogenesis and treatment law can be changed under the intervention of treatment measures. Pure Chinese medicine treatment groups were divided into early, middle and late three stages.Combination of traditional Chinese and western medicine treatment was divided into Perioperative group,Tumor free survival group and Survival group with tumor.There were 3 stages in the tumor free survival groups:adjuvant chemotherapy, adjuvant radiotherapy, and no tumor rehabilitation.The survival of the tumor bearing groups was divided into five stages:neoadjuvant chemotherapy,palliative anticancer therapy,maintenance therapy of traditional Chinese medicine,malliative symptom control and the final stage. [Conclusion] Traditional Chinese medicine treatment of malignant tumor is divided into two categories, four groups, thirteen phases.Group and phased treatment based on classification is easy to master and conducive to optimizing the traditional Chinese medicine diagnosis and treatment program.

Maintenance therapy with pemetrexed foradvanced non-small cell lung cancer:A Meta-analysis of RCTs / 实用肿瘤学杂志

Objective This paper aims to assess the clinical efficacy of pemetrexed maintenance therapy in patients with advanced non-small cell lung cancer( NSCLC) through Meta analysis.Me thods Systematic lit-erature searches were performed in Cochrane、Pubmed,Web of science, Embase and ClinicalTrials databases.The related references had been traced.We made quality assessment of qualified randomized controlled trials( RCTs) of pemetrexed maintenance therapy compared with best supportive care( BSC) in advanced NSCLC.Besides,we u-tilized stata 12.0,Revman 5.3 and GRADEpro software to evaluate the overall quality of the evidence,according to the Cochrane collaboration to perform Meta-analysis.Resutl s Three RCTs were eligible and included 1257 patients.Meta-analysis results suggested that:compared to BSC,pemetrexed maintenance therapy had a statisti-cally significant benefit in improving progression-free survival(PFS)(HR =0.55,95% CI:0.48~0.64)and overall survival(HR=0.76,95%CI:0.65~0.88).The objective response(ORR)did not reach statistical signif-icance(RR=0.97,95%CI:0.86~1.10).Conclusion Compared with BSC,pemetrexed maintenance therapy statistically significantly improve PFS and OS,but has no demonstrable impact on ORR in patients with advanced NSCLC.

Advances in the treatment of multiple myeloma: reports from the 56th American Society of Hematology annual meeting / 白血病·淋巴瘤

Multiple myeloma (MM) is the second most common hematological malignancy.In the 56th American Society of Hematology (ASH) annual meeting,there are mainly five hot and key topics focusing on development of MM treatment,including when is the opportunity of transplant-eligible patients in the era of novel therapy? Should continuous therapy be the standard therapeutic approach in MM? What is a practical approach to relapsed MM? How should the recurrence/refractory MM patients be managed and treated? And what are the approved agents and novel agents?