ABSTRACT
Therapy-resistant cancer stem cells (CSCs) contribute to the poor clinical outcomes of patients with recurrent glioblastoma (rGBM) who fail standard of care (SOC) therapy. ChemoID is a clinically validated assay for identifying CSC-targeted cytotoxic therapies in solid tumors. In a randomized clinical trial (NCT03632135), the ChemoID assay, a personalized approach for selecting the most effective treatment from FDA-approved chemotherapies, improves the survival of patients with rGBM (2016 WHO classification) over physician-chosen chemotherapy. In the ChemoID assay-guided group, median survival is 12.5 months (95% confidence interval [CI], 10.2-14.7) compared with 9 months (95% CI, 4.2-13.8) in the physician-choice group (p = 0.010) as per interim efficacy analysis. The ChemoID assay-guided group has a significantly lower risk of death (hazard ratio [HR] = 0.44; 95% CI, 0.24-0.81; p = 0.008). Results of this study offer a promising way to provide more affordable treatment for patients with rGBM in lower socioeconomic groups in the US and around the world.
Subject(s)
Antineoplastic Agents , Brain Neoplasms , Glioblastoma , Humans , Glioblastoma/drug therapy , Brain Neoplasms/drug therapy , Antineoplastic Agents/therapeutic use , Treatment Outcome , Neoplastic Stem CellsABSTRACT
BACKGROUND: With the easily available option for surgeons to soak their suture in antibiotic irrigation solution intraoperatively in mind, this study was designed to evaluate the ability of suture soaked in bacitracin irrigation solution to inhibit the growth of Staphylococcus aureus and Methicillin-resistant Staphylococcus aureus. MATERIALS AND METHODS: Using standard experimental procedure, sterile suture was soaked in Bacitracin, and dried for 10 min or 6 h, incubated for 24 h on inoculated plates, and examined for zone of inhibition around the suture. This was compared to control unsoaked suture and antimicrobial suture (AMS) currently on the market to determine if the minor intraoperative procedural change of placing suture in antibiotic irrigation solution instead of on the sterile table could confer comparable antimicrobial activity. RESULTS: The study found the Bacitracin-soaked suture (BSS) consistently inhibited the growth of the test organisms. For both organisms, the BSS exhibited a significantly larger zone of inhibition compared to the unsoaked control suture (P < 0.0001). However, both the AMS currently on the market, and a bacitracin aliquot, exhibited significantly larger zones of inhibition compared to both drying times of the BSS (P < 0.0001). CONCLUSIONS: Placing sutures in a bacitracin irrigation solution intraoperatively instead of directly on the sterile table can achieve some of the in vitro antimicrobial effect seen from AMS currently on the market. This may result in reduced rates of surgical site infections and associated costs without major procedural change and at reduced overhead.
Subject(s)
Anti-Infective Agents, Local , Methicillin-Resistant Staphylococcus aureus , Triclosan , Anti-Infective Agents, Local/pharmacology , Bacitracin/pharmacology , Humans , Surgical Wound Infection/prevention & control , Sutures , Triclosan/pharmacologyABSTRACT
Colloid cysts are a rare clinical finding with a unique clinical presentation: non-specific paroxysmal headaches. The current recommended treatment is microsurgery, which poses the greatest risk to the patient but allows complete removal of the cyst to prevent recurrence. A 41-year old man presented with a colloid cyst located in the foramen of Monro causing obstructive hydrocephalus. He had paroxysmal headaches and memory and personality changes. Transcortical transventricle microsurgery was performed to remove the entire cyst. A temporary shunt was placed to prevent post-operative hydrocephalus. Normal neurological function returned upon cyst removal.
