Efficacy of VEGFR-TKIs plus immune checkpoint inhibitors in metastatic renal cell carcinoma patients with favorable IMDC prognosis.

BACKGROUND: Combinations of PD-1/PD-L1 immune checkpoint inhibitors (ICI) with VEGFR-TKIs as first-line therapy significantly improve outcomes of metastatic renal cell carcinoma (mRCC) patients. The benefit of these combinations is well evident in the IMDC intermediate- and poor-risk population, but remains unclear in the subgroup of patients with favorable prognosis. Our meta-analysis aims at evaluating whether the addition of ICIs to VEGFR-TKIs is able to improve the outcome compared to VEGFR-TKIs alone in mRCC patients with favorable prognosis. METHODS: This meta-analysis searched MEDLINE/PubMed, the Cochrane Library and ASCO Meeting abstracts for randomized clinical trials (RCTs) testing the combination of VEGFR-TKI + ICI in mRCC. Data extraction was conducted according to the PRISMA statement. Summary hazard ratio (HR) was calculated using random- or fixed-effects models, depending on studies heterogeneity. RESULTS: Four RCTs were selected. VEGFR-TKI + ICI combinations improved PFS compared to sunitinib (fixed-effect, HR = 0.63; p < 0.00001). However, VEGFR-TKI + ICI combinations did not significantly prolong OS (fixed-effect; HR = 0.99; 95% CI 0.74-1.33; p = 0.95). CONCLUSION: VEGFR-TKI + ICI combinations improved PFS but not OS as first-line therapy for mRCC patients with favorable IMDC prognosis. Longer follow-up and further studies will increase the power of our analysis, suggesting the best first-line therapy for mRCC patients with favorable prognosis.

Values of SP-A protein in the nasal mucosa.

The paranasal sinus epithelium is exposed to the environment and therefore to a variety of biological, chemical and mechanical insults. Surfactant protein A (SP-A) is a 34-36 kD pulmonary surfactant-associated protein that appears to play an important role in mammalian first-line host defence. Recent studies have reported the possibility of local production of SP-A in the extrapulmonary organs and tissues of the human body. However, the presence of SP-A in the human paranasal sinus mucosa is not well known. The purpose of this study was to investigate the expression of SP-A protein in human turbinate mucosa and to compare the expression of SP-A mRNA in normal turbinate mucosa and turbinate mucosa of chronic rhinosinusitis patients. Reverse transcriptase polymerase chain reaction was used to detect SP-A mRNA. Student's t test was used for statistical comparison of the SP-A/GAPDH-mRNA ratio (GAPDH: glycerinaldehyde-3-phosphate dehydrogenase) of cases and controls. We found expression of SP-A mRNA in mucosa lining the inferior turbinates of healthy patients and its up-regulation in mucosa lining the inferior turbinates of patients with chronic rhinosinusitis. These results may provide targets for new therapies for chronic rhinosinusitis.

[Echographic diagnosis of hip dysplasia in neonates. Reflections on two years' work at our ultrasonography center]. / Diagnosi ecografica nella displasia dell'anca nel neonato. Considerazioni su due anni di lavoro nel nostro centro di ecografia.

The paper evaluates the role of ultrasound examinations of the hip joint in neonates by comparing the results of a one-year screening study (non-selected group) with the findings in a selected group of neonates with a high risk of hip dysplasia. The introduction to the paper contains a general discussion of the clinical aspects of hip dysplasia and describes the main anatomical findings using echography.

[Critical review of 222 cases of neoplastic pathology of the colon. Our experience using a computer]. / Revisione critica di 222 casi con patologia neoplastica del colon. Nostra esperienza mediante computer.

From August 1983 to December 1985, 2352 radiological examinations of the colon were performed in the Radiology Department of Università Cattolica del Sacro Cuore of Rome. From this group a sample of 222 patients was analyzed. They included 111 patients with colonic polyps and 111 with cancer. These cases were carefully examined, in terms of age, frequency of this pathology according to sex, symptom-illness rate, and the radiological data were compared with the endoscopic and histological findings. The data were processed using a computerized program. A critical correlation of the data obtained revealed that: 1) The surest symptom of colon carcinoma is blood in faeces with or without changes in defaecation frequency. Nor should isolated bowel disorders be ignored ("irritated" colon due to organic injuries). 2) The diagnostic accuracy of double contrast enema is very close to that of endoscopy, provided that intestinal cleaning is adequate (this in fact is an important aspect of the examination). 3) The mean age of patients in this group is high and cancer is more common than polyps. This seems to be due to the back of a complete diagnostic sequence, in which radiology has a specific and important role.

[Beta-thromboglobulin and platelet regeneration time in children with mitral valve prolapse]. / Beta-tromboglobulina e tempo di rigenerazione piastrinica in soggetti di etè pediatrica portatori di prolasso della valvola mitrale.

We studied 12 children with echocardiographic evidence of mitral valve prolapse (MVP) in order to demonstrate platelet activation or consumption as risk for thromboembolism. Therefore, with a standard radioimmunoassay, we measured the plasma levels of Beta-thromboglobulin (BTG), a platelet-specific protein released during platelet release reaction. Platelet turn-over was evaluated by measuring the Platelet Regeneration Time (PRT) with a non-radioisotopic method. Blood samples for BTG assay were collected at rest and after exercise. BTG plasma levels obtained in children with MVP were significantly higher than in normal subjects (p less than 0.01), both at rest and after exercise. We found no difference in either group between BTG level at rest and after exercise. The TRP was within the normal range in all patients except 2, in whom TRP was slightly shorter. Increased BTG levels and normal TRP suggest that in our patients platelet activation, but not consumption, was increased. In children with MVP, periodic controls of platelet activation may be useful to detect an increased risk of thromboembolism.