Efficacy and tolerance of cetuximab in combination with 5 FU plus irinotecan based chemotherapy in metastatic squamous cell anal carcinoma.

BACKGROUND: Squamous cell anal carcinoma (SCAC) is an uncommon neoplasia often cured by surgery and/or chemo-adiation therapy at the localized stage. Although the first-line treatment for metastatic anal canal cancer is now better codified with two validated treatment regimens, carboplatin-paclitaxel and modified docetaxel-cisplatin-5FU (DCF), there is little data and no consensus regarding subsequent lines [1-5]. In this study, we report the safety and efficacy of cetuximab (an epidermal growth factor receptor inhibitor) in combination with 5-FU plus irinotecan based chemotherapy. METHOD: A retrospective analysis of patients with metastatic SCAC (mSCAC), who failed on at least one prior line of treatment, before being treated with the combination FOLFIRI and cetuximab between March 2015 and February 2022 at Gustave Roussy cancer center, was performed. RESULTS: A total of 33 patients with a pre-treated mSCAC were analyzed. The combination of FOLFIRI and cetuximab provided a disease control rate (DCR) of 73%, and response rate of 30%. With a median follow-up of 38 months, the median progression free survival was 5.5 months, and the median overall survival was 13.7 months. Fourteen patients (42%) experienced grade III/IV adverse events that remained manageable. CONCLUSION: Our study suggests that FOLFIRI and cetuximab is a promising combination in the management of mSCAC with a very good DCR and a manageable toxicity profile. Further prospective trials would be needed to confirm our results.

Identity, expression and functional role of the sodium-activated potassium current in vestibular ganglion afferent neurons.

Vestibular afferent neurons (VANs) transmit information from the vestibular end organs to the central nuclei. This information is encoded within the firing pattern of these cells and is heavily influenced by the K⁺ conductances expressed by vestibular neurons. In the present study, we describe the presence of a previously unidentified Na⁺-activated K⁺ conductance (KNa) in these cells. We observed that the blocking of Na⁺ channels by tetrodotoxin (TTX) or the substitution of choline for Na⁺ in the extracellular solution during voltage clamp pulses resulted in the reduction of a sustained outward current that was dependent on the Na⁺ current. Furthermore, increases in the intracellular concentration of Na⁺ that were made by blocking the Na⁺/K⁺ ATPase with ouabain increased the amplitude of the outward current, and reduction of the intracellular Cl⁻ concentration reduced the TTX-sensitive outward current. The substitution of Li⁺ for Na⁺ in the extracellular solution significantly reduced the amplitude of the outward current in voltage clamp pulses and decreased the afterhyperpolarization (AHP) of the action potentials in current clamp experiments. These electrophysiological results are consistent with the presence of mRNA transcripts for the KNa subunits Slick and Slack in the vestibular ganglia and in the sensory epithelium, which were detected using reverse-transcription polymerase chain reaction (RT-PCR). These results are also consistent with the immunolabeling of Slick and Slack protein in isolated vestibular neurons, in the vestibular ganglion and in the vestibular sensory epithelium. These results indicate that KNa channels are expressed in VANs and in their terminals. Furthermore, these data indicate that these channels may contribute to the firing pattern of vestibular neurons.

Gastritis crónica asociada a Helicobacter pylori como causa de dolor abdominal recurrente en niños: estudio de 50 casos / Chronic gastritis associated with Helicobacter pylori as a cause for recurrent abdominal pain in children: study of 50 cases

Se estudió la asociación de Helicobater pylori gastritis crónica en 50 niños con dolor abdominal recurrente. En todos se hizo historia clínica completa y endoscopia con toma de dos muestras de antro gástrico. Una muestra se utilizó para estudio histológico y detección de Helicobacter pylori con tinciones de Warthin Starry, Giemsa y hematoxilina eosina. La otra muestra se utilizó para la prueba de ureasa rápida. En 25 de los 50 niños se diagnosticó gastritis crónica por estudio histológico y en 16 de éstos se detectó Helicobacter pylori, 12 por histología y prueba de ureasa rápida y cuatro sólo para la prueba de ureasa rápida. Se concluye que existe asociación entre gastritis crónica y la presencia de Helicobacter pylori, lo cual puede explicar el dolor abdominal recurrente en niños

Endoscopia con toma de biopsia esofágica en niños con enfermedad por reflujo gastroesofágico con un año o más de tratamiento / Endoscopy with wsophagical biopsy in childrens

Se estudiaron 30 niños con diagnóstico clínico de enfermedad por reflujo gastroesofágico, (ERGE) tratados con anácidos, con bloqueadores H21 con procinéticos, o con todos estos fármacos, durante un año o más. Al cabo de ese periodo presentaban remisión clínica y radiológica y crecimiento pondoestatural adecuado. Se practicó endoscopia y estudio histológico del esófago a todos un año después del tratamiento. Nueve de los 29 tuvieron esofagitis diagnosticada por endoscopia; en un niño no se describieron los hallazgos endoscópicos, y en 11 de 30 el diagnóstico fue por estudio histológico. No hubo diferencias estadísticamente significativas entre el grupo de pacientes con esofagitis en cuanto a edad de principio del tratamiento, edad al final del mismo, ni tiempo de tratamiento, de acuerdo con el análisis de varianza. A pesar de estos resultados, y de que el consenso general señala dar tratamiento médico a los niños con ERGE por un año, surge la duda sobre el tiempo que debe durar dicho tratamiento y cuándo deben considerarse curados estos pacientes.