ADXS11-001 LM-LLO as specific immunotherapy in cervical cancer.

Human papillomavirus (HPV) infection is a well-known cause of cervical cancer. Therapeutic cancer vaccines are part of the current therapeutic options for HPV-associated cancers. Axalimogen filolisbac (ADXS11-001) is an immunotherapy based on live attenuated Listeria monocytogenes-listeriolysin O (Lm-LLO), designed by biological engineering to secrete an antigen-adjuvant fusion protein, composed of a truncated fragment of LLO fused to HPV. The proposed mechanism of action is that Lm-based vectors infect antigen-presenting cells (APC) and secrete HPV-LLO fusion proteins within the APC cytoplasm, these proteins are processed and presented to cytotoxic T lymphocytes (CTL), thus generating a new population of CTLs specific to HPV antigens. These HPV-specific CTLs destroy HPV infected cells. ADXS11-001 has demonstrated safety results in phase I-II studies in women with cervical cancer and is being assessed in clinical trials in patients with HPV-positive anal canal and head and neck cancers.

[Laryngeal conservative surgery in patients candidates for combined treatment with chemo-radiotherapy]. / Cirugía conservadora de laringe en pacientes candidatos a tratamiento combinado con quimio-radiación por cáncer laríngeo.

BACKGROUND: The standard of care for advanced-stage laryngeal cancer is combined treatment (chemo-radiotherapy). However, the complications with this treatment are not few, mainly in swallowing. Conservative laryngeal surgery remains an effective alternative for cancer control without the complications of chemo-radiotherapy. MATERIAL AND METHODS: Retrospective study was conducted on patients with laryngeal cancer cT3, cN0 with paraglottic infiltration, fixation of the vocal cord, minimal invasion of the hyo-thyroepiglottic space, but with normal arytenoid mobility and no sub-glottic extension, were treated with subtotal supracricoid laryngectomy. Complications, sequels of treatment, and local recurrence were evaluated. Bronchial aspiration was studied with radioactive swallow. RESULTS: There were 25 patients, 22 with negative surgical margins, one had tumour contact with the surgical margins, and 2 were positive. Two patients received postoperative radiotherapy. The mean decannulation was 15 days and removal of nasogastric tube 25 days. During the mean follow-up of 26 months, none of the patients had tumour recurrence or required conversion to total laryngectomy. In all patients swallowing has been normal and none required permanent or temporary tracheotomy or definitive gastrostomy. The voice is considered intelligible in all patients. Radioactive swallow showed aspiration in 15/25 patients, with none being clinically relevant. There were postoperative complications in 5 patients, and 4 patients required re-intervention but no conversion to total laryngectomy. CONCLUSION: Conservative surgery is an effective surgical-alternative to chemo-radiotherapy in patients with locally advanced laryngeal cancer, providing oncological control, acceptable complications and minimal sequels. Although most patients have aspiration, this does not affect functional status.

[Adnexal neoplasms in the context of skin cancer: trichilemmal carcinoma. Apropos of a case]. / Neoplasias de anexos en el contexto del cáncer de piel: el carcinoma triquilemal. A propósito de un caso.

BACKGROUND: The trichilemmal carcinoma is a rare malignant neoplasm, whose origin lies in the annexes of the skin, because of its low prevalence often confused with other dermal tumors, the differential diagnosis is not easy and is usually made by exclusion; in theory, its behavior is slow with little tendency to send both regional lymph node metastasis and systemic. Due to the limited number of cases there is no consensus on the prognosis, although it is generally considered good. The aim of this report is to show a case that, contrary to previous reports, the clinical presentation is aggressive with large soft tissue tumor infiltration around the site of origin in a patient without risk factors for skin cancer. CLINICAL CASE: Male patient, 65 years old with cytologic diagnosis of carcinoma in a preprarotideal facial tumor, characteristics at diagnosis were infiltration of the facial skin, ear, and parotid gland. Complete block resection was performed, radical parotiroidectomy and radical neck dissection; the soft tissue defect was covered with a pediculated flap. The evolution was satisfactory it follow-up short though. We evaluated the experience in the literature regarding the prognosis and treatment of these patients. CONCLUSION: Trichilemmal carcinoma can be fully invasive behavior prognosis is difficult to know and probably depends on the clinical stage at diagnosis.

Antecedente: el carcinoma triquilemal es una neoplasia maligna poco frecuente originada en los anexos de la piel. Debido a su escasa prevalencia suele confundirse con otros tumores dérmicos, su presentación clínica no favorece el diagnóstico diferencial y generalmente éste se hace por exclusión. En teoría, su comportamiento es lento, con poca tendencia a enviar metástasis regionales ganglionares y sistémicas. Debido al escaso número de casos no existe consenso en relación con el pronóstico, aunque generalmente se estima bueno. El objetivo de este reporte es mostrar un caso que, contrario a lo informado, es de manifestación agresiva en un paciente sin factores de riesgo para cáncer de piel, con gran infiltración tumoral de los tejidos blandos alrededor del sitio de origen. Caso clínico: paciente masculino de 65 años de edad que acudió con diagnóstico citológico de carcinoma en un tumor facial preparotídeo; al momento del diagnóstico motraba infiltración de la piel de la cara, del pabellón auricular y de la glándula parótida. Se efectuó resección completa de la neoplasia en bloque con isla de piel facial, parotidectomía total y disección radical del cuello; el defecto de partes blandas fue cubierto con un colgajo pediculado. La evolución ha sido satisfactoria; sin embargo, el seguimiento es corto. Se evalúa la experiencia asentada en la bibliografía en relación con el pronóstico y tratamiento de estos pacientes. Conclusión: el carcinoma triquilemal puede tener comportamiento localmente invasor lo que hace difícil determinar el pronóstico, que quizá dependa de la etapa clínica al momento del diagnóstico.

[Hormonal therapy in metastatic breast cancer]. / Hormonoterapia en cáncer de mama metastásico.

The primary objective in metastatic breast cancer is tumor control and symptom palliation. Factors to be considered are: efficacy, tolerance and quality of life as well as patient preferences. In the Hormone Receptor Positive Group, Hormonal treatment is the best choice because of it's effectiveness and good toxicity profile. Endocrine therapy has two main targets: the first one is to block estrogen production. In premenopausal women this can be through ovarian ablation. In postmenopausal women this is achieved by blocking the peripheral conversion of androgens to estrogens by blocking the enzyme known as aromatase. The other option is to block the action of the estrogen on it's receptor with the group of drugs known as selective estrogen receptor modulators (SERM). This class of drugs can be used in pre and postmenopausal women. Treatment should be tailored according to patient characteristics and menopausal status.