RESUMEN
BACKGROUND: The epidermal growth factor receptor (EGFR) signaling system is frequently unbalanced in human malignancies due to increased ligand production, receptor overexpression, receptor mutations, and/or cross-talk with other receptor systems. For this reason, the EGFR is an attractive target for anticancer therapy. The epidermal growth factor also plays an important role in regulating multiple facets of cutaneous wound healing, including inflammation, wound contraction, proliferation, migration, and angiogenesis. In the Center of Molecular Immunology, a cancer vaccine is produced (CIMAvax® EGF) that blocks the binding of EGF to its receptor. This blockade causes a significant inverse association between the anti-EGF antibody titers and EGF concentration. Around 1,500 patients with non-small cell lung cancer have been treated, showing that this vaccine is safe, immunogenic, increases survival and improves quality of life. Taking into account the therapeutic benefits of CIMAvax® EGF vaccination and the role of EGF-EGFR system in the wound healing process, we decided to conduct a retrospective research with the aim of determining the effect to the CIMAvax® EGF vaccine on the wound healing process in patients undergoing surgical treatment. METHODS: Medical records of 452 vaccinated patients were reviewed and only six patients receiving surgical treatment were identified. Further information about these six patients was obtained from source documents, including medical records and operative reports using an observational list that included different variables. Post-surgical wound healing complications were identified using the National Cancer Institute Common Toxicity Criteria for Adverse Events (NCI-CTC) version 3.0. RESULTS: None of the six patients operated on presented adverse events related to the wound healing, that is to say, no wound dehiscence, wound infection, delayed wound healing, fistula formation, abscess formation or hemorrhage/bleeding associated with surgery during treatment with CIMAvax® EGF occurred. CONCLUSIONS: These results suggest that the use of CIMAvax® EGF does not produce a deleterious effect in the wound healing process.
Asunto(s)
Vacunas contra el Cáncer/uso terapéutico , Carcinoma de Pulmón de Células no Pequeñas/tratamiento farmacológico , Factor de Crecimiento Epidérmico/antagonistas & inhibidores , Receptores ErbB/antagonistas & inhibidores , Neoplasias Pulmonares/tratamiento farmacológico , Cicatrización de Heridas/efectos de los fármacos , Anciano , Carcinoma de Pulmón de Células no Pequeñas/inmunología , Carcinoma de Pulmón de Células no Pequeñas/metabolismo , Factor de Crecimiento Epidérmico/inmunología , Factor de Crecimiento Epidérmico/metabolismo , Receptores ErbB/inmunología , Receptores ErbB/metabolismo , Femenino , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/inmunología , Neoplasias Pulmonares/metabolismo , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Transducción de Señal/efectos de los fármacosRESUMEN
Se elaboraron y validaron 2 encuestas con el objetivo de determinar la percepción y el conocimiento de los médicos y el público sobre los ensayos clínicos. Los médicos fueron encuestados en instituciones hospitalarias hasta un total de 267 especialistas. Se encuestó una muestra de 405 personas tomadas al azar de la población en general. Algunos médicos y el público en general tienen dificultades para explicar que es un ensayo clínico. En Cuba se han incrementado los conocimientos sobre los ensayos clínicos, sin embargo, aún no existe una cultura general sobre este tipo de investigación. Deben aprovecharse todas las posibilidades de los medios de comunicación para la divulgación de temas relacionados con los ensayos clínicos