RESUMO
BACKGROUND: Patients with metastatic renal carcinoma (mRCC) treated with first-line pazopanib were not included in the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) prognostic model. SPAZO (NCT02282579) was a nation-wide retrospective observational study designed to assess the effectiveness and validate the IMDC prognostic model in patients treated with first-line pazopanib in clinical practice. PATIENTS AND METHODS: Data of 278 patients, treated with first-line pazopanib for mRCC in 34 centres in Spain, were locally recorded and externally validated. Mean age was 66 years, there were 68.3% male, 93.5% clear-cell type, 74.8% nephrectomized, and 81.3% had ECOG 0-1. Metastatic sites were: lung 70.9%, lymph node 43.9%, bone 26.3%, soft tissue/skin 20.1%, liver 15.1%, CNS 7.2%, adrenal gland 6.5%, pleura/peritoneum 5.8%, pancreas 5%, and kidney 2.2%. After median follow-up of 23 months, 76.4% had discontinued pazopanib (57.2% due to progression), 47.9% had received second-line targeted therapy, and 48.9% had died. RESULTS: According to IMDC prognostic model, 19.4% had favourable risk (FR), 57.2% intermediate risk (IR), and 23.4% poor risk (PR). No unexpected toxicities were recorded. Response rate was 30.3% (FR: 44%, IR: 30% PR: 17.3%). Median progression-free survival (whole population) was 11 months (32 in FR, 11 in IR, 4 in PR). Median and 2-year overall survival (whole population) were 22 months and 48.1%, respectively (FR: not reached and 81.6%, IR: 22 and 48.7%, PR: 7 and 18.8%). These estimations and their 95% confidence intervals are fully consistent with the outcomes predicted by the IMDC prognostic model. CONCLUSION: Our results validate the IMDC model for first-line pazopanib in mRCC and confirm the effectiveness and safety of this treatment.
Assuntos
Carcinoma de Células Renais/tratamento farmacológico , Terapia de Alvo Molecular , Prognóstico , Pirimidinas/administração & dosagem , Sulfonamidas/administração & dosagem , Adulto , Idoso , Carcinoma de Células Renais/patologia , Bases de Dados Factuais , Intervalo Livre de Doença , Feminino , Humanos , Indazóis , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Pirimidinas/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Espanha , Sulfonamidas/efeitos adversosRESUMO
Oxaliplatin has been approved for adjuvant treatment of colorectal cancer. Toxicity induced by oxaliplatin is moderate and manageable, but some isolated cases of severe pulmonary toxicity associated to oxaliplatin have been reported. Two fatal cases of interstitial pneumonitis rapidly evolving to pulmonary fibrosis are reported here (AU)
No disponible
Assuntos
Humanos , Masculino , Feminino , Idoso , Fibrose Pulmonar/induzido quimicamente , Compostos Organoplatínicos/efeitos adversos , Doenças Pulmonares Intersticiais/induzido quimicamente , Antineoplásicos Alquilantes/efeitos adversos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/secundário , Fibrose Pulmonar/patologia , Fibrose Pulmonar , Compostos Organoplatínicos/administração & dosagem , Doenças Pulmonares Intersticiais/patologia , Doenças Pulmonares Intersticiais , Terapia Combinada/métodos , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Fluoruracila/uso terapêuticoRESUMO
Gastrointestinal stromal tumors (GIST) appear in the abdominal cavity in less than 5% of patients. We present two cases of extraintestinal GIST attended in our service and treated with imatinib mesylate. We review the current treatment of these neoplasms with targeted therapies.
Assuntos
Tumores do Estroma Gastrointestinal/patologia , Pelve/patologia , Adulto , Idoso , Feminino , Tumores do Estroma Gastrointestinal/diagnóstico por imagem , Tumores do Estroma Gastrointestinal/cirurgia , Humanos , Laparotomia , Pelve/diagnóstico por imagem , Pelve/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Los tumores del estroma gastrointestinal se presentan fuera del tubo digestivo en menos del 5% de los casos. Presentamos 2 casos de tumores del estroma gastrointestinal extraintestinales atendidos en nuestro servicio y tratados con imatinib mesilato. Revisamos la situación actual del tratamiento de dichas neoplasias con terapias dirigidas
Gastrointestinal stromal tumors (GIST) appear in the abdominal cavity in less than 5% of patients. We present two cases of extraintestinal GIST attended in our service and treated with imatinib mesylate. We review the current treatment of these neoplasms with targeted therapies
Assuntos
Feminino , Adulto , Idoso , Humanos , Trato Gastrointestinal/patologia , Pelve/patologia , Trato Gastrointestinal , Trato Gastrointestinal/cirurgia , Laparotomia , Pelve , Pelve/cirurgia , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Este es el caso de un varón afecto de un probable melanoma meníngeo que debuta con una paraplejia por compresión medular. El melanoma maligno de localización en el sistema nervioso central varía en las características citológicas mucho más que en otros lugares. En ocasiones puede resultar muy dificultosa e incluso imposible su precisa clasificación histológica. Paralelamente se revisará el tratamiento bioquimioterápico en este tipo de tumores (AU)
Assuntos
Masculino , Pessoa de Meia-Idade , Humanos , Melanoma/complicações , Melanoma/diagnóstico , Paraplegia/complicações , Paraplegia/diagnóstico , Interferons/administração & dosagem , Imunoterapia/métodos , Imunoterapia/normas , Imunoterapia , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/diagnóstico , Neoplasias Meníngeas/terapia , Sistema Nervoso Central/patologia , Hipestesia/complicações , Hipestesia/diagnóstico , Laminectomia/métodos , Laminectomia/normasRESUMO
Propósito: Descripción de las características clínicas de la hipersensibilidad al Carboplatino (CBDCA).Material y métodos: Presentamos cuatro casos de hipersensibilidad al CBDCA recogidos a lo largo de 14 meses entre 143 pacientes tratados con esta medicación. Resultados: Todas habían recibido tratamiento previo con CBDCA sin problemas y la reacción apareció tras uno o más ciclos. Todas presentaron ansiedad, tres prurito, una exantema, otra eritema, una tos, otra disnea, otra hipotensión y otra dolor torácico. En dos de ellas inicialmente la reacción se achacó al paclitaxel. Conclusión: Una reacción alérgica al CBDCA puede comprometer la vida del paciente por lo que es importante conocer los signos y síntomas de la misma para tratarla y evitar reexposiciones graves (AU)
