RESUMO
This study evaluates the overall survival and disease free survival of melanoma patients that were treated with an autologous melanoma cell vaccine, administered as a post-operative adjuvant. Included are 43 patients with totally resected metastatic melanoma (28-AJCC stage III, 15-AJCC stage IV), with a median follow up of 34 months (6-62). The treatment consisted of eight doses of a vaccine made of 10-25x10(6) autologous melanoma cells either released from the surgical specimen or grown in cell cultures. Tumour cells were conjugated with hapten dinitrophenyl, mixed with Bacille Calmette Guérin and irradiated to 110 Gy. Both disease free survival and overall survival were found to be correlated with intensity of evolving delayed type hypersensitivity to subcutaneous injection of unmodified melanoma cells. Patients with a delayed type hypersensitivity reaction of > or =10 mm had a median disease free survival of 17 months (mean 35 months) and a mean overall survival of 63 months (median not reached). In contrast, patients with a negative or weak delayed type hypersensitivity had a median disease free survival of 9 months (relative risk of recurrence=4.5, P=0.001), and a median overall survival of 16 months (relative risk of death=15, P=0.001). Stage III patients with a positive delayed type hypersensitivity reaction had an improved disease free survival of 16 months and a mean overall survival of 38 months, whereas patients with a negative delayed type hypersensitivity had a median disease free survival of 7 months (relative risk=4.5, P=0.02) and a median overall survival of 16 months (relative risk=9.5, P=0.005). The adjuvant administration of autologous melanoma vaccine was associated with improved disease-free and overall survival to selected patients who successfully attained anti-melanoma reactivity as detected by positive delayed type hypersensitivity reactions to unmodified melanoma cells.
Assuntos
Vacinas Anticâncer/uso terapêutico , Imunoterapia Ativa , Melanoma/terapia , Vacinas Anticâncer/administração & dosagem , Neoplasias da Coroide/cirurgia , Neoplasias da Coroide/terapia , Terapia Combinada , Intervalo Livre de Doença , Seguimentos , Humanos , Hipersensibilidade Tardia/imunologia , Imunocompetência , Neoplasias Laríngeas/cirurgia , Neoplasias Laríngeas/terapia , Tábuas de Vida , Neoplasias Pulmonares/secundário , Metástase Linfática , Melanoma/imunologia , Melanoma/mortalidade , Melanoma/secundário , Melanoma/cirurgia , Recidiva Local de Neoplasia/epidemiologia , Estadiamento de Neoplasias , Seleção de Pacientes , Período Pós-Operatório , Neoplasias Retais/cirurgia , Neoplasias Retais/terapia , Risco , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/terapia , Análise de Sobrevida , Resultado do TratamentoRESUMO
[C-11]choline is a very promising radiomarker for the diagnosis of various human tumors using Positron Emission Tomography (PET). The existing quality control process for [C-11]choline is complicated and combines two HPLC methods with limited separation and sensitivity which prevent the accurate determination of the specific activity. We have developed a new efficient single HPLC method for the detection of choline chloride and dimethylaminoethanol with high resolution and sensitivity using cation-exchange chromatography.
Assuntos
Colina/química , Compostos Radiofarmacêuticos/química , Colina/normas , Cromatografia Líquida de Alta Pressão , Cromatografia por Troca Iônica , Deanol/química , Controle de Qualidade , Compostos Radiofarmacêuticos/normas , Padrões de Referência , SoluçõesRESUMO
Little is known about bromine trifluoride in organic chemistry. Under the right conditions, it can be a useful tool and generate a new and unprecedented chemistry. Thus, when reacted with oxime methyl ethers of alpha-ketoesters, BrF3 was able to convert the oxime group into a CF2 group and through a new type of rearrangement cause a shift of the carboxylate group to the nitrogen atom. The novel structure of the alpha,alpha-difluorocarbamate was also proven by 15N NMR as demonstrated for compounds 3, 8, 9, 12, 15, and 18. Another novel "double rearrangement" was observed during the formation of 19. Dynamic 19F NMR experiments indicate a high nitrogen inversion-rotation (NIR) barrier for these novel carbamates of about 12.5 kcal/mol.