Durvalumab monotherapy as a third-line treatment for extensive-stage small-cell lung cancer: a case report.

The global incidence and mortality rates of lung cancer are the highest of any cancer. Smallcell lung cancer (SCLC) is an undifferentiated carcinoma which accounts for 15-20% of all lung cancers. Compared with the other major lung cancer type, non-small cell lung cancer, SCLC exhibits worse biological behavior, has a higher degree of malignancy, and develops more rapidly. The majority of SCLC present with extensive-stage disease, and the prognosis for these patients remains poor. Recently, immunotherapy has been demonstrated clinical activity in extensive-stage SCLC (ES-SCLC); however, the efficacy and safety of immunotherapy in ES-SCLC needs further confirmation. Durvalumab, a selective, high-affinity human IgG1 monoclonal antibody that blocks PD-L1 binding to PD-1 and CD80, showed durable clinical activity and a manageable safety profile in patients with pretreated ES-SCLC as a first-line treatment. Here, we report the case of an ES-SCLC patient who achieved complete remission (CR) of local lesions after receiving durvalumab monotherapy as a third-line treatment, experiencing no obvious immune-related side effects, such as rash, diarrhea, fatigue, myelosuppression, or thyroid dysfunction. No immune-related pulmonary or hepatorenal toxicities occurred. The case suggests that immunotherapy can be selected for third-line or multi-line treatment of ES-SCLC, and anti-PD-L1 antibody may be the better choice for patients who have poor performance status (PS) scores.

Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis.

AIM: To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. METHODS: A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. RESULTS: No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. CONCLUSION: SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia. However, the aberration in the SMILE group is superior to that in the FS-LASIK group, and the loss of biomechanical effects may occur less frequently after SMILE than after FS-LASIK.

[Inhibitory effects of an antisense PCDGF vector on proliferation and invasion of highly malignant ovarian cancer cells and the related mechanism].

OBJECTIVE: To investigate the inhibitory effects of an antisense PC cell derived growth factor (PCDGF) vector on proliferation and invasion of highly malignant ovarian cancer cell lines Sw626 and A2780 cells, and preliminarily explore the related mechanisms. METHODS: MTT assay and Boyden chamber in vitro invasion assay were employed to detect the changes of proliferation and invasion ability in the Sw626 and A2780 cells transfected with anti-sense PCDGF. The expression levels of cyclin D1 and CDK4 proteins before and after transfection were detected by Western blotting. The effects on the expression and activity of MMP-2 were evaluated by quantitative RT-PCR and zymography, respectively. RESULTS: Comparing with the blank group, the proliferation inhibition rate of the Sw626 and A2780 cells transfected with anti-sense PCDGF was 72.9% and 70.9%, respectively, and the invasion ability was inhibited by 62.9% and 59.0%, respectively. The levels of cyclin D1 and CDK4 protein expression in antisense PCDGF transfected cells were 0.38 +/- 0.08 and 0.37 +/- 0.13, respectively, all significantly lower than 0.84 +/- 0.11 and 0.64 +/- 0.11, respectively, in the blank group (P < 0.01). The MMP-2 mRNA expression level in antisense PCDGF transfected cell group was 0.66 +/- 0.11, not significantly decreased in comparison with 0.89 +/- 0.09 in the blank group (P > 0.05), but the activity of MMP-2 was inhibited significantly. CONCLUSION: The antisense PCDGF vector may inhibit markedly the proliferation and invasion of highly malignant ovarian cancer cells, and partially reverses their malignant phenotype. It seems to be related with down-regulating the expression of cyclin D1 and CDK4 and inhibiting the activity of MMP-2. Our findings indicate that PCDGF may become a new target for antisense gene therapy of ovarian cancer.