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Efficacy and safety of thalidomide in patients with hepatocellular carcinoma

World Journal of Gastroenterology 2006年第43期12卷 6955-6960页

作者： Hsueh-Erh Chiou Tsang-En Wang Ying-Yue Wang Hui-Wen Liu Pharmacy Department Mackay Memorial Hospital Taipei Taiwan China Gastroenterology Section Department of Internal Medicine Mackay Memorial Hospital Taipei TaiwanChina

AIM: To evaluate which patients with hepatocellular carcinoma (HCC) are most likely to respond to thalidomide treatment. METHODS: From July 2002 to July 2004, patients with HCC who received thalidomide treatment, were enrolled. We extracted relevant data from the patients’ medical records, including history and type of hepatitis, comorbidity, serum α-fetoprotein (α-FP) level, volumetric changes in tumor, length of survival, and the dose, duration, side effects of thalidomide treatment. The tumor response was evaluated. On the basis of these data, the patients were divided into two groups: those with either partial response or stable disease (PR + SD group) and those with progressive disease (PD group). RESULTS: Two of 42 (5%) patients had a partial tumor response after treatment with thalidomide, 200 mg/d, and 9 (21%) had stable disease. Patients in the PR + SD group all had cirrhosis. Comparing patients with and without cirrhosis, the former were more likely to respond to thalidomide therapy (PR + SD: 100% vs PD: 64.5%, P = 0.041 < 0.05). Thalidomide was significantly more likely to be effective in tumors smaller than 5 cm (PR + SD: 63.6% vs PD: 25.8%, P = 0.034 < 0.05). Compared with patients with progressive disease (PD), patients in the PR + SD group had a higher total dose of thalidomide (13 669.4 ± 8446.0 mg vs 22 022.7 ± 11 461.4 mg, P = 0.023 < 0.05) and a longer survival (181.0 ± 107.1 d vs 304.4 ± 167.1 d, P = 0.047 < 0.05). Patients with comorbid disease had a significantly greater incidence of adverse reactions than those without (93.8% vs 60.0%, P = 0.021 < 0.05). The average number of adverse reactions in each person with a comorbid condition was twice as high as in those without other diseases (2.2 ± 1.3 vs 1.1 ± 1.2; P = 0.022 < 0.05). CONCLUSION: Thalidomide therapy is most likely to beeffective in patients with early stage small HCC, espe- cially in those with other underlying diseases. A low dose (200 mg/d) of thalidomide is recommended to continu

关键词： Thalidomide Hepatocellular carcinoma antiangiogenic agents Adverse events

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An Update on Pathophysiology and Medical Management of Endometriosis

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Advances in Reproductive Sciences 2016年第2期4卷 53-73页

作者： Kulvinder Kochar Kaur Gautam Allahbadia Department of Obstetrics and Gynaecology (Reproductive Neuroendocrinology and Infertility) Dr. Kulvinder Kaur Centre for Human Reproduction Jalandhar India Rotunda—A Centre for Human Reproduction Mumbai India

Endometriosis is an inflammatory oestrogen dependent disease defined by the presence of endometrial glands and stroma at extrauterine sites. The modern advance in treatment of endometriosis management is tackling the debilitating pain it causes, besides the infertility in patients desiring fertility in reproductive age group. This can be achieved by surgical or medical means, although in most cases a combination of both treatments is required. Usually, long term treatment is required in most cases. Unfortunately in most cases, pain symptoms recur between 6months and 12 months once treatment is stopped. A lot of research has gone in understanding the pathogenesis and further medical management of endometriosis besides surgery to be useful in relieving pain and use in patients desiring fertility besides hormonal treatments used earlier like hormonal contraceptives (oral, transdermal or vaginal administration), progestogens, danazol, Gonadotrophic releasing hormone agonist (GnRH), aromatase inhibitors. Newer agents like antiangiogenic drugs, phytochemical agents like resveratrol, TNF-α inhibitors, GnRH antagonists like egalogolix, statins, antiinflammatory agents like COX2 Inhibitors and PPARγ inhibitors like pioglitazone etc., with recent work of combined efficacy of telmesartan of both PPARγ partial agonism along with angiotensin 1 receptor agonism having more efficacy, role of immunomodulators like rapamycin, lipoxin 4 and pentoxyphylline, GnRH antagonists like egalogolix are still under study undergoing phase III trials although preliminary results show promising results with fewer side effects as compared to similar duration of GnRH agonist and much less BMD side effects. Increasing number of trials show the safety of SPRM’s, along with efficacy although disadvantage is suppression of fertility so cannot be used for women desiring fertility. Currently, only mifepristone and ulipristal have received FDA approval for indication in fibroid treatment, MTP and not for

关键词： antiangiogenic agents Phytotherapeutics Drugs (Resveratrol) PPAR Gamma Agonism with AT1R Agonism (Telmesartan) GnRH Antagonist (Elagolix) IL-17A SPRM Modulators (Ulipristal) Immunomodulators (Pentoxyphylline) Statins (Atorvastatin)

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Treatment strategies in cervical cancer:treatment of advanced disease

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Journal of Cancer Metastasis and Treatment 2022年第1期8卷 221-239页

作者： Augusto Valdivia Juan Francisco Grau-Béjar Carmen García-Durán Ana Oaknin Gynaecologic Cancer Programme Vall d’Hebron Institute of Oncology(VHIO) Hospital Universitari Vall d’HebronVall d’Hebron Barcelona Hospital CampusBarcelona 08035Spain

Cervical cancer is the fourth most common cancer in women worldwide,with a global incidence of 604,127 and an annual death rate of 341,831 in *** with recurrent,persistent,or metastatic disease not amenable to curative therapy represent a patient population with a dismal *** recently,the standard of care for these patients was based on platinum doublet chemotherapy with or without ***,significant advances in the treatment landscape of this disease have recently been achieved with the incorporation,among others,of immunotherapy in the therapeutic *** review summarizes the main treatment approaches developed throughout the past decades,with particular emphasis on immunotherapy and novel targeted therapies.

关键词： Cervical cancer advanced stage chemotherapy immunotherapy antiangiogenic agents targeted therapy

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