Exploration of predictors of benefit from nivolumab monotherapy for patients with pretreated advanced gastric and gastroesophageal junction cancer: post hoc subanalysis from the ATTRACTION-2 study

Abstract Background The phase 3 ATTRACTION-2 study demonstrated that nivolumab monotherapy was superior to placebo for patients with pretreated advanced gastric or gastroesophageal junction cancer, but early progression of tumors in some patients was of concern. Methods This post hoc analysis statistically explored the baseline characteristics of the ATTRACTION-2 patients and extracted a single-factor and double-factor combinations associated with early disease progression or early death. In the extracted patient subgroups, the 3-year restricted mean survival times of progression-free survival and overall survival were compared between the nivolumab and placebo arms. Results Two single factors (age and peritoneal metastasis) were extracted as independent predictors of early progression, but none of them, as a single factor, stratified patients into two subgroups with significant differences in restricted mean survival time. In contrast, two double-factor combinations (serum sodium level and white blood cell count; serum sodium level and neutrophil–lymphocyte ratio) stratifying patients into two subgroups with significant differences in the restricted mean survival time were extracted. Additional exploratory analysis of a triple-factor combination showed that patients aged < 60 years with peritoneal metastasis and low serum sodium levels (approximately 7% of all patients) might receive less benefit from nivolumab, and patients aged ≥ 60 years with no peritoneal metastasis and normal serum sodium levels might receive higher benefit. Conclusions A combination of age, peritoneal metastasis, and serum sodium level might predict benefit from nivolumab as salvage therapy in advanced gastric or gastroesophageal junction cancer patients, especially less benefit for patients having all three risk factors.

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Effect of Rehydration With Normal Saline Versus Ringer Lactate on Serum Sodium Level of Children With Acute Diarrhea and Severe Dehydration: A Randomized Controlled Trial

Indian Pediatrics ◽

10.1007/s13312-020-1848-0 ◽

2020 ◽

Vol 57 (6) ◽

pp. 519-522 ◽

Cited By ~ 1

Author(s):

Md Naseem ◽

A. P. Dubey ◽

T. K. Mishra ◽

Raghvendra Singh

Keyword(s):

Randomized Controlled Trial ◽

Serum Sodium ◽

Normal Saline ◽

Acute Diarrhea ◽

Sodium Level ◽

Serum Sodium Level ◽

Controlled Trial ◽

Severe Dehydration ◽

Ringer Lactate ◽

Randomized Controlled

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Altered acceptance and rejection of NaCl in rats with diabetes insipidus

American Journal of Physiology-Legacy Content ◽

10.1152/ajplegacy.1960.199.1.22 ◽

1960 ◽

Vol 199 (1) ◽

pp. 22-24 ◽

Cited By ~ 18

Author(s):

Libby F. Titlebaum ◽

John L. Falk ◽

Jean Mayer

Keyword(s):

Diabetes Insipidus ◽

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Extracellular Fluid ◽

Solution Concentration ◽

Lower Solution ◽

Extracellular Fluid Volume ◽

Internal Environment ◽

Nacl Solution

Groups of normal rats and animals with diabetes insipidus were tested on their relative acceptance and rejection of various concentrations of NaCl solution. Rats with diabetes inspidus drank more than normal rats in the hypotonic range. Their acceptance was maximal at a lower solution concentration than in the case of normal animals and relative rejection began at concentrations where normals ingested maximally. The results are discussed in relation to such factors in the internal environment as serum sodium level and extracellular fluid volume.

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Serum Sodium Level on the Recurrence of Febrile Seizure within the Same Febrile Illness-Experience in a District Level Hospital

TAJ Journal of Teachers Association ◽

10.3329/taj.v32i1.42734 ◽

2019 ◽

Vol 32 (1) ◽

pp. 39-45

Author(s):

M Luthfor Rahman ◽

Belal Hossain ◽

Belal Uddin ◽

Sanaul Haq Mia

Keyword(s):

Serum Sodium ◽

Febrile Seizure ◽

Sodium Level ◽

Serum Sodium Level ◽

Central Nervous System Infection ◽

Febrile Illness ◽

Febrile Seizures ◽

Febrile Episode ◽

Cross Sectional ◽

Recurrent Seizure

Introduction: Febrile convulsion is the most common seizure disorder in the pediatric age group. It occurs in 2-5% of children. A febrile seizure is a seizure accompanied by fever (temperature 100.4°F or 38°C by any method), without central nervous system infection, that occurs in infants and children 6 through 60 months of age. Aim: The study was conducted to see the effect of serum sodium level on the recurrence of febrile seizure during the same febrile illness. Materials and Method: A cross-sectional descriptive study which enrolled 65 children admitted with febrile seizures at 100 bed district hospital, Naogaon. They were divided in to two groups, those with a single seizure and the rest were children with more than one seizures. Serum sodium levels were estimated after stabilization of patients. The probability of recurrent febrile seizures and serum sodium level was analyzed. Results: Hyponatremia (serum sodium <135 mmol/l) was seen in 12(18.5%) of 65 children and the remaining 81.5% children had normal serum sodium level (serum sodium 135-145 mmol/l). Among the hyponatremia group all children developed more than one seizure during the same febrile episode. The mean serum sodium level in patients with single and recurrent seizure was 138.48±2.17mmol/l and 135.27±3.11mmol/(P<0.001). The relationship between the probability of a recurrent seizure and serum sodium level is statistically highly significant. Conclusion: Estimation of the seum sodium in children with febrile seizures help in deciding for admission in hospital as well as to predict seizure recurrence within the same febrile episode. TAJ 2019; 32(1): 39-45

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Continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia: A retrospective study of 13 cases

The International Journal of Artificial Organs ◽

10.1177/0391398819893381 ◽

2019 ◽

Vol 43 (6) ◽

pp. 416-421

Author(s):

Chen Huang ◽

Yirong Liu ◽

Li Li ◽

Hongbao Liu ◽

Peng Zhang

Keyword(s):

Serum Sodium ◽

Sodium Level ◽

Serum Sodium Level ◽

Reduction Rate ◽

Serum Levels ◽

Clinical Effects ◽

Sodium Reduction ◽

Replacement Fluid ◽

Hemodynamic Variables ◽

Sodium Replacement

Objectives: This study aimed to evaluate the clinical effects of continuous veno-venous hemofiltration in the treatment of severely burned patients with acute hypernatremia. Methods: A total of 13 severely burned patients with acute hypernatremia admitted to Xijing Hospital were included in this study. All patients received continuous veno-venous hemofiltration treatment in addition to conventional treatment. The original sodium level in the replacement fluid was set to be lower than the serum sodium level by 8 mmol/L and subsequently undergoes a reduction rate of 2.16 ± 0.18 mmol/L every 4 h. Patients’ clinical features, serum laboratory tests, hemodynamic variables, changes in sodium levels in serum, and replacement fluid during continuous veno-venous hemofiltration treatment were monitored. Results: Patients had an average total burn surface area of 66.69% ± 20.28%. Two patients died of systematic Pseudomonas aeruginosa infections, and 11 patients survived. After continuous veno-venous hemofiltration treatment, patients showed a significant reduction in the serum sodium level (168.91 ± 4.88 mmol/L vs 144.62 ± 2.98 mmol/L, p < 0.01). Likewise, the serum levels of urea and creatinine decreased from 24.8 ± 6.5 mmol/L to 14.9 ± 8.3 mmol/L and from 278.6 ± 155.3 μmol/L to 152.6 ± 29.7 μmol/L, respectively (p < 0.05). The patients also displayed improvements in the Acute Physiology and Chronic Health Evaluation II and Glasgow scores (p < 0.05) and showed a significant reduction in hemoglobin and serum albumin levels (p < 0.05), but no obvious change in levels of platelets, alanine aminotransferase, and aspartate aminotransferase (p > 0.05). Conclusion: Our results indicate that continuous veno-venous hemofiltration with gradient sodium replacement fluid is effective in treating hypernatremia in severely burned patients with the controllable sodium reduction rate and satisfactory clinical outcomes.

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