scholarly journals The use of immunotherapy for the treatment of refractory forms of Hodgkin lymphoma in real clinical practice.

2021 ◽  
Vol 2 (2) ◽  
pp. 34-41
Author(s):  
I. A. Kamaeva ◽  
I. B. Lysenko ◽  
N. V. Nikolaeva ◽  
T. F. Pushkareva ◽  
E. A. Kapuza ◽  
...  
Keyword(s):  
Young People ◽  
Checkpoint Inhibitors ◽  
Rescue Therapy ◽  
High Dose Chemotherapy ◽  
Malignant Neoplasms ◽  
High Dose ◽  
Standard Chemotherapy ◽  
Severe Comorbidity ◽  
History Of ◽  
Immune Check Points

With a frequency of 2.2 cases per 100,000 population in Russia, Hodgkin's lymphoma (HL) is one of the most common malignant neoplasms in young people. In connection with the predominant spread of HL among young people, the issue of effective treatment of various forms of HL remains relevant. Currently, 70-90 % of patients with HL who have received standard chemotherapy or chemoradiotherapy have a long period of remission. However, 10 % of patients with progressive course, can`t achieve a response, and 30 % of patients subsequently recur. The standard approach of treating recurrent and/or refractory HL after initial treatment is “salvage therapy” followed by consolidation with high-dose chemotherapy and stem cell transplantation. Although there is a model for treating these patients, recent research has focused on improving the effectiveness and tolerability of rescue therapy. The use of anti- PD-1 drugs opens up new possibilities for the treatment of recurrent/refractory HL. The article describes the results of using checkpoint inhibitors for patients with a history of multi- course chemotherapy. Inhibitors of immune check points were supplemented in the 3rd and subsequent lines of ChT. A clinical case with immunotherapy supplementation in a patient with severe comorbidity is also presented.

Atezolizumab-induced myositis and myocarditis in a patient with metastatic urothelial carcinoma

2020 ◽  
Vol 13 (12) ◽  
pp. e236357
Author(s):  
Mary Sessums ◽  
Siva Yarrarapu ◽  
Pramod K Guru ◽  
Devang K Sanghavi
Keyword(s):  
Urothelial Carcinoma ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Basic Knowledge ◽  
Malignant Neoplasms ◽  
Diverse Range ◽  
History Of ◽  
Metastatic Urothelial Carcinoma ◽  
Acute Hypercapnic Respiratory Failure

Immune checkpoint inhibitors have revolutionised cancer therapy in the past decade. Although they have been indicated to treat a diverse range of malignant neoplasms, they are also associated with various immune-related adverse effects. We report the case of a 74-year-old man with a history of urothelial carcinoma who had atezolizumab-induced myocarditis and myositis resulting in acute hypercapnic respiratory failure, despite the discontinuation of atezolizumab and aggressive treatment with corticosteroids. This case highlights the importance of a multidisciplinary approach for early diagnosis and treatment of immune-related adverse events. Physicians must be aware of the risks associated with immune checkpoint inhibitors and have a basic knowledge regarding their management.

scholarly journals Refractory constrictive pericarditis caused by an immune checkpoint inhibitor properly managed with infliximab: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Shohei Moriyama ◽  
Mitsuhiro Fukata ◽  
Ryoma Tatsumoto ◽  
Mihoko Kono
Keyword(s):  
Lung Cancer ◽  
Constrictive Pericarditis ◽  
Immune Checkpoint ◽  
Checkpoint Inhibitors ◽  
Rescue Therapy ◽  
Treatment Strategies ◽  
High Dose ◽  
Acute Pericarditis ◽  
Line Therapy ◽  
Steroid Refractory

Abstract Background Immune checkpoint inhibitors (ICIs) can cause cardiac immune-related adverse events (irAEs), including pericarditis. Cardiovascular events related to pericardial irAE are less frequent, but fulminant forms can be fatal. However, the diagnosis and treatment strategies for pericardial irAE have not established. Case summary A 58-year-old man was diagnosed with advanced non-small-cell lung cancer and nivolumab was administered as 5th-line therapy. Eighteen months after the initiation of nivolumab, the patient developed limb oedema and increased body weight. Although a favourable response of the cancer was observed, pericardial thickening and effusion were newly detected. He was diagnosed with irAE pericarditis after excluding other causes of pericarditis. Nivolumab was suspended and a high-dose corticosteroid was initiated. However, right heart failure (RHF) symptoms were exacerbated during the tapering of corticosteroid because acute pericarditis developed to steroid-refractory constrictive pericarditis. To suppress sustained inflammation of the pericardium, infliximab, a tumour necrosis factor-alfa inhibitor, was initiated. After the initiation of infliximab, the corticosteroid dose was tapered without deterioration of RHF. Exacerbation of lung cancer by irAE treatment including infliximab was not observed. Discussion IrAE should be considered when pericarditis develops after the administration of ICI even after a long period from its initiation. Infliximab rescue therapy may be considered as a 2nd-line therapy for steroid-refractory irAE pericarditis even with constrictive physiology.

scholarly journals Secondary malignant neoplasms after high-dose chemotherapy and autologous stem cell rescue for high-risk neuroblastoma

2014 ◽  
Vol 61 (8) ◽  
pp. 1350-1356 ◽  
Author(s):  
Alissa Martin ◽  
Jennifer Schneiderman ◽  
Irene B. Helenowski ◽  
Elaine Morgan ◽  
Kimberley Dilley ◽  
...  
Keyword(s):  
Stem Cell ◽  
High Risk ◽  
High Dose Chemotherapy ◽  
Malignant Neoplasms ◽  
High Dose ◽  
Stem Cell Rescue ◽  
Autologous Stem Cell Rescue

scholarly journals Densitometry as a monitoring method in the treatment of patients with multiple myeloma

2018 ◽  
pp. 106-113 ◽  
Author(s):  
E. V. Kryukov ◽  
V. N. Troyan ◽  
O. A. Rukavitsyn ◽  
S. V. Kozyrev ◽  
I. G. Daragan-Sushchov ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
High Dose Chemotherapy ◽  
Dual Energy ◽  
High Dose ◽  
Mineral Density ◽  
Standard Chemotherapy ◽  
Objective Criterion ◽  
Monitoring Method ◽  
Hematopoietic Stem ◽  
X Ray

The article is devoted to the study of the problem of the analysis of the degree of osteoporosis based on the results of dual-energy x-ray absorptiometry in multiple myeloma during treatment. The change in bone mineral density in patients with multiple myeloma treated with standard chemotherapy and high-dose chemotherapy with autotransplantation of hematopoietic stem cells is considered. The X-ray densitometry method can serve as an objective criterion for evaluating the effectiveness of the treatment in patients with multiple myeloma.

scholarly journals Squamous Cell Carcinoma of the Bulbar Urethra Accompanied by Lichen Sclerosus: A Case Report

2017 ◽  
Vol 12 (2) ◽  
pp. 493-497 ◽  
Author(s):  
Xufeng Peng ◽  
Hailin Guo ◽  
Chongrui Jin ◽  
Lin Wang ◽  
Yinglong Sa
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Lichen Sclerosus ◽  
High Dose Chemotherapy ◽  
High Dose ◽  
Ki 67 ◽  
Bulbar Urethra ◽  
Urethral Strictures ◽  
History Of

Squamous cell carcinoma (SCC) of the bulbar urethra accompanied by lichen sclerosus (LS) is rarely reported. This study reports the case of a 56-year-old man with urethral squamous cell carcinoma (USCC) accompanied by a long history of genital LS. The man presented with a painful perineal mass and had a long-term history of urethral strictures and urethral dilatation. The patient developed a periurethral abscess that expanded to the perineum and formed an urethrocutaneousperineal fistula. An organ-sparing perineal resection and fistulectomy was performed according to the patient’s wishes. During the operation, residue-like pus mixed with necrotic tissues drained out. A section of the prepuce and the necrotic tissues were sent for histological analysis. Hematoxylin and eosin (HE) staining of the excised prepuce revealed classical LS. HE and immunohistochemical (IHC) staining of the necrotic tissues showed well-differentiated USCC. IHC staining showed the USCC to be positive for P53 and Ki-67 and negative for P16, suggesting the USCC was probably associated with LS. The patient received high-dose chemotherapy and radiation therapy and died 10 months after surgery.

scholarly journals Very Late Local Relapse of Ewing's Sarcoma of the Head and Neck treated with Aggressive Multimodal Therapy

Sarcoma ◽  
2008 ◽  
Vol 2008 ◽  
pp. 1-4 ◽  
Author(s):  
J. Thariat ◽  
A. Italiano ◽  
F. Peyrade ◽  
I. Birtwisle-Peyrottes ◽  
L. Gastaud ◽  
...  
Keyword(s):  
Multimodal Therapy ◽  
Ewing’S Sarcoma ◽  
Ewing's Sarcoma ◽  
High Dose Chemotherapy ◽  
Local Relapse ◽  
High Dose ◽  
Curative Intent ◽  
First Occurrence ◽  
History Of ◽  
Left Maxillary Sinus

Ewing's sarcoma's relapse rarely occurs more than two years after the initial diagnosis. We report the case of a 26-year-old man with a history of Ewing's sarcoma of the left maxillary sinus at the age of 10 who presented with a very late local relapse, 16 years after the first occurrence of disease. Ultimate control was achieved after multimodal therapy including surgery, high-dose chemotherapy, and radiotherapy. This report indicates that local relapses of Ewing's sarcoma can be treated with curative intent in selected cases.

scholarly journals Immunotherapy in gynecological cancers

2021 ◽  
Author(s):  
Domenica Lorusso ◽  
Valentina Ceni ◽  
Gennaro Daniele ◽  
Antonella Pietragalla ◽  
Vanda Salutari ◽  
...  
Keyword(s):  
Poor Prognosis ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Single Agent ◽  
Parp Inhibitors ◽  
Antiangiogenic Agents ◽  
Gynecological Cancers ◽  
Standard Chemotherapy ◽  
Gynecological Malignancies ◽  
History Of

Immunotherapy has changed the natural history of several malignancies that, a decade ago, had a very poor prognosis, such as lung cancer and melanoma. Consequently, many attempts have been done to expand the indications of immunotherapy agents, predominantly immune checkpoint inhibitors (ICIs), in other cancers, including gynecological malignancies. Alongside promising results in cervical and endometrial neoplasms, there are not clear data on the benefit of ICIs as single agent or in combination with antiangiogenic agents in ovarian cancer (OC) and ongoing trials are focusing on combining ICIs with standard chemotherapy or PARP inhibitors. This chapter summarized the evidences of ICIs in gynecological malignancies and report the ongoing trials in cervical, endometrial and OC.

Myocarditis and diaphragmatic rhabdomyolysis with respiratory failure in a patient with metastatic melanoma treated with Nivolumab

2021 ◽  
pp. 107815522110674
Author(s):  
Cinzia Baldessari ◽  
Giuseppe Pugliese ◽  
Marta Venturelli ◽  
Stefano Greco ◽  
Leonardo Ferrara ◽  
...  
Keyword(s):  
Adverse Event ◽  
Metastatic Melanoma ◽  
Checkpoint Inhibitors ◽  
Vital Signs ◽  
High Dose ◽  
Diaphragmatic Dysfunction ◽  
Acute Rhabdomyolysis ◽  
Clinical Benefits ◽  
History Of ◽  
Diaphragmatic Weakness

Introduction Immunotherapy dramatically changed history of melanoma patients with a clinical benefit never seen before. Nevertheless, severe and unexpected adverse effects can occur, fortunately rarely. Case presentation We reported the case of a 75-year-old male patient affected by metastatic melanoma who developed myocarditis and acute rhabdomyolysis with secondary diaphragmatic dysfunction and consequent pulmonary restrictive syndrome after Nivolumab monotherapy. Blood tests and ultrasonography of the diaphragm revealing left hypokinesis suggested a Nivolumab-related rhabdomyolysis, as an immune-mediated adverse event. The rhabdomylolysis involved the diaphragm with consequent diaphragmatic weakness and respiratory distress. Mangement & outcome The patient had a slow but slight and progressive improvement of symptoms and vital signs post-treatment with high-dose corticosteroids. Discussion With this case report, we want to highlight the importance of rapid recognition and treatment of rare and unexpected, but potential serious immune-related adverse events. These events might happen despite the remarkable clinical benefits of immune checkpoint inhibitors. We do not know which patients will benefit from these therapies and why, when and in which cases adverse event will occur: we must not lower our attention.

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