scholarly journals Sorafenib in the Continuum of Care for Hepatocellular Carcinoma: Challenges in Defining Optimal Practice

Author(s):  
Ahmed O. ◽  
Laura M.

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4719
Author(s):  
Giulia Martini ◽  
Davide Ciardiello ◽  
Fernando Paragliola ◽  
Valeria Nacca ◽  
Walter Santaniello ◽  
...  

Hepatocellular carcinoma (HCC) is one of the leading causes of death worldwide. The use of local treatment, such as surgical resection, liver transplant, and local ablation, has improved the survival of patients with HCC detected at an early stage. Until recently, the treatment of patients with metastatic disease was limited to the use of the multikinase inhibitor (MKI) sorafenib with a marginal effect on survival outcome. New target approaches, such as the oral MKI lenvatinib in first-line treatment and regorafenib, ramucirumab, and cabozantinib in later lines of therapy, have demonstrated efficacy in patients with preserved liver function (Child–Pugh class A) and good performance status. On the other hand, the implementation of immune checkpoint inhibitors directed against PD-1 (nivolumab and pembrolizumab), PD-L1 (atezolizumab), and anti-CTLA4 (ipilimumab) in the management of advanced HCC has strongly changed the continuum of care of HCC. Future research should include the evaluation of molecular biomarkers that can help patient selection and provide new insight on potential combined approaches. In this review, we provide an overview of the clinical evidence of the use of immune checkpoint inhibitors in HCC, and discuss how immunotherapy has been implemented into the continuum of HCC care.



Author(s):  
Maitane GARCÍA-LÓPEZ ◽  
Ester VAL ◽  
Ion IRIARTE ◽  
Raquel OLARTE

Taking patient experience as a basis, this paper introduces a theoretical framework, to capture insights leading to new technological healthcare solutions. Targeting a recently diagnosed type 1 diabetes child and her mother (the principal caregiver), the framework showed its potential with effective identification of meaningful insights in a generative session. The framework is based on the patient experience across the continuum of care. It identifies insights from the patient perspective: capturing patients´ emotional and cognitive responses, understanding agents involved in patient experience, uncovering pain moments, identifying their root causes, and/or prioritizing actions for improvement. The framework deepens understanding of the patient experience by providing an integrated and multi-leveled structure to assist designers to (a) empathise with the patient and the caregiver throughout the continuum of care, (b) understand the interdependencies around the patient and different agents and (c) reveal insights at the interaction level.



Author(s):  
Partha Basu ◽  
Richa Tripathi ◽  
Ravi Mehrotra ◽  
Koninika Ray ◽  
Anurag Srivastava ◽  
...  


1992 ◽  
Vol 14 (3) ◽  
pp. 376-398 ◽  
Author(s):  
Baila Miller ◽  
Stephanie McFall


Author(s):  
Parasuraman Ganeshkumar ◽  
Rontgen Saigal ◽  
Bipin Gopal ◽  
Hari Shankar ◽  
Prabhdeep Kaur

Abstract Integrating noncommunicable disease (NCD) in health care delivery during emergency response posed a major challenge post-floods in Kerala. Kerala experienced an abnormally high rainfall during mid-2018 where more than 400 people lost their lives. State health officials and the Disaster Response Team were sensitized about the importance of including NCDs in the response action. More than 80% of patients with hypertension and diabetes were not under control in Kerala. Under the state NCD cell, an NCD expert group was consulted for drafting the treatment and referral strategies. Steps to tackle NCDs during the disaster response were formulated. The state NCD cell decided to integrate NCDs in the response measures. The technical guidance document by the World Health Organization South-East Asia Region was consulted to formulate actions. The activities were implemented in 6 steps: prioritizing of major NCDS, patient estimation and drug stock preparation, standard treatment protocol, mapping of referral facilities, public engagement, and daily reporting of NCD consultations. Prioritizing the continuum of care of NCDs during floods among the program managers and care providers was crucial. The health education and communication campaign was done to sensitize the known NCD patients to seek early care. Daily reporting of consultations was established.





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