response assessment
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2022 ◽  
Vol 22 ◽  
Author(s):  
Giulia Arrivi ◽  
Nicola Fazio

Background: The treatment options for GEP-NENs includes various drugs and is based on grading, morphology and location of the primary Objective: The aim of our work is to investigate the clinical impact of new immune checkpoint inhibitors in order to define a new possible strategy of use within GEP-NENs. Method: A scientific literature search from 2015 to January 2020 was performed by using PubMed and Embase: reviews and prospective or retrospective studies with a minimum of twenty patients were selected; conference proceedings were included Results: several studies have been conducted to assess the role of immune checkpoint inhibitors in NENs, but nowadays the current knowledge in this field is mainly based on a phase I-II studies. Immunotherapy showed limited antitumor activity, but higher response rate was reported in poor-differentiated neuroendocrine tumors. No specific biomarkers were identified for patient selection and response assessment Conclusion: Immunotherapy appears as a powerful possibility to help our patients, but nowadays we see many gaps in this field. We must balance therapeutic possibility offered by precision oncology with the understanding the limitations of application of testing and treatment in clinical practice. Future efforts should focus on research of the best patients to candidate for immunotherapy in term of disease characteristics and previous treatments, and how to select them with accurate biomarkers.


2022 ◽  
Vol 11 ◽  
Author(s):  
Rafael Alonso ◽  
Juan José Lahuerta

The development of new resources for a more accurate diagnosis and response assessment in multiple myeloma has been a long process for decades, mainly since the middle of the 20th century. During this time, the succession of technical advances has run parallel to the better knowledge of disease biology and the availability of novel therapeutic strategies. The cornerstone of standardized criteria to uniformly evaluate the disease response in myeloma dates back to the 1990s when the key role of complete remission was established. Since then, different updates have been implemented according to available scientific evidences not always without certain controversies. The progressive improvements in survival results of myeloma patients and the growing quality of responses due to the novel therapies have led to the need of developing new tools for better monitoring of tumor burden. In this way, the concept of minimal residual disease and its key value based on the prognostic significance and the clinical relevance has been consolidated during the last years, overcoming the value of conventional response criteria or classical adverse prognosis markers. Nevertheless, its precise role in the clinical management of myeloma patients to detect early treatment failure and trigger early rescue strategies is still pending to be defined. In this review, we revisit the major milestones in the understanding of tumor reduction in multiple myeloma until the most recent imaging techniques or liquid biopsy approaches, including a critical view of conventional response criteria, whose backbone has remained unchanged during the last 20 years.


2022 ◽  
Author(s):  
Steven P. Rowe ◽  
Andreas Buck ◽  
Ralph A. Bundschuh ◽  
Constantin Lapa ◽  
Sebastian E. Serfling ◽  
...  

AbstractProstate-specific membrane antigen (PSMA)-directed positron emission tomography (PET) has gained increasing interest for imaging of men affected by prostate cancer (PC). In recent years, 68Ga-labeled PSMA compounds have been widely utilized, although there is a trend towards increased utilization of 18F-labeled agents. Among others, [18F]DCFPyL (piflufolastat F 18, PYLARIFY) has been tested in multiple major trials, such as OSPREY and CONDOR, which provided robust evidence on the clinical utility of this compound for staging, restaging, and change in management. Recent explorative prospective trials have also utilized [18F]DCFPyL PET/CT for response assessment, e.g., in patients under abiraterone or enzalutamide, rendering this 18F-labeled PSMA radiotracer as an attractive biomarker for image-guided strategies in men with PC. After recent approval by the U.S. Food and Drug Administration, one may expect more widespread use, not only in the U.S., but also in Europe in the long term. In the present review, we will provide an overview of the current clinical utility of [18F]DCFPyL in various clinical settings for men with PC.


Author(s):  
Marco Basset ◽  
Paolo Milani ◽  
Virginia Valeria Ferretti ◽  
Mario Nuvolone ◽  
Andrea Foli ◽  
...  

Abstract Objectives Quantification of 24 h-proteinuria is the gold standard for diagnosing, staging, and monitoring of patients with renal AL amyloidosis. However, 24 h-urine collection is cumbersome and may result in preanalytical error. In this prospective study, we investigated the role of urinary albumin/creatinine ratio (UACR) (cut-off: 300 mg/g) identifying renal involvement, evaluated a UACR-based staging system (UACR cut-off: 3,600 mg/g) and assessed whether UACR response (UACR decrease >30% without worsening in eGFR >25%) predicts renal outcome in 531 patients with newly-diagnosed AL amyloidosis. Methods From October 2013 paired 24 h-proteinuria and UACR (on first morning void) were measured in all newly-diagnosed patients with AL amyloidosis. Correlation between 24 h-proteinuria and UACR at baseline was assessed by Pearson’s r test. Impact of UACR response on renal outcome was assessed in randomly created testing (n=354) and validation (n=177) cohorts. Results A strong linear correlation was found between 24 h-proteinuria and UACR at baseline (r=0.90; p<0.001). After a median follow-up of 31 months, 57 (11%) patients required dialysis. A UACR-based renal staging system identified three stages with significantly higher dialysis rate at 36 months comparing stage I with stage II and stage II with stage III. Achieving a renal response, according to a UACR-based criterion, resulted in lower dialysis rate in both testing and validation cohorts. Conclusions UACR is a reliable marker for diagnosis, prognosis, and organ response assessment in renal AL amyloidosis and can reliably replace 24 h-proteinuria in clinical trials and individual patients’ management.


eJHaem ◽  
2022 ◽  
Author(s):  
Thomas Millard ◽  
Ian Chau ◽  
Sunil Iyengar ◽  
Dima El‐Sharkawi ◽  
David Cunningham ◽  
...  

2022 ◽  
pp. 1-22
Author(s):  
Bijie Yang ◽  
Ricardo F. Martinez-Botas ◽  
Yingxian Xue ◽  
Mingyang Yang

Abstract One-dimensional (1D) modelling is critical for turbomachinery unsteady performance prediction and system response assessment of internal combustion engines. This paper uses a novel 1D modelling (TURBODYNA) and proposes two additional features for the application to a twin-entry turbocharger turbine. Compared to single-entry turbines, twin-entry turbines enhance turbocharger transient response and reduce engine exhaust valve overlap periods. However, out-of-phase high frequency pulsating pressure waves lead to an unsteady mixing process from the two flows and pose great challenges to traditional 1D modelling. The present work resolves the mixing problem by directly solving mass, momentum and energy conservation equations during the mixing process instead of applying constant pressure assumption at the limb-rotor joint. Comparisons of TURBODYNA and an experimentally validated CFD suggest that TURBODYNA can not only provide a very good agreement on turbine performance, but also accurately capture unsteady features due to flow field inertial and pressure wave propagation. Levels of accuracy achieved by TURBODYNA have proved superior to traditional 1D modelling on turbine performance and the generality of the current 1D modelling has been explored by extending the application to another turbine featuring distinct characteristics.


2022 ◽  
Vol 13 (1) ◽  
Author(s):  
Jinrong Qu ◽  
Ling Ma ◽  
Yanan Lu ◽  
Zhaoqi Wang ◽  
Jia Guo ◽  
...  

Abstract Objectives To assess volumetric DCE-MRI radiomics nomogram in predicting response to neoadjuvant chemotherapy (nCT) in EC patients. Methods This retrospective analysis of a prospective study enrolled EC patients with stage cT1N + M0 or cT2-4aN0-3M0 who received DCE-MRI within 7 days before chemotherapy, followed by surgery. Response assessment was graded from 1 to 5 according to the tumor regression grade (TRG). Patients were stratified into responders (TRG1 + 2) and non-responders (TRG3 + 4 + 5). 72 radiomics features and vascular permeability parameters were extracted from DCE-MRI. The discriminating performance was assessed with ROC. Decision curve analysis (DCA) was used for comparing three different models. Results This cohort included 82 patients, and 72 tumor radiomics features and vascular permeability parameters acquired from DCE-MRI. mRMR and LASSO were performed to choose the optimized subset of radiomics features, and 3 features were selected to create the radiomics signature that were significantly associated with response (P < 0.001). AUC of combining radiomics signature and DCE-MRI performance in the training (n = 41) and validation (n = 41) cohort was 0.84 (95% CI 0.57–1) and 0.86 (95% CI 0.74–0.97), respectively. This combined model showed the best discrimination between responders and non-responders, and showed the highest positive and positive predictive value in both training set and test set. Conclusions The radiomics features are useful for nCT response prediction in EC patients.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Nicolas Aide ◽  
Amir Iravani ◽  
Kevin Prigent ◽  
Diane Kottler ◽  
Ramin Alipour ◽  
...  

Abstract18F-FDG PET/CT plays an increasingly pivotal role in the staging and post-treatment monitoring of high-risk melanoma patients, augmented by the introduction of therapies, including tyrosine kinase inhibitors (TKI) and immune checkpoint inhibitors (ICIs), that have novel modes of action that challenge conventional response assessment. Simultaneously, technological advances have been regularly released, including advanced reconstruction algorithms, digital PET and motion correction, which have allowed the PET community to detect ever-smaller cancer lesions, improving diagnostic performance in the context of indications previously viewed as limitations, such as detection of in-transit disease and confirmation of the nature of small pulmonary metastases apparent on CT.This review will provide advice regarding melanoma-related PET protocols and will focus on variants encountered during the imaging of melanoma patients. Emphasis will be made on pitfalls related to non-malignant diseases and treatment-related findings that may confound accurate interpretation unless recognized. The latter include signs of immune activation and immune-related adverse events (irAEs). Technology-related pitfalls are also discussed, since while new PET technologies improve detection of small lesions, these may also induce false-positive cases and require a learning curve to be observed. In these times of the COVID 19 pandemic, cases illustrating lessons learned from COVID 19 or vaccination-related pitfalls will also be described.


Author(s):  
Abhijeet Giri ◽  
Shaikh Faruque Ali ◽  
Arunachalakasi Arockiarajan

Abstract Multi-stable configurations of piezoelectric harvesters are quite successful in achieving the two important goals, the broadband frequency response and large orbit oscillations exhibiting periodic, multi-periodic, and chaotic solutions. However, in the quest of achieving large amplitude broadband frequency response, assessment of induced strain levels considering the limits on the strain in piezoelectric material has received minimal attention. In this context, the investigation presents an analytical formulation for the assessment of induced strain and voltage(s) in piezoelectric unimorph and bimorph cantilevers. The formulation quantifies not only the induced voltage(s) in individual piezoelectric layers of a bimorph, but also the equivalent voltages in parallel and series connection modes, respectively. Also, while computing the induced voltage in the first piezoelectric layer, the contribution from the induced voltage of the second piezoelectric layer to the acting bending moment is captured in the formulation. The formulations are validated through the experiments and results from the literature. Further, we have applied two practically useful normalization schemes, the tp- and tt-normalizations to the analytical expressions. Using the two normalization schemes, influences of variation of substrate and adhesive layer thicknesses, elastic moduli of layers, and substrate-to-composite length fraction are visualized and discussed. Based on the results, summarized guidelines for design and selection of geometric and material parameters are presented, which are also applicable for other sensing and actuation applications. At last, practically suitable ranges and optimum values for the normalized design variables are proposed.


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