Showing posts with label pembrolizumab. Show all posts
Showing posts with label pembrolizumab. Show all posts

Monday, 18 December 2023

Investigate the Impact of Drug-Induced Podocytopathies | Chapter 8 | Advanced Concepts in Medicine and Medical Research Vol. 8

 This branch focuses on reviewing drug-induced podocytopathies by newsgathering four cases. Kidney harm due to medications is a familiar clinical entity. Even though drug-induced tubulointerstitial ailment is commonly encountered, skilled are few reports in the literature guide glomerular injury due to drugs. The recognition of this type of sort injury is critical, as rapid discontinuation of the displeasing agent is critical to maximizing the prospect of quick and persuasive renal function recovery. For case 1, a 49-year-traditional female presented in 2017 accompanying 1-week history of minor edema, increase in body weight until 10 kg and intermittent concerned with one side lumbar pain has been selected. A 46-period-old female presented accompanying nephrotic syndrome guide new-onset significant minor edema and 1-day history of abandoned-sided pleuritic rib cage pain has been chosen for the case 2. For the case 3, a 75-period-old female was refer to our clinic by her treating rheumatologist in 2012, accompanying 15-day history of lower appendage and bilateral eyelid edema and A 74-period-old man presented in 2020 accompanying nephrotic syndrome and acute sort injury has happened selected as the case 4.This study presents four cases that presented accompanying nephrotic syndrome and were determined with biopsy-justified podocytopathies, associated with exposure to the medication.  The preferred sample has experienced a complete resolution of nephrotic disease within days or weeks after stop of the offending drug. This study likewise present the data, which were in the direction of a Medline search from the year 1963 as far as  present, regarding cases with podocytopathies guide penicillamine, tamoxifen and the combination of pembrolizumab-axitinib, including only adult cases from the English drama. This reviewrevealed nineteen cases of penicillamine- induced slightest-change disease (MCD), one case of tamoxifen-inferred MCD, and none associated with pembrolizumab-axitinib analysis. We also follow the largest studies and meta-analyses concerning drug-induced podocytopathies after an onlinesearch from 1967 to the of the English literature Subsequently, the chapter is concluded that skilled is a variety of cures affecting the glomeruli and podocytes, manifested accompanying various clinical pictures contingent on the affected part. Early acknowledgment of these drug-induced glomerular diseases is required and crucial, because swift discontinuation of the insulting agent is critical to be dramatic the likelihood of renal function improvement.

Author(s) Details:

Diamanto Athanasopoulou,
Department of Nephrology and Transplantation, National and Kapodistrian University of Athens, Laiko Hospital, 115 27 Athens, Greece.

Sophia Lionaki,
Department of Nephrology, National and Kapodistrian University of Athens, Attiko Hospital, 124 62 Athens, Greece.

Chrysanthi Skalioti,
Department of Nephrology and Transplantation, National and Kapodistrian University of Athens, Laiko Hospital, 115 27 Athens, Greece.

George Liapis,
Department of Pathology, National and Kapodistrian University of Athens, Laiko Hospital, 115 27 Athens, Greece.

Panayiotis Vlachoyiannopoulos,
Department of Pathophysiology, National and Kapodistrian University of Athens, Laiko Hospital, 115 27 Athens, Greece.

Ioannis Boletis,
Department of Nephrology and Transplantation, National and Kapodistrian University of Athens, Laiko Hospital, 115 27 Athens, Greece.

Please see the link here: https://stm.bookpi.org/ACMMR-V8/article/view/12790


Thursday, 11 November 2021

Cardiothoracic Related Complications of Anti-PD/PD-L1 Immunotherapy | Chapter 01 | Recent Developments in Medicine and Medical Research Vol. 7

 Background: Anti-PD/PD-L1-targeted immunotherapy is associated with shockingly high rates of sustained clinical responses in patients with a variety of tumour types, despite the high prevalence of dermatological, gastrointestinal, and endocrine side effects. The hazards of pneumonitis and cardiotoxicity associated with checkpoint inhibitor therapy are understudied.A systematic analysis of the literature on randomised clinical trials (RCTs) comparing anti-PD/PD-L1 mono-immunotherapy (IMM) to chemotherapy (CTH) methods was conducted in cancer patients. The rate of pneumonitis in IMM versus CTH was the primary outcome.Secondary endpoints included (I) high-grade pneumonitis rate in IMM compared to CTH, (II) tumour response rate, progression-free survival (PFS), and overall survival (OS) between IMM and CTH, (III) cardiotoxicity grade comparison in IMM to others, (IV) cardiotoxicity grade difference between IMM and other studies with lung cancer and other cancer subgroups, and in IMM compared to chemotherapy (CTH) only studies, and (V) outcome of IMM We used a random model, a leave-one-out analysis, and meta-regression.Thirteen RCTs with a total of 7,246 patients for pneumonitis and 11 RCTs with a total of 6574 patients for cardiotoxicity were included in the study. When compared to the CTH arm, patients in the IMM arm had more high-grade and all-grade pneumonitis (OR =4.39, 95 percent CI =1.65–11.69, P=0.003 and OR =2.46, 95 percent CI =1.29–4.6, P=0.007). The immunotherapy arm had a significantly higher tumour response rate (OR =2.31, 95 percent CI =1.62–3.29, P0.001). Patients who received IMM had a longer PFS and OS than those who received CTH (HR =0.75, 95 percent CI =0.65–0.85, P0.001, and HR =0.71, 95 percent CI =0.66–0.77, P0.001). There was no difference in all-grade cardiotoxicity across all studies (RR: 1.15; 95 percent CI: 0.73–1.80; p = 0.55) or subgroups of lung cancer (RR: 0.68; 95 percent CI: 0.22–2.09; p = 0.50) or other malignancies (RR: 1.27; 95 percent CI: 0.78–2.08; p = 0.34). Similarly, there was no difference in high-grade cardiotoxicity across all trials (RR: 1.47; 95 percent CI: 0.87–2.46; p = 0.15) or across lung cancer subgroups (RR: 0.80; 95 percent CI: 0.25–2.50; p = 0.70) or other cancers (RR: 1.71, 95 percent CI: 0.96–3.06; p = 0.07).


Conclusions: Anti-PD-1 therapy produced more high-grade and all-grade pneumonitis than standard CTH regimens for NSCLC and melanoma, but not anti-PD-L1 therapy. Aside from that, the CTH arm had a higher rate of high-grade adverse events. IMM outperforms CTH in terms of tumour response rate, PFS, and overall survival. These findings can be used to assist patients choose the right therapy and set realistic treatment goals. Cardiotoxicity was statistically insignificant regardless of whether the patients received chemotherapy or dual immunotherapy. When utilised in the lung cancer subgroup, anti-PD/PDL1 produced improved response and survival rates.

Author(S) Details

Mohamed Rahouma
Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt and Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York 14853, NY, USA.

Massimo Baudo
Cardiac Surgery Department, Spedali Civili di Brescia, Brescia, Italy.

Shon Shmushkevich
Cardiothoracic Surgery Departments, Weill Cornell Medicine, New York 14853, NY, USA and Department of Neurosurgery, Johns Hopkins University, Baltimore, Maryland, USA.

Ayah Hassan
Department of Pharmacognosy, Faculty of Pharmacy, Cairo University, Egypt.

Mostafa Rahouma
Information Technology Department, National Cancer Institute, Cairo University, Egypt.

Maha Yahia
Medical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.

Abdelrahman Mohamed
Surgical Oncology Department, National Cancer Institute, Cairo University, Cairo, Egypt.

View Book:- https://stm.bookpi.org/RDMMR-V7/article/view/4521