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| 1 | 帕博利珠单抗单用或与放疗联用治疗转移性非小细胞肺癌:两个随机试验的汇总分析显示文摘背景放疗可以提高整个机体对免疫治疗的应答。在Ⅱ期PEMBRO-RT研究和Ⅰ/Ⅱ期MDACC研究中,患有转移性非小细胞肺癌(NSCLC)的患者被随机分配入组,接受免疫治疗(帕博利珠单抗)+放疗联合疗法,或免疫治疗单一疗法。当上述2个研究单独分析时,联合疗法组显示出潜在获益。由于每个研究的样本量较小,缓解率和结局并未显示出统计学意义,然而却有显著的临床获益。因此,本研究进行汇总分析,来判断放疗是否会改善转移性NSCLC患者的免疫治疗应答。方法PEMBRO-RT和MDACC研究纳入标准:患者年龄≥18岁,患有转移性NSCLC,且有≥1处未经放疗照射的病灶,以便进行射野外应答监测。PEMBRO-RT研究纳入曾接受过化疗患者,MDACC研究纳入曾接受过治疗或新诊断患者。2个研究中的患者均未接受过免疫治疗。在PEMBRO-RT研究中患者被等比例随机分配入组,并根据吸烟状态进行分层(分为<10年组和≥10年组)。MDACC研究的患者根据放疗计划可行性被等比例随机分配入2个受试组。由于联合治疗组的干预本质,每个研究中的放疗均不适用盲法。在2个研究中,不论是否进行放疗,均静脉滴入帕博利珠单抗(每3周200 mg)。在PEMBRO-RT研究中,在放疗(24 Gy 3次分割照射)结束后1周给予第1剂帕博利珠单抗。在MDACC研究中,在第1次放疗(50 Gy 4次分割照射或45 Gy 15次分割照射)同时给予帕博利珠单抗。仅检测未经照射病灶的应答。本研究的终点为最佳射野外(远隔)应答率(ARR)、最佳射野外疾病控制率(ACR)、12周时ARR、12周时ACR、无进展生存期(PFS)和总生存期(OS)。2个研究的意向治疗(ITT)人群均纳入分析。PEMBRO-RT研究(NCT02492568)和MDACC研究(NCT02444741)均在ClinicalTrials.gov上注册。发现纳入148例患者,76例接受帕博利珠单抗治疗,72例接受帕博利珠单抗+放疗治疗。所有患者随访时间中位数为33个月[四分位距(IQR):32.4~33.6]。148例患者中124例(84%)组织学特征为非鳞癌,111例(75%)患者曾经接受过化疗。组间没有基线特征差异,包括PD-L1表达状态和转移灶体积。最常见的照射部位为肺转移灶(39%,28/72)、胸腔内淋巴结(21%,15/72)和非原发灶(17%,12/72)。帕博利珠单抗组和联合治疗组的最佳ARR分别为19.7%(15/76)和41.7%(30/72),OR=2.96,95%CI:1.42~6.20,P=0.0039;最佳ACR分别为43.4%(33/76)和65.3%(47/72),OR=2.51,95%CI:1.28~4.91,P=0.0071;PFS中位数分别为4.4(IQR:2.9~5.9)和9.0个月(IQR:6.8~11.2),HR=0.67,95%CI:0.45~0.99,P=0.045;OS中位数分别为8.7(IQR:6.4~11.0)和19.2个月(IQR:14.6~23.8),OR=0.67,95%CI:0.54~0.84,P=0.0004。在汇总分析中没有发现新的安全问题。解读帕博利珠单抗免疫疗法+放疗显著提高转移性NSCLC患者的应答和改善治疗结局。这些结果需要在三期临床试验中进行验证。 | 陈大卫(翻译) 于金明(校对) Willemijn S M E Theelen Vivek Verma Brian P Hobbs Heike M U Peulen Joachim G J V Aerts Idris Bahce Anna Larissa N Niemeijer Joe Y Chang Patricia M de Groot Quynh-Nhu Nguyen Nathan I Comeaux George R Simon Ferdinandos Skoulidis Steven H Lin Kewen He Roshal Patel John Heymach Paul Baas James W Welsh | 2021 | 中华肿瘤防治杂志2021，28，24： | 49 |
| 2 | Predictors of spine deformity progression in adolescent idiopathic scoliosis: A systematic review with meta-analysis显示文摘AIM: To evaluate published data on the predictors of progressive adolescent idiopathic scoliosis(AIS) in order to evaluate their efficacy and level of evidence. METHODS: Selection criteria:(1) study design: randomized controlled clinical trials, prospective cohort studies and case series, retrospective comparative and none comparative studies;(2) participants: adolescents with AIS aged from 10 to 20 years; and(3) treatment: observation, bracing, and other. Search method: Ovid MEDLINE, Embase, the Cochrane Library, Pub Medand patent data bases. All years through August 2014 were included. Data were collected that showed an association between the studied characteristics and the progression of AIS or the severity of the spine deformity. Odds ratio(OR), sensitivity, specificity, positive and negative predictive values were also collected. A metaanalysis was performed to evaluate the pooled OR and predictive values, if more than 1 study presented a result. The GRADE approach was applied to evaluate the level of evidence.RESULTS: The review included 25 studies. All studies showed statistically significant or borderline association between severity or progression of AIS with the following characteristics:(1) An increase of the Cobb angle or axial rotation during brace treatment;(2) decrease of the rib-vertebral angle at the apical level of the convex side during brace treatment;(3) initial Cobb angle severity(> 25o);(4) osteopenia;(5) patient age < 13 years at diagnosis;(6) premenarche status;(7) skeletal immaturity;(8) thoracic deformity;(9) brain stem vestibular dysfunction; and(10) multiple indices combining radiographic, demographic, and physiologic characteristics. Single nucleotide polymorphisms of the following genes:(1) calmodulin 1;(2) estrogen receptor 1;(3) tryptophan hydroxylase 1;(3) insulin-like growth factor 1;(5) neurotrophin 3;(6) interleukin-17 receptor C;(7) melatonin receptor 1B, and(8) Scoli Score test. Other predictors included:(1) impairment of melatonin signaling in osteoblasts and peripheral blood mononuclear cells(PBMC);(2) G-protein signaling dysfunction in PBMC; and(3) the level of platelet calmodulin. However, predictive values of all these findings were limited, and the levels of evidence were low. The pooled result of brace treatment outcomes demonstrated that around 27% of patents with AIS experienced exacerbation of the spine deformity during or after brace treatment, and 15% required surgical correction. However, the level of evidence is also low due to the limitations of the included studies.CONCLUSION: This review did not reveal any methods for the prediction of progression in AIS that could be recommended for clinical use as diagnostic criteria. | Andriy Noshchenko Lilian Hoffecker Emily M Lindley Evalina L Burger Christopher MJ Cain Vikas V Patel Andrew P Bradford | 2015 | World Journal of Orthopedics2015，6，7： | 4 |
| 3 | Adjuvant imatinib mesylate after resection of localised, primary gastrointestinal stromal tumour: a randomised, double-blind, placebo-controlled trial显示文摘 | Ronald P DeMatteo Karla V Ballman Cristina R Antonescu Robert G Maki Peter WT Pisters George D Demetri Martin E Blackstein Charles D Blanke Margaret von Mehren Murray F Brennan Shreyaskumar Patel Martin D McCarter Jonathan A Polikoff Benjamin R Tan Kouros | 2009 | The Lancet2009，，9669： | 2 |
| 4 | Cutaneous lupus erythematosus:a review显示文摘 | PATEL P WERTH V | 2002 | Dermatol Clin2002，20，3： | 1 |
| 5 | Solid phase grafting of Various monomers on hydroperoxidized polypropylene 显示文摘 | PATEL A C BRAHMBHATT R B RAO P V C | 2000 | Eur Polym J2000，36，： | 1 |
| 6 | Dissolution enhancement of glipizide using liquisolid tablet technology显示文摘 | Patel V P Patel N M | 2008 | Indian Drugs2008，45，4： | 1 |
| 7 | Gastric bacterial overgrowth accompanies profound acid suppression 显示文摘 | Patel TA Abraham P Ashar V J | 1995 | Indian J Gastroenterol1995，14，4： | 1 |
| 8 | Measurement of vertices in model pump-intake bay by PIV显示文摘 | Rajendran V P Patel V C | 2000 | Journal of Hydraulic Engineering ASCE2000，126，5： | 1 |
| 9 | Calcaneonavicular coalition:treatment by excision and fat graft显示文摘 | Mubarak S J Patel P N Upasani V V | 2009 | J Pediatr Orthop2009，29，5： | 1 |
| 10 | Galectin-1 induces partial TCR zeta-chain phosphorylation and antagonizes processire TCR signal transduction显示文摘 | Chung C D Patel V P Moran M | 2000 | J Immunol2000，165，7： | 1 |
| 11 | Analyzing spatial patterns of meteorological drought using standardized precipitation in dex显示文摘 | Patel N R Chopra P Dadhwal V K | | 0，，4： | 1 |
| 12 | Strategies for effective use of exergy-based modeling of data center thermal management systems 显示文摘 | McAllister S Carey V P Shah A Bash C Patel C | 2008 | Microelectronics Journal2008，39，7： | 1 |
| 13 | Operational Slack and Venture Survival 显示文摘 | Azadegan A Patel P C Parida V | 2013 | Production and Operations Management2013，22，1： | 1 |
| 14 | Acute kidney injury and aberrantplanar cell polarity induce cyst formation in mice lacking renal cilia显示文摘 | Patel V Li L Cobo-Stark P | 2008 | Hum Mol Genet2008，17，： | 1 |
| 15 | Repeat stool testing for C]ostridium difficile using enzyme immnnoassay in patients with in- flammatory bowel disease increases diagnostic yield 显示文摘 | Deshpande A Pasupuleti V Patel P | 2012 | Curr Med Res Opin2012，28，9： | 1 |
| 16 | A prospective randomized,controlled study comparing low pressure versus high pressure pneumoperitoneum during laparoscopic cholecystectomy显示文摘 | Joshipura V P Haribhakti S P Patel N R | 2009 | Surg Laparosc Endosc Percutan Tech2009，19，3： | 1 |
| 17 | A performance evaluation of three drug-induced liver injury biomarkers in the rat:alpha-glutathione S-transferase,arginase 1,and 4-hydroxyphenyl-pyruvate dioxygenase显示文摘 | Bailey WJ Holder D Patel H Devlin P Gonzalez RJ Hamilton V | 2012 | Toxicol Sci2012，130，2： | 1 |
| 18 | Transfer of human frozen-thawed embryos with further cleavage during culture increases pregnancy rates显示文摘 | JOSHI B V BANKER M R PATEL P M | 2010 | J Hum Reprod Sci2010，3，2： | 1 |
| 19 | Work accidents among shift workers in industry 显示文摘 | NAG P K PATEL V G | 1998 | Int J Ind ergonomics1998，21，： | 1 |
| 20 | Comparative study of plateletpheresis using Baxter CS 3000 plus and Haemonetics MCS 3P显示文摘 | PATEL A P KAUR A PATEL V | 2004 | J Clin Apher2004，19，： | 1 |
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