Base de dados : LILACS
Pesquisa : D03.066.515.530 [Categoria DeCS]
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Id: biblio-838973
Autor: Seo, Hyang-Hee; Kim, Sang Woo; Lee, Chang Youn; Lim, Kyu Hee; Lee, Jiyun; Choi, Eunhyun; Lim, Soyeon; Lee, Seahyoung; Hwang, Ki-Chul.
Título: A spleen tyrosine kinase inhibitor attenuates the proliferation and migration of vascular smooth muscle cells
Fonte: Biol. Res;50:1, 2017. tab, graf.
Idioma: en.
Projeto: Future Planning; . Future Planning.
Resumo: BACKGROUND: Pathologic vascular smooth muscle cell (VSMC) proliferation and migration after vascular injury promotes the development of occlusive vascular disease. Therefore, an effective chemical agent to suppress aberrant proliferation and migration of VSMCs can be a potential therapeutic modality for occlusive vascular disease such as atherosclerosis and restenosis. To find an anti-proliferative chemical agent for VSMCs, we screened an in-house small molecule library, and the selected small molecule was further validated for its anti-proliferative effect on VSMCs using multiple approaches, such as cell proliferation assays, wound healing assays, transwell migration assays, and ex vivo aortic ring assay. RESULTS: Among 43 initially screened small molecule inhibitors of kinases that have no known anti-proliferative effect on VSMCs, a spleen tyrosine kinase (Syk) inhibitor (BAY61-3606) showed significant anti-proliferative effect on VSMCs. Further experiments indicated that BAY61 attenuated the VSMC proliferation in both concentration- and time-dependent manner, and it also significantly suppressed the migration of VSMCs as assessed by both wound healing assays and transwell assays. Additionally, BAY61 suppressed the sprouting of VSMCs from endothelium-removed aortic rings. CONCLUSION: The present study identified a Syk kinase inhibitor as a potent VSMC proliferation and migration inhibitor and warrants further studies to elucidate its underlying molecular mechanisms, such as its primary target, and to validate its in vivo efficacy as a therapeutic agent for restenosis and atherosclerosis.
Descritores: Pirimidinas/farmacologia
Movimento Celular/efeitos dos fármacos
Niacinamida/análogos & derivados
Miócitos de Músculo Liso/efeitos dos fármacos
Proliferação de Células/efeitos dos fármacos
Quinase Syk/antagonistas & inibidores
Músculo Liso Vascular/efeitos dos fármacos
-Aorta Torácica/efeitos dos fármacos
Fatores de Tempo
Cicatrização/efeitos dos fármacos
Células Cultivadas
Western Blotting
Reprodutibilidade dos Testes
Ratos Sprague-Dawley
Niacinamida/farmacologia
Relação Dose-Resposta a Droga
Avaliação Pré-Clínica de Medicamentos
Ensaios de Migração Celular
Músculo Liso Vascular/citologia
Limites: Animais
Ratos
Tipo de Publ: Estudo de Avaliação
Responsável: CL1.1 - Biblioteca Central


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Id: biblio-1153964
Autor: Marta, Guilherme Nader; da Fonseca, Leonardo G; Braghiroli, Maria Ignez; Moura, Fernando; Hoff, Paulo M; Sabbaga, Jorge.
Título: Efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma
Fonte: Clinics;76:e2498, 2021. tab, graf.
Idioma: en.
Resumo: OBJECTIVES: To evaluate the efficacy and safety of sorafenib in elderly patients with advanced hepatocellular carcinoma (HCC). METHODS: We analyzed data from a cohort of patients with advanced HCC treated using systemic treatment according to the local institutional protocol. Patients were divided into two groups, Group A, individuals <70 years of age, and Group B, individuals 70 years of age or older at the time of treatment initiation. Efficacy, measured based on overall survival (OS) and time to treatment failure (TTF), and toxicity were compared between groups. RESULTS: A total of 238 patients with advanced HCC who received sorafenib between 2007 and 2018 were evaluated. The median age for Group A was 59.1 years and that for Group B 73.6 years. The major prognostic characteristics were balanced between the groups. There were no significant differences in OS between Group A (8.0 months, 95%CI 6.34-9.3) and Group B (9.0 months, 95%CI 5.38-12.62), p=0.433, or in TTF between Group A (3.0 months, 95%CI 2.39-3.60) and Group B (3.0 months, 95%CI 1.68-4.32), p=0.936. There were no significant differences between Groups A and B with respect to the incidence of adverse events or treatment discontinuation because of toxicity. CONCLUSION: Efficacy and safety of sorafenib did not differ significantly between younger and older patients with HCC. Our data suggest that age alone should not restrict clinical decision-making for patients with advanced HCC.
Descritores: Carcinoma Hepatocelular/tratamento farmacológico
Neoplasias Hepáticas/tratamento farmacológico
Antineoplásicos/efeitos adversos
-Compostos de Fenilureia/efeitos adversos
Prognóstico
Niacinamida/efeitos adversos
Sorafenibe/efeitos adversos
Limites: Humanos
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME


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Id: biblio-887229
Autor: Varghese, Joy; Kedarisetty, Chandan Kumar; Venkataraman, Jayanthi; Srinivasan, Vijaya; Deepashree, Thiruchunapalli; Uthappa, Mangerira Chinnappa; Ilankumaran, Kaliamurthy; Govil, Sanjay; Reddy, Mettu Srinivas; Rela, Mohamed.
Título: Combination of TACE and Sorafenib Improves Outcomes in BCLC Stages B/C of Hepatocellular Carcinoma: A Single Centre Experience
Fonte: Ann. hepatol;16(2):247-254, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background & Aim. Transarterial chemoembolization (TACE) or sorafenib is recommended for hepatocellular carcinoma BCLC stages B and C respectively. We studied the role of combination of TACE and sorafenib in BCLC stages B/C. Material and methods. We undertook an observational study on a cohort of cirrhotics with HCC from August 2010 through October 2014. Patients in BCLC stages B/C who had received TACE and/or sorafenib were included. mRECIST criteria were used to assess tumor response. The primary end point was overall survival. Results. Out of 124 patients, 47.6% were in BCLC-B and 52.4% in BCLCC. Baseline characteristics were comparable. The predominant etiology was cryptogenic (37.2% and 38.5%, p = NS). 49.1% in BCLC-B and 56.9% in BCLC-C had received TACE+sorafenib. In BCLC-B, the overall survival improved from 9 months (95% CI 6.3-11.7) using TACE only to 16 months (95% CI 12.9-19.1) using TACE+sorafenib (p < 0.05). In BCLC-C, addition of TACE to sorafenib improved the overall survival from 4 months (95%CI 3-5) to 9 months (95%CI 6.8-11.2) (p < 0.0001). As per mRECIST criteria, patients on TACE+sorafenib had reduced progressive disease (37.8% vs. 83.3%), improved partial response (43.2% vs. 3.3%) and one had complete response compared to those on sorafenib alone (p < 0.0001) in BCLC-C but not in BCLC-B group. Hand foot syndrome was noted in 27.7% patients on sorafenib and post TACE syndrome in 80.2% patients, but both were reversible. No major adverse events were noted. Conclusion. TACE+sorafenib was more effective than TACE or sorafenib alone in HCC BCLC stages B or C with a significant survival benefit and improved tumour regression especially in BCLC-C patients.
Descritores: Compostos de Fenilureia/uso terapêutico
Niacinamida/análogos & derivados
Carcinoma Hepatocelular/terapia
Inibidores de Proteínas Quinases/uso terapêutico
Neoplasias Hepáticas/terapia
Antineoplásicos/uso terapêutico
-Compostos de Fenilureia/efeitos adversos
Fatores de Tempo
Resultado do Tratamento
Quimioembolização Terapêutica/efeitos adversos
Quimioembolização Terapêutica/mortalidade
Niacinamida/efeitos adversos
Niacinamida/uso terapêutico
Carcinoma Hepatocelular/etiologia
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Inibidores de Proteínas Quinases/efeitos adversos
Carga Tumoral
Estimativa de Kaplan-Meier
Neoplasias Hepáticas/etiologia
Neoplasias Hepáticas/mortalidade
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-887230
Autor: Carvalho, Sandra R. Almeida; Ferraz, Maria L. Gomes; Matos, Carla A. Loureiro; Silva, Antônio E. Benedito; Carvalho Filho, Roberto J; Perez, Rogério Renato; Gonzalez, Adriano Miziara; Salzedas-Netto, Alcides A; Szejnfeld, Denis; D'Ippolito, Giuseppe; Lanzoni, Valéria Pereira; Silva, Ivonete S. Souza.
Título: Practical Considerations of Real Life of Hepatocellular Carcinoma in a Tertiary Center of Brazil
Fonte: Ann. hepatol;16(2):255-262, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background. Hepatocellular carcinoma (HCC) is the most common malignancy that develops in cirrhotic livers. Its clinical and epidemiological characteristics and mortality rates vary according to geographical region. The objective of this study was to evaluate the clinical profile, epidemiological characteristics, laboratory parameters, treatment and survival of patients with HCC. Material and methods. Patients with HCC seen between 2000 and 2012 were studied. The Kaplan-Meier method was used for survival analysis according to variables in question. Results. The study included 247 patients with a mean age of 60 ± 10 years. There was a predominance of males (74%). The main etiologies of HCC were HCV infection (55%), excessive alcohol consumption (12%), and HBV infection (8%). Liver cirrhosis was present in 92% of cases. The mean tumor number and diameter were 2 and 5 cm, respectively. Patients meeting the Milan criteria corresponded to 43% of the sample. Liver transplantation was performed in 22.4% of patients of the Milan subset and in 10% of the whole sample. The overall mean survival was 60 months, with a 1-, 3- and 5-year survival probability of 74%, 40% and 29%, respectively. Lower survival was observed among patients with alcoholic etiology. Survival was higher among patients submitted to liver transplantation (P < 0.001), TACE (P < 0.001), or any kind of treatment (P < 0.001). However, no difference was found for surgical resection (P = 0.1) or sorafenib (P = 0.1). Conclusion. Patients with HCC were mainly older men diagnosed at an advanced stage. Treatment was associated with better overall survival, but few patients survived to be treated.
Descritores: Transplante de Fígado
Quimioembolização Terapêutica
Carcinoma Hepatocelular/terapia
Técnicas de Ablação
Hepatectomia
Neoplasias Hepáticas/terapia
Antineoplásicos/uso terapêutico
-Compostos de Fenilureia/uso terapêutico
Fatores de Tempo
Brasil/epidemiologia
Fatores de Risco
Resultado do Tratamento
Quimioembolização Terapêutica/efeitos adversos
Quimioembolização Terapêutica/mortalidade
Niacinamida/análogos & derivados
Carcinoma Hepatocelular/etiologia
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Carga Tumoral
Estimativa de Kaplan-Meier
Centros de Atenção Terciária
Hepatectomia/efeitos adversos
Hepatectomia/mortalidade
Neoplasias Hepáticas/etiologia
Estadiamento de Neoplasias
Antineoplásicos/efeitos adversos
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-887231
Autor: Branco, Fernanda; Alencar, Regiane S. M; Volt, Fernanda; Sartori, Giovana; Dode, Andressa; Kikuchi, Luciana; Tani, Claudia M; Chagas, Aline L; Pfiffer, Tulio; Hoff, Paulo; Carrilho, Flair J; Mattos, Angelo Alves de.
Título: The Impact of Early Dermatologic Events in the Survival of Patients with Hepatocellular Carcinoma Treated with Sorafenib
Fonte: Ann. hepatol;16(2):263-268, Mar.-Apr. 2017. tab, graf.
Idioma: en.
Resumo: ABSTRACT Background and Aims. The presence of dermatologic reaction as an adverse event to sorafenib treatment in patients with unresectable hepatocellular carcinoma has been indicated as a prognostic factor for survival in a recent prospective analysis. To date, this is the only clinical predictor of treatment response, which can be evaluated earlier in the treatment and, therefore, contribute to a better and more individualized patient management. Material and methods. This retrospective study included 127 patients treated with sorafenib under real-life practice conditions in two hepatology reference centers in Brazil. Demographic data, disease/medical history and time of sorafenib administration as well as adverse events related to the medication were recorded in a database. Results. Cirrhosis was present in 94% of patients, 85.6% were Child-Pugh A, 80.3%BCLC-C, 81% had vascular invasion and/or extrahepatic spread and 95% had a performance status 0 to 1.The median duration of treatment was 10.1 months (range: 0.1-47 months).The most common adverse event within the first 60 days of treatment were diarrhea (62.2%) and dermatological reaction (42%).The median overall survival for the cohort was 20 months, and it was higher for patients who developed dermatological reactions within the first 60 days compared to those who did not present this adverse event. Conclusion. This retrospective analysis showed the use of sorafenib in patients selected according to BCLC staging, and it is the first external validation of early dermatologic adverse events as a predictor of overall survival in patients with advanced hepatocellular carcinoma.
Descritores: Compostos de Fenilureia/efeitos adversos
Niacinamida/análogos & derivados
Erupção por Droga/etiologia
Carcinoma Hepatocelular/tratamento farmacológico
Neoplasias Hepáticas/tratamento farmacológico
Antineoplásicos/efeitos adversos
-Fatores de Tempo
Modelos de Riscos Proporcionais
Estudos Retrospectivos
Fatores de Risco
Resultado do Tratamento
Niacinamida/efeitos adversos
Erupção por Droga/diagnóstico
Erupção por Droga/mortalidade
Carcinoma Hepatocelular/mortalidade
Carcinoma Hepatocelular/patologia
Estimativa de Kaplan-Meier
Sorafenibe
Neoplasias Hepáticas/mortalidade
Neoplasias Hepáticas/patologia
Estadiamento de Neoplasias
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: biblio-838797
Autor: Esposito, Evangelina; Aldrees, Sultan; Mastromonaco, Christina; Zoroquiain, Pablo; Vila, Natalia; Logan, Patrick T; Hari, Shriya; Burnier, Miguel N.
Título: Evaluation of nicotinamide as an anti-inflammatory and anti-angiogenic agent in uveal melanoma cell lines / Avaliação da nicotinamida como agente anti-inflamatório e anti-angiogênico em linhas celulares de melanoma uveal
Fonte: Arq. bras. oftalmol;80(2):74-77, Mar.-Apr. 2017. tab.
Idioma: en.
Resumo: ABSTRACT Purpose: To investigate the effect of nicotinamide on the secretion of pro-an giogenic and pro-inflammatory cytokines in uveal melanoma cell lines. Methods: Two human uveal melanoma cell lines (92.1 and OCM-1) were treated with nicotinamide (10 mmol/L) or control media for 48 hours in culture. The su perna tant from each culture was used in sandwich enzyme-linked immuno sorbent assay-based angiogenesis and inflammation arrays to evaluate the effects of exogenously administered nicotinamide on the secretion of a total of 20 pro-an gio genic and pro-inflammatory proteins. Results: Seven pro-angiogenic cytokines were detected under control conditions for both uveal melanoma cell lines. Treatment with nicotinamide resulted in a significant decrease in secretion of the following pro-angiogenic cytokines: angiogenin, angiopoietin-2, epidermal growth factor, and vascular epithelial growth factor-A in the 92.1 cells; basic fibroblast growth factor in the OCM-1 cells; and placenta growth factor in both cell lines. Among the pro-inflammatory proteins, monocyte chemotactic protein-1 and interleukin-8 were expressed in both untreated cell lines and both were significantly reduced when treated with nicotinamide. Conclusions: Results from this in vitro model suggest that nicotinamide may have anti-inflammatory and anti-angiogenic properties, which may open the possibility of using it as a chemopreventive agent for uveal melanoma; however, further studies including animal models are warranted.

RESUMO Objetivo: Acredita-se que a nicotinamida (NIC) seja capaz de diminuir a angiogênese induzida pelo fator de crescimento endotelial vascular (VEGF). Investigar os efeitos da nicotinamida sobre a secreção de citocinas pró-angiogênicas e pró-inflamatórias em linhagens de células de melanoma uveal humano (UM). Métodos: Duas linhagens de células humanas de UM (92,1 e OCM-1) foram tratadas com NIC (10 mmol/L) ou apenas com meio de cultura por 48 horas. O sobrenadante das culturas obtido após a administração de nicotinamida foi comparado com o sobrenadante das culturas controle quanto à expressão de 20 fatores pró-angiogênicos e pró-inflamatórios, pela técnica de enzyme-linked immunosorbent assay (ELISA). Resultados: Sete citocinas pró-angiogênicas foram detectadas nas condições de controle em ambas as linhagens de células de UM. O tratamento com nicotinamida promoveu uma redução significativa da secreção das seguintes citocinas angiogênicas: Angiogenina, ANG2, EGF e VEGF-A em células 92.1; bFGF em células OCM-1; PIGF em ambas as linhagens celulares. Quanto às proteínas pró-inflamatórias, a expressão de MCP-1 e IL-8 foi significativamente reduzida com a administração de nicotinamida em relação às culturas de células que não receberam o tratamento. Conclusões: Nicotinamida apresenta propriedades anti-inflamatórias e anti-angiogênicas em modelo experimental in vitro. Tais efeitos sugerem a possibilidade de utilizar esta substância na quimioprevenção do UM. Entretanto, estudos com modelos experimentais in vivo são necessários para melhor avaliar o benefício do tratamento do UM com nicotinamida.
Descritores: Neoplasias Uveais/metabolismo
Citocinas/efeitos dos fármacos
Niacinamida/farmacologia
Inibidores da Angiogênese/farmacologia
Melanoma/metabolismo
Anti-Inflamatórios/farmacologia
-Ribonuclease Pancreático/efeitos dos fármacos
Neoplasias Uveais/irrigação sanguínea
Citocinas/metabolismo
Fator 2 de Crescimento de Fibroblastos/efeitos dos fármacos
Interleucina-8/efeitos dos fármacos
Quimiocina CCL2/efeitos dos fármacos
Linhagem Celular Tumoral
Angiopoietina-2/metabolismo
Fator de Crescimento Epidérmico/efeitos dos fármacos
Fator de Crescimento Placentário/efeitos dos fármacos
Melanoma/irrigação sanguínea
Limites: Humanos
Responsável: BR1.1 - BIREME


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Id: lil-757374
Autor: Pitoia, Fabián; Abelleira, Erika; Jerkovich, Fernando; Urciuoli, Carolina; Cross, Graciela.
Título: Partial response to sorafenib treatment associated with transient grade 3 thrombocytopenia in a patient with locally advanced thyroid cancer
Fonte: Arch. endocrinol. metab. (Online);59(4):347-350, Aug. 2015. tab, ilus.
Idioma: en.
Resumo: Advanced radioactive refractory and progressive or symptomatic differentiated thyroid carcinoma (DTC) is a rare condition. Sorafenib was recently approved for the treatment of these patients. We present the case of a 67 year old woman diagnosed with DTC who underwent a total thyroidectomy with central, lateral-compartment neck dissection and shaving of the trachea and esophagus due to tumor infiltration. A local recurrence was detected 14 months later requiring, additionally, two tracheal rings resection. The patient received a cumulative 131I dose of 650 mCi and developed dysphagia and dyspnea 63 months after initial surgery. A 18FGD-PET/CT showed progression of the local mass associated to hypermetabolic pulmonary nodules. Sorafenib 800 mg/day was then prescribed. A dose reduction to 400 mg/day was necessary due to grade 3 thrombocytopenia that appeared four months after drug prescription. Platelet count went to normal after this dose reduction. Five months after initiation of sorafenib, a partial response of the local mass with significant intra-tumoral necrosis was observed. We conclude that sorafenib is a valid option for locally advanced DTC and that the platelet count should be evaluated regularly because it seems that thrombocytopenia might be more frequently observed in DTC than in other types of tumors.
Descritores: Compostos de Fenilureia/uso terapêutico
Trombocitopenia/induzido quimicamente
Neoplasias da Glândula Tireoide/terapia
Niacinamida/análogos & derivados
Recidiva Local de Neoplasia/terapia
Antineoplásicos/uso terapêutico
-Compostos de Fenilureia/administração & dosagem
Tireoidectomia
Neoplasias da Glândula Tireoide/complicações
Niacinamida/administração & dosagem
Niacinamida/uso terapêutico
Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada
Sorafenibe
Estadiamento de Neoplasias
Antineoplásicos/administração & dosagem
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-950060
Autor: Danilovic, Debora L S; Castro Jr, Gilberto; Roitberg, Felipe S R; Vanderlei, Felipe A B; Bonani, Fernanda A; Freitas, Ricardo M C; Coura-Filho, George B; Camargo, Rosalinda Y; Kulcsar, Marco A; Marui, Suemi; Hoff, Ana O.
Título: Potential role of sorafenib as neoadjuvant therapy in unresectable papillary thyroid cancer
Fonte: Arch. endocrinol. metab. (Online);62(3):370-375, May-June 2018. graf.
Idioma: en.
Resumo: Summary Total thyroidectomy, radioiodine (RAI) therapy, and TSH suppression are the mainstay treatment for differentiated thyroid carcinomas (DTCs). Treatments for metastatic disease include surgery, external-beam radiotherapy, RAI, and kinase inhibitors for progressive iodine-refractory disease. Unresectable locoregional disease remains a challenge, as standard therapy with RAI becomes unfeasible. We report a case of a young patient who presented with unresectable papillary thyroid carcinoma (PTC), and treatment with sorafenib allowed total thyroidectomy and RAI therapy. A 20-year-old male presented with severe respiratory distress due to an enlarging cervical mass. Imaging studies revealed an enlarged multinodular thyroid gland, extensive cervical adenopathy, severe tracheal stenosis, and pulmonary micronodules. He required an urgent surgical intervention and underwent tracheostomy and partial left neck dissection, as the disease was deemed unresectable; pathology revealed PTC. Treatment with sorafenib was initiated, resulting in significant tumor reduction allowing near total thyroidectomy and bilateral neck dissection. Postoperatively, the patient underwent radiotherapy for residual tracheal lesion, followed by RAI therapy for avid cervical and pulmonary disease. The patient's disease remains stable 4 years after diagnosis. Sorafenib has been approved for progressive RAI-refractory metastatic DTCs. In this case report, we describe a patient with locally advanced PTC in whom treatment with sorafenib provided sufficient tumor reduction to allow thyroidectomy and RAI therapy, suggesting a potential role of sorafenib as an induction therapy of unresectable DTC.
Descritores: Compostos de Fenilureia/administração & dosagem
Neoplasias da Glândula Tireoide/terapia
Carcinoma Papilar/terapia
Niacinamida/análogos & derivados
Radioisótopos do Iodo/administração & dosagem
Antineoplásicos/administração & dosagem
-Tireoidectomia
Neoplasias da Glândula Tireoide/diagnóstico por imagem
Carcinoma Papilar/diagnóstico por imagem
Tomografia Computadorizada por Raios X
Resultado do Tratamento
Niacinamida/administração & dosagem
Terapia Neoadjuvante
Sorafenibe
Câncer Papilífero da Tireoide
Limites: Humanos
Masculino
Adulto Jovem
Tipo de Publ: Relatos de Casos
Responsável: BR1.1 - BIREME


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Id: biblio-887000
Autor: Chiriac, Anca; Coros, Marius Florin; Podoleanu, Cristian; Stolnicu, Simona.
Título: Grade III hand-foot skin reaction induced by sorafenib
Fonte: An. bras. dermatol;92(4):590-591, July-Aug. 2017. graf.
Idioma: en.
Descritores: Compostos de Fenilureia/efeitos adversos
Niacinamida/análogos & derivados
Erupção por Droga/etiologia
Antineoplásicos/efeitos adversos
-Índice de Gravidade de Doença
Niacinamida/efeitos adversos
Erupção por Droga/patologia
Carcinoma Hepatocelular/tratamento farmacológico
Eritema/induzido quimicamente
Eritema/patologia
Sorafenibe
Neoplasias Hepáticas/tratamento farmacológico
Limites: Humanos
Feminino
Idoso
Tipo de Publ: Relatos de Casos
Carta
Responsável: BR1.1 - BIREME


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Id: biblio-891404
Autor: Campregher, Paulo Vidal; Mattos, Vinicius Renan Pinto de; Salvino, Marco Aurélio; Santos, Fabio Pires de Souza; Hamerschlak, Nelson.
Título: Successful treatment of post-transplant relapsed acute myeloid leukemia with FLT3 internal tandem duplication using the combination of induction chemotherapy, donor lymphocyte infusion, sorafenib and azacitidine. Report of three cases / Tratamento bem-sucedido de leucemia mieloide aguda recorrente após transplante com duplicação interna em tandem FLT3 usando combinação de indução por quimioterapia, infusão de linfócitos de doador, soferanib e azacitidina. Relato de três casos
Fonte: Einstein (Säo Paulo);15(3):355-358, July-Sept. 2017.
Idioma: en.
Resumo: ABSTRACT Acute myeloid leukemia is a hematopoietic stem cell neoplastic disease associated with high morbidity and mortality. The presence of FLT3 internal tandem duplication mutations leads to high rates of relapse and decreased overall survival. Patients with FLT3 internal tandem duplication are normally treated with hematopoietic stem cell transplantation in first complete remission. Nevertheless, the incidence of post-transplant relapse is considerable in this group of patients, and the management of this clinical condition is challenging. The report describes the outcomes of patients with FLT3 internal tandem duplication positive acute myeloid leukemia who relapsed after allogeneic hematopoietic stem cell transplantation and were treated with the combination of re-induction chemotherapy, donor lymphocyte infusion, sorafenib and azacitidine. Three cases are described and all patients achieved prolonged complete remission with the combined therapy. The combination of induction chemotherapy followed by donor lymphocyte infusion, and the maintenance with azacitidine and sorafenib can be effective approaches in the treatment of post-hematopoietic stem cell transplant and relapsed FLT3 internal tandem duplication positive acute myeloid leukemia patients. This strategy should be further explored in the context of clinical trials.

RESUMO A leucemia mieloide aguda é uma doença neoplásica de células-tronco hematopoiéticas com alta morbimortalidade. A presença de mutações de duplicação em tandem de FLT3 leva a altas taxas de recorrência e a menor sobrevida global. Os pacientes com duplicação em tandem de FLT3 são normalmente tratados com transplante de células-tronco hematopoiéticas na primeira remissão completa. No entanto, a incidência de recidiva pós-transplante é considerável neste grupo de pacientes, e a conduta, nestes casos, é um desafio. O relato descreve os resultados do tratamento de pacientes com leucemia mieloide aguda positiva e duplicação em tandem de FLT3 que recidivaram depois do transplante alogênico de células-tronco hematopoiéticas e que foram tratados com combinação de quimioterapia de reindução, infusão de linfócitos de doador, sorafenib e azacitidina. São descritos três casos, e todos os pacientes apresentaram remissão completa prolongada com a terapia combinada. A combinação de quimioterapia de indução, seguida de infusão de linfócitos do doador, e a manutenção com azacitidina e sorafenib podem ser abordagens eficazes no tratamento da recorrência pós-transplante em pacientes com leucemia mieloide aguda e duplicação em tandem de FLT3. Essa estratégia deve ser mais explorada no contexto de ensaios clínicos.
Descritores: Compostos de Fenilureia/administração & dosagem
Azacitidina/administração & dosagem
Leucemia Mieloide Aguda/terapia
Niacinamida/análogos & derivados
Transfusão de Linfócitos
Tirosina Quinase 3 Semelhante a fms/genética
Quimioterapia de Indução
Antineoplásicos/administração & dosagem
-Recidiva
Leucemia Mieloide Aguda/genética
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico
Resultado do Tratamento
Niacinamida/administração & dosagem
Terapia Combinada/métodos
Recidiva Local de Neoplasia/terapia
Limites: Humanos
Masculino
Feminino
Adulto
Pessoa de Meia-Idade
Idoso
Responsável: BR1.1 - BIREME



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