Patients with metastatic NSCLC (mNSCLC) treated with immune checkpoint inhibitors in clinical practice may often not meet the strict inclusion criteria of clinical trials. Our aim was to assess the ...trial eligibility of patients with mNSCLC treated with pembrolizumab monotherapy in real-world and to compare the outcome of “trial-ineligible” and “potentially trial-eligible” patients.
Data from the prospective, clinical research platform CRISP were used to compare patient characteristics, treatment, and outcome of patients with programmed cell death-ligand 1 tumor proportion score greater than or equal to 50% tumors treated with pembrolizumab monotherapy who are deemed either “potentially trial-eligible” or “trial-ineligible” according to inclusion and exclusion criteria of the registrational studies (KEYNOTE-024 and -042).
Of 746 patients included, 343 patients (46.0%) were classified as “trial-ineligible” and had significantly worse outcomes compared with “potentially trial-eligible” patients (n = 403, 54.0%): median progression-free survival: 6.2 (95% confidence interval CI: 5.2–8.4) versus 10.3 (95% CI: 8.4–13.8) months, hazard ratio (trial-ineligible versus potentially trial-eligible) of 1.43 (95% CI: 1.19–1.72), p less than 0.001; median overall survival: 15.9 (95% CI: 11.4–20.3) versus 25.3 (95% CI: 19.8–30.4) months, hazard ratio of 1.36 (95% CI: 1.10–1.67), p equals 0.004.
Our data reveal that a considerable proportion of patients with mNSCLC are not eligible to participate in a clinical trial and were found to have worse outcomes than potentially trial-eligible patients, whose outcomes were comparable with those obtained from pivotal clinical trials. This is of substantial clinical relevance for physicians discussing outcomes to be expected with their patients and stresses the need for real-world effectiveness analyses.
Wireless technologies in licence-free bands are already used to an extend, where mutual interference decreases the performance. Therefore, an automated coexistence management shall be implemented, ...which distributes the resources space, time and frequency in an optimal manner. Firstly, we define appropriate quality-of-coexistence (QoC) parameters which are determined by the distributed wireless systems and transmitted to a central coordination point (CCP). Secondly, we introduce an algorithm where the resources space, frequency, and time are considered as discrete variables. Additionally, channel sensing provides important information for the allocation decision by the CCP. The purpose of the concept is a resource allocation, which reduces the likelihood of interferences by considering all resources.
CME: Vaskuläre Malformationen Patriki, Dimitri; Amann-Vesti, Beatrice R; Meier, Thomas O ...
Praxis (Bern. 1994)
105, Številka:
18
Journal Article
Recenzirano
Zusammenfassung. Vaskuläre Missbildungen entstehen kongenital und können jedes Strombett betreffen. Trotz ihrer Benignität können sie einen destruktiven Verlauf nehmen, indem sie umliegende ...Strukturen verdrängen. Die Unterteilung erfolgt nach Stromgebiet und Morphologie. In mehr als 50 % der Fälle ist die Zuweisungsdiagnose trotz adäquater Bildgebung inkorrekt. Häufig werden fälschlicherweise Begriffe wie «Hämangiom» oder das Eponym «Klippel-Trénaunay-Syndrom» verwendet. Da über 80 % der korrekten Diagnosen klinisch gestellt werden könnten, ist die klinische Untersuchung und Beschreibung der beteiligten Gefässe von entscheidender Bedeutung.
Abstract only Background and purpose: Recurrent ischemic stroke in patients with CS and PFO has been proposed as a marker of increased risk for paradoxical embolism. It is unclear, whether the excess ...risk is driven by specific features of the PFO (right-to-left shunt (RLS) size, RLS at rest, associated atrial septum aneurysm (ASA)) or the presence of vascular risk factors (vRF). We compare the prevalence of vRF, TEE features, and baseline medications in PFO patients with first-ever versus multiple CS. Methods: From September 2008 to March 2013, the International PFO Consortium enrolled 993 patients with ischemic stroke or transient ischemic attack (TIA) and newly diagnosed PFO. In this analysis of baseline data, we included 386 patients with first-ever CS and no radiological evidence of prior cerebral ischemia (first-ever CS group, mean age, 52y) as well as 71 patients with recurrent CS and multiple ischemic lesions on CT and/or MRI (multiple CS group, mean age, 59y). Patients with TIA as index event, those with first-ever CS but additional “silent” ischemic lesions on imaging as well as those with recurrent CS without radiological findings of prior cerebral ischemia were excluded. We used nonparametric tests for independent samples and the Bonferroni correction for multiple comparisons. Results: Age > 55y (63% vs. 44%, P=0.001), hypertension (52% vs. 30%, P=0.001), hyperlipidemia (64% vs. 44%, P=0.003), and coronary artery disease (15% vs. 3%, P=0.001) were significantly more frequent in the multiple CS than in the first-ever CS group. The frequencies of male gender, current smoking, diabetes, migraine with or without aura, associated ASA, RLS size, and RLS at rest did not differ between groups. At baseline, patients with multiple CS were more likely to be on antiplatelets (50% vs. 18%), antihypertensive (51% vs. 22%) or lipid lowering drugs (44% vs. 10%, P=0.001 for each comparison) than patients with first-ever CS. The frequency of anticoagulant treatment did not differ between groups. Conclusions: In patients with CS, vRF but not specific PFO features were associated with recurrent cerebral ischemic events. The ongoing prospective part of the International PFO Consortium will likely shed light upon the role of vRF control for secondary stroke prevention in patients with PFO.
Wireless control systems for factory automation (FA) applications are subject to coexistence impairments, especially in license-free spectrum bands. Evaluating the coexistence impact requires the ...knowledge of appropriate characteristic parameters and the usage of a suitable simulation method. In this paper we propose an integral approach for the event-based simulation of wireless coexisting close-loop networked control systems (NCSs) for mutual impact evaluations based upon the integration of an ordinary differential equation resolving library within an event-based wireless network simulation framework. The approach is evaluated within a harsh FA scenario of two identical closed-loop NCS with two coexisting wireless technologies IEEE 802.11 and PNO WSAN-FA.
Industrial Automation (IA) applications require deterministic communication channels to ensure a reliable operation. As the wireless medium is a shared medium used by many other wireless ...technologies, a deterministic medium access method (MAM) is necessary. An improvement of the coexistence behavior can be achieved by applying adaptive MAMs, but they cannot meet any real-time demands. A promising approach to meet real-time as well as coexistence demands are cognitive MAMs. We evaluate the performance of three different cognitive MAMs which differ in the probabilistic prediction model: Two methods are based on Markov modelling (MM) and one method is based on an auto-regressive (AR) model. The MAMs are experimentally evaluated in a worst case wireless measurement scenario.
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