Los nuevos escenarios laborales han propiciado la construcción de una identidad que legitima la precariedad y la atipicidad como dinámicas propias de mercado. Este artículo retoma presupuestos, ...categorías y metodologías propias del análisis de contenido cualitativo con el fin de indagar en los discursos e historia laboral de mujeres trabajadoras de una organización del sector inmobiliario ubicada en el Municipio de Chía; inferencias que dan cuenta de la transformación del trabajo femenino. El análisis muestra desde tres categorías -precariedad, atipicidad e identidad- la forma en que el trabajo se estructura como el eje articulador de la vida social y la identidad de las mujeres entrevistadas, para garantizar su permanencia en el mundo laboral.
We evaluated the effects of Syrah red wine treated with salicylic acid (RW SA) and its control red wine (RW) on metabolic parameters, systolic blood pressure and adipose tissue insulin signaling in ...high-fructose (F) fed rats. Grape treated with SA increased the anthocyanin (ANTs) levels in RW. F induced increased systolic blood pressure, dislipidemia and insulin resistance (HOMA:IR). F rats treated with RW significantly prevented these alterations while RW SA partially attenuated triglycerides levels and HOMA:IR without modifications in HDL cholesterol levels. F impaired the adipose tissue response to insulin. Supplementation with RW and RW SA partially attenuated these alterations. Rats supplemented with RW SA had lesser beneficial effects on metabolic alterations than control RW, while both RW and RW SA attenuated altered adipose response to insulin. More studies are necessary to deeply evaluate the effect on SA-induced RW rich in ANTs levels on metabolic alterations associated to MetS.
In the primary analysis of the pivotal JULIET trial of tisagenlecleucel, an autologous anti-CD19 chimeric antigen receptor (CAR) T-cell therapy, the best overall response rate was 52% and the ...complete response rate was 40% in 93 evaluable adult patients with relapsed or refractory aggressive B-cell lymphomas. We aimed to do a long-term follow-up analysis of the clinical outcomes and correlative analyses of activity and safety in the full adult cohort.
In this multicentre, open-label, single-arm, phase 2 trial (JULIET) done at 27 treatment sites in ten countries (Australia, Austria, Canada, France, Germany, Italy, Japan, the Netherlands, Norway, and the USA), adult patients (≥18 years) with histologically confirmed relapsed or refractory large B-cell lymphomas who were ineligible for, did not consent to, or had disease progression after autologous haematopoietic stem-cell transplantation, with an Eastern Cooperative Oncology Group performance status of 0–1 at screening, were enrolled. Patients received a single intravenous infusion of tisagenlecleucel (target dose 5 × 108 viable transduced CAR T cells). The primary endpoint was overall response rate (ie, the proportion of patients with a best overall disease response of a complete response or partial response using the Lugano classification, as assessed by an independent review committee) at any time post-infusion and was analysed in all patients who received tisagenlecleucel (the full analysis set). Safety was analysed in all patients who received tisagenlecleucel. JULIET is registered with ClinialTrials.gov, NCT02445248, and is ongoing.
Between July 29, 2015, and Nov 2, 2017, 167 patients were enrolled. As of Feb 20, 2020, 115 patients had received tisagenlecleucel infusion and were included in the full analysis set. At a median follow-up of 40·3 months (IQR 37·8–43·8), the overall response rate was 53·0% (95% CI 43·5–62·4; 61 of 115 patients), with 45 (39%) patients having a complete response as their best overall response. The most common grade 3–4 adverse events were anaemia (45 39%), decreased neutrophil count (39 34%), decreased white blood cell count (37 32%), decreased platelet count (32 28%), cytokine release syndrome (26 23%), neutropenia (23 20%), febrile neutropenia (19 17%), hypophosphataemia (15 13%), and thrombocytopenia (14 12%). The most common treatment-related serious adverse events were cytokine release syndrome (31 27%), febrile neutropenia (seven 6%), pyrexia (six 5%), pancytopenia (three 3%), and pneumonia (three 3%). No treatment-related deaths were reported.
Tisagenlecleucel shows durable activity and manageable safety profiles in adult patients with relapsed or refractory aggressive B-cell lymphomas. For patients with large B-cell lymphomas that are refractory to chemoimmunotherapy or relapsing after second-line therapies, tisagenlecleucel compares favourably with respect to risk–benefit relative to conventional therapeutic approaches (eg, salvage chemotherapy).
Novartis Pharmaceuticals.
This study compared overall survival (OS), progression-free survival (PFS), complete response rate (CRR), and overall response rate (ORR) of tisagenlecleucel (tisa-cel) and lisocabtagene maraleucel ...(liso-cel) in relapsed or refractory large B-cell lymphomas (r/r LBCL). Using matching-adjusted indirect comparison (MAIC), individual patient-level data from JULIET (tisa-cel) were weighted to match the patient population in TRANSCEND (liso-cel). The main analysis compared infused JULIET patients (N = 106) with the TRANSCEND efficacy-evaluable set (EES) (N = 256 infused). After adjustment, OS, PFS, and the CRR were comparable between tisa-cel and liso-cel EES patients. The estimated adjusted 2-year OS, 2-year PFS, ORR, and CRR were 45.6, 38.2, 62.9, and 47.7%, respectively, for tisa-cel vs. 43.8, 42.1, 72.7, and 53.1% for liso-cel. A scenario analysis compared JULIET patients to the TRANSCEND primary analysis set (PAS) (N = 133). ORR was significantly higher in the TRANSCEND PAS compared with matched JULIET patients, but no significant differences in CRR were observed.
Tisagenlecleucel and liso-cel are effective chimeric antigen receptor T-cell therapies for relapsed/refractory diffuse large B-cell lymphoma (R/R DLBCL). However, there have been no head-to-head ...randomized controlled trials.
Compare efficacy of tisagenlecleucel and liso-cel in R/R DLBCL using matching-adjusted indirect comparison (MAIC).
Individual patient-level data (IPD) from JULIET (tisagenlecleucel; NCT02445248; 02/2020 data cut) were weighted to match the population in TRANSCEND (liso-cel; NCT02631044; 08/2019 data cut). Baseline prognostic factors available in both trials were adjusted for age, sex, histology, ECOG performance status (ECOG PS), left ventricular ejection fraction, radiologic sum of product diameters, lactate dehydrogenase, prior stem cell transplantation (SCT), use of bridging therapy, and number of and refractoriness to prior therapies, in the MAIC. Overall survival (OS), progression-free survival (PFS), complete response rate (CRR), and overall response rate (ORR) were compared.
Primary analyses compared JULIET infused patients (N=106, excluding 8 without lymphodepleting chemotherapy LDC and 1 large-cell neuroendocrine carcinoma) with TRANSCEND efficacy-evaluable patients (N=256, infused patients). A scenario analysis compared JULIET infused to TRANSCEND primary analysis set (PAS) (N=133, dose level 2, excluding ECOG PS 2, prior alloSCT, primary mediastinal B-cell lymphoma, follicular lymphoma FL 3B, or transformation from indolent lymphoma besides FL). Sensitivity analyses included JULIET patients with only fludarabine-based LDC or only adjusted significantly different baseline prognostic factors. MAIC cannot adjust for between-trial differences in adverse event management; therefore, safety outcomes were not compared.
OS (HR: 1.12; 95%CI: 0.62–2.05, P=0.71), PFS (HR: 1.16; 95%CI: 0.64–2.09; P=0.63), and CRR difference (–5.4%; 95%CI: –15.5%–4.7%; P=0.29) were comparable for tisagenlecleucel-infused patients and the liso-cel efficacy-evaluable set after adjusting for differences in baseline characteristics. Results were consistent across all scenario and sensitivity analyses. ORR trended higher in the TRANSCEND efficacy-evaluable set (72.7% vs 62.9%, P=0.07) and was higher in TRANSCEND PAS versus the matched JULIET infused set (74.4% vs 60.9%, P<0.05).
MAIC results indicate there is no evidence of differences in OS, PFS, and CRR between tisagenlecleucel and liso-cel in R/R DLBCL. These findings should be confirmed using IPD from both trials and/or real-world evidence. The study was funded by Novartis.
No head-to-head trials have compared the efficacy of tisagenlecleucel vs historical treatments for adults with relapsed or refractory diffuse large B-cell lymphoma (r/r DLBCL). This study indirectly ...compared the overall survival (OS) and overall response rate (ORR) associated with tisagenlecleucel, using data from the JULIET study (Study of Efficacy and Safety of CTL019 in Adult DLBCL Patients; #NCT02445248), vs historical treatments assessed in the CORAL (Collaborative Trial in Relapsed Aggressive Lymphoma) study follow-up population. To assess treatment effects in the treated (full analysis set FAS) and enrolled (intention-to-treat ITT) study populations, the JULIET FAS vs the CORAL follow-up FAS and JULIET ITT vs CORAL follow-up ITT populations were separately compared. Propensity score weighting using standardized mortality ratio weight (SMRW) and fine stratification weight (FSW) was used to compare OS and ORR, adjusting for baseline confounders. The results indicated that tisagenlecleucel was associated with a lower hazard of death among the FAS (adjusted hazard ratio 95% confidence interval, both FSW and SMRW, 0.44 0.32, 0.59) and ITT populations (FSW, 0.60 0.44, 0.77; SMRW, 0.57 0.44, 0.73; all, P < .001). Median OS was 12.48 months (JULIET) vs 4.34 to 4.40 months (CORAL) for the FAS, and 8.25 (JULIET) months vs 4.04 to 4.86 (CORAL) months for the ITT populations. Tisagenlecleucel was associated with a significantly higher ORR compared with historical treatments among the FAS (adjusted response rate difference 95% confidence interval, both FSW and SMRW, 36% 22%, 0.48%; P < .001) and among the ITT populations after SMRW adjustment (11% 0%, 22%; P = .043). This analysis supports that improved response and OS are achieved in patients with r/r DLBCL treated with tisagenlecleucel compared with those treated with alternative historical treatments.
•OS and ORR of tisagenlecleucel were compared with those of historical therapy for r/r DLBCL after ≥2 therapy lines.•Tisagenlecleucel was associated with significantly longer OS and higher response rate vs historical therapy.
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En este artículo se presentan experiencias realizadas en el aula como espacio privilegiado para promover la oralidad. El maestro en su rol de acompañante genera situaciones para dar la palabra al ...estudiante a fin de que aprenda a tomar decisiones, a afirmar su individualidad y a potenciar su desarrollo integral. Las vivencias de oralidad descritas se llevaron a cabo en el ciclo inicial y contribuyeron al desarrollo social, cognitivo, afectivo, académico y convivencial de los niños, niñas y sus acompañantes, facilitando, además, procesos significativos de lectura y escritura.
Hormonal therapy in metastatic breast cancer Martínez-Prieto, Marcela; Flores de la Torre, Celia B; Rivera Rivera, Samuel ...
Ginecologia y obstetricia de Mexico
77, Številka:
10
Journal Article
The primary objective in metastatic breast cancer is tumor control and symptom palliation. Factors to be considered are: efficacy, tolerance and quality of life as well as patient preferences. In the ...Hormone Receptor Positive Group, Hormonal treatment is the best choice because of it's effectiveness and good toxicity profile. Endocrine therapy has two main targets: the first one is to block estrogen production. In premenopausal women this can be through ovarian ablation. In postmenopausal women this is achieved by blocking the peripheral conversion of androgens to estrogens by blocking the enzyme known as aromatase. The other option is to block the action of the estrogen on it's receptor with the group of drugs known as selective estrogen receptor modulators (SERM). This class of drugs can be used in pre and postmenopausal women. Treatment should be tailored according to patient characteristics and menopausal status.
We report the case of a 69 year-old patient that suffered breast cancer with metastasis to orbits. Diagnostic process and medical treatment are described.
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