Objective: To compare effectiveness of topical 5-aminolevulinic acid-mediated photodynamic therapy (5-ALA PDT) and loop electrosurgical excision procedure (LEEP) among patients with cervical intraepithelial neoplasia (CIN).
Methods: We retrospectively identified patients who underwent either 5-ALA PDT or LEEP from Sep. 2012 to Dec. 2019 in Chinese PLA general hospital. Patients' outcomes were compared according to the HPV genotyping, cytological tests within 3-6-month follow-up post-treatment, the pathological examination would be performed if the cytological results indicated the risk of CIN. Propensity score matching (PSM) was adapted to pair the baseline. Complete remission (CR), partial remission (PR) and the remission rate of HPV infections were used to evaluate the efficacy of 5-ALA PDT versus LEEP.
Results: In total, 30 pairs were matched as the matching tolerance was set as 0.03. There was no significant difference about the CR and PR between 5-ALA PDT and LEEP group (73.33% vs 84.00%, P = 0.340; 3.33% vs 4.00%, P = 1.000). Among different CIN group, there was no statistic difference between 5-ALA PDT and LEEP. Moreover, in terms of HPV remission rate, 5-ALA PDT showed the same efficacy as LEEP (59.26% vs 53.85%, P = 0.691).
Conclusions: In essence, topical 5-ALA PDT emerges as a non-invasive, repeatable procedure with minimal side effects for cervical lesions, preserving cervical structure. Overall, the efficacy of 5-ALA PDT is comparable to LEEP in achieving successful outcomes.
目的：比较外用5-氨基乙酰丙酸介导的光动力疗法（5-ALA PDT）和环形电切术（LEEP）治疗宫颈上皮内瘤变（CIN）的疗效。方法：回顾性分析2012年9月至2019年12月在中国人民解放军总医院接受5-ALA PDT或LEEP治疗的患者。根据HPV基因分型、治疗后随访3-6个月细胞学检查比较患者结局，细胞学结果提示有CIN风险时行病理检查。采用倾向评分匹配（PSM）对基线进行配对。用HPV感染完全缓解（CR）、部分缓解（PR）和缓解率来评价5-ALA PDT与LEEP的疗效。结果：共匹配30对，匹配公差设为0.03。5-ALA PDT组与LEEP组CR、PR差异无统计学意义(73.33% vs 84.00%, P = 0.340；3.33% vs 4.00%, P = 1.000)。不同CIN组间5-ALA PDT与LEEP差异无统计学意义。在HPV缓解率方面，5-ALA PDT与LEEP的疗效相同（59.26% vs 53.85%, P = 0.691）。结论：从本质上讲，局部5-ALA PDT是一种无创、可重复的手术，对宫颈病变的副作用最小，保留了宫颈结构。总体而言，5-ALA PDT在获得成功结果方面的疗效与LEEP相当。
{"title":"Topical 5-aminolevulinic acid-mediated photodynamic therapy versus loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia.","authors":"Yidi Liu, Yi Li, Huan Wu, Ying Wang, Jing Zeng, Hui Li, Haixia Qiu, Ying Gu","doi":"10.1007/s44178-024-00127-3","DOIUrl":"https://doi.org/10.1007/s44178-024-00127-3","url":null,"abstract":"<p><strong>Objective: </strong>To compare effectiveness of topical 5-aminolevulinic acid-mediated photodynamic therapy (5-ALA PDT) and loop electrosurgical excision procedure (LEEP) among patients with cervical intraepithelial neoplasia (CIN).</p><p><strong>Methods: </strong>We retrospectively identified patients who underwent either 5-ALA PDT or LEEP from Sep. 2012 to Dec. 2019 in Chinese PLA general hospital. Patients' outcomes were compared according to the HPV genotyping, cytological tests within 3-6-month follow-up post-treatment, the pathological examination would be performed if the cytological results indicated the risk of CIN. Propensity score matching (PSM) was adapted to pair the baseline. Complete remission (CR), partial remission (PR) and the remission rate of HPV infections were used to evaluate the efficacy of 5-ALA PDT versus LEEP.</p><p><strong>Results: </strong>In total, 30 pairs were matched as the matching tolerance was set as 0.03. There was no significant difference about the CR and PR between 5-ALA PDT and LEEP group (73.33% vs 84.00%, <i>P</i> = 0.340; 3.33% vs 4.00%, <i>P</i> = 1.000). Among different CIN group, there was no statistic difference between 5-ALA PDT and LEEP. Moreover, in terms of HPV remission rate, 5-ALA PDT showed the same efficacy as LEEP (59.26% vs 53.85%, <i>P</i> = 0.691).</p><p><strong>Conclusions: </strong>In essence, topical 5-ALA PDT emerges as a non-invasive, repeatable procedure with minimal side effects for cervical lesions, preserving cervical structure. Overall, the efficacy of 5-ALA PDT is comparable to LEEP in achieving successful outcomes.</p>","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"3 1","pages":"56"},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604713/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142775308","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prospect of immunotherapy alone in patients with advanced NSCLC with high btmb: a review and a meta-analysis","authors":"Feiyu Zhao, Xiaochen Qiu, Qinna Yang, Shuyue Gao, Fan Yang, Niansong Qian","doi":"10.1007/s44178-023-00065-6","DOIUrl":"https://doi.org/10.1007/s44178-023-00065-6","url":null,"abstract":"","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"22 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138948436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-20DOI: 10.1007/s44178-023-00066-5
Yichen Jin, Fan Yang, Kezhong Chen
{"title":"An overview of current development and barriers on liquid biopsy in patients with early-stage non-small-cell Lung cancer","authors":"Yichen Jin, Fan Yang, Kezhong Chen","doi":"10.1007/s44178-023-00066-5","DOIUrl":"https://doi.org/10.1007/s44178-023-00066-5","url":null,"abstract":"","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"12 24","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138955403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-12-01DOI: 10.1007/s44178-023-00064-7
A. H. Nwabo Kamdje, Richard Tagne Simo, Hetvet Paulain Fogang Dongmo, Amel Renaud Bidias, Palmer Masumbe Netongo
{"title":"Role of signaling pathways in the interaction between microbial, inflammation and cancer","authors":"A. H. Nwabo Kamdje, Richard Tagne Simo, Hetvet Paulain Fogang Dongmo, Amel Renaud Bidias, Palmer Masumbe Netongo","doi":"10.1007/s44178-023-00064-7","DOIUrl":"https://doi.org/10.1007/s44178-023-00064-7","url":null,"abstract":"","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":" 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138615619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose Peripheral T-cell lymphoma (PTCL) is notorious for its heterogeneity as well as poor prognosis. High mortality remains a challenge. Our study aims to assess whether the leukocyte-lymphocyte ratio (LLR) and neutrophil-lymphocyte ratio (NLR) can be applied as prognostic indexes for patients with PTCL and supplement the prognostic system of PTCL. Methods We reviewed the data of 108 newly diagnosed PTCL patients in the clinic. The χ 2 test was applied to contrast baseline characteristics between patients in different groups divided according to the cut-off value of LLR or NLR. The Kaplan-Meier method was adapted to develop the survival curve. The COX ratio risk regression model was used to identify the indexes related to patient survival. Results LLR ≥ 10.30, NLR ≥ 8.25, Eastern Cooperative Oncology Group (ECOG) score ≥ 2, International prognostic index (IPI) score > 2, Prognostic Index for T cell lymphoma (PIT) ≥ 2, B symptom, Ann Arbor stage III-IV and high level of Lactic dehydrogenase (LDH) were poor prognosis factors impacting patients’ overall survival (OS) by the univariate analysis. The multivariate analysis illustrated that only LLR ≥ 10.30 was significantly related to OS ( P all < 0.05). Conclusion Overall, our analysis revealed that LLR ≥ 10.30 was significantly associated with poorer OS and was a novel prognostic index for PTCL.
{"title":"Identification of leukocyte-lymphocyte ratio as a novel prognostic factor in Peripheral T-cell lymphoma","authors":"Shi-Qi Gao, Bo-Ya Lei, Yue Xu, Zi-Jian Zhang, Xing-Jian Niu, Wen-Hui Zhao, Qing-Yuan Zhang, Shu Zhao","doi":"10.1007/s44178-023-00062-9","DOIUrl":"https://doi.org/10.1007/s44178-023-00062-9","url":null,"abstract":"Abstract Purpose Peripheral T-cell lymphoma (PTCL) is notorious for its heterogeneity as well as poor prognosis. High mortality remains a challenge. Our study aims to assess whether the leukocyte-lymphocyte ratio (LLR) and neutrophil-lymphocyte ratio (NLR) can be applied as prognostic indexes for patients with PTCL and supplement the prognostic system of PTCL. Methods We reviewed the data of 108 newly diagnosed PTCL patients in the clinic. The χ 2 test was applied to contrast baseline characteristics between patients in different groups divided according to the cut-off value of LLR or NLR. The Kaplan-Meier method was adapted to develop the survival curve. The COX ratio risk regression model was used to identify the indexes related to patient survival. Results LLR ≥ 10.30, NLR ≥ 8.25, Eastern Cooperative Oncology Group (ECOG) score ≥ 2, International prognostic index (IPI) score > 2, Prognostic Index for T cell lymphoma (PIT) ≥ 2, B symptom, Ann Arbor stage III-IV and high level of Lactic dehydrogenase (LDH) were poor prognosis factors impacting patients’ overall survival (OS) by the univariate analysis. The multivariate analysis illustrated that only LLR ≥ 10.30 was significantly related to OS ( P all < 0.05). Conclusion Overall, our analysis revealed that LLR ≥ 10.30 was significantly associated with poorer OS and was a novel prognostic index for PTCL.","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"121 7-8","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136381488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Purpose We aimed to analyse the correlation between prostaglandin D2 synthase (PTGDS) and a diffuse large B-cell lymphoma (DLBCL) prognosis. Methods We retrospectively collected two hundred paraffin-embedded tissue specimens that were pathologically diagnosed as DLBCL in the Fujian Tumour Hospital between January 2014 and December 2018. An abundance of paraffin-embedded tumour tissues were obtained. Twenty patients with lymphocyte-rich, benign, tissue-reactive, hypertrophic tonsillitis were selected as controls. Wax blocks were selected for primary cases and the controls were screened by professional pathologists. The levels of prostaglandin D2 synthase (PTGDS) and the EMT-related molecules, E-cadherin and vimentin, were detected by immunohistochemistry in clinical samples. A chi-square test revealed the correlations between PTGDS expression and clinicopathological characteristics, including age, sex, primary site, clinical stage, immunotyping, and International Prognostic Index (IPI) score. The Kaplan–Meier survival analysis was performed, and the diagnostic value was evaluated by receiver operating characteristic (ROC) curve analysis. Results A total of 138 cases (69%) were found to be PTGDS positive (> 30% positive cells). PTGDS staining was negative (< 30% positive cells) in 62 cases (31%). We collected the corresponding clinicopathological information and found that PTGDS expression was not significantly related to the patients’ age, tumour stage, presence of extranodal invasion, or IPI score. According to the follow-up data, patients with low PTGDS expression had poor progression-free survival (PFS) and overall survival (OS), with 2-year PFS and OS rates of 41.7% and 50%, respectively. The 2-year PFS and OS rates of PTGDS-positive patients were 89.3% and 92.9%, respectively ( P < 0.0001), and the differences were significant. Conclusion We found that the expression level of PTGDS is significantly correlated with the prognosis of diffuse large B-cell lymphoma.
{"title":"Prognostic analysis of prostaglandin D2 synthase in diffuse large B-cell lymphoma","authors":"Jiesong Wang, Yun Xu, Wei Yu, Yanbin Zheng, Hongming He, Daoguang Chen, Siping Zou, Chang Wang, Ying Chen, Ningbin Chen, Hui Wu, Jianchao Wang, Jianyang Lin","doi":"10.1007/s44178-023-00060-x","DOIUrl":"https://doi.org/10.1007/s44178-023-00060-x","url":null,"abstract":"Abstract Purpose We aimed to analyse the correlation between prostaglandin D2 synthase (PTGDS) and a diffuse large B-cell lymphoma (DLBCL) prognosis. Methods We retrospectively collected two hundred paraffin-embedded tissue specimens that were pathologically diagnosed as DLBCL in the Fujian Tumour Hospital between January 2014 and December 2018. An abundance of paraffin-embedded tumour tissues were obtained. Twenty patients with lymphocyte-rich, benign, tissue-reactive, hypertrophic tonsillitis were selected as controls. Wax blocks were selected for primary cases and the controls were screened by professional pathologists. The levels of prostaglandin D2 synthase (PTGDS) and the EMT-related molecules, E-cadherin and vimentin, were detected by immunohistochemistry in clinical samples. A chi-square test revealed the correlations between PTGDS expression and clinicopathological characteristics, including age, sex, primary site, clinical stage, immunotyping, and International Prognostic Index (IPI) score. The Kaplan–Meier survival analysis was performed, and the diagnostic value was evaluated by receiver operating characteristic (ROC) curve analysis. Results A total of 138 cases (69%) were found to be PTGDS positive (> 30% positive cells). PTGDS staining was negative (< 30% positive cells) in 62 cases (31%). We collected the corresponding clinicopathological information and found that PTGDS expression was not significantly related to the patients’ age, tumour stage, presence of extranodal invasion, or IPI score. According to the follow-up data, patients with low PTGDS expression had poor progression-free survival (PFS) and overall survival (OS), with 2-year PFS and OS rates of 41.7% and 50%, respectively. The 2-year PFS and OS rates of PTGDS-positive patients were 89.3% and 92.9%, respectively ( P < 0.0001), and the differences were significant. Conclusion We found that the expression level of PTGDS is significantly correlated with the prognosis of diffuse large B-cell lymphoma.","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"15 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136381385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.1007/s44178-023-00057-6
Xianqun Fan
Abstract Cancer immunotherapy represents a groundbreaking paradigm shift in the field of cancer treatment, harnessing the power of the immune system to combat cancer cells. As an innovative approach, it has shown immense promise and has revolutionized the way we perceive and treat cancer. This commentary aims to highlight the recent important advances in cancer immunotherapy, including immune checkpoint blockade therapy, chimeric antigen receptor T cell therapy, T cell receptor-gene engineered T cell therapy, and tumor vaccines.
{"title":"Recent highlights of cancer immunotherapy","authors":"Xianqun Fan","doi":"10.1007/s44178-023-00057-6","DOIUrl":"https://doi.org/10.1007/s44178-023-00057-6","url":null,"abstract":"Abstract Cancer immunotherapy represents a groundbreaking paradigm shift in the field of cancer treatment, harnessing the power of the immune system to combat cancer cells. As an innovative approach, it has shown immense promise and has revolutionized the way we perceive and treat cancer. This commentary aims to highlight the recent important advances in cancer immunotherapy, including immune checkpoint blockade therapy, chimeric antigen receptor T cell therapy, T cell receptor-gene engineered T cell therapy, and tumor vaccines.","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"15 21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135616160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-20DOI: 10.1007/s44178-023-00061-w
Zhu Jiayu, Qingyuan Zhang
Abstract Diffuse large B cell lymphoma (DLBCL) is the most common type of lymphoma in adults with high heterogeneity. Recent studies have manifested that the occurrence and development of DLBCL is related to hepatitis B virus (HBV) infection. As a medium-to-high prevalence area of HBV infection in China, the importance and exact mechanism of HBV infection in the occurrence of DLBCL have attracted considerable attention. HBV-associated DLBCL has unique clinical characteristics, poor treatment effect and inferior prognosis. HBV reactivation caused by DLBCL treatment also needs for constant vigilance. In this review we summarize the current research progress in the epidemiology, pathogenesis, clinical characteristics, HBV reactivation and antiviral therapies of HBV-associated DLBCL, in order to provide reference for clinical diagnosis and treatment.
{"title":"Hepatitis B virus–associated diffuse large B cell lymphoma: epidemiology, biology, clinical features and HBV reactivation","authors":"Zhu Jiayu, Qingyuan Zhang","doi":"10.1007/s44178-023-00061-w","DOIUrl":"https://doi.org/10.1007/s44178-023-00061-w","url":null,"abstract":"Abstract Diffuse large B cell lymphoma (DLBCL) is the most common type of lymphoma in adults with high heterogeneity. Recent studies have manifested that the occurrence and development of DLBCL is related to hepatitis B virus (HBV) infection. As a medium-to-high prevalence area of HBV infection in China, the importance and exact mechanism of HBV infection in the occurrence of DLBCL have attracted considerable attention. HBV-associated DLBCL has unique clinical characteristics, poor treatment effect and inferior prognosis. HBV reactivation caused by DLBCL treatment also needs for constant vigilance. In this review we summarize the current research progress in the epidemiology, pathogenesis, clinical characteristics, HBV reactivation and antiviral therapies of HBV-associated DLBCL, in order to provide reference for clinical diagnosis and treatment.","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135570252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.1007/s44178-023-00059-4
Lijie Xing, Hui Wang, Dan Liu, Qiang He, Zengjun Li
Abstract Objective Richter syndrome (RS) occurs in approximately 2–10% of chronic lymphocytic leukemia (CLL) patients, more often during the disease course than at diagnosis, with a diffuse large B-cell Lymphoma (DLBCL) histology in 95% of cases. Despite great advances in the treatment of CLL in recent years, RS also develops in patients treated with novel agents, as summarized in our case report and review. Methods We summarized 3 patients with RS treated with immunochemotherapy combined with BTK inhibitor (BTKi) or BCL2 inhibitor (BCL2i) and reviewed the literature. Results Three RS patients were summarized. Patient 1 was transformed into DLBCL during dose reductions in ibrutinib and achieved bone marrow (BM) minimal residual disease (MRD)-negative complete response (CR) after rituximab etoposide, dexamethasone, doxorubicin, cyclophosphamide, and vincristine (R-EDOCH) combined with BTKi treatment and sustained progression-free survival (PFS) for more than 2 years. Patient 2, who transformed at the time of diagnosis, progressed after being treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), followed by PD1 antibody combined with cytosine, arabinoside, cisplatin and dexamethasone (DHAP) treatment and PD1 antibody combined with ifosfamide, carboplatin, and etoposide (ICE) treatment. Patient 2 achieved CR after treatment with rituximab, gemcitabine, and oxaliplatin (R-GemOx) combined with BTKi. Patient 3, who transformed at the time of diagnosis with CARD11, TP53, and ATM mutations, progressed after being treated with R-EDOCH combined with BTKi and achieved MRD-negative CR after treatment with R-GemOx and venetoclax, which has continued for 3 months. We summarized new protocols utilizing targeted therapy, such as BTKi acalabrutinib, and checkpoint inhibition, and the potential role of precision medicine in future trials of RS treatment. The efficacy of these protocols as single agents or in combination with immunochemotherapy is currently being evaluated. Conclusion In our study, immunochemotherapy combined with BTKi or BCL2i achieved favorable efficacy in the treatment of RS. The treatments should be optimized by the combination of both chemotherapies and targeted therapy to develop a specific individual approach for each patient, according to previous treatment and biological characteristics.
{"title":"Immunochemotherapy combined with novel agents for Richter syndrome: report of 3 cases","authors":"Lijie Xing, Hui Wang, Dan Liu, Qiang He, Zengjun Li","doi":"10.1007/s44178-023-00059-4","DOIUrl":"https://doi.org/10.1007/s44178-023-00059-4","url":null,"abstract":"Abstract Objective Richter syndrome (RS) occurs in approximately 2–10% of chronic lymphocytic leukemia (CLL) patients, more often during the disease course than at diagnosis, with a diffuse large B-cell Lymphoma (DLBCL) histology in 95% of cases. Despite great advances in the treatment of CLL in recent years, RS also develops in patients treated with novel agents, as summarized in our case report and review. Methods We summarized 3 patients with RS treated with immunochemotherapy combined with BTK inhibitor (BTKi) or BCL2 inhibitor (BCL2i) and reviewed the literature. Results Three RS patients were summarized. Patient 1 was transformed into DLBCL during dose reductions in ibrutinib and achieved bone marrow (BM) minimal residual disease (MRD)-negative complete response (CR) after rituximab etoposide, dexamethasone, doxorubicin, cyclophosphamide, and vincristine (R-EDOCH) combined with BTKi treatment and sustained progression-free survival (PFS) for more than 2 years. Patient 2, who transformed at the time of diagnosis, progressed after being treated with rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), followed by PD1 antibody combined with cytosine, arabinoside, cisplatin and dexamethasone (DHAP) treatment and PD1 antibody combined with ifosfamide, carboplatin, and etoposide (ICE) treatment. Patient 2 achieved CR after treatment with rituximab, gemcitabine, and oxaliplatin (R-GemOx) combined with BTKi. Patient 3, who transformed at the time of diagnosis with CARD11, TP53, and ATM mutations, progressed after being treated with R-EDOCH combined with BTKi and achieved MRD-negative CR after treatment with R-GemOx and venetoclax, which has continued for 3 months. We summarized new protocols utilizing targeted therapy, such as BTKi acalabrutinib, and checkpoint inhibition, and the potential role of precision medicine in future trials of RS treatment. The efficacy of these protocols as single agents or in combination with immunochemotherapy is currently being evaluated. Conclusion In our study, immunochemotherapy combined with BTKi or BCL2i achieved favorable efficacy in the treatment of RS. The treatments should be optimized by the combination of both chemotherapies and targeted therapy to develop a specific individual approach for each patient, according to previous treatment and biological characteristics.","PeriodicalId":73245,"journal":{"name":"Holistic integrative oncology","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135993193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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