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Integrated safety profile of selinexor in multiple myeloma: experience from 437 patients enrolled in clinical trials.

Selinexor is an oral, small molecule inhibitor of the nuclear export protein exportin 1 with demonstrated activity in hematologic and solid malignancies. Side effects associated with selinexor include nausea, vomiting, fatigue, diarrhea, decreased appetite, weight loss, thrombocytopenia, neutropenia, and hyponatremia. We reviewed 437 patients with multiple myeloma treated with selinexor and assessed the kinetics of adverse events and impact of supportive care measures. Selinexor reduced both platelets and neutrophils over the first cycle of treatment and reached a nadir between 28 and 42 days.

Secondary Immunodeficiency in Hematological Malignancies: Focus on Multiple Myeloma and Chronic Lymphocytic Leukemia.

Secondary immunodeficiency is reported in most patients with hematological malignancies such as chronic lymphocytic leukemia and multiple myeloma. The aim of our review was to evaluate the existing literature data on patients with hematological malignancies, with regard to the effect of immunodeficiency on the outcome, the clinical and therapeutic approach, and on the onset of noninfectious complications, including thrombosis, pleural effusion, and orofacial complications. Immunodeficiency in these patients has an intense impact on their risk of infection, in turn increasing morbidity and mort

On CAR-Ts, decentralized in-house models, and the hospital exception. Routes for sustainable access to innovative therapies.

Chimeric Antigen Receptor T cells, or CAR-Ts, are a novel class of gene and cell 'one-shot' therapies based upon collecting, reprogramming, and using patients' own immune cells to treat their cancer. The article discusses the status, prospects, and some relevant legal issues of this frontier of personalized medicine. In particular, it explores the legitimacy of 'in-house' CAR-Ts, ie treatments manufactured and delivered to patients within the same clinical center by relying upon automated cell processing systems, a decentralized model which is very different from the one currently adopted for

In Vivo Bone Tissue Engineering Strategies: Advances and Prospects.

Reconstruction of critical-sized bone defects remains a tremendous challenge for surgeons worldwide. Despite the variety of surgical techniques, current clinical strategies for bone defect repair demonstrate significant limitations and drawbacks, including donor-site morbidity, poor anatomical match, insufficient bone volume, bone graft resorption, and rejection. Bone tissue engineering (BTE) has emerged as a novel approach to guided bone tissue regeneration. BTE focuses on in vitro manipulations with seed cells, growth factors and bioactive scaffolds using bioreactors. The successful clinical

Функциональное лекарство и долгосрочное выживание в множестве миеломы: как бросить вызов ранее невозможному.

Множественная миелома (ММ) — разнородная болезнь, выживающая от месяцев до десятилетий. Большинство пациентов по-прежнему не могут достичь цели «чистоты», однако это оказалось возможным с долгосрочной ремиссией и переходом к фазе плато (аналогично моноколональной гаммопатии неопределенного значения/холодящей миэломы). В настоящем обзоре two Для иллюстрации того, каким образом это возможно и что еще предстоит определить для обеспечения функциональной борьбы с заболеваниями в течение длительного периода времени, используются репрезентативные случаи. Был достигнут ряд изменений, таких, как соверш

The role of heat shock protein 90 in idiopathic pulmonary fibrosis: state of the art.

Heat shock protein 90 (HSP 90) and its isoforms are a group of homodimeric proteins that regulate several cellular processes, such as the elimination of misfolded proteins, cell development and post-translational modifications of kinase proteins and receptors. Due to its involvement in extracellular matrix (ECM) remodelling, myofibroblast differentiation and apoptosis, HSP 90 has been investigated as a key player in the pathogenesis of lung fibrosis. Idiopathic pulmonary fibrosis (IPF) is the most common and deadly interstitial lung disease, due to the progressive distortion of lung parenchyma

Integrating Palliative Care into Oncology Care Worldwide: The Right Care in the Right Place at the Right Time.

Opinion statementWhile the benefits of early palliative care are indisputable, most of the current evidence has emerged from resource-rich settings in urban areas of high-income countries, with an emphasis on solid tumors in outpatient settings; this model of palliative care integration is not currently scalable internationally. A shortage of specialist palliative care clinicians means that in order to meet the needs of all patients who require support at any point along their advanced cancer trajectory, palliative care must also be provided by family physicians and oncology clinicians who req

Multidisciplinary Care for the Prevention and Treatment of Venous Thromboembolism in Patients with Cancer-Associated Thrombosis (CAT): Impact of Educational Interventions on CAT-Related Events and on Patients' and Clinicians' Awareness.

Cancer is a leading cause of death. Venous thromboembolism (VTE) is an often-overlooked cause of morbidity and mortality in cancer patients that can be readily prevented and treated. Actions are needed to reduce the morbidity and mortality of patients with cancer-associated thrombosis (CAT). There is a need to increase awareness of the impact of CAT on cancer patients' morbidity and mortality, on their quality of life and to understand the importance of more effective preventions and treatments of VTE in cancer patients. Moreover, it is of great importance to systematically assess the risk of

A decision support tool with health economic modelling for better management of DVT patients.

BackgroundResponding to the increasing demand for Deep Vein Thrombosis (DVT) treatment in the United Kingdom (UK) at times of limited budgets and resources is a great challenge for decision-makers. Therefore, there is a need to find innovative policies, which improve operational efficiency and achieve the best value for money for patients. This study aims to develop a Decision Support Tool (DST) that assesses the impact of implementing new DVT patients' management and care policies aiming at improving efficiency, reducing costs, and enhancing value for money.MethodsWith the involvement of stak

Abstract

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Clinical Performance of Implant-Supported Prostheses in the Rehabilitation of Patients Previously Treated for Medication-Related Osteonecrosis of the Jaws (MRONJ): A Systematic Review.

There is a lack of consensus on managing resultant bone and soft tissue defects or on restoring oral function and aesthetics following medication-related osteonecrosis of the jaws (MRONJ) lesion healing. This clinical challenge presents a dilemma for practitioners. Removable prostheses pose a recurrence risk if poorly fitted and may inadequately restore function or aesthetics in cases of significant bone defect. Dental implant-supported prostheses could enhance function and quality of life, though their risks and indications are not well-defined. This systematic review examines the clinical ou

Digital Life Coaching During Stem Cell Transplantation: Development and Usability Study.

BACKGROUND: For patients with multiple myeloma receiving high-dose chemotherapy followed by autologous stem cell transplantation (SCT), acute life disruptions and symptom burden may lead to worsened quality of life (QOL) and increased emotional distress. Digital life coaching (DLC), whereby trained coaches deliver personalized well-being-related support via phone calls and SMS text messaging, has been shown to improve QOL among SCT survivors. However, DLC has not been investigated during the acute peri-SCT period, which is generally characterized by symptomatic exacerbations and 2-week hospita

Амбулаторное расширение дозирования би специфических антител в реанимированных или рефрактных множественных миеломах: онкологическая система ухода за больными для мониторинга и оказания поддержки.

Биконкретные антитела расширили возможности лечения повторной или рефрактной множественной миеломы, однако начало лечения по-прежнему сопряжено с трудностями в оперативном плане, поскольку повышение уровня дозирования конкретных продуктов концентрирует наибольший риск ранней иммунной токсичности. В этом структурном обзоре описательной части обобщаются имеющаяся информация о предписаниях, отчеты о клинической безопасности, экспертные рекомендации, имплементационная литература и соответствующие данные об оказании помощи медсестрам в целях расширения масштабов амбулаторного дозирования. Мы пересм

From Prescription to Prevention: Patient Awareness, Risk Perceptions, and Predictors of Knowledge of Medication-Related Osteonecrosis of the Jaw.

Background/Objectives: Proactively informing the patient prior to initiating medication and implementing preventive strategies are essential for mitigating the risk of developing medication-related osteonecrosis of the jaw (MRONJ). This study evaluated the awareness of MRONJ among a group of dental faculty patients who were scheduled to use, were using, or had previously utilized bisphosphonate and/or denosumab. Methods: A structured questionnaire-based survey was used as the survey tool to evaluate the patients' awareness of MRONJ. A non-probability convenience sampling method was employed th

Clinical Applications and Future Directions of Minimal Residual Disease Testing in Multiple Myeloma.

In the last years, the life expectancy of multiple myeloma (MM) patients has substantially improved thanks to the availability of many new drugs. Our ability to induce deep responses has improved as well, and the treatment goal in patients tolerating treatment moved from the delay of progression to the induction of the deepest possible response. As a result of these advances, a great scientific effort has been made to redefine response monitoring, resulting in the development and validation of high-sensitivity techniques to detect minimal residual disease (MRD). In 2016, the International Myel

Health inequalities in cancer care: a literature review of pathways to diagnosis in the United Kingdom.

This literature review discusses current health disparities in cancer care in the United Kingdom, spanning access to services, diagnosis, and outcomes. These inequities stem from a complex interplay of factors such as health literacy, ethnicity, socioeconomic status, age, gender, geography, and lifestyle choices. Health literacy plays a crucial role in timely healthcare seeking and diagnosis, while cultural beliefs significantly shape perceptions and behaviours. Socioeconomic barriers often result in delayed diagnosis and inferior outcomes due to limited access to preventive measures and high-

How I approach smoldering multiple myeloma.

The current standard of care in smoldering multiple myeloma (SMM) is close surveillance, outside of clinical trials. Efforts are being made to understand the pathobiologic process that leads to the progression of SMM to active MM. This review provides a critical description of available data, including risk factors and risk models of progression, as well as clinical trials investigating interventions for this patient population. We describe 2 cases in which patients were seen before the concept of a myeloma-defining event was established. Today, based on the International Myeloma Working Group

Toxicities associated with CAR-T therapy compared with standard treatments in hematologic malignancies: a systematic review and meta-analysis.

BACKGROUND: Chimeric antigen receptor T-cell (CAR-T) treatment has revolutionized the therapeutic approach for relapsed or refractory hematologic malignancies. But its unique toxicity profile, particularly immune-mediated adverse events, is a significant question in comparison with other high-intensity therapy strategies. Systematic, comparative, specific assessment of CAR-T–associated toxicities are essential to guide clinical practice and institutional preparedness. METHODS: We conducted a systematic review and meta-analysis comparing the incidence and management of significant toxicities as

Update on Occupational Cancer for Better Cancer Prevention and Control.

Occupational cancer remains an ongoing and emerging issue in cancer prevention and control and is more easily preventable in practice than other causes. As of 2024, changes in various aspects, such as methods for estimating the burden of cancer, evidence on novel carcinogens and classification systems, modernization of working conditions, job characteristics, occupational exposure, and societal changes have played a significant role. Furthermore, advances in technology, including wearable devices, exposome, and biomedical technology, offer more precise methods for identifying the associations

Совпадение в полном тексте источника
… Modern technologies such as online tools that facilitate hospital workflows play a role in generating data for the mandatory reporting of work-related cancer and initiating investigations and surveillance [ 69 ]. …

Primary Gastric Lymphoma, Epidemiology, Clinical Diagnosis, and Treatment.

Primary gastric lymphoma (PGL) is the most common extranodal non-Hodgkin lymphoma and represents a wide spectrum of disease, ranging from indolent low-grade marginal zone lymphoma or mucosa-associated lymphoid tissue (MALT) lymphoma to aggressive diffuse large B-cell lymphoma. The PGL is a relatively rare cancer and easily misdiagnosed due to its unspecific symptoms of the digestive tract. The medical literature and ongoing clinical trials were reviewed on the clinical presentation, diagnosis, prognosis, prevention, and treatment of PGL. Primary gastric lymphoma is an event in the course of ca