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Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH): Optimal Management.

Hyponatremia, defined as serum sodium concentration <135 mEq/l, is the most common electrolyte balance disorder in clinical practice. Many causes are listed, but syndrome of inappropriate antidiuretic hormone secretion (SIADH) is certainly the most relevant, mainly in oncological and hospitalized patients. In this review, the pathophysiological and clinical aspects are described in detail. Patients' extensive medical history and structured physical and biochemical tests are considered the milestones marking the way of the SIADH management as to provide early detection and proper correction. We

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… The most relevant side effects with these drugs are immune-related diseases, and hyponatremia seems to be linked to hypophysitis. 17 Even palliative medications (non-steroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, opioid analgesics), anticonvulsants, antipsychotics, antidiabetic …

Immunologic and clinical effects of targeting PD-1 in lung cancer.

Therapeutic antibodies that block the programmed cell death protein-1 (PD-1) immune checkpoint pathway prevent T-cell downregulation and promote immune responses against cancer. Several PD-1 pathway inhibitors have shown robust activity in initial trials. This article reviews the preclinical evidence, rationale, and clinical pharmacology of blockade of PD-1 or its ligands as therapy for lung cancer and provides an overview of agents in development, clinical evidence to date, and implications for clinical application.

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… This includes ruling out perforation in colitis, seeking appropriate consultation (e.g., endocrinology for hypophysitis or adrenal insufficiency or pulmonology for pneumonitis), and increasing the monitoring frequency of patients experiencing irAEs, including monitoring of liver function and timely follow-up …

Retrospective analysis of the preparation and application of immunotherapy in cancer treatment (Review).

Monoclonal antibody technology plays a vital role in biomedical and immunotherapy, which greatly promotes the study of the structure and function of genes and proteins. To date, monoclonal antibodies have gone through four stages: murine monoclonal antibody, chimeric monoclonal antibody, humanised monoclonal antibody and fully human monoclonal antibody; thousands of monoclonal antibodies have been used in the fields of biology and medicine, playing a special role in the pathogenesis, diagnosis and treatment of disease. In this review, we compare the advantages and disadvantages of hybridoma te

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… Different from others, the toxicity profile of ipilimumab mainly manifests as symptoms associated with infusion, including rigor, pruritus, fatigue, nausea, dizziness, colitis, less frequently hypophysitis, hepatitis pneumonitis, and even hypotension, angioneurotic oedema, and dyspnoea ( 159 - 161 ). … At present, the anti-PD-1 mAbs are mostly used in combination therapies, because traditional therapy using anti-PD-1 mAbs alone can lead to various IRAEs, including fatigue, skin rash, colitis, hypophysitis, pneumonitis, myasthenia gravis and interstitial nephritis ( 171 ). …

Bone Effects of Anti-Cancer Treatments in 2024.

Considerable progress has been made in the management of cancer patients in the last decade with the arrival of anti-cancer immunotherapies (immune checkpoint inhibitors) and targeted therapies. As a result, a broad spectrum of cancers, not just hormone-sensitive ones, have seen several patients achieve profound and prolonged remissions, or even cures. The management of medium- and long-term side-effects of treatment and quality of life of patients are essential considerations. This is especially true for bone, as bone fragility can lead to increased fractures and loss of autonomy, ultimately

Potential role of immunotherapy and targeted therapy in the treatment of cancer: A contemporary nursing practice.

Immunotherapy and targeted therapy have emerged as promising therapeutic options for cancer patients. Immunotherapies induce a host immune response that mediates long-lived tumor destruction, while targeted therapies suppress molecular mechanisms that are important for tumor maintenance and growth. In addition, cytotoxic agents and targeted therapies regulate immune responses, which increases the chances that these therapeutic approaches may be efficiently combined with immunotherapy to ameliorate clinical outcomes. Various studies have suggested that combinations of therapies that target diff

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… squamous cell carcinoma (ESCC), melanoma | Hypersensitivity, erythema, renal failure, muscle spasms, peripheral neuropathy, elevated amylase levels, infusion-related reaction, thyroiditis, hepatitis, and maculopapular rash | [ [114] , [116] , [117] ] Ipilimumab | CTLA-4 | Metastatic melanoma | Nephritis, hypophysitis … acetaminophen, continue immunotherapy | [ 168 ] Grade 2 | A rheumatology consultation, - Intra-articular steroid injection, oral prednisone 10–20 mg/day, immunotherapy can be paused Grades 3–4 | Pause immunotherapy, immunomodulatory therapy in steroid non-responders, oral prednisone 0.5–1 mg/kg/day Hypophysitis …

Ход работы 34th Симпозиум ESVN-ECVN 23rd-24th сентябрь 2022.

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PD-1 as a potential target in cancer therapy.

Recently, an improved understanding of the molecular mechanisms governing the host response to tumors has led to the identification of checkpoint signaling pathways involved in limiting the anticancer immune response. One of the most critical checkpoint pathways responsible for mediating tumor-induced immune suppression is the programmed death-1 (PD-1) pathway, normally involved in promoting tolerance and preventing tissue damage in settings of chronic inflammation. Many human solid tumors express PD ligand 1 (PD-L1), and this is often associated with a worse prognosis. Tumor-infiltrating lymp

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… Drug-related AEs of special interest (AEOSIs, AEs with potentially immune-related etiology) included vitiligo, pneumonitis, hepatitis, colitis, thyroiditis, and hypophysitis. …

Knowledge mapping and visualized analysis of research progress in onconephrology: a bibliometric analysis.

OBJECTIVES: Onconephrology is an expanding subspecialty focused on the management of cancer patients with renal injury. This study used a comprehensive bibliometric analysis to emphasize the need for cooperation between oncologists and nephrologists, exploring current trends and future research areas in onconephrology. METHODS: Relevant literature on onconephrology published between 1 January 2000 and 27 April 2024 was retrieved from the Science Citation Index Expanded of the Web of Science Core Collection, followed by manual screening. Bibliometric analyses were performed using CiteSpace, VO

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… There have been an increasing number of case reports highlighting hypophysitis and secondary adrenal insufficiency as the underlying cause of hyponatremia in patients receiving immune checkpoint inhibitors [ 44 ]. …

Turning Points in Cross-Disciplinary Perspective of Primary Hyperparathyroidism and Pancreas Involvements: Hypercalcemia-Induced Pancreatitis, MEN1 Gene-Related Tumors, and Insulin Resistance.

We aimed to provide an in-depth analysis with respect to three turning points in pancreas involvement in primary hyperparathyroidism (PHP): hypercalcemia-induced pancreatitis (HCa-P), MEN1 (multiple endocrine neoplasia)-related neuroendocrine tumors (NETs), and insulin resistance (IR). This was a comprehensive review conducted via a PubMed search between January 2020 and January 2024. HCa-P (n = 9 studies, N = 1375) involved as a starting point parathyroid NETs (n = 7) or pancreatitis (n = 2, N = 167). Case report-focused analysis (N = 27) showed five cases of pregnancy PHP-HCa-P and three rep

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… Another study provided the genetic analysis in 40 suspected individuals for MEN1; 32/40 subjects had a syndrome confirmation, and they displayed the following spectrum: 100% had primary hyperparathyroidism; 68.7% were associated with gastro-entero-pancreatic NETs; and 66% were confirmed with a hypophyseal … Furthermore, immune checkpoints inhibitors, monoclonal antibodies that increase the immune anti-tumor response, have been shown to affect endocrine glands, including the parathyroid and endocrine pancreas in addition to inducing hyper- and hypothyroidism, hypophysitis, and primary adrenal insufficiency …

Cardiotoxicity of Biological Therapies in Cancer Patients: An In-depth Review.

Cardiotoxicity from chemotherapy regimens has been long reported. However, the understanding of cardiac side effects of biological therapies is rapidly evolving. With cancer patients achieving higher life expectancy due to the use of personalized medicine and novel targeted anticancer agents, the occurrence of cardiotoxicity is becoming more significant. Novel biological therapies include anti-HER2 antibodies, tyrosine kinase inhibitors, bruton kinase inhibitors, antivascular endothelial growth factors, proteasome inhibitors, immunomodulator drugs, and immune checkpoint inhibitors. Potential c

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… High-dose glucocorticoids for the treatment of ipilimumab-induced hypophysitis is associated with reduced survival in patients with melanoma. Cancer. 2018;124(18):3706–3714. doi: 10.1002/cncr.31629. 122. Downey S.G., Klapper J.A., Smith F.O., et al. …

Innovative therapeutic concepts of progressive multifocal leukoencephalopathy.

Progressive multifocal leukoencephalopathy (PML) is an opportunistic viral disease of the brain-caused by human polyomavirus 2. It affects patients whose immune system is compromised by a corresponding underlying disease or by drugs. Patients with an underlying lymphoproliferative disease have the worst prognosis with a mortality rate of up to 90%. Several therapeutic strategies have been proposed but failed to show any benefit so far. Therefore, the primary therapeutic strategy aims to reconstitute the impaired immune system to generate an effective endogenous antiviral response. Recently, an

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… Secondary autoimmune phenomena such as pneumonitis, or hypophysitis are common with anti-PD-1 therapy, and neurologists should be vigilant for evidence of such side effects [ 71 ]. …

Cardiotoxicity of immune checkpoint inhibitors.

Cardiac toxicity after conventional antineoplastic drugs (eg, anthracyclines) has historically been a relevant issue. In addition, targeted therapies and biological molecules can also induce cardiotoxicity. Immune checkpoint inhibitors are a novel class of anticancer drugs, distinct from targeted or tumour type-specific therapies. Cancer immunotherapy with immune checkpoint blockers (ie, monoclonal antibodies targeting cytotoxic T lymphocyte-associated antigen 4 (CTLA-4), programmed cell death 1 (PD-1) and its ligand (PD-L1)) has revolutionised the management of a wide variety of malignancies

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… They are caused by the immune infiltration into the thyroid or pituitary glands, resulting in thyroiditis or hypophysitis, respectively. 112 PD-1 and PD-L1 blocking agents display different adverse effect profiles compared with ipilimumab. 107 The most common adverse events are mild fatigue, rash, pruritus …

Cancer therapy-associated Takotsubo cardiomyopathy: A narrative review of mechanisms, drug associations, and clinical implications.

Anticancer therapies have been increasingly associated with Takotsubo cardiomyopathy (TTC). As prior reports remain fragmented across case studies and drug-specific reviews, this paper offers one of the most comprehensive reviews to date of cancer therapy-associated TTC. While classically triggered by emotional or physical stress, TTC has been increasingly associated with chemotherapy and other cancer-directed therapies. This literature review explores the pathophysiology, clinical features, and evolving evidence linking anticancer agents to TTC, with a focus on cytotoxic cancer therapy, hormo

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… Pembrolizumab-induced broken heart syndrome, pneumonitis, and hypophysitis occurring concurrently; a deadly triad. J. Community Hosp. Intern. Med. Perspect. 2023;13(3):88–90. doi: 10.55729/2000-9666.1173. …

Vaccines against human carcinomas: strategies to improve antitumor immune responses.

Multiple observations in preclinical and clinical studies support a role for the immune system in controlling tumor growth and progression. Various components of the innate and adaptive immune response are able to mediate tumor cell destruction; however, certain immune cell populations can also induce a protumor environment that favors tumor growth and the development of metastasis. Moreover, tumor cells themselves are equipped with various mechanisms that allow them to evade surveillance by the immune system. The goal of cancer vaccines is to induce a tumor-specific immune response that ultim

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… in patients with cancer after antibody blockade of cytotoxic T-lymphocyte-associated antigen 4 Journal of Clinical Oncology 2006 24 15 2283 2289 16710025 10.1200/JCO.2005.04.5716 PMC2140223 105 Blansfield JA Beck KE Tran K Cytotoxic T-lymphocyte-associated antigen-4 blockage can induce autoimmune hypophysitis …

Gene and Cell Therapy for Sarcomas: A Review.

Background: The heterogeneity of sarcomas and resulting distinct sub-type specific characteristics, their high recurrence rates, and tendency for distant metastasis, continue to present significant challenges to providing optimal treatments. Objective: To provide a comprehensive review of current literature and clinical trials in gene and cell therapies for sarcomas. Methods: A comprehensive literature search was conducted utilizing the following databases: PubMed, Medline, Google Scholar and clinicaltrials.gov. Search terms included "gene therapy", "cell therapy", "NK cell therapy, "CAR-T the

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… Adverse events were generally mild, with only one immune-related adverse event (hypophysitis) reported. The combination therapy demonstrated promising efficacy and was well tolerated, particularly in ICI-refractory patients. PFS was 3.5 months [ 35 ]. …

Epidemiology, Clinical Data, and Management of Aseptic Abscess Syndrome: Review of Published Cases Outside France.

Aseptic abscess syndrome is a clinical entity that is being increasingly documented. Unfortunately, apart from the French registry, there are no other studies presenting collective data. In this review, we sought to analyze clinical and laboratory data from case reports published from the rest of the world. A total of 107 articles were found through our literature search in PubMed, Scopus, and Google, which contained 108 patients who met our eligibility criteria, including pediatric cases. The mean age at diagnosis was 39.1 years, and 54.6% of the patients were female. Cases were found affecti

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… Sterile pituitary abscess associated with hypophysitis and panhypopituitarism: Case report. Endocr. Abstr. 2014;35:867. doi: 10.1530/endoabs.35.P867. 40. Li X., Chandra S. A case of ulcerative colitis presenting as pyoderma gangrenosum and lung nodule. J. Community Hosp. Intern. Med. …

PD-1 Pathway Inhibitors: Immuno-Oncology Agents for Restoring Antitumor Immune Responses.

Immune checkpoint inhibitors are designed to restore a patient's own antitumor immune response that has been suppressed during tumor development. The first monoclonal antibodies against the immune checkpoint programmed death 1 (PD-1) receptor, nivolumab and pembrolizumab, are now approved for clinical use. Both agents are indicated for the treatment of advanced melanoma, as well as for the treatment of metastatic non-small cell lung cancer (NSCLC). Nivolumab is also approved for the treatment of advanced renal cell carcinoma. In patients with melanoma, these agents result in objective response

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… infusion over 30 min every 3 wks Withhold | Grade 2 pneumonitis Grade 2 or 3 colitis AST or ALT > 3–5 × ULN or total bilirubin > 1.5–3 × ULN Creatinine > 1.5–6 × ULN or > 1.5 × baseline level Any severe or grade 3 treatment‐related adverse reaction | Grade 2 pneumonitis Grade 2 or 3 colitis Symptomatic hypophysitis …

From Cellular Stress to Systemic Adaptation: The Circadian Clock and Stress Response at Cellular and Systemic Levels.

The stress response is essential for cellular and organismal survival as it acts as a protective and adaptive mechanism to maintain homeostasis. At the organismal level, physical stressors induce responses in mammals that are mediated primarily by the hypothalamic-pituitary-adrenal (HPA) axis, which regulates glucocorticoid secretion. The HPA axis functions as a circadian-regulated, multi-oscillator system, in which the paraventricular nucleus, the pituitary, and the adrenal gland exhibit intrinsic rhythmicity while remaining coordinated by the output from the suprachiasmatic nucleus. Glucocor

Bone Metabolism Effects of Medical Therapy in Advanced Renal Cell Carcinoma.

The medical therapy of advanced renal cell carcinoma (RCC) is based on the use of targeted therapies, such as tyrosine kinase inhibitors (TKI) and immune-checkpoint inhibitors (ICI). These therapies are characterized by multiple endocrine adverse events, but the effect on the bone is still less known. Relatively few case reports or small case series have been specifically focused on TKI and ICI effects on bone metabolism. However, the importance to consider these possible side effects is easily intuitable because the bone is one of the most frequent metastatic sites of RCC. Among TKI used in R

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… Hypophysitis induced by immune checkpoint inhibitors: A 10-year assessment. Expert Rev. Endocrinol. Metab. 2019;14:381–398. doi: 10.1080/17446651.2019.1701434. 35. Hudes G., Carducci M., Tomczak P., Dutcher J., Figlin R., Kapoor A., Staroslawska E., Sosman J., McDermott D., Bodrogi I., et al. …

Cancer Immunotherapies: What the Perioperative Physician Needs to Know.

Purpose of reviewFor patients with cancer, treatment may include combination therapy, including surgery and immunotherapy. Here, we review perioperative considerations for the patient prescribed immunotherapeutic agents.Recent findingsThe perioperative period is a poignant moment in the journey of a patient with cancer, potentially deemed most influential compared to other moments in the care continuum. Several immunotherapeutic medications have been employed near the time of surgery to potentially increase effectiveness. Of the various drug classes, including immune checkpoint inhibitors, cyt

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… Endocrinopathies were more pronounced, featuring hypophysitis, thyroiditis, and most dangerously, adrenal insufficiency [ 16 ]. Pulmonary toxicity ranged as mild as pneumonitis and pneumonia to severe hypoxia and ARDS [ 17 ]. ICI-induced vasculitis is rare, but potentially life-threatening. …