RESUMEN
PURPOSE: The role of mean platelet volume (MPV) as a predictor of outcomes in various cancer entities including colorectal cancer (CRC) has already been analyzed. However, data on the prognostic and predictive value of MPV in CRC over multiple lines of systemic therapy are missing. METHODS: In this retrospective single-center cohort study, 690 patients with UICC stage II, III or IV CRC receiving adjuvant and/or palliative chemotherapy were included. Primary endpoints in the adjuvant, palliative and best supportive care (BSC) setting were 3-year recurrence-free survival (RFS), 6-months progression-free survival (PFS), and 6-months overall survival (OS), respectively. Kaplan-Meier estimators, log-rank tests, and uni- and multivariable Cox models were used to analyze RFS, PFS and OS. A cut-off defining patients with low MPV was chosen empirically at the 25th percentile of the MPV distribution in the respective treatment setting. RESULTS: Three-year RFS was 76%. Median 6-month PFS estimates in 1st, 2nd and 3rd line therapy were 59, 37 and 27%, respectively. Median 6-month OS in BSC was 31%. Small platelets as indicated by low MPV did not predict for shorter RFS. In the first 3 palliative treatment lines a consistent association between low MPV and decreased 6-month PFS was not observed. In the BSC setting, patients with low MPV had numerically but not significantly shorter OS. Higher MPV levels did not consistently predict for ORR or DCR across the first 3 palliative treatment lines. CONCLUSION: Small platelets are not predicting CRC outcomes, and thus are hardly useful for influencing clinical decision making.
Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Plaquetas/patología , Neoplasias Colorrectales/sangre , Volúmen Plaquetario Medio/estadística & datos numéricos , Recurrencia Local de Neoplasia/sangre , Anciano , Biomarcadores de Tumor , Plaquetas/efectos de los fármacos , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/patología , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Recurrencia Local de Neoplasia/tratamiento farmacológico , Recurrencia Local de Neoplasia/patología , Pronóstico , Estudios Retrospectivos , Tasa de SupervivenciaRESUMEN
The options for the treatment and control of sheep scab (psoroptic mange) have been increased in recent years through the introduction of the endectocides ivermectin, doramectin and moxidectin. Whilst therapeutic efficacy is good, the current injectable formulations offer limited protection against re-infestation with Psoroptes ovis. An intraruminal controlled-release formulation of ivermectin has been developed to provide therapeutic and prophylactic activity against a range of sensitive endo- and ecto-parasites of sheep for 100 days after administration. These ivermectin boluses are designed to release ivermectin at 20-40 microg/kg/day over 100 days and were developed for use in sheep of 20-90 kg bodyweight. Several controlled therapeutic and prophylactic trials against sheep scab have been conducted under a variety of protocols with such boluses in Europe and South America. The results of these studies indicate that the bolus provides 100% therapeutic efficacy against established P. ovis infestations and equivalent prophylactic efficacy against challenge infestations administered during the active life of the bolus.
Asunto(s)
Preparaciones de Acción Retardada/uso terapéutico , Insecticidas/uso terapéutico , Ivermectina/uso terapéutico , Infestaciones por Ácaros/veterinaria , Enfermedades de las Ovejas/prevención & control , Animales , Brasil , Alemania , Insecticidas/administración & dosificación , Insecticidas/normas , Irlanda , Ivermectina/administración & dosificación , Ivermectina/normas , Infestaciones por Ácaros/tratamiento farmacológico , Infestaciones por Ácaros/prevención & control , Ácaros/efectos de los fármacos , Distribución Aleatoria , Rumen/fisiología , Ovinos , Enfermedades de las Ovejas/tratamiento farmacológicoRESUMEN
Three trials including 42 sheep were conducted in Brazil or Germany to evaluate the therapeutic (two trials) and prophylactic (one trial) efficacy of an ivermectin controlled release capsule (CRC) against Psoroptes ovis infestation. In one therapeutic trial naturally infested sheep were used while in the other trials infestations were experimentally induced. In each trial half of the animals were treated on Day 0 with one ivermectin controlled release capsule that delivers ivermectin at a rate of 1.6 mg/day for approximately 100 days, that is 20 mcg/kg/day to a 80 kg animal, while the other half remained untreated. In both therapeutic trials mites were counted in skin scrapings and their presence was recorded at predilection sites one day before treatment and at weekly intervals from Day 7 to Day 56. In the trial conducted to evaluate the prophylactic efficacy the sheep were experimentally infested with P. ovis 21 and 28 days post-treatment and mites were counted and recorded at predilection sites on Days 42, 49 and 56. The ivermectin controlled release capsule was completely effective in eliminating the P. ovis mites within 28 days of administration and it prevented the establishment of an infestation of P. ovis induced 21 and 28 days after administration.