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This study arises from the need to understand the different therapies for cutaneous squamous cell carcinoma (SCC), especially in challenging clinical situations where conventional therapeutic options may not be optimal. The purpose of the study is to assess the efficacy and safety of intralesional methotrexate (MTX) as neoadjuvant therapy in the treatment of periocular SCC. The outcome of a patient after two separate intralesional MTX infiltrations 2 weeks apart is described. Therapeutic response was evaluated, achieving a significant reduction in tumor size and subsequently performing surgical excision of the residual lesion. The procedure was well tolerated, with no local or distant recurrences in the follow up. Intralesional MTX may be an effective and safe option in the neoadjuvant treatment of periocular SCC. Furthermore, we highlight the growing importance of immunotherapy in the approach to SCC and the need to familiarize specialists with these new treatments.

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PurposeWe retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution.Methods and patientsElectronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan–Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models.ResultsForty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2–NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death.ConclusionOverall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.

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PURPOSE: We retrospectively analysed overall survival (OS) and potential predictive biomarkers of OS in patients with metastatic melanoma treated with ipilimumab plus nivolumab in a single institution. METHODS AND PATIENTS: Electronic medical records of patients with advanced melanoma receiving ≥ 1 dose of a combined ipilimumab plus nivolumab regimen between March 3, 2016 and March 7, 2020 in a single institution, were reviewed. OS was analysed using the Kaplan-Meier method. Sub-group analyses were conducted to examine several endpoints according to relevant clinical, molecular and pathological variables using logistic and Cox models. RESULTS: Forty-four cases were reviewed, 38 (86.4%), of whom had cutaneous melanoma, 21 (47.7%) were BRAF mutant, 21 (47.7%) presented high lactate dehydrogenase (LDH) values, 23 (52.3%) had ≥ 3 disease sites, and 10 (22.7%) patients had brain metastases. The median follow-up was 37.7 months, and the median OS was 21.1 months (95% CI 8.2-NR). In the multivariate analysis, the OS was significantly longer in patients with an Eastern Cooperative Oncology Group (ECOG) score of 0, LDH ≤ upper limit of normal, absence of liver metastases and neutrophil-to-lymphocyte ratio (NLR) < 5 (all p ≤ 0.05, log-rank test). These factors allowed the classification of patients into three prognostic risk groups (low/intermediate/high risk) for death. CONCLUSION: Overall survival of real-world patients from our cohort receiving ipilimumab plus nivolumab was lower than in previous studies. The ECOG score, LDH values, the presence of liver metastases and the NLR were independent prognostic factors for survival.

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Therapy response assessment is one of the most challenging indications of imaging studies. In clinical trial patients is usually measured with standardized response criteria. However, in the clinical practice, many studies are carried out in which the clinical question is whether or not the treatment is being effective. Answering this question is one of the greatest challenges for diagnostic imaging physicians, especially when a new treatment modality is being introduced, whose effects on tumoral lesions are firstly poorly understood. We have an essential role in the introduction of new therapies, assessing their effects and benefits. The knowledge of these effects has led to the development of many response criteria that, despite being applicable only in clinical trials, offer us information on how to interpret the findings in clinical practice.

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La prevalencia de la alergia alimentaria en pediatría presenta un incremento en los últimos años; el alimento más frecuentemente involucrado es la leche de vaca. La alergia a proteína de leche de vaca (APLV) afecta la calidad de vida del paciente y su familia porque requiere dieta de exclusión y medicación de rescate por probables reacciones frente a ingesta accidental del alimento. Actualmente se está avanzando en el estudio de la inmunoterapia oral (ITO) con leche de vaca (LV) como alternativa de tratamiento. Algunos estudios demuestran descenso de la IgE específica (IgEs) para LV4, mientras otros autores refieren que no hay cambios posteriores al tratamiento con ITO3.

The prevalence of food allergy in paediatrics has increased in recent years; the most frequent food involved is cow's milk1. Allergy to cow's milk protein (CMPA) affects the quality of life of the patient and his or her family because it requires exclusion diet and rescue medication for probable reactions to accidental food intake1. There are currently advances in the study of oral immunotherapy (OIT) with cow's milk (CM). Some studies show a decrease in specific IgE (IgEs) for CM, while other authors refer no changes after treatment with OIT3.

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OBJECTIVE: To investigate the long-term prophylactic effect of a vaccine on lower urinary tract infections (UTI) of bacterial and the impact of the intensity of the symptoms on the quality of life (QoL). METHODS: Adult female could be enrolled in this study if they had acute UTI at the enrolment visit and bacterial microbiological count of ≥103 CFU/mL of Escherichia coli. RESULTS: A total of 21 patients were included. Fifteen days after the administration of a vaccine for 3 months, the number of infections dropped almost to zero. Significant differences were observed in the QoL score (p < 0.05). The safety profile was good. CONCLUSIONS: In patients diagnosed with recurrent UTI and treated for 3 months with the vaccine the number of UTI episodes fell very quickly (15 days), and patients remained free of episodes and improved their QoL significantly for 1 year. These results suggest that bacterial vaccines are a possible effective alternative in the prevention of recurrent UTI.

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Autoimmune encephalitis has been a subject of research in the past few years; most of the cases are non-paraneoplastic and associated with an antibody to a surface protein of neurons. Studies have shown that VGKC complex is indeed represented by three proteins, and LGI1 is the most prevalent in limbic encephalitis. This entity is characterized by monophasic presentation with acute or subacute onset, memory loss, confusion, seizures and psychiatric symptoms. The presentation of anti-LGI1 antibodies in serum or CSF confirms the diagnosis. The treatment consists of immunotherapy with good clinical response, which is a criterion for diagnosis. We report a case of a patient with diagnosis confirmed six months after the symptoms onset, improvement after immunotherapy, but with episodes of relapse.

A encefalite autoimune tem sido assunto de pesquisa nos últimos anos, a maioria dos casos é não paraneoplásica e associada ao anticorpo para uma proteína de superfície dos neurônios. Estudos têm mostrado que o complexo VGKC é efetivamente representado por três proteínas, e a LGI1 é a mais prevalente na encefalite límbica. Essa entidade é caracterizada por apresentação monofásica com início agudo ou subagudo, perda de memória, confusão mental, crises convulsivas e sintomas psiquiátricos. A apresentação de anticorpos anti-LGI1 no soro ou no LCE confirma o diagnóstico. O tratamento consiste em imunoterapia com boa resposta clínica, que é um critério diagnóstico. Relatamos o caso de um paciente com diagnóstico confirmado seis meses após o início dos sintomas, com melhora após imunoterapia, porém com episódios de recaídas.

La encefalitis autoinmune ha sido asunto de investigación en los últimos años; la mayoría de los casos es no paraneoplásica y asociada al anticuerpo para una proteína de superficie de las neuronas. Estudios han mostrado que el complejo VGKC es efectivamente representado por tres proteínas, y la LGI1 es la más prevalente en la encefalitis límbica. Esa entidad es caracterizada por presentación monofásica con inicio agudo o subagudo, pérdida de memoria, confusión mental, crisis convulsivas y síntomas psiquiátricos. La presentación de anticuerpos anti-LGI1 en el suero o en el LCE confirma el diagnóstico. El tratamiento consiste en inmunoterapia con buena respuesta clínica, que es un criterio diagnóstico. Relatamos el caso de un paciente con diagnóstico confirmado seis meses después del inicio de los síntomas, con mejora después de inmunoterapia, aunque con episodios de recaídas.

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El cáncer de células no pequeñas de pulmón es primera causa de mortalidad en el mundo. Lamentable mente la quimioterapia sistémica ha alcanzado una meseta en cuanto a su efectividad por ende nuevos enfoques son necesarios para el tratamiento. La Inmunoterapia activa específica (producción de vacunas) es un área de la oncología que rapidamente se está  expandiendo con resultados prometedores. La Sipuleucel-T para el tratamiento de cáncer prostático fue la primera vacuna para el cáncer aprobada por la FDA. En cuanto al campo de cáncer de pulmón, hay múltiples vacunas enfocadas en realizar una actividad específica anti-tumoral en el cáncer de pulmón de células no pequeñas. Estas vacunas están siendo actualmente investigadas por ensayos clínicos. Vacunas completas como Belagenpumatucel-L y vacunas antígeno-específicas como L-BLP25, TG4010, vacunas EGF y MAGE-A3 están pasando por la tercera fase de ensayos clínicos luego de haber demostrado resultados alentadores en ensayos clínicos previos.

Non small cell lung cancer is the leading cause of death worldwide. Sistemic chemotherapy has reach a plateau in terms of its effectiveness, thus new treatment approaches are required. Active specific immunotherapy (vaccine production) is an area of oncology that is quickly expanding with promising results. The Sipuleucel -T for the treatment of prostate cancer was the first cancer vaccine approved by the FDA. Regarding the field of lung cancer there are multiple vaccines focused on creating an specific anti-tumor activity for non-small cell lung cancer. These vaccines are being currently investigated in clinical trials. Complete vaccines as Belagenpumatucel-L and antigen-specific vaccines and as L - BLP25, TG4010, EGF vaccines and MAGE-A3 are going through the third phase of clinical trials after having shown encouraging results in previous clinical trials .

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