Publications by authors named "Fernando Monteiro"

Studies conducted in the last few years have suggested a connection between clinical outcomes and the time of immune checkpoint inhibitors (ICIs) infusion. However, few data are available regarding the differences between early and late time-of-day (ToD) administration in metastatic renal cell carcinoma (mRCC) patients receiving immunotherapy and immune-based combinations. In this meta-analysis, we aimed to fully investigate the influence of timing of administration on the efficacy of mRCC immunotherapy, by comparing early ToD versus late ToD dosing in this setting.

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Immune checkpoint inhibitors have revolutionized cancer treatment, but they are associated with a range of immune-related adverse events (irAEs), and emerging evidence suggests significant sex differences in the incidence, type, and severity of these toxicities, suggesting an influential factor and understanding sex-related differences in irAEs as crucial for optimizing patient care and improving clinical outcomes. In MOUSEION-07 study, we aimed to assess the association between sex and treatment-related adverse events in cancer patients treated with immunotherapy through a large up-to-date meta-analysis of available clinical trials. The present systematic review and meta-analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis.

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Article Synopsis
  • - Enfortumab vedotin (EV) is effective for patients with advanced urothelial carcinoma who have previously received platinum chemotherapy and immune therapy, despite lacking research on those treated with avelumab maintenance.
  • - A study of 182 patients showed a median overall survival of 12.7 months and a progression-free survival of 7.9 months, with 39% achieving a positive response to EV after avelumab treatment.
  • - The study confirms EV's effectiveness, suggesting it can be a viable option for patients previously treated with avelumab, with manageable side effects like grade ≥ 3 neuropathy and skin rash occurring in a minority of cases.
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  • Advances in immuno-oncology have improved treatment for renal cell carcinoma, but patients with "primary refractory" disease have poor outcomes; our study found a 19% prevalence of this group among 1,709 metastatic clear cell patients across 72 centers in 22 countries.
  • The highest primary refractory rate was 27% with nivolumab/ipilimumab, while pembrolizumab/lenvatinib had the lowest at 10%; those classified as primary refractory only had a median survival of 7.6 months compared to 55.7 months for non-primary refractory patients.
  • Significant predictors of survival for primary refractory patients included factors like prior nephrectomy and presence of bone/brain metastases, highlighting the complex
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  • - Metastatic renal cell carcinoma (mRCC) with sarcomatoid features (sRCC) is aggressive and has a poor prognosis; this study aimed to investigate its clinical features and outcomes compared to non-sarcomatoid patients.
  • - The study analyzed data from 1362 mRCC patients, finding that the median overall survival for sRCC patients was 26.8 months, significantly lower than the 35.3 months for non-sRCC patients.
  • - Both first-line treatment strategies, immunotherapy combined with immunotherapy (IO + IO) and immunotherapy with a tyrosine kinase inhibitor (IO + TKI), showed similar survival outcomes, confirming that
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  • Penile squamous cell carcinoma (PSCC) is a rare cancer, more prevalent in developing countries, and understanding its molecular changes can help in finding better treatments.
  • A study of 23 Brazilian mPSCC patients revealed that most had clinically significant genomic alterations, with high PD-L1 expression in 63.6% of cases and specific mutations linked to worse survival rates.
  • The findings indicate similar molecular characteristics between developing and developed countries, highlighting potential for targeted therapies, despite the lack of predictive biomarkers for immunotherapy like TMB high or MSI.
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The addition of metastasis-directed radiotherapy (MDRT) to immunotherapy in patients with advanced urothelial carcinoma (aUC) has shown promising results. We report the real-world data from the ARON-2 study (NCT05290038) on the impact of conventional (CRT) or stereotactic body radiotherapy (SBRT) on the outcome of aUC patients receiving pembrolizumab after platinum-based-chemotherapy. Medical records of 837 patients were reviewed from 60 institutions in 20 countries.

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Introduction: Fibroblast growth factor receptor (FGFR) mutations and fusions are relevant biomarkers in metastatic urothelial carcinoma (mUC). However, the prevalence of genomic alterations and their impact on clinical outcomes in a Latin American population remains unknown. This study aimed to explore the prevalence of FGFR mutations and/or fusions in patients with mUC in Latin America (LATAM) and its association with clinicopathological characteristics, Bellmunt's prognostic model, and survival outcomes.

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Article Synopsis
  • The study focuses on the effectiveness of pembrolizumab, an immune checkpoint inhibitor, for advanced urothelial carcinoma (UC) patients with poor performance status (ECOG-PS 2).
  • Among 1,040 patients, those with ECOG-PS 2 had significantly lower median overall survival (3.7 months) compared to those with ECOG-PS 0-1 (18.2 months), highlighting the challenges faced by this group.
  • Key factors affecting outcomes included the presence of liver metastases and disease progression during first-line therapy, indicating a need for careful evaluation of these patients' conditions.
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Upper tract urothelial carcinoma (UTUC) accounts for the 5-10% of all urothelial carcinomas (UCs). In this analysis, we reported the real-world data from the ARON-2 study (NCT05290038) on the efficacy of pembrolizumab in patients with UTUC who recurred or progressed after platinum-based chemotherapy. Medical records of patients with metastatic UTUC treated with pembrolizumab as second-line therapy were reviewed from 34 institutions in 14 countries.

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  • There is ongoing debate about whether sex influences the effectiveness of immune checkpoint inhibitors in cancer treatment, specifically for metastatic renal cell carcinoma (mRCC).
  • A study involving 1,827 mRCC patients from multiple countries found that overall median overall survival (OS) was similar for both sexes, but males performed better in specific subgroups, particularly younger patients and those with certain cancer histologies.
  • Interestingly, female sex was identified as a negative prognostic factor in patients with sarcomatoid differentiation, suggesting that despite women having stronger immune responses, their outcomes in these cases were worse than those of men.
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  • Chronic hepatitis B infection (CHB) affects 300 million people and is part of a global effort by the United Nations and WHO to eliminate it as a health threat by 2030.
  • Peer support workers (PSWs) are people who have experienced similar health issues and can help others by providing education and emotional support, especially for those with CHB.
  • Investing in peer support can help improve healthcare access, reduce stigma, and ultimately contribute to the goal of eliminating hepatitis B around the world.
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This study employs a meshless computational model to investigate the impacts of compression and traction on angiogenesis, exploring their effects on vascular endothelial growth factor (VEGF) diffusion and subsequent capillary network formation. Three distinct initial domain geometries were defined to simulate variations in endothelial cell sprouting and VEGF release. Compression and traction were applied, and the ensuing effects on VEGF diffusion coefficients were analysed.

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Background: About 20% of patients with renal cell carcinoma present with non-clear cell histology (nccRCC), encompassing various histological types. While surgery remains pivotal for localized-stage nccRCC, the role of cytoreductive nephrectomy (CN) in metastatic nccRCC is contentious. Limited data exist on the role of CN in metastatic nccRCC under current standard of care.

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Article Synopsis
  • - The ARON-2 study investigated the real-world effectiveness of pembrolizumab, an immune checkpoint inhibitor, in patients with advanced urothelial carcinoma who had progression after platinum-based chemotherapy, utilizing data from 836 patients across 88 institutions in 23 countries.
  • - Results showed median overall survival (OS) of 10.5 months and overall response rate (ORR) of 31%; those who progressed after initial chemotherapy (cohort A) had lower OS (9.1 months) compared to those who recurred within a year post-chemotherapy (cohort B) with 14.6 months OS.
  • - Multivariate analysis identified several prognostic factors affecting OS and progression-free survival (PFS),
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Purpose: Renal cell carcinoma is an aggressive disease with a high mortality rate. Management has drastically changed with the new era of immunotherapy, and novel strategies are being developed; however, identifying systemic treatments is still challenging. This paper presents an update of the expert panel consensus from the Latin American Cooperative Oncology Group and the Latin American Renal Cancer Group on advanced renal cell carcinoma management in Brazil.

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Background: Combinations of immune checkpoint inhibitors (ICI) with platinum-based chemotherapy (PlatinumCT) or with another ICI in the first-line setting for patients with metastatic urothelial carcinoma (mUC) have mixed results.

Methods: Records were searched electronically from January 2019 to January 2024. A meta-analysis was performed to evaluate OS, progression-free survival (PFS), and overall response rate (ORR).

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The accurate measurement of joint angles during patient rehabilitation is crucial for informed decision making by physiotherapists. Presently, visual inspection stands as one of the prevalent methods for angle assessment. Although it could appear the most straightforward way to assess the angles, it presents a problem related to the high susceptibility to error in the angle estimation.

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Nanoparticle (NP) research is an area of scientific interest with high potential for application in biomedical, optical, and electronic fields. Due to their relatively large surface area compared to their mass, NPs can be more chemically reactive and change their reactive strength or other properties. NP-based drug delivery systems provide transport and an effective and controlled way to release the drugs.

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One of the complex challenges faced presently by tissue engineering (TE) is the development of vascularized constructs that accurately mimic the extracellular matrix (ECM) of native tissue in which they are inserted to promote vessel growth and, consequently, wound healing and tissue regeneration. TE technique is characterized by several stages, starting from the choice of cell culture and the more appropriate scaffold material that can adequately support and supply them with the necessary biological cues for microvessel development. The next step is to analyze the attained microvasculature, which is reliant on the available labeling and microscopy techniques to visualize the network, as well as metrics employed to characterize it.

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Background: Systemic treatment with immune combinations is the gold standard for metastatic renal cell carcinoma (mRCC) worldwide. The systemic immune-inflammation index (SII) is a prognostic marker for several types of malignant neoplasms, including mRCC, in the era of tyrosine kinase inhibitor (TKI) treatment. Data regarding the prognostic value of the SII in patients with mRCC treated with immunotherapy are scarce and controversial.

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Local delivery of antibiotics has gained increasing interest in the treatment of osteomyelitis due to its effectiveness and safety. Since the regeneration of bone tissue at the site of infection is as important as bacterial eradication, implantable drug delivery systems should not only release the drugs in a proper manner but also exert the osseointegration capability. Herein, we present an implantable drug delivery system in a scaffold form with a unique set of features for local treatment of osteomyelitis.

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Background: Concomitant medications may potentially affect the outcome of cancer patients. In this sub-analysis of the ARON-2 real-world study (NCT05290038), we aimed to assess the impact of concomitant use of proton pump inhibitors (PPI), statins, or metformin on outcome of patients with metastatic urothelial cancer (mUC) receiving second-line pembrolizumab.

Methods: We collected data from the hospital medical records of patients with mUC treated with pembrolizumab as second-line therapy at 87 institutions from 22 countries.

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Background: The upfront treatment of metastatic renal cell carcinoma (mRCC) has been revolutionized by the introduction of immune-based combinations. The role of cytoreductive nephrectomy (CN) in these patients is still debated. The ARON-1 study (NCT05287464) was designed to globally analyze real-world data of mRCC patients receiving first-line immuno-oncology combinations.

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