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Function: _error_handler
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Randomized trials showed inconsistent survival benefit with immune checkpoint inhibitors (ICIs) in patients with advanced non-small-cell lung cancer with low programmed death-ligand 1 (PD-L1) tumors (< 1%) and in elderly patients (> 65 years old) and never-smokers. We conducted a systematic review and meta-analysis to assess the efficacy of single agent ICIs in these pre-defined subgroups. The electronic databases PubMed and EMBASE were searched for relevant randomized trials. Pooled hazard ratios (HRs) for overall survival (OS) and progression-free survival (PFS) were meta-analyzed using the generic inverse variance method. Nine studies were included. Compared with chemotherapy, the use of single agent ICIs in the second-line setting reduced the risk of death independent of PD-L1 expression (HR, 0.79; 95% confidence interval [CI], 0.66-0.96 and HR, 0.75; 95% CI, 0.61-0.85 for patients with PD-L1-negative and -positive tumors, respectively). Yet, a PFS benefit was only seen in patients with PD-L1-positive tumors. Similarly, an OS benefit was seen in patients independent of age (HR, 0.79; 95% CI, 0.69-0.89 and HR, 0.76; 95% CI, 0.66-0.88 for elderly and non-elderly patients, respectively). Conversely, an OS benefit was only seen in ever-smokers (HR, 0.78; 95% CI, 0.68-0.89) and a detrimental effect on PFS in never-smokers (HR, 1.68; 95% CI, 1.07-2.63). Patients with advanced non-small-cell lung cancer derive a survival benefit from ICIs independent of tumor PD-L1 expression and age, particularly in the second line, whereas never-smokers do not. Caution should be exercised when offering single-agent ICIs to elderly patients in the first line, and other treatment options should be considered in never-smokers.
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http://dx.doi.org/10.1016/j.cllc.2019.11.004 | DOI Listing |
Liver Int
January 2025
Depatrtment of Medicine, Karsh Division of Gastroenterology, Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background: The increasing prevalence of metabolic dysfunction-associated steatotic liver disease (MASLD), formerly known as non-alcoholic fatty liver disease (NAFLD), parallels the rise in sedentary lifestyles. MASLD is the most common form of steatotic liver disease (SLD), which represents the umbrella beneath which the vast majority of chronic liver diseases fall, including alcohol-related liver disease and their overlap. These conditions are the leading contributors to chronic liver disease, significantly impacting global morbidity and mortality.
View Article and Find Full Text PDFAm J Prev Cardiol
March 2025
Department of Cardiology, Second Affiliated Hospital of Harbin Medical University, Harbin, China.
Objective: Secondhand smoke (SHS) is a strong but comparatively controllable cardiometabolic risk factor. This study aims to assess the present and future burden of cardiometabolic diseases (CMDs) from SHS exposure.
Methods: Using the Global Burden of Disease (GBD) framework, we examined mortality and disability-adjusted life year (DALY) from CMDs attributable to SHS, by age, sex, and year, including cardiovascular disease [CVD, ischemic heart disease (IHD) and/or stroke], and/or Type 2 Diabetes Mellitus (T2DM) from 1990 to 2019.
EClinicalMedicine
January 2025
Department of Neurosurgery and Chinese Evidence-Based Medicine Centre and Cochrane China Centre and MAGIC China Centre and IDEAL China Centre, West China Hospital, Sichuan University, Chengdu, China.
Background: Surgical interventions for spontaneous supratentorial intracerebral haemorrhage (ICH) include conventional craniotomy (CC), decompressive craniectomy (DC), and minimally invasive surgery (MIS), with the latter encompassing endoscopic surgery (ES) and minimally invasive puncture surgery (MIPS). However, the superiority of surgery over conservative medical treatment (CMT) and the comparative benefits of different surgical procedures remain unclear. We aimed to evaluate the efficacy and safety of various surgical interventions for treating ICH.
View Article and Find Full Text PDFPan Afr Med J
December 2024
Service d'Epidémiologie et Médecine Communautaire, Centre Hospitalier Universitaire Hedi Chaker de Sfax, Sfax, Tunisie.
The benefits of permanent cardiac pacing have been widely demonstrated. However, the literature on complications remains inconsistent. We lack precise information about the frequency of complications and their predictive factors in our center.
View Article and Find Full Text PDFCureus
November 2024
Internal Medicine, Nishtar Medical University, Multan, PAK.
This systematic review provides a comprehensive comparison of beta-blockers and angiotensin-converting enzyme (ACE) inhibitors in the management of chronic heart failure (CHF), with a focus on their long-term efficacy and safety profiles. By synthesizing evidence from randomized controlled trials (RCTs) and clinical studies, the review highlights the significant benefits of both drug classes in reducing mortality and hospital readmissions, and improving patient outcomes. Beta-blockers, such as bisoprolol and carvedilol, demonstrated superior efficacy in reducing sudden cardiac death, particularly in patients with heart failure with reduced ejection fraction (HFrEF).
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