Background: Neuroendocrine neoplasms (NENs) are a heterogeneous group of cancers that had a significant increase in annual incidence in the last decade. They can be divided into well-differentiated neuroendocrine tumors (NETs) and poorly differentiated neuroendocrine carcinomas (NECs). Poorly differentiated NECs are aggressive forms of cancers with limited therapeutic options. The first line treatment of metastatic poorly differentiated NECs is similar to small cell lung cancer, with cytotoxic chemotherapy (etoposide plus platinum). Patients who progress have limited therapeutic options and poor overall survival, calling for other novel agents to combat this deadly disease. Therefore, in this article, we summarized the effects of a novel component, Thymoquinone (TQ, C10H12O2), which is the main bioactive component of the black seed (, Ranunculaceae family), plus immunotherapy in case series of patients with refractory metastatic extra-pulmonary NEC (EP-NEC) and one case of mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN).
Methods: We report the effect of TQ plus dual immune checkpoint inhibitors (nivolumab plus ipilimumab) in four patients with poorly differentiated gastrointestinal Ep-NEC and MiNEN who progressed on cytotoxic chemotherapy.
Results: This is the first case series to report the clinical activity of TQ plus dual immune checkpoint inhibitors (nivolumab plus ipilimumab) in patients with refractory metastatic EP-NEC. The four patients showed benefits with the combined regimen TQ plus dual ICPIs with durable response and exceeded the two years of progression-free survival. None of the four patients experienced significant toxicity, and all of them showed improvement in quality of life.
Conclusion: The reported clinical courses suggest that combined TQ plus ICPIs is a potential promising regimen for refractory EP-NEC and MiNEN that deserves further prospective investigation.
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http://dx.doi.org/10.3390/curroncol29110707 | DOI Listing |
Harm Reduct J
January 2025
Asociación Bajacaliforniana de Salud Pública A.C, Tijuana, Baja California, Mexico.
Background: Xylazine is a α2-adrenergic receptor agonist, used for sedation in veterinary contexts. Although it is increasingly found in overdose deaths across North America, the clinical management of xylazine-involved overdoses has not been extensively studied, especially in community-based harm reduction settings. Here we present a clinical series of xylazine-involved overdose and share the clinical approach and lessons learned by a community overdose response team in Tijuana, Mexico amidst the arrival of xylazine.
View Article and Find Full Text PDFBMJ Case Rep
January 2025
Medical Department, Lyell McEwin Hospital, Elizabeth Vale, South Australia, Australia.
Ehlers-Danlos syndromes (EDS) are a group of connective tissue disorders associated with skin, ligament, blood vessel and organ abnormalities. Skin hyperextensibility, joint hypermobility and widened atrophic scars are characteristic of classical EDS. Vascular complications, though rare in classical EDS, can be life-threatening, and this necessitates one to look for vascular associations in non-vascular, such as classical, forms of EDS due to the heterogeneity of the syndrome.
View Article and Find Full Text PDFIndian Pacing Electrophysiol J
January 2025
Royal Jubilee Hospital, Vancouver Island Health Authority, British Columbia, Canada.
Transthyretin Cardiac amyloidosis (ATTR-CA) is an increasingly recognised cause of heart failure in our elderly patients with preserved ejection fraction. Patients with ATTR-CA who require permanent pacemaker implantation often have preserved ejection fraction and do not meet the clinical indication for cardiac resynchronization therapy (CRT). In these patients, left bundle branch area pacing (LBBAP) can be a reasonable option to maximise physiological activation of the left ventricle.
View Article and Find Full Text PDFJ Clin Neurosci
January 2025
Department of Neurovascular Research, Kobe City Medical Center General Hospital, 2-1-1 Minatojima Minamimachi, Chuo-ku, Kobe, Hyogo 650-0047, Japan; Department of Neurosurgery, Seijinkai Shimizu Hospital, 11-2 Yamadanakayoshimicho, Nishikyo-ku, Kyoto, Japan.
Background: Past studies have reported that vertebrobasilar dolichoectasia (VBD) patients may develop similar arteriopathies other than the vertebrobasilar system. However, the details of these VBD-related arteriopathies are still unclear.
Methods: We retrospectively enrolled patients diagnosed with VBD at two stroke centers in Japan between January 2012 and December 2023.
Pediatr Blood Cancer
January 2025
Departments of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Rearrangements of cytokine receptor-like factor 2 gene (CRLF2) are present in ∼50% of B-lymphoblastic leukemia/lymphoma (B-ALL) with BCR::ABL1-like features. Herein, we report three patients with CRLF2-rearranged mixed phenotype acute leukemia (MPAL). All three cases were B/myeloid MPAL in young patients harboring P2RY8::CRLF2 or IGH::CRLF2 with additional genomic alterations in signaling (JAK and RAS) and cell cycle (CDKN2A/B) pathways, a genomic profile similar to that in BCR::ABL1-like B-ALL.
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