tbuckley/cabot-search huggingface dataset:
Natural killer cells and their activity as a potential biomarker for predicting response to checkpoint inhibitors in non-small cell lung cancer.
Authors: Paul Y. Song, Yong-Hee Cho, Myeong Geun Choi, Dong Ha Kim, Yun Jung Choi, Seon Ye Kim, Ki Jung Sung, Jae Cheol Lee, Sang-Yeob Kim, Jin Kyung Rho, Chang-Min Choi
Journal: Journal of Clinical Oncology (2020)

e15559 Background: Despite the increased promise of checkpoint inhibitors in the treatment of non-small cell lung cancer, the majority of patients do not respond and the potential for severe toxicity is significant. Unfortunately, the predictive value of PD-L1 expression has not always proven to be definitive and the overall need to find better biomarkers that will optimize the selection of patients who will best respond to therapy remains. Recent evidence has pointed to Natural Killer (NK) cells as an essential mediator in overall response to checkpoint inhibitors. We explore whether NK cell populations and/or their activity have any correlation with response. Methods: Peripheral blood mononuclear cells (PBMCs) from nine patients with Stage IV non-small cell lung cancer (four adenocarcinoma, five squamous cell carcinoma) were collected pre and post six-weeks of checkpoint immunotherapy (six received pembrolizumab, and three received nivolumab). Overall, four of nine (44.5%) were diagnosed as SD or PR via RECIST 1.1. The immune cell composition of the PBMCs of all nine patients was analyzed using multi-variated single-cell analysis using mass cytometry (CyTOF) with an optimized 32-marker panel. Natural Killer (NK) cell activity was measured with the NKVue kit which detects NK-secreted IFN-γ levels using a quantitative sandwich ELISA from NK cells exposed to a specific recombinant cytokine. Results: The overall percentages of NK cell populations found in the immune cells of PBMCs were prominently elevated in patients who responded (SD or PR) to checkpoint therapy compared to those who had progressive disease (non-responders). While there were no significant differences in the population of other immune cells between these two groups, the overall NK cell activity in patients who responded was highly elevated compared to the NK cell activity in non-responders. From the analysis of NK subsets, there were no differences in the population of early NK cells between the two groups, but the functionally differentiated late NK cells were prominently high in the responder group. Conclusions: Natural Killer (NK) cells have been recently implicated to play a key role in anti-tumor response to checkpoint inhibitors and our results suggest that the overall number of NK cells and their activity could prove to be an independent and reliable predictive tool/biomarker in patients with NSCLC.
Clinical and laboratory features of 58 patients with positive cryoglobulin
Authors: Wen Wen, Chun Li, Rulin Jia, Zhanguo Li
Journal: BMJ (2016)

Objective
To study the disease spectrum, clinical and lab characteristic of cryoglobulinaemia.


Methods
The clinical and laboratory data of 58 patients with positive cryoglobulin admitted in Peking University People's Hospital from April 2010 to May 2014 were retrospectively analyzed.


Results
Among 58 patients, 34 were diagnosed as autoimmune disease, 8 as infectious disease, 4 as hematological disease and 12 as primary cryoglobulinemia.Renal involvement was the most frequent clinical presentation among all cryoglobulin positive patients.Patients with autoimmune disease presented all clinical manifestations related to cryoglobulinaemia.Renal involvement (7/8) was prominent in patients with HBV/HCV infection, while other clinical presentations were rare.Among 4 patients with hematological disease, purpura was presented in 3 cases, renal involvement in 2, arthralgia in 2, fatigue, thrombosis or hyperviscosity was presented in 1 case, respectively; however, none of these patients had elevated rheumatoid factor (RF) level.Renal lesions were the most common reason for patients with primary cryoglobulinaemia to consult doctors, and 5 of them had positive antinuclear antibodies (ANA).


Conclusions
There is a broad spectrum of disease in cryoglobulinaemia.Multi-system involvement was most common in patients with autoimmune disease.For patients with HBV/HCV infection, extra-hepatic presentations were rare except renal involvement.Hyperviscosity syndrome tended to occur in patients with hematological disease.Since patients with primary cryoglobulinaemia had a relatively high rate of positive antinuclear antibodies, we should keep vigilance at the occurrence of autoimmune disease.


Key words: 
Cryoglobulin; Autoimmune disease; Hepatitis, viral, human; Hematological disease
晕厥93例临床分析
Authors: 康孝理
Journal: BMJ (2010)

晕厥是突然发生的一过性全脑血流量减少导致短暂意识丧失状态,患者肌张力消失,不能站立而倒地,可于短时间内恢复.它属临床常见急症,占急诊患者的3%以上~([1]).现对于我院就诊的93例晕厥患者临床资料进行回顾性分析。
Characterization of weakly hormone receptor (HR)-positive, HER- negative breast cancer (BC) and current treatment strategies.
Authors: Johanna Poterala, Kari Braun Wisinski
Journal: Journal of Clinical Oncology (2020)

e12621 Background: HR and HER2 status is critical for determining initial management of BC. Current guidelines define estrogen receptor (ER) and progesterone receptor (PR)+ as ≥1%. Previous reports of small cohorts with low HR+/HER2- disease showed similar rates of pathologic complete response (pCR) following neoadjuvant chemotherapy (NAC) as triple negative BC (TNBC). This study aims to further characterize this group of patients (pts), focusing on modern management and breast/axillary pCR rates following NAC. Methods: Pts with newly diagnosed stage I-III, HR+/HER2- BC from 1/1/2009–4/1/2019 were found using the University of Wisconsin Hospital and Clinics Cancer Registry. Medical records were reviewed for demographics, tumor characteristics with quantification level of ER and PR ( &lt; 33%), treatments including NAC and adjuvant chemotherapy (chemo), endocrine therapy, surgery and radiation, and follow-up clinical data. Results: Data reviewed from 2,905 pts: 2,604 (89.6%) were HR+/HER2-, 282 (9.7%) were ER+/PR-, and 19 (0.7%) were ER-/ PR+. A total of 64 pts [median age 54 (22-87), 100% female] met inclusion criteria. At diagnosis, 23 (36%) were anatomic stage 1, 30 (47%) stage II, and 11 (17%) stage III; 18 (28%) had biopsy (bx) proven nodal disease. 57 (89%) had invasive ductal carcinoma; 9 (14%) were ER+/PR+, 43 (67%) ER+/PR-, and 12 (19%) ER-/ PR+. The majority [51 (80%)] received chemo, ~ half with NAC 30 (48%), 1 pt chemo plan was unknown. NAC regimens included an anthracycline (A) and taxane (T) [26 (41%)], a sole A regimen [1 (1%)], and an A+T and platinum regimen [3 (5%)]. 4 pts received capecitabine after NAC. 50 (78%) pts had a sentinel lymph node bx, but 13 (20%) had an axillary node dissection (ALND). 10 (16%) pts did not receive any endocrine therapy, 28 (44%) got tamoxifen, 22 (34%) an aromatase inhibitor, and 4 (6%) unknown. Of 28 pts who had NAC followed by breast and axillary surgery, 12 (43%) had pCR (ypT0/Tis/ypN0). Of the 12 pts who had bx proven nodal disease at diagnosis and NAC, 7 (64%) pts had pCR at the axilla. One pt had progressive disease on NAC, 1 had local recurrence and 8 (13%) pts had distant recurrence. Median time to recurrence was 13.6 (5.6 – 48.7) months. Only 2 pts with pCR had distant recurrence. Conclusions: BC that are HER2- and weakly HR+ treated with NAC demonstrated an axillary and overall pCR rate more similar to TNBC than breast cancers with strong HR+. Neoadjuvant approaches may reduce need for ALND and pCR may provide important prognostic information. Clinical trials should be developed to focus on this unique patient cohort.
Patient-centered pathology reports for breast cancer care: Interim results of a randomized pilot study.
Authors: John L. Gore, Sara Javid, Elizabeth Austin, Mark Kilgore, Elizabeth Parker, Sarah K Holt, Elena Brewer, William Chan, Lawrence D. True
Journal: Journal of Clinical Oncology (2020)

e19157 Background: Receiving a new cancer diagnosis event is a daunting event, quickly followed by complex decision-making between patients and care teams. In order for patients to fully engage in shared decision-making with their providers, they must have access to understandable, patient-centered information that empowers them to take an active role. Yet cancer pathology reports currently target providers and are marred by complex medical terminology. To address this gap, we designed and piloted patient-centered pathology reports (PCPRs) for breast cancer surgical pathology. We hypothesized that PCPRs would result in patients having greater pathology knowledge and decisional self-efficacy. Methods: PCPRs were designed with continuous guidance from breast surgeons, pathologists, and patient advocates with the goal of providing a supplemental tool to translate standard pathology reports to layman’s terms for patients. PCPRs were built into the electronic medical record and tested for quality and accuracy over a 4-month period. Participants were recruited from the clinical practices of two breast surgeons and randomized to receive either the PCPR and standard pathology report or standard pathology report alone. Patients were surveyed at baseline and one month after to assess their breast cancer knowledge and ratings of confidence (scale 1-5) and decisional self-efficacy (DSE) for treatment decision-making (scale 0-100). Results: Of a planned 40 pilot patients, 30 have been enrolled, randomized (20 standard report patients, 10 PCPR patients), and have follow up data. Evaluation of patient knowledge showed that compared with the control group, patients who received a PCPR had similar knowledge of the important elements of their report (p = 0.10-p = 0.69) with greater specificity for those report elements. Confidence in their diagnosis slightly favored PCPR recipients (confidence rating mean 4.00 vs. 3.77 for control patients, p = 0.67). Patients receiving the PCPR had better DSE immediately after receipt of the pathology report than standard report patients (DSE 96.0 vs. 82.2, respectively, p = 0.05) with a more attenuated DSE difference one month later (DSE 87.3 vs. 79.2, respectively, p = 0.35). Conclusions: This interim analysis suggests that providing breast cancer patients with patient-centered pathology reports may contribute to an improved ability to engage in shared decision-making. Confirming these results with complete pilot data could inform a larger multicenter study to validate their effectiveness in clinical cancer care.
Survey on resident participation in community health management service
Authors: Ronghua Wang, Yuntao Li, Xiaomin Zhao, Jinyan Wang, Yaoqi Ge, Jinhui An, Guozhong Ji
Journal: BMJ (2019)

Objective
To survey the resident participation in community health management service and its influencing factors.


Methods
A survey on the resident participation in community health management service with self-designed questionnaire was conducted during January to March 2018 among residents in one of the subdistricts in Nanjing Gulou district. The questionnaire includes basic information of residents, understanding health management service, and the participation in the health management.


Results
Total 500 questionnaire were distributed, 449 copies were retrieved and 402 were valid. The rates of engagement in health archives, management of blood pressure, blood glucose and blood lipids, attending health education, regular health check-up, health follow-ups, and equipping family medicine kits were 62.2% (250/402), 71.0% (286/402), 49.5% (199/402), 59.9% (241/402), 72.6% (292/402), 66.9% (269/402), respectively. The rates of engagement of health archives, attending health education, regular health check-up and equipping family medicine kits for healthy residents were higher than those with chronic diseases (χ2=6.31, 4.09, 10.83, 10.83; P<0.05). The logistic regression analysis suggested that age, income, and understanding health management services were independent influence factors for resident active participation in health management.


Conclusion
The survey indicates that the young, high-income and healthy residents are more likely to participate in health management service, and the overall resident participation needs to be further improved.


Key words: 
General practitioner; Health management; Patient engagement
Patch tests and screening for new allergen in 215 cases with contact dermatitis
Authors: Hui Yu, Zhan-ying Hou, Lang-feng Xu, Heng Chen, Fang Liu
Journal: BMJ (2010)

Patch tests were performed in 215 cases with contact dermatitis and 59 cases with noncontact dermatitis who visited the clinic of Xili Hospital, Shenzhen.Results showed that top four allergen for them were 0.1% Merthiolate, 5% nickel sulfate, 7% aromatic compounds and 1% formaldehyde in sequence.There was significant difference in occurrence of dermatitis at the hands, trunk, extremities,face, and periumbilicus caused by these four kinds of allergen (P ＜0.01 ), with 0.1% Merthiolate mainly causing dermatitis at the face, hands, trunk and extremities, 5% nickel sulfate causing dermatitis at the periumbilicus, trunk and extremities, 7% aromatic compounds causing dermatitis at the hands, trunk,extremities and face, whereas 1% formaldehyde mainly causing facial dermatitis.Concentration of pentyl acetate and rosin spirit used for patch tests should be 20 % and 25 %, respectively.

Key words: 
Dermatitis,contant;  Patch test
Clinical characteristics of patients with Behcet's disease in China
Authors: 侯小萌, 张卓莉, 董怡
Journal: BMJ (2005)

白塞病(Behcet's disease,BD)是一种以血管炎症及多系统损害为特征的自身免疫性疾病,高发地区为地中海国家及部分东亚国家,据统计BD在我国的患病率为1.4/万.根据BD国际研究组制订的诊断标准,具有复发性口腔溃疡每年至少发作3次,并附加生殖器溃疡、眼病、皮肤病变、针刺反应阳性4项临床表现中至少2项者可以诊断.我们通过中国医学数字图书馆CHKD期刊全文库,以白塞病为关键词对1994年1月至2004年12月的文章进行检索、分析,总结了BD多系统损害的临床特点和发生频率,希望有助于提高临床医师对BD的认识。
About online consultation and online clinical tutorials
Authors: Zhaoqi Zeng
Journal: BMJ (2018)

结合案例阐述远程会诊和远程带教中需要传送的病历材料可靠、有关数据准确、图像清晰，要求基层医生临床基本功扎实、查体认真。会诊医生和带教医生在远程交流中，应及时注意修正补充基层医生收集病史和体格检查中的不足，结合病例体现缜密的观察思维分析，准确把控诊断治疗方向，从而既有利于患者，又对基层医生基本功的提高提供切实的帮助。
Influence of pharmaceutical care pathway on cancer-related fatigue and negative emotion in patients with advanced lung cancer undergoing chemotherapy
Authors: Xiangwei Xu, Meihong Zhou, Peizhen Zhu, Yinqiao Chen, Qunqiu Tong, Ankang Li
Journal: BMJ (2019)

Objective
To investigate the influence of pharmaceutical care pathway on cancer-related fatigue (CRF) and negative emotion in patients with advanced lung cancer undergoing chemotherapy.


Methods
Patients with advanced lung cancer admitted to the oncology department of Yongkang first people′s hospital from January 2017 to June 2018 for chemotherapy were randomly divided into two groups:61 cases received conventional clinical pathway management (control group), and 64 cases received conventional clinical pathway combined with pharmaceutical pathway management (intervention group). Fatigue, anxiety, depression scores were compared between the two groups before and after 2, 4 cycles chemotherapy.


Results
There was no significant difference in baseline condition between the two groups (P>0.05). After 4 cycles of chemotherapy, emotional, physical and cognitive fatigue scores in the intervention group were lower than control group (t=2.975, 1.512, 2.393, P<0.05). With the increase of chemotherapy cycles, scores of fatigue dimensions in control group were increased (F=44.274,21.740,29.261,7.206, P<0.05). In the intervention group, there were statistically significant differences in scores of fatigue dimensions (F=17.083, 15.902, 17.055, 10.543, P<0.01), among which, scores of behavioral and physical fatigue dimensions were increased (P<0.01), while scores of emotional and cognitive fatigue dimensions were decreased (P<0.01). In terms of negative emotions, depression scores in the intervention group were lower than those in control group at 2 cycles of chemotherapy (t=2.578, P<0.05), and at 4 cycles, anxiety and depression scores were lower than control group (t=7.004, 7.454, P<0.05). As the chemotherapy cycle increased, anxiety and depression scores in the control group increased (F=12.333, 14.819, P<0.05), while those in the intervention group decreased (F=4.992, 3.826, P<0.05).


Conclusion
The pathway of clinical pharmaceutical care can significantly improve the CRF and negative emotions of patients with advanced lung cancer undergoing chemotherapy.


Key words: 
Lung neoplasms; Fatigue; Anxiety; Depression; Pharmacy
Use of immune checkpoint inhibitors (ICIs) after prior ICI in metastatic renal cell carcinoma (mRCC): Results from a multicenter collaboration.
Authors: Praful Ravi, Charlene Mantia, Christopher Su, Karl Sorenson, Nityam Rathi, Ziad Bakouny, Neeraj Agarwal, Brian Addis Costello, Rana R. McKay, Vivek Narayan, Ajjai Shivaram Alva, Bradley Alexander McGregor, Xin Gao, David F. McDermott, Toni K. Choueiri
Journal: Journal of Clinical Oncology (2020)

5077 Background: Several ICIs are used in first and subsequent lines of therapy for mRCC, either alone or in combination with another ICI or targeted therapy (TT). There are no data on the efficacy and safety of using an ICI in patients who have already received an ICI in a prior line of therapy. Methods: We reviewed patients with mRCC at 8 institutions who received 2 separate lines of ICI therapy (ICI-1, ICI-2), including as a single-agent and/or combination with other agents. The primary outcomes were overall response rate (ORR) and time to progression (TTP) with ICI-1 and ICI-2. Immune-related adverse events (irAEs) were graded using CTCAEv5.0. Results: 65 patients were included. Median age at diagnosis of mRCC was 60 years (range 30-86) and the majority had clear cell RCC (n=56, 86%). Median follow-up was 3.5 years (95% CI 2.9-4.4). Median lines at which ICI-1 and ICI-2 were received were 1 (1-6) and 3 (2-8) respectively. Reasons for discontinuing ICI-1 were disease progression (n=47, 72%), toxicity (n=15, 23%) or other (n=3, 5%). Therapies received at ICI-2 were single-agent ICI (n=26, 40%), or combinations of ICI with another ICI (n=20, 31%), TT (n=11, 17%) or other agent (n=8, 12%). Responses to ICI-1 and ICI-2 are shown in the Table; ORR to ICI-2 was significantly lower than to ICI-1 (23% vs. 36%, p=0.044). Amongst those who responded to ICI-2 (n=14), 7 (50%) received single-agent ICI, and the remainder received ICI in combination with another ICI (n=4, 29%) or TT (n=3, 21%); 7 patients (50%) had previously responded to ICI-1. The ORR to ICI-2 was higher in responders to ICI-1 (32%) compared to those with SD (17%) or PD (15%) to ICI-1. Median TTP (mTTP) at ICI-2 was shorter compared to ICI-1 (5.3 months vs. 8.5 months, Wilcoxon p=0.024). 29 patients (45%) experienced an irAE with ICI-2; 8 (12%) and 3 (5%) had a grade 3 or 4 irAE respectively, with 3 (30%) of these patients having previously had ≥grade 3 irAE to ICI-1. There were no treatment-related deaths. Conclusions: The ORR to ICI-2 was 23%, which is comparable to that seen with ICI after prior TT. Responses were seen even amongst those receiving single-agent ICI at ICI-2 and the likelihood of response to ICI-2 was higher if a patient had previously responded to ICI-1. No increase in toxicity with ICI-2 was apparent. Additional data from prospective studies are needed to determine whether sequential ICI has a role in treatment of mRCC. [Table: see text]
Application value of laryngeal mask airway and trachea cannula under different conditions of emergency medical service
Authors: Minghua Li, Feiyue Teng, Yue Zhang, Degen Wu, Feng Lu
Journal: BMJ (2014)

First-aid stations were divided randomly into 4 groups. Advanced airway for sudden cardiac arrest patients with laryngeal mask airway (LMA) was established in groups A and C while trachea cannula was inserted on spot of emergency medical service (EMS) or in ambulance in groups B and D. According to the results, the success rate of insertion and cardiopulmonary resuscitation (CPR) of groups A and C were higher than the other two groups (P<0.05). However, the required time was shorter (P<0.05). Due to a difficult catheterization environment, LMA is more effective and convenient than trachea cannula in EMS.


Key words: 
emergency medical service; laryngeal mask airway
肾综合征出血热并发急性呼吸窘迫综合征10例
Authors: 张景遥, 于丽君, 高淑春, 郭超英, 于淑丽, 盖中涛, 吴世英
Journal: BMJ (2005)

肾综合征出血热(HFRS)以肾脏损伤为主,可出现多种并发症,其中急性呼吸窘迫综合征(ARDS)病情凶险,病死率极高.我院自2002年1月至2004年1月共收治HFRS 454例,其中并发HFRS 10例,现总结如下。
Vitamin C, Hydrocortisone, and Thiamine for Septic Shock
Authors: Micah T. Long, Pierre Kory, Paul Marik
Journal: JAMA (2020)

To the Editor The Vitamin C, Hydrocortisone, and Thiamine in Patients With Septic Shock (VITAMINS) trial found that vitamin C, hydrocortisone, and thiamine, compared with hydrocortisone alone, did not improve outcomes in patients with septic shock.1
活动和锻炼的物理疗法、激素封闭治疗或随诊观察治疗网球肘：随机研究
Authors: Leanne, Bisset, Elaine, Belier, Gwendolen, Jull, Peter, Brooks, Ross, Darnell, Bill, Vicenzino, 王英民
Journal: BMJ (2008)

目的与随诊观察和局部激素封闭治疗相比较，探讨物理疗法治疗网球肘52周的有效性。 设计单盲随机对照研究。 地点澳大利亚伯瑞斯班的一个社区。 参与者198例网球肘临床诊断患者，年龄18～65岁，病史至少6周以上，半年内未接受积极的治疗。 干预8个疗程的物理治疗，激素封闭治疗，或随诊观察。 结局评估指标总体改善情况；握力；治疗开始、6周和52周时的严重程度评估。 结果6周内激素封闭治疗比物理治疗有明显效果，但复发率较高（前期有效的患者逐步复发达47／65），长期随访效果比物理治疗差。短期内理疗组比随诊观察组效果好，52周时两组患者无差别，大多数患者效果较好。理疗组较封闭组和随诊观察组寻求辅助治疗的概率低，比如非甾体类抗炎药物。 结论合并手法和肘部锻炼的物理疗法在6周内比随诊观察组效果好，6周以后比激素封闭组效果好，因此，中长期治疗中，除激素封闭外，物理治疗可以作为另外一种合理的选择。激素封闭治疗在短期是有效的，但6周以后容易出现反复，且复发率较高，因此对网球肘采取封闭治疗须谨慎。
A phase III, randomized, placebo-controlled trial of nivolumab or nivolumab plus ipilimumab in patients with localized renal cell carcinoma at high-risk of relapse after radical or partial nephrectomy (CheckMate 914).
Authors: Axel Bex, Paul Russo, Yoshihiko Tomita, Viktor Grünwald, Luz-Margarita Ramirez, Brent M. McHenry, Robert J. Motzer
Journal: Journal of Clinical Oncology (2020)

TPS5099 Background: Surgery is standard treatment for nonmetastatic renal cell carcinoma (RCC). Unfortunately, patients (pts) with stage II or III RCC have high risk of relapse with 5-year disease-free survival rates of ~51%–56%; prevention of recurrence is an unmet need. In CheckMate 214, first-line nivolumab plus ipilimumab (NIVO+IPI) demonstrated significant overall survival improvements in pts with advanced/metastatic RCC, with a manageable safety profile. Moreover, while not yet confirmed in randomized controlled trials, evidence suggests that anti-PD-(L)1 monotherapy may provide sufficient clinical activity in some pts with advanced RCC. These findings indicate a potential for improved clinical outcomes in the early-stage adjuvant RCC setting. As such, the phase 3, double-blind CheckMate 914 study will evaluate NIVO and NIVO+IPI vs placebo in pts with high risk of relapse after nephrectomy (NCT03138512). Methods: Key inclusion criteria: radical or partial nephrectomy with negative surgical margins &gt; 4 weeks and ≤12 weeks before randomization; predominantly clear cell histology; pathologic TNM staging T2a (grade [G] 3 or 4), T2b (any G), T3 (any G), or T4 (any G) N0M0, or any T (any G) N1M0; Eastern Cooperative Oncology Group performance status ≤1; no clinical/radiological evidence of macroscopic residual disease or distant metastases post-nephrectomy; and tumor tissue obtained ≤3 months pre-enrollment. Key exclusion criteria: conditions requiring corticosteroid or immunosuppressive systemic treatment, autoimmune disease, prior treatment with drugs specifically targeting T-cell co-stimulation or checkpoint pathways, and prior systemic treatment for RCC. In part A, pts are randomized 1:1 to receive NIVO+IPI or placebo infusions; in part B, pts are randomized 1:1:2 to receive NIVO+IPI, placebo infusions, or NIVO with IPI placebo. All treatments are given for 24 weeks or until disease recurrence, unacceptable toxicity, or withdrawal of consent. Stratification factors: TNM staging and type of nephrectomy procedure. Primary endpoint: disease-free survival per blinded independent central review (part A: NIVO+IPI vs placebo; part B: NIVO vs placebo). Secondary endpoints: overall survival (part A: NIVO+IPI vs placebo; part B: NIVO vs placebo and NIVO+IPI vs NIVO), disease-free survival (part B: NIVO+IPI vs NIVO), and safety. Enrollment in the study is ongoing. Total target enrollment across parts A and B is 1600 pts. Clinical trial information: NCT03138512 .