tbuckley/cabot-search huggingface dataset:
A phase I clinical trial on intratumoral and intracavitary administration of ipilimumab and nivolumab in patients with recurrent glioblastoma.
Authors: Julia Katharina Schwarze, Johnny Duerinck, Ines Dufait, Gil Awada, Samuel Klein, Lydia Fischbuch, Laura Seynaeve, Freya Vaeyens, Anne Rogiers, Hendrik Everaert, Anne-Marie Vanbinst, Alex Michotte, Bart Neyns
Journal: Journal of Clinical Oncology (2020)

2534 Background: Intravenous (IV) administration of ipilimumab (IPI) and nivolumab (NIVO) has low activity in recurrent glioblastoma (rGB). Intratumoral (IT) and intracavitary (IC) administration of IPI and NIVO is under evaluation in the GlITIpNi phase I clinical trial. Methods: Patients (pts) with resectable rGB were recruited to cohorts C1, C2 and C4; pts with non-resectable rGB were recruited in C3 (biopsy only). IT administration (brain tissue lining the resection cavity during surgery) of IPI (10 mg)(C1), or IPI (5 mg) plus NIVO (10 mg)(C2, C3 and C4), was followed by IC administration of NIVO at escalating doses of 1, 5 or 10 mg Q2w in both C3 and C4 (via an Ommaya reservoir). In all cohorts, pts received 10 mg NIVO IV Q2w (6x in C1/C2, and 12x in C3/C4). Corticosteroids were contraindicated. Results: Forty-six pts (31 male; median age 56y (38-74); IDH1 R132H mutation in 2 pts in C1/C2; NGS somatic mutation analysis for C3/C4 ongoing) with rGB following resection, RT and temozolomide were enrolled (3, 24, 13 and 6 pts in C1, C2, C3 and C4, respectively). All pts received IT administrations. Pts in C1/C2 received a median of 5 IV NIVO administrations. Study treatment has been completed in all pts in C1/C2, in 9 pts in C3, and in 3 pts in C4; pts received a median of 4 (0-10) and 3 (0-7) postoperative IC/IV administrations in C3 and C4, respectively. Two pts in C2 and 1 pt in C3 had an increased perilesional cerebral edema (G3) with neurological deterioration after surgery/IT-injection, that was reversible with steroids. Most frequent AE were fatigue (32 pts, 64%), fever (20 pts, 44%), and headache (25 pts, 50%). In 4 pts from C3, the Ommaya was removed because of bacterial colonization (asymptomatic). There were no G5 AE. There was no dose/AE correlation with increasing IC NIVO doses in C3/C4. Repetitive CSV analysis during therapy (C3/C4) revealed increased lymphocyte counts in 4 pts; scRNA- and TCR-sequencing is ongoing. Gene expression profiling for C1/C2, and pharmacokinetic analysis of NIVO and IPI in CSV for C3/C4 are ongoing. After a median FU of 62w (16-165) for pts in C1/C2, 16 pts have died; median OS is 71w (95% CI 8-134), 1- and 2y-OS% are respectively 51% (95% CI 31-71), and 34% (95% CI 10-59). OS compares favorably to a historical cohort of Belgian rGB pts (n = 469; Log-Rank p .001). After a median FU of 10w (1-37) for pts in C3/C4, 2 pts have died; median OS has not been reached. One pt in C3 achieved a PR that is ongoing at 12m. Conclusions: IT/IC administration of NIVO and IPI is feasible and sufficiently safe to warrant further investigation in pts with rGB. Clinical trial information: NCT03233152 .
女性尿道旁腺囊肿26例临床分析
Authors: 刘连地, 黄建忠, 庄东阳, 黄唯庶
Journal: BMJ (2007)

女性尿道旁腺分布于尿道中下段的黏膜下层,有细小的腺管通向尿道外口的两侧.如果腺管排出口阻塞,腺体分泌物堆积而扩张,则可形成尿道旁腺囊肿;一旦感染,常成为慢性尿道炎的隐性病灶,亦可形成尿道旁腺脓肿.我科于1994年8月至2006年12月共收治26例女性尿道旁腺囊肿,均经手术治疗取得良好效果。
Suggestions on community training for general practice residency
Authors: Wen Ren, Ying Liu, Yan Qiu
Journal: BMJ (2017)

Residency training is the main way to cultivate qualified general practitioners, while community training is an indispensable part of the training. However, currently the curricula and teaching plan of community training are various in terms of departments and time for residency rotation. It is important to formulate nationwide united standard and curricula of community training for cultivation of highly qualified general practitioners.


Key words: 
General practitioners; Standard training
认识双氯芬酸钾
Authors: 施桂英
Journal: BMJ (2006)

疼痛是困扰人类最大的医学问题之一,其中头痛、痛经、牙痛及术后痛等在临床上比较常见.解除这些疼痛的方法固然很多,而选择药物止痛则被公认为是最简便、迅速、经济和有效的方法.在众多的止痛类别药物中,兼有解热、止痛和抗炎三大功效于一体的非甾类抗炎药(简称抗炎药)在上述疼痛的治疗中占有重要地位。
儿童后天性心脏病原因的首位:川崎病
Authors: 吴明昌, 闫宗荣
Journal: BMJ (2009)

吴明昌:川崎病又称皮肤黏膜淋巴结综合征,1967年日本首先报道.本病是一种以免疫介导的全身血管炎为主要病变的急性热性发疹性疾病,可合并心脏损害,引起冠状动脉(简称冠脉)病变、心肌炎、心包炎及心内膜炎等。
DUO-E/GOG-3041/ENGOT-EN10: a randomized phase III trial of first-line carboplatin (carb) and paclitaxel (pac) in combination with durvalumab (durva), followed by maintenance durva with or without olaparib (ola), in patients (pts) with newly diagnosed (nd) advanced or recurrent endometrial cancer (EC).
Authors: Shannon Neville Westin, Kathleen N. Moore, Els Van Nieuwenhuysen, Amit M. Oza, Linda R. Mileshkin, Aikou Okamoto, Akiko Suzuki, Kassondra Meyer, Laura Barker, Joon Rhee, Ignace Vergote
Journal: Journal of Clinical Oncology (2020)

TPS6108 Background: There is a high unmet need for advances in EC treatment that provide progression-free survival (PFS) and overall survival (OS) benefits. EC tumors are sensitive to carb/pac (Pectasides et al. Gynecol Oncol 2008). Maintenance therapy with the poly(ADP-ribose) polymerase inhibitor (PARPi) ola (with or without bevacizumab) led to significant PFS benefits in advanced ovarian cancer pts with either nd (SOLO1, Moore et al. NEJM 2018; PAOLA-1, Ray-Coquard et al. NEJM 2019) or recurrent (SOLO2, Pujade-Lauraine et al. Lancet Oncol 2017; Study 19, Friedlander et al. Br J Cancer 2018) platinum-sensitive disease, regardless of BRCA mutation status (PAOLA-1; Study 19), and in BRCA-mutated metastatic pancreatic cancer pts (POLO, Golan et al. NEJM 2019). Molecular features of EC could predict sensitivity to PARPi (de Jonge et al. Clin Cancer Res 2019; Auguste et al. Mod Pathol 2018). PARPi has been shown to prime the immune microenvironment in a preclinical BRCA1 mutant ovarian model (Higuchi et al. Cancer Immunol Res 2015). Clinical trials have demonstrated antitumor activity of the anti-programmed cell death ligand-1 (anti-PD-L1) blocker durva (Antill et al. J Clin Oncol 2019) and anti-programmed cell death-1 (anti-PD-1) antibody therapies (Makker et al. ESMO 2019; Oaknin et al. SGO 2019) in EC pts. The DUO-E trial (EUDRACT 2019-004112-60, D9311C00001, NCT04269200) will investigate whether the addition of durva to carb/pac, followed by durva (with or without ola) maintenance treatment, improves PFS in pts with nd advanced or recurrent EC. Methods: Eligible pts for this multicenter, double-blind, Phase III trial must have nd Stage III/IV or recurrent EC and be naïve to first-line chemotherapy. Pts will be randomized (1:1:1; n=~233 per arm) to: arm A) carb/pac + placebo (pbo) (q3w for six cycles) followed by pbo maintenance treatment; arm B) carb/pac + durva (1120 mg; q3w for six cycles) followed by maintenance treatment with durva (1500 mg q4w) + pbo (tablets bid); or arm C) carb/pac + durva (1120 mg; q3w for six cycles) followed by maintenance treatment with durva (1500 mg q4w) + ola (300 mg bid tablets). Pts received maintenance treatment until disease progression. Primary endpoint: investigator-assessed PFS (RECIST 1.1) of arm B vs. arm A. Key secondary endpoints: PFS of arm C vs. arm A; OS of arm B vs. arm A, and of arm C vs. arm A. Enrollment began in Q1 2020. Clinical trial information: 2019-004112-60.
TFEB is a master regulator of tumor-associated macrophages in breast cancer
Authors: Yong Li, Johnie Hodge, Qing Liu, Junfeng Wang, Yuzhen Wang, Trent D Evans, Diego Altomare, Yongzhong Yao, E Angela Murphy, Babak Razani, Daping Fan
Journal: Journal for ImmunoTherapy of Cancer (2020)

Tumor-associated macrophages (TAMs) play key roles in the development of many malignant solid tumors including breast cancer. They are educated in the tumor microenvironment (TME) to promote tumor growth, metastasis, and therapy resistance. However, the phenotype of TAMs is elusive and how to regulate them for therapeutic purpose remains unclear; therefore, TAM-targeting therapies have not yet achieved clinical success. The purposes of this study were to examine the role of transcription factor EB (TFEB) in regulating TAM gene expression and function and to determine if TFEB activation can halt breast tumor development.Microarrays were used to analyze the gene expression profile of macrophages (MΦs) in the context of breast cancer and to examine the impact of TFEB overexpression. Cell culture studies were performed to define the mechanisms by which TFEB affects MΦ gene expression and function. Mouse studies were carried out to investigate the impact of MΦ TFEB deficiency or activation on breast tumor growth. Human cancer genome data were analyzed to reveal the prognostic value of TFEB and its regulated genes.TAM-mimic MΦs display a unique gene expression profile, including significant reduction in TFEB expression. TFEB overexpression favorably modulates TAM gene expression through multiple signaling pathways. Specifically, TFEB upregulates suppressor of cytokine signaling 3 (SOCS3) and peroxisome proliferator-activated receptor γ (PPARγ) expression and autophagy/lysosome activities, inhibits NLRP3 (NLR Family Pyrin Domain Containing 3) inflammasome and hypoxia-inducible factor (HIF)-1α mediated hypoxia response, and thereby suppresses an array of effector molecules in TAMs including arginase 1, interleukin (IL)-10, IL-1β, IL-6 and prostaglandin E2. MΦ-specific TFEB deficiency promotes, while activation of TFEB using the natural disaccharide trehalose halts, breast tumor development by modulating TAMs. Analysis of human patient genome database reveals that expression levels of TFEB, SOCS3 and PPARγ are positive prognostic markers, while HIF-1α is a negative prognostic marker of breast cancer.Our study identifies TFEB as a master regulator of TAMs in breast cancer. TFEB controls TAM gene expression and function through multiple autophagy/lysosome-dependent and independent pathways. Therefore, pharmacological activation of TFEB would be a promising therapeutic approach to improve the efficacy of existing treatment including immune therapies for breast cancer by favorably modulating TAM function and the TME.
Comparison of StemPrintER, a novel biology-based genomic predictor of distant recurrence in breast cancer, with Oncotype DX in the TransATAC cohort.
Authors: Salvatore Pece, Ivana Sestak, Francesca Montani, Micol Tillhon, Stefano Freddi, Patrick Maisonneuve, Marco Colleoni, Paolo Veronesi, Davide Disalvatore, Giuseppe Viale, Richard Buus, Jack M. Cuzick, Mitchell Dowsett, Pier Paolo Di Fiore
Journal: Journal of Clinical Oncology (2020)

1020 Background: Accurate prediction of distant metastasis (DM) in early stage ER+/HER2- breast cancer (BC) patients is vital to avoid over/under-treatment with adjuvant chemotherapy (CT). The OncotypeDX Recurrence Score (RS) is a widely used tool to assist clinical decision-making for CT. The StemPrintER Risk Score (SPRS) is an alternative genomic predictor based on the biology of cancer stem cells that predicts recurrence risk in ER+/HER2- BCs (Pece S. et al., EBioMedicine 2019). Here, we analyze the prognostic value of SPRS in the TransATAC cohort of post-menopausal ER+/HER2- BC patients, and compare the prognostic information provided by SPRS and RS for 10-year risk of DM. Methods: The likelihood χ 2 (LRχ 2 ) and Kaplan-Meier survival analyses were used to assess prognostic information provided by SPRS, RS and the clinical treatment score (CTS) in 818 TransATAC patients treated with anastrozole or tamoxifen for 5 years. Comparative analyses were made for DM risk over the 10-year follow-up, as well as in the early (0-5 years) or late (5-10 years) interval, according to nodal status. Results: Used as a continuous variable, SPRS was an independent predictor of DM in years 0-10 among all patients when adjusted for clinical parameters as expressed by the CTS [HR=1.43 (1.18-1.73), P&lt;0.0001], as well as in node-negative [HR=1.51 (1.17-1.94), P=0.001] but not node-positive (N1-3) patients [HR=1.29 (0.95-1.75), P=0.11]. A predefined SPRS cut-off was used to stratify patients into low vs. high risk groups [LOW: N=454, 10-year DM rate=5.8%; HIGH: N=364, 10-year DM rate=21.9%; HR HIGH vs. LOW =2.96 (1.85-4.73); P&lt;0.0001]. SPRS outperformed RS in providing prognostic information for 10-year DM risk (SPRS: HR=1.79, P&lt;0.0001, LRχ 2 =33.4; RS: HR=1.52, P&lt;0.0001, LRχ 2 =22.1), with even greater differences in late DM prediction in N0 patients. SPRS also provided more prognostic information than RS to CTS (ΔLRχ 2 : SPRS+CTS vs. CTS= 14.9; RS+CTS vs. CTS= 9.7). Conclusions: In ER+/HER2- TransATAC BC patients, SPRS was highly prognostic for DM and was superior to RS in providing additional prognostic information to conventional clinicopathological parameters.
Gender disparity on cigarette smoking among cancer survivors: Results from the National Health Interview Survey.
Authors: Changchuan Jiang, Haowei Wang, Lei Deng, Qian Wang, Xuesong Han, Charles L. Shapiro
Journal: Journal of Clinical Oncology (2020)

e24040 Background: The smoking rate has been declining in the United States. Smoking cessation is a critical part of cancer survivorship care. Males have higher smoking rate than females in the general population. However, it remains unclear if cancer status modified the effect of gender on smoking rates. Methods: To evaluate the long-term pattern of smoking prevalence among female cancer survivors, we used the National Health Interview Survey 2000-2017 to estimate the age-adjusted current smoking rates among cancer survivors and participants without a history of cancer for men and women separately. Multivariable linear regression was used to estimate age-adjusted smoking rate in each group, using the US 2010 Census as the standardization population. We also used multivariable logistic regression to examine the whether cancer history modified the influence of gender on current smoking rate. All statistical analyses were performed with SAS 9.4 and accounted for NHIS survey design. Results: Of 526,547 participants, we identified 32,091 cancer survivors, including 11,642 male and 20,449 female cancer survivors. Male cancer survivors had a slightly lower smoking rates than non-cancer male participants (cancer survivors: 16.2%-29.7% vs non-cancer participants: 16.8%-24.4%; OR = 0.94, 95%CI 0.88-1.00, p = 0.05) after adjusting age and year of survey. However, female cancer survivors had a significant higher prevalence of smoking compared with non-cancer female participants (cancer survivors: 20.1-32.6% vs non-cancer participants: women: 12.8%-20.4%; OR = 1.45, 95%CI 1.38-1.52, p &lt; 0.001) during the same period. The gaps in smoking prevalence between female cancer survivors and male cancer survivors were more significant than the gaps between male non-cancer participants and female non-cancer participants from 2000 to 2017 (p interaction &lt; 0.001). Conclusions: Although more men smoke among people without a history of cancer, female survivors had a higher age-adjusted smoking rate than their male counterparts. Effective smoking cessation interventions need to target female survivors as well as male survivors. A gender-sensitive approach is required to address their specific needs in smoking cessation. [Table: see text]
Treatment patterns in men with metastatic castration sensitive prostate cancer (mCSPC) in the United States (US).
Authors: Xuehua Ke, Marie-Hélène Lafeuille, Hela Romdhani, Frederic Kinkead, Peter St. John Francis, Denise D'Andrea, Charles J. Ryan, Stephen J. Freedland
Journal: Journal of Clinical Oncology (2020)

e19131 Background: Given recent advances in treatment options for mCSPC, this study assessed US real-world treatment patterns of mCSPC patients over time. Methods: The Optum Clinformatics Extended DataMart was used to identify men with ≥2 claims for PC, ≥1 claim for metastasis, ≥1 castration sensitivity (CS) indicator (CS diagnosis code [dx]; castration and no prostate-specific antigen [PSA] rise; or hormone/castration naive for ≥18 months [mo] before metastasis). Index (idx) date was the 1 st metastasis dx date on or after 1 st PC dx and from 2015-2018. Patients were excluded if they had a pre-idx castration-resistance (CR) indicator (CR dx; castration within ≥90 days pre-idx or with PSA rise; or a claim for a drug solely recommended for metastatic CRPC). mCSPC period (F/U) was defined as time from idx until CR (i.e., any post-idx CR indicator or initiation of abiraterone acetate [ABI] or docetaxel [DOC] ≥12 mo after post-idx androgen deprivation therapy [ADT] initiation or ≥12 mo post-idx for those with no ADT) or end of data. mCSPC treatment patterns in F/U were assessed overall and in patients with idx years (yrs) in 2015-2016 and in 2017-2018, separately. Descriptive statistics were used: n (%) for binary and mean [SD] for continuous variables. Results: In the 2,825 mCSPC patients identified (age: 75 [9] yrs; F/U: 10.9 [9.0] mo), 43% were in the 2015/16 cohort (age: 75 [9] yrs; F/U: 15.8 [10.2] mo); and 57% were in the 2017/18 cohort (age: 75 [9] yrs; F/U: 7.2 [4.7] mo). The most common first-line (1L) mCSPC therapy was ADT only (Table), but patients in the 2017/18 cohort had fewer ADT only as 1L (43% vs. 52%) and more 1L ABI (10% vs. 4%) compared to the 2015/16 cohort. About 4% (2015/16: 5%; 2017/18: 3%) of patients received second-line (2L) mCSPC therapies, with ABI (74%) and DOC (25%) as the main 2L therapies observed. In patients receiving 2L mCSPC therapies, the 2017/18 cohort had more 2L ABI (81% vs. 68%) and fewer 2L DOC (19% vs. 30%) compared to the 2015/16 cohort. Conclusions: A large proportion of men with mCSPC were untreated/deferred treatment or were treated with ADT only, highlighting unmet needs in this patient group. As additional therapies for mCSPC become available, this trend is expected to improve, as supported by more recent treatment patterns. [Table: see text]
PREDIX II HER2: Improving pre-operative systemic therapy for human epidermal growth factor receptor 2 (HER2) amplified breast cancer (BC).
Authors: Renske Kornalijnslijper-Altena, Anne Andersson, Yvonne Brandberg, Luisa Edman Kessler, Ellinor Elinder, Johan Hartman, Mats Hellstrom, Hemming Johansson, Fredrika Killander, Barbro Kristina Linderholm, Henrik Lindman, Antonios Valachis, Anna Karin Wennstig, Hanjing Xie, Thomas Hatschek, Jonas C. S. Bergh
Journal: Journal of Clinical Oncology (2020)

TPS605 Background: Neo-adjuvant systemic therapy (NAT) is the standard of care for most patients with early HER2-amplified and triple negative breast cancer (BC). Increasing the rate of pathological complete response (pCR) is highly meaningful for those patients, as pCR is strongly predictive for improved long-term disease-related outcomes. Clinical and preclinical evidence support the hypothesis that pCR-rates may be augmented by the addition of checkpoint inhibitors, such as monoclonal antibodies targeting the Programmed Death Ligand receptor 1 (PD-L1), to standard systemic NAT. Studies in different BC patient cohorts (e.g., IMPassion130, PANACEA, KATE2) have indicated that PD-L1 protein expression on tumor-infiltrating lymphocytes (TIL’s) is a predictive marker for checkpoint inhibitor efficacy. Methods: We have initiated a phase II open-label, 2:1 randomized clinical trial where women with early HER2-amplified, PD-L1+ BC (cT2-3 and/or cN+) are treated with standard NAT (composed of anti-HER2 antibodies with a chemotherapy backbone of sequentially taxanes + carboplatin and epirubicin + cyclophosphamide [EC]) +/- atezolizumab during EC. N = 190 patients will be accrued in nine centers in Sweden to be able to demonstrate a 20% increase in pCR-rate, with a power of 80% and a two-sided alpha of 10%. Firstly, a prescreening is performed to select patients with a PD-L1 expression of &gt; 1% on TIL’s. Important exclusion criteria are significant organ dysfunction and (with some exceptions) active auto-immune diseases. Extensive translational side-studies are performed to explore predictive markers for treatment efficacy, including clinicopathologic studies, molecular imaging and microbiome analyses, as well as monitoring of acute and chronic treatment-related toxicity, objective cognitive function and quality of life. As of February 11 th , 4 patients have been prescreened and 1 enrolled in the trial. The clinical trial registry number is NCT03894007. Clinical trial information: NCT03894007 .
院前急救心肺复苏中常见错误及正确方法
Authors: 杨秀玲
Journal: BMJ (2010)

在长期的院前急救工作中,发现急救人员在院前心肺复苏过程中常出现各种各样的错误,现总结如下,同时提出正确的方法. 一、意识判断错误:拍打患者面颊部或摇动患者肩部用力过猛,容易造成患者头、颈、肩部二次损伤.呼唤患者喂!你怎么了?时声音太弱,特别是在噪音大、情况复杂的现场,会将有意识的患者误断为无意识。
Neoadjuvant apalutamide (APA) plus leuprolide (LHRHa) with or without abiraterone (AA) in localized high-risk prostate cancer (LHRPC).
Authors: Eleni Efstathiou, Myrto A Boukovala, Nicholas Spetsieris, Sijin Wen, Anh Hoang, Justin Alexander Weldon, Rebecca Tidwell, John W. Davis, Brian Francis Chapin, Paul Gettys Corn, Sumit Kumar Subudhi, Ana Aparicio, Curtis Alvin Pettaway, Louis L. Pisters, John N. Papadopoulos, Mehrad Adibi, Jennifer Wang, Amado J. Zurita, Christopher Logothetis, Patricia Troncoso
Journal: Journal of Clinical Oncology (2020)

5504 Background: Novel androgen signaling inhibitors (ASI) with medical castration may improve outcomes in LHRPC. We previously reported relapse free survival association with pathologic measures of tumor regression. However a wide range of persistent cancers was recorded. To build on our findings and test candidate predictors of outcome, we conducted a study examining APA effect in LHRPC. Methods: This is a phase II neoadjuvant study of 6 months APA+LHRHa +/- AA (randomized 1:1) in LHRPC (≥ cT2 + Gleason Score ≥ 8 or ≥ cT2b + Gleason ≥ 7 + PSA &gt; 10 ng/mL) followed by radical prostatectomy (RP). We studied treatment effect by pathology measures [path. stage, tumor volume (TV), tumor cellularity % (TC), tumor epithelial volume (TEV: TC x TV)]. Tumor expression of candidate markers of outcome was assessed in the diagnostic biopsy by IHC [AR signaling (AR-N, ARC19, ARV7, PSA), PTEN, glucocorticoid receptor (GR), Ki67, p53, RB] and DNA/RNA seq. A previously identified candidate predictive molecular signature (AR-N overexpression, nARV7 absence, no GR overexpression, Ki67 ≤10%) was tested. Univariate (Fisher’s exact, Wilcoxon) and multivariate (logistic, linear models) analyses employed. Results: Sixty three -of 65 pts enrolled- had RP. PS-ECOG 0, median age 65 (43-77). Treatment was well tolerated with Grade 3 hypertension in 7 (2 APA + LHRHa). Presurgical PSA was ≤0.1 in 62/63 (98%). Organ confined disease (≤ypT2N0) found in 13/32(41%) APA+LHRHa vs. 12/31 (39%) APA+AA+LHRHa treated. 2 (3%) had pathologic complete remission (APA+AA+LHRHa), 6 (10%) minimal residual disease (5 on APA +LHRHa). Despite uniformity in PSA response, we recorded heterogeneity in measures of tumor viability: TV (0-11.5cc), TC (1-80%), TEV (0-6.1cc). ≤ypT2N0 associates with diagnostic biopsy positivity for the prespecified molecular signature (p &lt;0.0001), PTEN expression (p: 0.004), absence of cribriform/ intraductal spread (p 0.002) but not with Gleason Score. On multivariate analysis only the prespecified biopsy signature associates with outcome (p 0.003). Findings were replicated when analyzed by TV, TC and TEV measures. Conclusions: Neoadjuvant Apalutamide plus LHRHa is tolerable and results in tumor regression in a subset of LHRPC patients. Dual ASI treatment does not further improve outcomes. Biopsy positive for a prespecified molecular signature, associated with response. Study results emphasize the need to consider biologic heterogeneity and pursue validation of predictors of response in order to improve therapeutic outcomes in LHRPC. Clinical trial information: NCT03279250 .
Paroxetine in treatment of depression and anxiety in patients with type 2 diabetes mellitus
Authors: Xiaobo Guan, Zheng Lu
Journal: BMJ (2017)

Epidemiological studies have shown that patients with diabetes are prone to have depression and anxiety. This article reviews the evidence, mechanism, complications and strategy of selective serotonin reuptake inhibitors paroxetine in treatment of depression and anxiety in patients with type 2 diabetes mellitus.


Key words: 
Diabetes mellitus, type 2; Paroxetine