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Journal of Clinical Oncology : Official... Sep 2022To update the ASCO Biomarkers to Guide Systemic Therapy for Metastatic Breast Cancer (MBC) guideline.
PURPOSE
To update the ASCO Biomarkers to Guide Systemic Therapy for Metastatic Breast Cancer (MBC) guideline.
METHODS
An Expert Panel conducted a systematic review to identify randomized clinical trials and prospective-retrospective studies from January 2015 to January 2022.
RESULTS
The search identified 19 studies informing the evidence base.
RECOMMENDATIONS
Candidates for a regimen with a phosphatidylinositol 3-kinase inhibitor and hormonal therapy should undergo testing for mutations using next-generation sequencing of tumor tissue or circulating tumor DNA (ctDNA) in plasma to determine eligibility for alpelisib plus fulvestrant. If no mutation is found in ctDNA, testing in tumor tissue, if available, should be used. Patients who are candidates for poly (ADP-ribose) polymerase (PARP) inhibitor therapy should undergo testing for germline and pathogenic or likely pathogenic mutations to determine eligibility for a PARP inhibitor. There is insufficient evidence for or against testing for a germline pathogenic variant to determine eligibility for PARP inhibitor therapy in the metastatic setting. Candidates for immune checkpoint inhibitor therapy should undergo testing for expression of programmed cell death ligand-1 in the tumor and immune cells to determine eligibility for treatment with pembrolizumab plus chemotherapy. Candidates for an immune checkpoint inhibitor should also undergo testing for deficient mismatch repair/microsatellite instability-high to determine eligibility for dostarlimab-gxly or pembrolizumab, as well as testing for tumor mutational burden. Clinicians may test for fusions to determine eligibility for TRK inhibitors. There are insufficient data to recommend routine testing of tumors for mutations, for homologous recombination deficiency, or for TROP2 expression to guide MBC therapy selection. There are insufficient data to recommend routine use of ctDNA or circulating tumor cells to monitor response to therapy among patients with MBC.Additional information can be found at www.asco.org/breast-cancer-guidelines.
Topics: Adenosine Diphosphate; Antibodies, Monoclonal, Humanized; Biomarkers, Tumor; Breast Neoplasms; Circulating Tumor DNA; Class I Phosphatidylinositol 3-Kinases; Female; Fulvestrant; Humans; Immune Checkpoint Inhibitors; Ligands; Phosphatidylinositol 3-Kinases; Poly(ADP-ribose) Polymerase Inhibitors; Prospective Studies; Retrospective Studies; Ribose
PubMed: 35759724
DOI: 10.1200/JCO.22.01063 -
BMC Musculoskeletal Disorders May 2023To systematically review the studies regarding to the safety, efficacy and application methods of PRP in promoting the talar cartilage repair. (Meta-Analysis)
Meta-Analysis
PURPOSE
To systematically review the studies regarding to the safety, efficacy and application methods of PRP in promoting the talar cartilage repair.
METHODS
A systematic review was performed by searching PubMed, Web of Science, OVID and EMBASE to identify studies that compared the clinical efficacy of PRP for talar cartilage repair. Main outcome was the American Orthopedic Foot and Ankle Society (AOFAS) score for function and Visual Analog Scale (VAS) for pain was the second outcome.
RESULTS
A total of 10 studies were included in this systematic review, including 4 randomized controlled trials, 1 controlled trial, 3 case series and 2 cohort studies. Four RCTs were analyzed using meta-analysis. For all outcomes, statistical results favored PRP group (AOFAS: MD = 7.84; 95% CI= [-0.13, 15.80], I = 83%, P < 0.01; VAS: MD = 1.86; 95% CI= [0.68, 3.04], I = 85%, P < 0.01). There were almost no reports of adverse events related to PRP intervention. Subgroup analysis showed that whether PRP was used alone or combined with other treatments could result in high heterogeneity but no more specific factors were identified to contribute to this.
CONCLUSION
PRP is safe and effective for talar cartilage repair. In addition to the standardization of PRP preparation and application, it is necessary to distinguish the effects of PRP used alone or in combination with other treatments. In PRP studies, surgical treatment of talar cartilage repair remains the mainstream. The regulation of PRP in surgical applications are worth exploring. The most relative component is the mesenchymal stem cell because it is the only exposed chondrocyte precursor in the articular cavity whether it is microfracture or cell transplantation.
TRIAL REGISTRATION
The study was registered in the PROSPERO International prospective register of systematic reviews (CRD42022360183).
Topics: Humans; Chondrocytes; Fractures, Stress; Joints; Platelet-Rich Plasma; Cartilage; Randomized Controlled Trials as Topic
PubMed: 37161527
DOI: 10.1186/s12891-023-06466-y -
Cell-based therapies for experimental chronic kidney disease: a systematic review and meta-analysis.Disease Models & Mechanisms Mar 2015Cell-based therapy is a promising strategy for treating chronic kidney disease (CKD) and is currently the focus of preclinical studies. We performed a systematic review... (Meta-Analysis)
Meta-Analysis Review
Cell-based therapy is a promising strategy for treating chronic kidney disease (CKD) and is currently the focus of preclinical studies. We performed a systematic review and meta-analysis to evaluate the efficacy of cell-based therapy in preclinical (animal) studies of CKD, and determined factors affecting cell-based therapy efficacy in order to guide future clinical trials. In total, 71 articles met the inclusion criteria. Standardised mean differences (SMD) and 95% confidence intervals (CI) were calculated for outcome parameters including plasma urea, plasma creatinine, urinary protein, blood pressure, glomerular filtration rate, glomerulosclerosis and interstitial fibrosis. Sub-analysis for each outcome measure was performed for model-related factors (species, gender, model and timing of therapy) and cell-related factors (cell type, condition and origin, administration route and regime of therapy). Overall, meta-analysis showed that cell-based therapy reduced the development and progression of CKD. This was most prominent for urinary protein (SMD, 1.34; 95% CI, 1.00-1.68) and urea (1.09; 0.66-1.51), both P<0.001. Changes in plasma urea were associated with changes in both glomerulosclerosis and interstitial fibrosis. Sub-analysis showed that cell type (bone-marrow-derived progenitors and mesenchymal stromal cells being most effective) and administration route (intravenous or renal artery injection) were significant predictors of therapeutic efficacy. The timing of therapy in relation to clinical manifestation of disease, and cell origin and dose, were not associated with efficacy. Our meta-analysis confirms that cell-based therapies improve impaired renal function and morphology in preclinical models of CKD. Our analyses can be used to optimise experimental interventions and thus support both improved preclinical research and development of cell-based therapeutic interventions in a clinical setting.
Topics: Animals; Blood Pressure; Cell- and Tissue-Based Therapy; Disease Models, Animal; Kidney; Outcome Assessment, Health Care; Proteinuria; Publication Bias; Regression Analysis; Renal Insufficiency, Chronic; Urea
PubMed: 25633980
DOI: 10.1242/dmm.017699 -
Journal of Biological Regulators and... 2016Study has shown that stem cellbased therapies are promising strategies in the treatment of several chronic diseases, but their overall benefit in the treatment of... (Meta-Analysis)
Meta-Analysis Review
Study has shown that stem cellbased therapies are promising strategies in the treatment of several chronic diseases, but their overall benefit in the treatment of diabetic nephropathy (DN) remains controversial. The purpose of this study is to summarize the evidence of the effect of cell-based therapy in the treatment of DN to guide future clinical trials. We searched PubMed, EmBase, and the Cochrane Library for studies from the inception of cell-based therapies up to July 2015. We included animal trials that reported the effects of cell-based therapy on kidney function, cardiovascular risk factors, and body factors. A random-effects model was used to process the data, and the standard mean difference (SMD) was used to evaluate the efficacy of cell-based therapy. We included eight studies that reported data on 159 mice. Overall, we noted that cell-based therapies were associated with significantly reduced plasma creatinine level (P = 0.003), glomerular filtration rate (P less than 0.001), plasma glucose level (P = 0.004), serum cholesterol level (P = 0.010), serum triglyceride level (P = 0.032), plasma urea level (P less than 0.001), proteinuria (P = 0.008), and Cl- fractional excretion (P = 0.023). Furthermore, cell-based therapies were associated with lower kidney weight (P = 0.003), and kidney/body weight (P = 0.004). A sensitivity analysis suggested that cell-based therapy might play an important role in increased body weight. In conclusion, cell-based therapies significantly improve kidney function, cardiovascular risk factors, and body factors in the treatment of DN.
Topics: Animals; Diabetic Nephropathies; Disease Models, Animal; Mice; Stem Cell Transplantation
PubMed: 28078852
DOI: No ID Found -
International Wound Journal Apr 2024The primary objective of this study is to examine the efficiency of various regenerative medicine approaches, such as platelet-rich plasma, cell therapy, stromal... (Review)
Review
A systematic review of the efficacy, safety and satisfaction of regenerative medicine treatments, including platelet-rich plasma, stromal vascular fraction and stem cell-conditioned medium for hypertrophic scars and keloids.
The primary objective of this study is to examine the efficiency of various regenerative medicine approaches, such as platelet-rich plasma, cell therapy, stromal vascular fraction, exosomes and stem cell-conditioned medium, in the process of healing hypertrophic and keloid scars. Major databases including PubMed, Scopus and Web of Science were systematically searched, and based on the content of the articles and the inclusion and exclusion criteria, eight articles were selected. Out of these eight articles, there were two non-randomized clinical trial studies (25%), one randomized, single-blinded comparative study (12.5%), one retrospective clinical observational study (12.5%) and four randomized clinical trial studies (50%). We employed EndNote X8 and Google Sheets to conduct article reviews and extract relevant data. Following the review phase, the studies underwent analysis and categorization. In all eight reviewed studies, the effectiveness of regenerative medicine in treating hypertrophic scars and keloids has been proven. Out of these studies, five (62.5%) focused on the effectiveness of platelet-rich plasma, two study (25%) examined the effectiveness of stromal vascular fraction and one study (12.5%) explored the efficacy of stem cell-conditioned medium. In two studies (25%), the treatment methods were added to standard treatment, while in six studies (75%), regenerative medicine was used as the sole treatment method and compared with standard treatment. The use of these treatment methods did not result in any serious side effects for the patients. Regenerative medicine is an effective method with minimal side effects for the treatment of hypertrophic scars and keloids. It can be used as a monotherapy or in combination with other treatment methods. However, further studies are needed to thoroughly evaluate the effectiveness of all sub-branches of this method.
Topics: Humans; Cicatrix, Hypertrophic; Culture Media, Conditioned; Keloid; Personal Satisfaction; Platelet-Rich Plasma; Regenerative Medicine; Stromal Vascular Fraction; Treatment Outcome; Clinical Trials as Topic
PubMed: 38126221
DOI: 10.1111/iwj.14557 -
Clinics in Orthopedic Surgery Sep 2021We performed a systematic review on the management of patellar fracture nonunion and report a novel suture-based non-metallic fixation technique associated with...
BACKGROUD
We performed a systematic review on the management of patellar fracture nonunion and report a novel suture-based non-metallic fixation technique associated with platelet-rich plasma and mesenchymal stem cell injections in the management of this injury.
METHODS
A systematic search was performed up to August 2020 in PubMed and Scopus electronic databases of scholarly articles evaluating different surgical techniques used for nonunion of patellar fractures, with no restrictions on language or year of publication. Furthermore, we describe our novel non-metallic suture fixation technique and a patient in whom this technique was applied.
RESULTS
A total of 9 articles were included in the systematic review. Tension band wiring was the most commonly used procedure (62.7%). Nonoperative procedures (8.1%) resulted in nonunion in all patients. The most common complication after open reduction and internal fixation was infection (7.8%). Our patient at the latest follow-up reported full functional recovery and full extension and flexion of the affected knee with no pain and subjectively normal strength.
CONCLUSIONS
The management of patella nonunions is still a challenge. The technique reported here can be used in patellar fracture nonunion, as well as in primary patellar fractures.
Topics: Fracture Fixation, Internal; Fractures, Bone; Fractures, Ununited; Humans; Injections, Intralesional; Mesenchymal Stem Cell Transplantation; Patella; Platelet-Rich Plasma; Suture Techniques
PubMed: 34484627
DOI: 10.4055/cios20175 -
AIDS Care Sep 2022HIV infection causes a constant activation of the immune system and contributes to an enhanced systemic pro-inflammatory cytokine milieu, which has been associated with... (Meta-Analysis)
Meta-Analysis
Association between frailty phenotype, quantification of plasma HIV-1 RNA, CD4 cell count and HAART in HIV-positive subjects: a systematic review and meta-analysis of observational studies.
HIV infection causes a constant activation of the immune system and contributes to an enhanced systemic pro-inflammatory cytokine milieu, which has been associated with premature aging and frailty. We performed a systematic review and meta-analysis to analyze whether the HIV-1 RNA load, CD4+ T-lymphocyte counts and exposure to HAART in HIV-positive subjects are associated with frailty phenotype. Searches were performed in PubMed, SCOPUS, Lilacs, Web of Science, Google Scholar, and OpenThesis databases. We used the odds ratio as a measure of the association. We used either a fixed or random-effects model to pool the results of individual studies depending on the presence of heterogeneity. Eleven studies were included in the review. Data from 8035 HIV-positive subjects were analyzed; 2413 of the subjects had viral load detectable, 981 had a CD4T-cell count <350 cells/μL, and 1342 had HAART exposure information. We found an association between frailty and CD4T-cell count <350 cells/μL (OR 2.68, CI 95% 1.68-4.26, I= 46%), HIV-1 RNA load detectable (OR 1.71, CI 95% 1.38-2.12, I= 0%), and protease inhibitor-containing HAART regimen (OR 2.21, CI 95% 1.26-3.89, I = 0%). Further studies are necessary to evaluate the effects of other factors on the development of clinical features related to frailty.
Topics: Antiretroviral Therapy, Highly Active; CD4 Lymphocyte Count; Frailty; HIV Infections; HIV Seropositivity; HIV-1; Humans; Phenotype; RNA; RNA, Viral; Viral Load
PubMed: 34292108
DOI: 10.1080/09540121.2021.1956414 -
European Journal of Cancer (Oxford,... Aug 2021Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southeast Asia, particularly Southern China. The classical non-keratinising cell type is almost unanimously...
INTRODUCTION
Nasopharyngeal carcinoma (NPC) is an endemic malignancy in Southeast Asia, particularly Southern China. The classical non-keratinising cell type is almost unanimously associated with latent Epstein-Barr virus (EBV) infection. Circulating plasma EBV DNA can be a useful biomarker in various clinical aspects, but comprehensive recommendations and international guidelines are still lacking. We conducted a systematic review of all original articles on the clinical application of plasma EBV DNA for NPC; we further evaluated its strengths and limitations for consideration as standard recommendations.
METHODS
The search terms 'nasopharyngeal OR nasopharynx', and 'plasma EBV DNA OR cell-free EBV OR cfEBV' were used to identify full-length articles published up to December 2020 in the English literature. Three authors independently reviewed the article titles, removed duplicates and reviewed the remaining articles for eligibility.
RESULTS
A total of 81 articles met the eligibility criteria. Based on the levels of evidence and grades of recommendation assessed, it is worth considering the inclusion of plasma EBV DNA in screening, pre-treatment work-up for enhancing prognostication and tailoring of treatment strategy, monitoring during radical treatment, post-treatment surveillance for early detection of relapse, and monitoring during salvage treatment for recurrent or metastatic NPC. One major limitation is the methodology of measurement requiring harmonisation for consistent comparability.
CONCLUSIONS
The current comprehensive review supports the inclusion of plasma EBV DNA in international guidelines in the clinical aspects listed, but methodological issues must be resolved before global application.
Topics: DNA, Viral; Epstein-Barr Virus Infections; Humans; Nasopharyngeal Carcinoma; Plasma
PubMed: 34153713
DOI: 10.1016/j.ejca.2021.05.022 -
Science China. Life Sciences Feb 2024The endoplasmic reticulum (ER), which is composed of a continuous network of tubules and sheets, forms the most widely distributed membrane system in eukaryotic cells.... (Review)
Review
The endoplasmic reticulum (ER), which is composed of a continuous network of tubules and sheets, forms the most widely distributed membrane system in eukaryotic cells. As a result, it engages a variety of organelles by establishing membrane contact sites (MCSs). These contacts regulate organelle positioning and remodeling, including fusion and fission, facilitate precise lipid exchange, and couple vital signaling events. Here, we systematically review recent advances and converging themes on ER-involved organellar contact. The molecular basis, cellular influence, and potential physiological functions for ER/nuclear envelope contacts with mitochondria, Golgi, endosomes, lysosomes, lipid droplets, autophagosomes, and plasma membrane are summarized.
Topics: Endoplasmic Reticulum; Golgi Apparatus; Cell Membrane; Mitochondria; Lysosomes; Endosomes
PubMed: 38212460
DOI: 10.1007/s11427-023-2443-9 -
Journal of Cardiothoracic Surgery Sep 2021Platelet rich plasma or PRP is a supraphysiologic concentrate of platelets derived by centrifugation and separation of whole blood components. Along with platelets and... (Review)
Review
Platelet rich plasma or PRP is a supraphysiologic concentrate of platelets derived by centrifugation and separation of whole blood components. Along with platelets and plasma, PRP contains various cell types including white blood cells (WBC)/leukocytes, both granulocytes (neutrophils, basophils, eosinophils) and agranulocytes (monocytes, lymphocytes). Researchers and clinicians have explored the application of PRP in wound healing and prevention of surgical wound infections, such as deep sternal wounds. We conducted this systematic literature review to evaluate the preclinical and clinical evidence for the antibacterial effect of PRP and its potential mechanism of action. 526 records were identified for screening. 34 unique articles were identified to be included in this literature review for data summary. Overall, the quality of the clinical trials in this review is low, and collectively qualify as Oxford level C. Based on the available clinical data, there is a clear trend towards safety of autologous PRP and potential efficacy in deep sternal wound management. The preclinical and bench data is very compelling. The application of PRP in treatment of wounds or prevention of infection with PRP is promising but there is a need for foundational bench and preclinical animal research to optimize PRP as an antibacterial agent, and to provide data to aid in the design and conduct of well-designed RCTs with adequate power to confirm antimicrobial efficacy of PRP in specific disease states and wound types.
Topics: Animals; Anti-Bacterial Agents; Platelet-Rich Plasma; Surgical Wound Infection; Wound Healing
PubMed: 34583720
DOI: 10.1186/s13019-021-01652-2