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An Update on Access to Novel Treatment for Metastatic Melanoma in Europe — A 2024 Survey of the European Melanoma Registry and the European Association of Dermato-Oncology
(Elsevier BV, 2024-11)
Kandolf, L
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Ascierto, P
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Bastholt, L
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Gavrilova, I
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Haanen, J
Advances in cancer treatments have significantly improved their effectiveness, yet access to first-line therapies remains limited. A 2017 survey revealed that over 25% of metastatic melanoma patients in Europe lacked access to recommended therapies. To address this, the European Association of Dermato-Oncology and the European Melanoma Registry conducted a follow-up study on the registration and reimbursement of first-line treatments.A web-based survey using LimeSurvey was distributed to melanoma experts across 27 European countries from February to April 2022 and updated from February to April 2024. The questionnaire covered the percentage of patients receiving recommended treatments, as well as treatment authorization and reimbursement dates for systemic and adjuvant therapies.There has been significant improvement in the registration and reimbursement of BRAFi/MEKi, anti-PD1, and anti-PD1/anti-CTLA4 therapies, increasing from 48%, 63%, and 37% in 2017 to 96%, 96%, and 78% in 2024, respectively. Despite these gains, restrictions persist. Anti-PD1/anti-CTLA4 combination immunotherapy is still not available without restrictions in 48% of the surveyed countries. The nivolumab/relatlimab combination is licensed only for PDL-1-negative melanoma and reimbursed in seven countries of Europe. Tebentafusp is reimbursed in 12 countries and talimogene laherpervec in 6. In 2024, adjuvant treatments for stage III melanoma are reimbursed in 22 countries for dabrafenib/trametinib and 24 of 27 for anti-PD1 antibodies. Pembrolizumab and nivolumab are reimbursed in 16 and 8 countries, respectively, for stage IIB/IIC disease.While there have been improvements in the reimbursement of metastatic melanoma treatments in Europe, challenges and discrepancies remain. Further efforts at European and global levels are needed to harmonize and enhance access to cancer medicines.
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Programmed death-ligand 1 expression in triple negative breast cancer
(Springer, 2019-09)
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Background & Objectives: Triple negative breast cancer (TNBC) account for 10-20% of all breast subtypes and are associated with poor prognosis. There is no approved targeted therapy for these patients, yet. Programmed death-ligand 1 (PD-L1) expression has been identified in different cancers achieving good results with immunotherapy. There is limited data reporting the PD-L1 expression in TNBC. The aim of this study is to evaluate the expression of PD‑L1 in TNBC patients and to analyse the relationship between PD‑L1 expression and clinicopathological features of the patients. Methods: Paraffin tissue blocks from 19 TNBC patients were used. PD-L1 immunohistochemistry was performed using monoclonal mouse anti-PD-L1, Clone 22C3. Expression of PD-L1 was correlated with clinicopathological features. Tumours were defined as PD-L1 positive if there was membranous expression in ≥ 1% of tumour cells. Results: Median age at diagnosis was 56 (range 33-74). PD-L1 was expressed in 7 (36, 8%) of the patients. Six of the patients showed low PD-L1 expression (3-20%) and only one patient showed high expression (>50%). The PD-L1 expression showed no significant correlation with clinicopathological parameters. Although statistically not significant (p>0,05), PD-L1 was more often expressed in high grade tumours with larger size, high clinical stage and mutated p53. Conclusion: Expression of PD-L1 was found in more than one third of TNBC and correlated with poor prognostic factors. PD‑L1 may be a significant marker for predicting prognosis of TNBC patients. These data need to be confirmed in larger study group.
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Immunological Outcomes of Allergen-Specific Immunotherapy in Food Allergy
(Frontiers Media SA, 2020)
Schoos, Ann-Marie Malby
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Bullens, Dominique
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Chawes, Bo Lund
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Costa, Joana
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De Vlieger, Liselot
IgE-mediated food allergies are caused by adverse immunologic responses to food proteins. Allergic reactions may present locally in different tissues such as skin, gastrointestinal and respiratory tract and may result is systemic life-threatening reactions. During the last decades, the prevalence of food allergies has significantly increased throughout the world, and considerable efforts have been made to develop curative therapies. Food allergen immunotherapy is a promising therapeutic approach for food allergies that is based on the administration of increasing doses of culprit food extracts, or purified, and sometime modified food allergens. Different routes of administration for food allergen immunotherapy including oral, sublingual, epicutaneous and subcutaneous regimens are being evaluated. Although a wealth of data from clinical food allergen immunotherapy trials has been obtained, a lack of consistency in assessed clinical and immunological outcome measures presents a major hurdle for evaluating these new treatments. Coordinated efforts are needed to establish standardized outcome measures to be applied in food allergy immunotherapy studies, allowing for better harmonization of data and setting the standards for the future research. Several immunological parameters have been measured in food allergen immunotherapy, including allergen-specific immunoglobulin levels, basophil activation, cytokines, and other soluble biomarkers, T cell and B cell responses and skin prick tests. In this review we discuss different immunological parameters and assess their applicability as potential outcome measures for food allergen immunotherapy that may be included in such a standardized set of outcome measures.

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