Objective To evaluate the impact of fractionated CO2 laser therapy on vaginal atrophy and mild/moderate stress urinary incontinence (SUI) symptoms in patients with physiological or surgically-induced menopause. Materials and Methods Post-menopausal patients (n = 33) presenting vaginal atrophy and/or SUI, underwent three vaginal CO2 laser treatment sessions, performed at 1-month intervals. Vaginal symptoms were evaluated using the Vaginal Health Index Score (VHI-S), Visual Analogue Scales (VAS) for dyspareunia and global patient satisfaction. The impact of urinary incontinence on patient quality of life was evaluated using the International Consultation on Incontinence Questionnaire (ICIQ). Symptoms were evaluated before treatment and at every subsequent treatment session, as well as 3 months following the last treatment session. RESULTS The three-session treatment series led to a significant improvement in both subjective symptoms (dryness, burning, dyspareunia) and clinical signs (VHI-S) (P < 0.01). In addition, reductions in the frequency and severity of SUI symptoms (P < 0.01) were noted during the treatment period, and were maintained after for at least 3 months after completion of the treatment course. Improvements in VHI-S were significantly greater in patients with surgically-induced menopause, as compared to those with physiological menopause. The vast majority of patients (90%) were satisfied with the procedure, and reported a significant improvement in quality of life. No adverse events were recorded throughout the study period. Conclusions Fractionated CO2 laser therapy is a safe, effective and easy-to-perform treatment modality for menopause-related vaginal atrophy and SUI.

Cancer immunotherapy is now recognized to be fundamental in modern oncology, because immune system recruitment may represent a powerful and innovative strategy in cancer therapy. Pembrolizumab, a highly selective humanized monoclonal antibody directly blocking the interaction between programmed cell death-1 expressed by tumor-associated T-cells and its ligand programmed cell death-L1 present on tumor and stromal cells, was recently approved by US Food and Drug Administration for the treatment of patients with unresectable or metastatic melanoma and disease progression upon ipilimumab and BRAF inhibitor. This review will focus on the clinical development and use of pembrolizumab in the clinical practice and in the management of advanced melanoma.

Objective: To assess the predictive and prognostic value of progressive metabolic disease (PMD) by the use of early ¹⁸Fluorodeoxyglucose positron emission tomography (¹⁸FDG-PET) in patients with clinical stage IV non-small cell lung cancer (NSCLC) treated with first-line chemotherapy. Methods: An ¹⁸FDG-PET performed following the first cycle of chemotherapy (PET-1) was compared with a pretreatment ¹⁸FDG-PET (PET-0) and a computed tomography (CT) scan after the third cycle (CT-3). The primary endpoint was the positive predictive value (PPV) of PMD. Secondary endpoints included the prognostic value of PMD. Results: Eleven of 38 patients (29%) had a PMD by PET-1, and 15 (39%), including all patients with a PMD, experienced a progressive disease by CT-3. The PPV of PMD was 100% according to both the European Organization for Research and Treatment of Cancer (EORTC) criteria and the PET Response Criteria In Solid Tumors (PERCIST) (p value for both, <0.0001). Patients with a PMD by PET-1 had a median overall survival of 7.0 months versus 14.0 months for those without a PMD (p = 0.04, according to the EORTC criteria). Conclusions: Early ¹⁸FDG-PET assessment deserves further investigation for the identification of NSCLC patients who do not benefit from first-line chemotherapy.

No abstract

ObjectiveTo evaluate the efficacy and tolerability of a neoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy in patients with locally advanced cervical carcinoma.MethodsPatients with histologically confirmed locally advanced cervical carcinoma, aged ≥18 years, were treated with intravenous ifosfamide 5,000 mg/m2 and mesna 5,000 mg/m2, on day 1; intravenous paclitaxel 175 mg/m2 and cisplatin 75 mg/m2, on day 2; every 3 weeks for three cycles. Following chemotherapy, operable patients underwent radical hysterectomy and pelvic lymphadenectomy, and, if necessary, adjuvant radiotherapy.ResultsOne hundred fifty-two patients with median age 53 years (range, 24 to 79 years), FIGO stage IIB in 126 (89%), were treated with chemotherapy for median 3 cycles (range, 1 to 3). Treatment was delayed or withdrawn in 23 patients (15%). One hundred thirty-nine patients (91%) underwent surgery. Postchemotherapy pathological complete response rate was 18% (25 patients). Postoperative radiotherapy was administered in 100 patients (72%). The 5-year overall survival and progression-free survival were 87.3% (95% confidence interval [CI], 84.5 to 90.3) and 76.4% (95% CI, 73.5 to 79.5), respectively.ConclusionNeoadjuvant paclitaxel, ifosfamide, and cisplatin chemotherapy was feasible and effective in the treatment of locally advanced cervical carcinoma patients with older age and more advanced disease stage than reported in previous studies. Hematological and renal toxicity could be carefully prevented.