Second-line FOLFIRI plus ramucirumab (RAM) is one of standard treatments for metastatic colorectal cancer (mCRC) following progression on anti-EGFR therapy in RAS wild-type tumors. However, biomarkers for RAM efficacy remain unclear. We conducted a translational analysis to evaluate the association of plasma biomarkers, including angiogenesis-related factors (AFs) and RAS mutations in circulating tumor DNA (ctDNA), with clinical outcomes. This biomarker study was embedded within the JACCRO CC-16 trial, which enrolled patients with mCRC with RAS wild-type tumors receiving FOLFIRI plus RAM after anti-EGFR therapy. Plasma samples were collected at baseline, day 15, and post-treatment. RAS status in ctDNA was analyzed using BEAMing digital PCR; AFs were assessed using Luminex multiplex assay. Associations with progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) were analyzed. Among 41 evaluable patients with RAS wild-type tumors, RAS mutations were detected in ctDNA at pretreatment in 44
Abstract Background This study aimed to evaluate the safety and effectiveness of the Kanshas drug-coated balloon (DCB) with paclitaxel for the treatment of atherosclerotic lesions in the superficial femoral artery (SFA) and/or proximal popliteal artery (PA) over a 3-year period. Results A prospective, multicenter, single-arm trial enrolled 121 patients with symptomatic lower extremity artery disease (LEAD). At 3 years, the primary patency rate was 63.4%, and freedom from clinically driven target lesion revascularization (CD-TLR) was 83.2%. Sustained improvements were observed in Rutherford classification, ankle brachial index (ABI), and walking impairment questionnaire (WIQ) scores. No device- or procedure-related deaths or major amputations occurred. Conclusions The Kanshas DCB showed favorable safety and effectiveness for treating atherosclerotic lesions in the SFA and/or proximal PA over 3 years. Trail registration Registration ID: UMIN000034122. Registration Date: September 13, 2018. Registration site URL: https://center6.umin.ac.jp/cgi-openbin/ctr/ctr.cgi?function=brows&action=brows&recptno=R000038612&type=summary&language=J . Graphical Abstract
In the 5th edition of the WHO classification, Epstein-Barr virus (EBV)-positive nodal T/NK-cell lymphoma (EBV+ nTNKL) is a newly defined, poor-prognosis disease originating from cytotoxic T cells. Here, we report a rare case of lymphoma arising in immune deficiency/dysregulation with an immunophenotype of EBV+ nTNKL that emerged during treatment for follicular lymphoma (FL). A 71-year-old woman was diagnosed with FL grade 3A and received chemotherapy with rituximab. Despite treatment, the disease relapsed repeatedly. During follow-up, she presented with fever and lymphadenopathy. An axillary lymph node biopsy revealed a diffuse proliferation of abnormal lymphocytes expressing CD3, CD4, TIA-1, granzyme B, and EBER, consistent with the EBV+ nTNKL immunophenotype. CHOP therapy was administered; however, disease control proved difficult, and the patient died 5 weeks after diagnosis. This case exemplifies a rare occurrence of EBV-associated lymphoma arising during the course of B-cell lymphoma. Our experience underscores that rapid clinical deterioration (e.g., fever, hepatosplenomegaly, or B symptoms) during the course of FL should prompt consideration of EBV-associated lymphoma in the differential diagnosis, alongside histologic transformation. Further case reports and molecular analyses should help improve diagnostic accuracy and establish treatment strategies for this rare and aggressive disease.
BACKGROUND Intraocular pressure (IOP) elevation secondary to intraocular hemorrhage after intravitreal anti-vascular endothelial growth factor (anti-VEGF) injection for age-related macular degeneration (AMD) is exceedingly rare. Although mild, transient hyphema has been reported, secondary glaucoma caused by hemolysis or ghost cell formation has not previously been documented in this setting. CASE REPORT A 54-year-old man presented with decreased vision and was diagnosed with exudative AMD in the right eye. Baseline evaluation showed subretinal hemorrhage and macular neovascularization, and intravitreal aflibercept injections were initiated and continued for 1 year. Three days after the tenth injection, the patient developed blurred vision, progressing to hand-motion vision by day 4. Slit-lamp examination revealed hyphema with a fluid level, and IOP increased to 50 mmHg despite conservative therapy. The patient underwent anterior chamber irrigation and phacoemulsification with pars plana vitrectomy. Intraoperatively, mild vitreous hemorrhage was observed, and temporal scleral indentation revealed a localized blood clot adherent to the pars plana and vitreous base at the injection site. Postoperatively, IOP normalized, without recurrence of vitreous hemorrhage or exudative activity during 1-year follow-up. CONCLUSIONS This case demonstrates that hemolytic glaucoma can develop even after intravitreal anti-VEGF injection in AMD, a context in which intraocular bleeding is uncommon. Clinicians should remain vigilant to postinjection IOP elevation, and timely surgical intervention can yield favorable visual and pressure outcomes.
