Prognostic factors of refractory NSCLC patients receiving anlotinib hydrochloride as the third-or further-line treatment

Objective:Anlotinib hydrochloride is a multitarget tyrosine kinase inhibitor that targets vascular endothelial growth factor receptor,fibroblast growth factor receptor,platelet-derived growth factor receptor,c-Kit,and c-MET;therefore,it exhibits both antitumor and anti-angiogenetic activities.A phase III trial has shown that anlotinib improved progression-free survival(PFS)and overall survival(OS)in patients with advanced non-small cell lung cancer(NSCLC),who presented with progressive disease or intolerance after standard chemotherapy.This study aimed to analyze the characteristics of patients receiving anlotinib treatment to determine the dominant populations who are fit for the treatment.Methods:Data were collected from March 2015 to January 2017 from a randomized,double-blind,placebo-controlled,multicenter,phase III trial of anlotinib(ALTER0303).A total of 437 patients were enrolled and randomly allocated(2:1)to the anlotinib and placebo groups.Kaplan–Meier analysis and log-rank test were performed to compare PFS and OS.Cox proportional hazards model was adopted for multivariate prognostic analysis.Results:Multivariate analysis indicated that high post-therapeutic peripheral blood granulocyte/lymphocyte ratio and elevated alkaline phosphatase levels were independent risk factors for PFS.Meanwhile,elevated thyroid-stimulating hormone,blood glucose,and triglyceride levels;hypertension;and hand–foot syndrome were independent protective factors of PFS.High posttherapeutic peripheral blood granulocyte/lymphocyte ratio,an Eastern Cooperative Oncology Group(ECOG)score≥2,and the sum of the maximal target lesion length at baseline were independent risk factors of OS,and hypertriglyceridemia was an independent protective factor of OS.Conclusions:This study preliminarily explored the possible factors that affected PFS and OS after anlotinib treatment in patients with advanced refractory NSCLC,and the baseline characteristics of the therapeutically dominant populations were then identified.

Mycoplasma hominis Pneumonia Presented as a Cavitary Mass with a Halo Sign in an Immunocompetent Adult Male:A Case Report

Mycoplasma hominis is an opportunistic microorganism that colonizes the genitourinary tract and causes genitourinary infections.However,pulmonary infections caused by M.hominis have rarely been reported in immunocompetent individuals.Herein,we report a rare case of an immunocompetent adult male with M.hominis pneumonia who presented with multiple pulmonary nodules that progressed to a cavitary mass with a halo sign.The presence of M.hominis infection was confirmed using multiplex polymerase chain reaction(mPCR)of the bronchoalveolar lavage fluid.The patient demonstrated no response to the initial levofloxacin therapy;however,the symptoms subsequently improved after the administration of moxifloxacin.M.hominis may be an underestimated causative agent of community-acquired pneumonia of unknown etiology in immunocompetent adults,and the involvement of the organism should be especially suspected in sexually active patients.Molecular diagnostic methods,such as mPCR,can be used to identify the etiology of atypical pneumonia.Appropriate antibiotics are crucial for effective treatment.

Clinical practice of rapid antigen tests for SARS-CoV-2 Omicron variant:A single-center study in China

Responding to the fast-spreading SARS-CoV-2 Omicron variant, to improve screening efficiency, rapid antigen tests(RATs) were first added as a supplementary detection method in China in mid-March, 2022. What and how big a role RATs should play need to be supported by clinical data. Here, RAT performance and relevant factors in comparison with nucleic acid amplification tests(NAATs) were assessed in Omicron-infected inpatients. From the NAAT results, nasopharyngeal swabs(NPs) performed better than oropharyngeal swabs(OPs). RATs tested on NAAT positive NPs performed better than those with OP-positive samples. The RAT positivity rate was strongly associated with high levels of N and OFR1ab genes, especially in NPs where patients also had significantly longer hospital stays and shorter days from symptom onset to RAT testing. Self-performed RATs had a detection accuracy that was comparable to professionally performed RATs when the subjects were well guided. The antigen negative rate of the studied patients was 100% at discharge. These findings suggest that, in addition to a supplementary detection role, RATs can be an important strategy for evaluating the disease progression of Omicron-infected inpatients. This study provides important clinical data to support better rules regarding RATs under China’s COVID-19 prevention and control policy.

Longitudinal dynamics of antibody responses in recovered COVID-19 patients

Dear Editor,The coronavirus disease 2019(COVID-19)has resulted in more than 66.5 million cases globally in more than 191 countries with overl,529,000 mortalities as of 6 December.Currently,the COVID-19 continued to spread around the world,while the duration of antibody lasts and antibody level remained poorly understood,which are primary for safe and effective antiviral treatments and vaccines in the future.In this study,we comprehensively characterized the longitudinal changes of antibodies in recovered patients from 5-7 to 34-42 weeks after symptom onset.