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Fitri NK, Nainggolan BWM, Firsty NN, Pradana A, Sari DK. The Addition of Atezolizumab to Chemotherapy in Non-Small Cell Lung Cancer: A Trial-Based Review and Meta-Analysis. World J Oncol 2024; 15:72-80. [PMID: 38274722 PMCID: PMC10807920 DOI: 10.14740/wjon1701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/06/2023] [Indexed: 01/27/2024] Open
Abstract
Background Non-small cell lung cancer (NSCLC) stands as one of the most prevalent types of cancer worldwide, driving extensive research in oncologic therapeutic approaches. Atezolizumab, among the treatments under scrutiny, is undergoing evaluation as a potential first-line therapy for NSCLC. This review aims to assess the efficacy of atezolizumab in treating patients with NSCLC and to shed light on the ongoing quest for the most effective treatment. Methods Multiple scientific databases, including PubMed, Cochrane, and ScienceDirect, were consulted. The literature identification utilized the strategic Boolean term method of keywords relating to "non-small cell lung cancer" and "atezolizumab" to suggest the analyzed population in our review without restricting the potential outcomes. The primary inclusion criterion is clinical studies that attempted to determine the efficacy of atezolizumab in NSCLC patients. Results We included four trials to be analyzed in the final analysis, which we stratified into the programmed cell death-ligand 1 (PD-L1) expressivity status aside from the pooled intention-to-treat (ITT) population. We found the addition of atezolizumab may significantly improve the overall survival (OS) in the respective arm, remarkably among the high PD-L1 expression group (TC3 or IC3). The result of our meta-analysis presented the pooled OS of 0.79 (0.72, 0.87) in 95% confidence interval (CI) with a P value of < 0.05. Sub-analysis of the PD-L1's expression revealed TC3 population benefits the most (hazard ratio (HR): 0.55, 95% CI (0.42, 0.73)), compared to low (HR: 0.80, 95% CI (0.68, 0.93)) and negative expression (HR: 0.79, 95% CI (0.68, 0.93)); which is statistically meaningful (P < 0.05). Similar result was also observed in progression-free survival (PFS) analysis with the HR value of 0.63 (0.55, 0.72), with P value of < 0.05, favoring atezolizumab arm. Conclusions Upon examination, the study reveals that the addition of atezolizumab demonstrates notable improvements in both OS and PFS among NSCLC patients. These findings present promising attributes for atezolizumab as a viable treatment for NSCLC. However, it is important to acknowledge that the future holds further revelations in this realm, and more insights are yet to be uncovered.
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Affiliation(s)
| | | | | | - Andika Pradana
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Dina Keumala Sari
- Department of Nutrition, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Siahaan AMP, Nainggolan BWM, Susanto M, Indharty RS, Tandean S. Managing the "big black brain" in low resource setting: A case report of early outcome after hinge craniotomy. Surg Neurol Int 2023; 14:427. [PMID: 38213438 PMCID: PMC10783690 DOI: 10.25259/sni_715_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/09/2023] [Indexed: 01/13/2024] Open
Abstract
Background The big black brain (BBB) phenomenon is described as an infant's response to an acute subdural hematoma (SDH). It is characterized by hypodensity and swelling of the supratentorial compartment as a whole. Numerous factors may contribute to the formation of the BBB. Due to its high morbidity and mortality, the management of BBB is still debatable. In this report, we describe a 2-month-old boy who had bilateral hemispheric hypodensity and underwent hinge craniotomy. Case Description The patient was referred to our hospital with decreased consciousness. The patient had a history of seizures and cardiopulmonary arrest. There is no history of trauma. The computed tomography revealed a subacute SDH on the left parietal and occipital lobe along with hypodensity in both hemispheres with preservation of posterior fossa, consistent with hemispheric hypodensity. We performed a hinge craniotomy for the emergency procedure and evacuated only the hemisphere with the bleeding side. The patient cried spontaneously 24 hours after the procedure and was discharged six days later. Conclusion Early outcomes of hinge craniotomy as an alternative procedure for treating the BBB were positive. However, long-term outcomes, particularly the infant's development, should be monitored.
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Affiliation(s)
| | | | - Martin Susanto
- School of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Rr Suzy Indharty
- Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
| | - Steven Tandean
- Department of Neurosurgery, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
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Siahaan AMP, Indharty S, Tandean S, Tommy T, Loe ML, Nainggolan BWM, Pangestu D, Susanto M. Middle meningeal artery embolization and pediatric chronic subdural hematoma: a systematic review of the literature. Neurosurg Rev 2023; 46:239. [PMID: 37697174 DOI: 10.1007/s10143-023-02130-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/13/2023]
Abstract
Chronic subdural hematoma (CSDH) is a disease commonly found in the elderly and not a typical finding in pediatric population. History of shunt surgery, child abuse, and blood disorder are some of the common causes of pediatric CSDH (pCSDH). There is growing evidence about the role of middle meningeal artery embolization (MMAE) to manage CSDH in the elderly population with a high risk of rebleeding. However, the evidence in the pediatric population is still sparse. A systematic literature search was conducted on PubMed, Scopus, and Web of Science database from January, 2023, to March, 2023. Search strings were generated based on the combination of modified search terms, such as CSDH, MMA embolization, and child. Risk of bias was assessed using the Cochrane Risk of Bias in Nonrandomized Study for Intervention. Nine articles were included in this review. The success rate of MMA embolization in pediatric CSDH was 88.8%. Histories of ventriculoperitoneal shunt, blood coagulation disorder, and trauma were the causes of CSDH. Time to achieve success was varied from 2 to 9 months. No study with low risk of bias was found. This systematic review found no high-quality evidence regarding the role of MMA embolization in the management of pCSDH. However, due to its high success rate, MMAE could be a promising approach to treat pCSDH.
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Affiliation(s)
| | - Suzy Indharty
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Thomas Tommy
- Department of Neurosurgery, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | | | | | - Dimas Pangestu
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Martin Susanto
- Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Siahaan AMP, Tandean S, Nainggolan BWM, Tarigan J, Sitanggang JS. A Critical Analysis of Intracranial Hemorrhage as a Fatal Complication of Dengue Fever. J Korean Neurosurg Soc 2023; 66:494-502. [PMID: 36642946 PMCID: PMC10483153 DOI: 10.3340/jkns.2022.0205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 12/21/2022] [Accepted: 01/12/2023] [Indexed: 01/17/2023] Open
Abstract
Dengue fever is the most rapidly spreading mosquito-borne virus in the world, infecting about 100 million individuals. A rare but possibly dangerous consequence of dengue illness is intracranial hemorrhage (ICH). Currently, the pathogenesis of ICH is unknown. A number of studies have found a variety of risk factors for ICH in dengue. In addition, studies have reported the use of emergency surgery while monitoring thrombocytopenia in the therapy of dengue ICH. This review enumerates the potential predictors of ICH in dengue, discusses the use of brain imaging, and mentions the possibility of emergency surgery.
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Affiliation(s)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | | | - Junita Tarigan
- Division of Infection and Tropical Medicine, Department of Internal Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
| | - Johan Samuel Sitanggang
- Undergraduate Program in Medicine, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Harapan H, Fathima R, Kusuma HI, Anwar S, Nalapraya WY, Wibowo A, Wati KDK, Medina A, Defrita AH, Astri Y, Prasetyowati A, Nurfarahin N, Khusna A, Oktariana S, Anwar S, Yussar MO, Khotimah S, Nainggolan BWM, Badri PRA, Argarini R, Winardi W, Indah R, Sallam M, Rajamoorthy Y, Wagner AL, Mudatsir M. Drivers of and Barriers to COVID-19 Vaccine Booster Dose Acceptance in Indonesia. Vaccines (Basel) 2022; 10:vaccines10121981. [PMID: 36560390 PMCID: PMC9783536 DOI: 10.3390/vaccines10121981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/15/2022] [Accepted: 11/19/2022] [Indexed: 11/24/2022] Open
Abstract
Obtaining a booster dose of coronavirus disease 2019 (COVID-19) vaccine is required to maintain the protective level of neutralizing antibodies and therefore herd immunity in the community, and the success of booster dose programs depends on public acceptance. The aim of this study was to determine the acceptance of a booster dose of COVID-19 vaccine and its drivers and barriers in Indonesia. A cross-sectional survey was conducted in the provinces of Indonesia between 1 and 15 August 2022. Individuals who completed the primary series of the COVID-19 vaccine were asked about their acceptance of a booster dose. Those who refused the booster dose were questioned about their reasons. A logistic regression was used to determine the determinants associated with rejection of a booster dose of COVID-19 vaccine. A total of 2935 respondents were included in the final analysis. With no information on the efficacy and safety of the COVID-19 vaccine, 95% of respondents agreed to receive a booster dose if it were provided for free by the government. This acceptance was reduced to only 50.3% if the vaccine had a 75% efficacy with a 20% chance of side effects. The adjusted logistic regression analysis indicated that there were eight factors associated with the rejection of the booster dose: age, marital status, religion, occupation, type of the first two vaccines received, knowledge regarding the importance of the booster dose, belief that natural immunity is sufficient to prevent COVID-19 and disbelief in the effectiveness of the booster dose. In conclusion, the hesitancy toward booster doses in Indonesia is influenced by some intrinsic factors such as lack of knowledge on the benefits of the booster dose, worries regarding the unexpected side effects and concerns about the halal status of the provided vaccines and extrinsic determinants such as the effectiveness and safety of the vaccine. These findings suggest the need for more campaigns and promotions regarding the booster dose benefits to increase its acceptance.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Tsunami and Disaster Mitigation Research Center (TDMRC), Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Correspondence:
| | - Raisha Fathima
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Hendrix Indra Kusuma
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Biology, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Biology Education Department, Faculty of Tarbiyah and Teacher Training, Universitas Islam Negeri Ar-Raniry, Banda Aceh 23111, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Widhy Yudistira Nalapraya
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Islam Bandung, Bandung 40116, Indonesia
| | - Adityo Wibowo
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Lampung, Bandar Lampung 35145, Indonesia
| | - Ketut Dewi Kumara Wati
- Department of Child Health, Faculty of Medicine, Universitas Udayana, Denpasar 80234, Indonesia
| | - Ayunda Medina
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | | | - Yesi Astri
- Neurology Department, Faculty of Medicine, Universitas Muhammadiyah Palembang, Palembang 30263, Indonesia
| | | | - Nurfarahin Nurfarahin
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Afriyani Khusna
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Setya Oktariana
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Sarifuddin Anwar
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Tadulako University, Palu 94148, Indonesia
| | - Milza Oka Yussar
- Faculty of Public Health, University Muhammadiyah Aceh, Banda Aceh 23245, Indonesia
| | - Siti Khotimah
- Biochemistry Laboratory, Medical Faculty of Mulawarman University, Samarinda 75119, Indonesia
| | | | - Putri Rizki Amalia Badri
- Public Health Department, Faculty of Medicine, Universitas Muhammadiyah Palembang, Palembang 30263, Indonesia
| | - Raden Argarini
- Department of Medical Physiology and Biochemistry, Universitas Airlangga, Surabaya 60132, Indonesia
| | - Wira Winardi
- Department of Pulmonology and Respiratory Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Rosaria Indah
- Medical Education Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman 11942, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman 11942, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, 22184 Malmö, Sweden
| | - Yogambigai Rajamoorthy
- Department of Economics, Faculty of Accountancy and Management, Universiti Tunku Abdul Rahman, Kuala Lumpur 43200, Malaysia
| | - Abram L. Wagner
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
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Siahaan AMP, Tandean S, Nainggolan BWM. Spontaneous epidural hematoma induced by rivaroxaban: A case report and review of the literature. Surg Neurol Int 2022; 13:420. [PMID: 36324933 PMCID: PMC9610455 DOI: 10.25259/sni_608_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 09/03/2022] [Indexed: 11/17/2022] Open
Abstract
Background: Trauma is the most frequent reason for epidural bleeding. However, numerous investigation had discovered that anticoagulants such as rivaroxaban could cause epidural hematoma. Here, we present a case of epidural hematoma in young man who got rivaroxaban as treatment of deep vein thrombosis. Case Description: A 27-year-old male with a history of deep vein thrombosis and one month of rivaroxaban medication presented with seizure and loss of consciousness following a severe headache. A CT scan of the head revealed epidural bleeding, and emergency blood clot removal was performed. As a reversal, prothrombin complex was utilized. Conclusion: Rivaroxaban has the potential to cause an epidural hemorrhage. Reversal anticoagulant should be administered before doing emergency surgery.
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Affiliation(s)
| | - Steven Tandean
- Department of Neurosurgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
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Siahaan AMP, Tandean S, Saragih EB, Nainggolan BWM. Spontaneous acute subdural hematoma in dengue fever: Case report and review of the literature. Int J Surg Case Rep 2022; 98:107512. [PMID: 35985111 PMCID: PMC9411658 DOI: 10.1016/j.ijscr.2022.107512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 08/07/2022] [Accepted: 08/11/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance A very uncommon dengue fever consequence is subdural hematoma. IgG positivity, increased AST, and ALT levels may all be risk factors for bleeding in dengue fever patients. Case presentation We report the case of a 65-year-old man who presented with dengue fever symptoms and developed altered consciousness and focal neurological deficits. The findings of the tests showed thrombocytopenia, increased AST and ALT, positive anti-dengue IgG, and subdural hematoma on brain imaging. The urgent operations were completed satisfactorily. Clinical discussion Dengue-related intracerebral haemorrhage is still a complicated condition. Thrombocytopenia and leukopenia are the first symptoms that point to dengue. Some risk factors, such as thrombocytopenia and increased AST and ALT, have been identified as bleeding factors in dengue fever. For a possible intracerebral haemorrhage, radiological imaging should be performed. In an emergency neurosurgery setting, thrombocyte administration could be used to monitor thrombocytopenia. Conclusion Subdural hematoma is a possible dengue fever complication. If the patient's symptoms with thrombocytopenia and elevated liver enzymes indicate the possibility of intracranial haemorrhage, immediate radiological imaging should be performed. Elevated AST and ALT as a risk factor of intracranial bleeding in dengue fever Immediate radiological imaging to the patients with positive IgG and intracranial haemorrhage symptoms. Emergency surgical intervention should be conducted depending on patient's status with thorough care in hematologic profile.
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