Oncolytic virus effective in MCC
A South Australian case report demonstrates that intralesional therapy with talimogene laherparepvec (TVEC) can be effective in refractory merkel cell carcinoma (MCC).
The 75-year-old man diagnosed with MCC, against a background of sun damage and keratinocyte cancers, was initially managed with excisional biopsy then wider excision and skin graft. Pathology revealed clear surgical margins and a negative sentinel lymph node biopsy.
Adjuvant radiotherapy was followed by anti-PD-L1 immune checkpoint inhibitor avelumab after the appearance of metastatic lesions. He went on to receive two cycles of peptide receptor radionuclide therapy (PRRT) with Lu-177 DOTA octreotate (LuTate) concurrent with immunotherapy with only a short lived response to therapy then two cycles of IV carboplatin chemotherapy with no meaningful response.
Fortunately the patient had a dramatic and durable response to intratumoural injections of TVEC made available through compassionate access from the pharmaceutical company.
“In our patient, the introduction of TVEC appears to have augmented the immune response in some way, possibly through the local release of tumour antigens from the injected site, either leading to or combined with induction of systemic immunity,” the study authors said.
Read more in the Australasian Journal of Dermatology
Promise from JAKi in cutaneous sarcoidosis
The JAK inhibitor tofacitinib is showing promise in a small US trial of patients with long standing sarcoidosis.
Patients ranged in age from 53 to 63 years and had lived with sarcoidosis for an average of 13 years.
The researchers at Yale University reported that all ten patients in the trial with skin sarcoidosis saw improvements to their skin. Six patients had a complete response.
Of the nine patients with internal organ involvement, more than half showed improvement in either pulmonary or myocardial involvement.
“Four of five patients entering the study taking prednisone were able to discontinue or significantly reduce the dose.”
“Our mechanistic evaluation suggested that IFN-γ is a key driver of sarcoidosis and is a critical cytokine targeted by tofacitinib with effective treatment.”
Read more in Nature Communications
Long COVID common in healthcare staff
Almost three-quarters of healthcare staff continue to suffer from the consequences of COVID-19 for months after acute infection, a German study has found.
A survey of 2053 healthcare workers who had PCR confirmed COVID-19 disease in 2020 found that 73% experienced persistent symptoms for more than three months, with fatigue/exhaustion, concentration/memory problems and shortness of breath being most frequently reported.
Ongoing symptoms were associated with poor physical and mental health-related quality of life, with one-fifth of staff with persistent symptoms reporting depression and anxiety symptoms.
Risk factors for long term symptoms after acute infection included older age, female gender, previous illness, many and severe symptoms during the acute infection, and outpatient medical care.
The findings “demonstrate the urgent need for rehabilitation measures among those affected so that they can achieve an improved quality of life in terms of their health and work ability,” the researchers said.
More details: International Journal of Environmental Research and Public Health.