Ochsner Medical Center

About: Ochsner Medical Center is a healthcare organization based out in New Orleans, Louisiana, United States. It is known for research contribution in the topics: Population & Medicine. The organization has 980 authors who have published 1159 publications receiving 49961 citations. The organization is also known as: Ochsner Hospital & Ochsner Foundation Hospital.

190 Timing of steroid doses and response rates to immune-checkpoint inhibitors in metastatic cancer

Abstract: Background Corticosteroids (CS) are the mainstay of immune-related adverse effect (irAE) management, as well as for other indications in cancer treatment. Previous studies evaluating whether CS affect immune checkpoint inhibitor (CPI) efficacy compared patients receiving steroids vs. no steroids.1 This comparison may be confounded by different rates of irAEs, which are known to be associated with higher response rates to CPIs. Preclinically CS have been shown to diminish naive T-cell proliferation and differentiation,2 though there is a paucity of clinical data evaluating how the timing of concomitant CS affects CPI efficacy. Methods We retrospectively collected data from patients treated with CPIs alone, who received CS during their CPI treatment at a single institution. Patients were allocated into two cohorts based on timing of initiation of CS (> 2 months vs. Results We identified 247 patients with metastatic cancer who received CS concurrently with CPIs alone. The majority of patients had non-small cell lung cancer (n=98), followed by renal cell carcinoma (n=43), and melanoma (n=30). 242 patients were on PD-1 inhibitor monotherapy, while 45 patients received CPI in combination with anti-CTLA-4 ipilimumab (table 1). The median time on steroids for all patients was 1.8 months. After adjusting for differences in rates of treatment type, tumor type, brain metastases and irAEs, patients who were treated with CS > 2 months after starting CPI had a statistically significant longer progression free survival (PFS) [HR of 0.33, p≤0.0001], and overall survival (OS) [HR of 0.36, p≤0.0001] than those who received steroids 2 months was 39.8%, vs. ORR for patients Conclusions After adjusting for possible confounding factors such as rates of irAEs, our results suggest that early use of steroids during CPI treatment significantly hinders CPI efficacy. These data need to be validated prospectively. Future studies should focus on the immune mechanisms by which CS affect T-cell function early in CPI treatment course. References Garant A, Guilbault C, Ekmekjian T, Greenwald Z, Murgoi P, & Vuong T. ( 2017). Concomitant use of corticosteroids and immune checkpoint inhibitors in patients with hematologic or solid neoplasms: a systematic review. Critical reviews in oncology/hematology120, 86–92. Giles AJ, Hutchinson MKN, Sonnemann HM, Jung J, Fecci PE, Ratnam NM,. .. & Reid CM. Dexamethasone-induced immunosuppression: mechanisms and implications for immunotherapy. Journal for immunotherapy of cancer 2018;6(1):1–13.

Late breaking trials of 2014 in structural heart disease and peripheral arterial disease: Commentary covering ACC, EuroPCR, SCAI, TCT, VIVA, ESC, and AHA: Late Breaking Structural Trials of 2014

Abstract: With the plethora of clinical trials, it is difficult for busy interventional cardiologists to stay up to date. Therefore, the SCAI Publications Committee concisely summarizes and provides editorial commentary on the most important structural heart and peripheral arterial disease trials from the large international meetings of 2014. The intent is to allow quick assimilation of trial results into interventional practice. © 2015 Wiley Periodicals, Inc.

Community Redevelopment, Tax Increment Financing and CRED

Abstract: One of the most important aspects of community development is the notion of private public partnerships in which a government entity partners with a private sector developer to complete a development that neither could have done on their own. One of the most widely used forms of public-private partnership development agreements is tax increment financing, better known as TIF. This chapter looks at the history and pros and cons of TIF when it comes to community redevelopment and how it has benefited and benefits CRED.