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Severe coronavirus disease (COVID-19) is characterized by an excessive proinflammatory cytokine storm, resulting in acute lung injury and development of acute respiratory distress syndrome (ARDS). The role of corticosteroids is controversial in severe COVID-19 pneumonia and associated hyper-inflammatory syndrome. We reported a case series of six consecutive COVID-19 patients with severe pneumonia, ARDS and laboratory indices of hyper-inflammatory syndrome. All patients were treated early with a short course of corticosteroids, and clinical outcomes were compared before and after corticosteroids administration. All patients evaded intubation and intensive care admission, ARDS resolved within 11.8 days (median), viral clearance was achieved in four patients within 17.2 days (median), and all patients were discharged from the hospital in 16.8 days (median). Early administration of short course corticosteroids improves clinical outcome of patients with severe COVID-19 pneumonia and evidence of immune hyperreactivity., (© 2020 Wiley Periodicals LLC.)

Purpose: To assess the overall survival (OS) of metastatic hormone-refractory prostate cancer (mHRPC) patients when treated with zoledronic acid (ZOL) in combination with docetaxel-based chemotherapy (docetaxel combined with estramustine or oxaliplatin or gemcitabine)., Methods: A retrospective chart review of mHRPC patients in our clinic was performed. At the time of data collection, 23 patients with mHRPC were identified, of which 15 were still alive at data analysis. Survival data was analyzed through Kaplan-Meier methodology. OS stratification by prostatic specific antigen (PSA) response (50% and 80% decline) and multivariate analysis of prognostic variables were also conducted., Results: 182 cycles of chemotherapy (mean 8.27 cycles, range 1-23) were recorded. Median OS was 26 months (range 5-56; 95% CI: 4.0-48.0). No patient achieved complete response (CR), 5 (21.7%) showed partial response (PR), 2 (8.7%) minor response (MR), 7 (30.4%) stable disease (SD) and 9 (39.1%) progressive disease (PD). Twelve (52.2%) patients exhibited a decrease in PSA levels >50% (9 of 12 >80%). No association of age, PSA response, or tumor response with OS could be demonstrated. The most frequent toxicities were anaemia (52.1%) and neutropenia (26%)., Conclusion: In our clinical setting, ZOL and docetaxel- containing chemotherapy was a beneficial therapeutic scheme for the patients in terms of safety and survival.

Background/aims: Although research on new effective treatments against pancreatic cancer is intense, limited therapeutic schemes are currently approved. The aim of the present study was to record the efficacy and safety of gemcitabine-erlotinib plus docetaxel combination therapy in patients with advanced and/or metastatic pancreatic cancer., Methodology: Twenty-five chemotherapy naive patients with histologically confirmed unresectable pancreatic cancer and documented extrapancreatic metastases, received biweekly gemcitabine 1,500mg/m2 during a 28-day long cycle; daily erlotinib 100mg per os; and docetaxel 80mg/m2 as intravenous infusion administered every 15 days. Patients were monitored every 4 cycles for survival, adverse events and tumour response with Computed Tomography scans., Results: Patients received 153 cycles in total, with a median of 7.64 cycles (range, 1-24). The median overall survival was 10 months and 45% of the patients reached and surpassed 1-year survival. No grade IV toxicities were recorded. The only grade III recorded toxicities were thrombopenia (4 patients, 16%), anaemia (1 patient, 4%) and neutropenia (1 patient, 4%). Overall the most frequently experienced adverse events were grade I anaemia (18 patients, 72%) and grade II rash (13 patients, 52%)., Conclusions: Biweekly gemcitabine with erlotinib plus docetaxel administration is a practical alternative to pancreatic cancer treatment, presenting comparable results to weekly gemcitabine administration.