Blood serum from immunized humans or animals (e.g., horses) contains relevant antibodies and has been used as serum therapy to treat many diseases or envenomation events. The effectiveness of blood serum was initially discovered in 1890 when Kitasato and von Behring observed the effectiveness of this type of therapy against diphtheria and tetanus. Serum therapies played an important role in the advancement of modern medicine prior to the development of penicillin and steroids. At present, several types of serum therapy remain in clinical use. However, some physicians have a limited understanding of the nature and the benefits of serum therapy and the factors that require particular attention. In this review, we set out to clarify the benefits, cautions, and potential applications of serum therapy in the context of conditions such as gas gangrene, diphtheria, botulism, and tetanus and bites from three snake species (mamushi, habu, and yamakagashi) and the redback spider. It is hoped that this review will help clinicians to learn about clinical serum therapies and become familiar with their applications.
We describe the case of a 55-year-old man who underwent four cycles of cabazitaxel therapy for castration-resistant prostate cancer (CRPC). After the fourth cycle of cabazitaxel, the patient experienced severe headaches. Brain gadolinium (Gd) contrast-enhanced magnetic resonance imaging (MRI) revealed multiple brain metastases. A few days later, the patient suffered impaired consciousness that progressed rapidly. The patient was treated for the symptoms of increased intracranial pressure and underwent whole-brain radiation. One month later, the patient’s consciousness level and headache had improved. Although brain metastases of prostate cancer are rare, the possibility of brain metastases should be considered for prostate cancer patients, especially when a CRPC patient complains of headache. Additionally, even if major conditions such as cerebral hemorrhage are excluded by the use of non-contrast-enhanced computed tomography, brain Gd contrast-enhanced MRI should be performed in consideration of the possibility of brain metastases of prostate cancer.
Unresectable gastrointestinal cancers, such as gastric, hepatocellular, biliary tract or pancreatic carcinomas, are often resistant to anti-cancer systemic therapies, and often recur locally or even after aggressive local therapies leading to dismal survival rates. Recent developments in oncology, have offered renewed hoped for the development of more efficacious therapies. For example, our understanding of the oncogenic drivers in carcinogenesis has increased exponentially, and may potentially allow personalization of therapy. In addition, a great interest has been recently to target immune checkpoints, and unleash the potential of the immune system against cancers. Finally, new radiation techniques (proton therapy) allow delivery of curative doses in a safely manner. However, optimal translation of these new therapeutic approaches will require a concerted effort in clinical trials and in preclinical studies. I will present results from clinical correlative studies and preclinical models of these diseases performed at our institution and in collaboration with other American and European investigators. The insights gained from this bench-to-the-bedside and back approach raise the hope for a more efficient development of targeted agents in gastrointestinal cancers, with the goal of increasing survival in patients afflicted with these aggressive and deadly diseases. (Presented at the 1951st Meeting, October 30th, 2017)