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edenmartinez · 6 months ago

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Performed felled

Durability/performance/ safety/Se

Related infections

Result

transmission rates

• prove the case

• Me bought is posible in what store Instrumentive 90% in the intuiticion Patient injury

I Endoscopy design

small convention sgap expected contamination In 0%

Sign and sinthomy

Risk of contamination

For not cime constipation new scope 10%

now one solution what is 5the future hold

Señas de proves

Novel washing modalitié Table top

& Some remove biofil

other modalities Capaple o esterilazation long lumens, in develoments

*pinzas *electrolisis

sponge

*Refrigator

*Pale Cleaner

China Karten

*Desinfection termica- baño de maria

*alcohol

*Miltrex Instrument

*Surgery cleaner

*desinfection for methods chemystre

*evaporation

*Germicide[ Glutaraldehido; peroxido de hidrogeno y acido peritico

Cloruro mg

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Silicato ppm

Valor ph

Acido citrico

Fosforicos

Orto-phalardehido

Peroxido de hidrogeno

Acido peracético

Miltex instrument

Surgery Jeaner

Destinacion por metodo

Circulo de Sinner

resistence corrosive presencia el agua

potable

Desalinizacion unsesfully del ag

Sal regenerator dragged ion exchangers

Comprobar con Norma Iso 10993 -3 Evaluacion Biologica de productos sanitarios

Level Antidrug concentracion high Concentration can result increase toxicity Low result in efficary biologics immunogenicity non- I ENF

Commonly performen other situation in

ransomized of considered dosie an adition

of therapy drug monitorizing

Ciclosporine an tacroliti-mas user organ

trasplation

Dancomycin angentamycin in sepsia

The presentation regarder show the monotherapy and study How is needly the cortecosteroide and others transition

considerations in the treatment inclusive options treatment

Conmeeting have the wormen virgin period its premenospause

Maintenance drops, for induction and derivates of quimiotherapy of that list of medicament is necesary for the study and benefict of patient pharmaeconomic benefict.

Potencial TDM and STRC

Redused in drug concentration

Monitorizing Drug with inmunohilatores to antibodys of immunogenocity..

Certolizumab pegol >20

Golimumab post induction > 10

Vedolizumab > 3

Ustekinomab > 5

Cledolizumab week >2,4 10 Cledoligimen. week 2,8 post induction, 8, 3, 5

of week 14 levels prediting duabiling

Sustained

PIFX Dose Dashboard

For Symphony of reflux electrodo-up the next quipement

One consicered

GERD = Infectious System To prevent rejection of organ transplant recipients

Hermozone: Cream with metamethazone conicoids: gel fusicor

Gel fusico GERD = Infectious System To prevent rejection of organ transplant recipients

What are antibodys - Drug congugates monoclonal antibodys Linked to a cytotoxic drug des to -n the therapeulic window by focusing a delivery to specifics cells.

*Tumor antigen *binding site

*monoclonal antibody

* selective for antigeno

with high copy numbers in target tumor celk with minimal inmyngenic response.

Linkers Can be cleavable (a temo Cells, Linkers Can be cleabank via tumor-

associated factors) or non-cleavable (via tumor associated factor of monel cavable (Lysosomalal degration

Payload:enhances cytoxicity all Thoughes and septicity although antibody raty afecct and clearance

Antibody bind target antigeno. Internalized → → payload releas +

bystander gel

ADCS may circulate as dynamic mixture of contact conjugate, naked antibodys,and

free payload

ACDS Reach tumors via capiliares releasing somepayload in micro

enviroment ass diffuse toward target

Any's independing tacles

Antibody engagement payload -

independent antitumor activity

Disruption o receptor dimerization and

funtion leads to disruption ofdownstream signaling

Antibody Drug congugates: Mechanism of action

• what are antibodys - Drug Congutgates + Monoclonal antidays Linked To a

CYTOTOXIC drog designes to ovide the therapevtic window by focusing a delivery To specific cells

Turmor antigen the hy

•Antibody binds target antigen Internalized 7 Payload release ADCS may circulate as dynamic mixture of context congujate, naked antibodys,

Conjugate, naked antibody, and free payload

ADCS reach tumors via capiliares releasing some payload in tumor micro enviroment aa diffuse toward target

ADCS: More than the Sum of their parts

Efective in heavily pretreated patient of those who have resistance to treatment antibody or chemotherapy components may be due to a superior therapeutic index Components vary, eg, FDM1 vs I-Dxd! vs Additive benefit from best. bystander Effect

Identifying the mechanist of effacey is challenging given multiple contributing part

ACDS toxicityies

Grade 3/4 Neutropenia by ADC on targeted ADC pivatuzumab off target an off tumor more difusse payload release inadverted

cellular uptake.

Anemia, neutropenia seen with many ADCS unknow pulmonaty toxicitys with many ADCS unknow pulmonaty with t-Dxd

THC imunohistochemistry

predictive biomarkers for ADCs hard to establish

•Where will ADCs for within the current

treatment Porading for lung cancer?

• Consideration of ADCs in combination with agent thar increase APC delivery modulate target antigen any or for internalization Promove antitumor immunity,

in comon, up Be complex bypass infysion guideline Opideline (ACD proteins)

by an antibody drug conjugate 's wely expressed IGFR mutation with con monosiclive tumor with adquired resistance To EGFR Targeted is Antigen is the ADC ressistention to antibodies

monociclive from tumor cell via endoson recicly prior to payload release Minimum issues chemotherapy or quimiotherapy

Halganior promore antllemor

is Antigen is the ADC. ressistention to Antibodies monactive From Tumor cell vier end es gon feciding, prior to praylord Teles

Lover is the thored meal for cance

example Urothelia Camer

Whal I describe of Her 3 itsel

Lmmunohibidor

HER3 DX d

operacion (Surgery 2 operasion (Surgery)

By pas asi minth

The atmen

I operacion (Sunger) operasion (Surgery,

By pas asiaminib

fuimia her afte -reatmen is overall 3 Mon

inimum issues

Insugnificance issues

Chemotherapy or Quimiotherapy Mechanism of resistance, to osimetris

Toaclina

Water

Witch GI is no have phrase

Hiz incidence of lineage plasticity including both small cell and squamous transformation by Frequent adquired gene alteration (eg, gene fusion)

Anticipate a role for non biomarker select in therapies in setting of osirmertinib resistance

Progresion Oh Osimertinib subpectos

• obtein brain MRI and chest/abdomen/ pelvis Ct

•Radiographic progressing lesion and submit for biomarker testing consider Liquid biopsy if tissue biopsy not feasible

but less sensitive for fusion/

transformations.

• Oligome ometastatic continue TX with addition of log ablative

•Slows and/or asymptomatic. Continue to beyond progression

•

CNS only. If Limited, continue tx with addition

if diffuse transition to CNS-penetrant Systemic

Progression on Osimerinibs. Supped to

Obtein brain MRI and Chess/aboomen, peluk- Pabgraphy of progresing confirmed! Consider whether special circumstances are obtein tissue present

obiopsy of progresing lesion and Submit for biomarker testing: consider liquid biopsy of tissue biopsy nor feaside, but

less sensitive for fusion/ transformation

bypass pathways

⚫met amplification

⚫clinical trial of Combined EGFR/MET

Inhibition

• Osimetinib + Met inhibitor (eg, crizotinibtinib, capmatinib

Fusion clinical trial

RET: OsimerTinibt

Ret Inhibitor (eg, Pralsetinib selpercatinib

ARK: Osimertive +ALK TIKE

Ros1 osimertinibt ROSTRI

Anexo.

maintenance Therapy observation

Osimetinib is almost in clinical

Considerated

is the standar of care Chemo Therapy (Histology, driven, platinum-based

Long Cancer

Anemia >

EGFR

PHASE III

Pembrolizumab - Carboplatin /

permetraxes.co alone in Advanced NSCLC Vs Chemotherapy add EGFR mutations with L858R or del19 EFRG mutations after EGFR IKI Therapy

mechanism or fusion of therapy

transformation of histology teatretment, follow up with, X Ray, abdomen of confirmed Progress

1First chemotherapy

2 on therapy I will aproximing

3 hemoestasis

4 Metastasis

trombotic Nervious sistem

Adjuvant treatmen in deumatic diseases o Spookify your armets, Juvenile reumatoid arthritis, post-traumatic Osteoarthritis, etc.) or in exacerbation of rheumatoid psoriatic arthrit.

Peace dose gradually avoid disease High doses decrease song every 1-2 days Weeks up to 18mg gay 19 Average dose 20-60mg day decreasdz by 5mg by 5.g

Starting at 10 ming day, decrease by 2,5 mg every 1-2 weeks.

mild dermal and Join Outbreaks Can be enough Short Courses of Cortecosteroids evidence how to be the construction in future of organ trasplnt in benefic of surge

What Phase no Have metatasis.

Ciclofosfamida

Classic Indications

Vasculitis Sistemicas con afectation and organs remopulmonary syndrome

Nefropatia Lupica Tipo III, IV Alveolitis fibrosane of multiple sclerosis sistemica

In monarche patient with hormone receptor (HR)-positive/HER2-mode- positive high risk EBC and previous

surgery and radiotherapy an indicated and adjuvant chemotherapy were randomize to receive adjuvant endocrine Therapy with or without adjuvant abemaceclir for two year. After a median follow of 19.1 month

treatmen with aberacidib up plus endocrine therapy significantly reduced the risk of an invasive desease-free

survival (IDFS) event hazan ratio 0,71, 95% Cl: 0,58-082; P=01) The benefit was even greater in patient with a Ki-67=20% (Harzard ratio 0.69, 95% CI: 052-092

Lon biopsy confirms invasive ductal carcinome estrogen receptor (ER) Positive, progesterone keeptor PR positive and HER2 negative Ki-67- Scome was 60% Germline mutation testing confirms no patogeny Vananita She plans to underjo Meoadjuvant Chemotherapy followed by

surgery

Guideline Recommended Biomaker testing For Breast Cancer

[on biopsy confirms invasive ductal carcinome estrogen receptor (ER) positive, progesterone keeptor positive and HER2 negative K1-67- Scone was 60% Germline noutation testing confins no patogeny Varianita She plans to undergo

Medadjuvant Chemotherapy followed by

surgery

Guideline Recommended Biomarker testing For Breast Cancer

Breast cancer receptor status Should be determinated as part of the diagnostic Workup for patient worth newly aliagnosed or current breast cancer, including Here statue by inmonohistochemistry with or witho Fluorescence in situ hybridization if needed and HR Status including ER and PR F3. several gene expres assays are avalaible that can help predict risk of recurrence and response to systemic therapy More recently germine mutation resting has been incorporated"

manregements of £BC, especif booking for BREA mutation To quide at uvant Herapy Select For patient with Her 2 negative breast cancer. "Las

me asurement of the Ki-67 antigen can be helpful when Considery specific targeted the rapies Such as aberma why the begen of breast tumlr like drive to cancer

Among pation with metas

breast cancer approximately 50% will desselop brain To F

metastaser managing brain metastases is a critical Before the last year

part of caring the population - There were no agent that Where no feven to be to treat central nervous metastases and result improved outcome me

Optimising systemic therapy for patient with Herz Pos. The early breast cancer

based den deseas charac-

terist and risk

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