The aim of the study is to analyze reports of adverse drug reactions published in the scientific literature occurring during and after the use of kinase inhibitors for the treatment of rheumatologic diseases to determine their type, frequency, and severity. The search was conducted in the MEDLINE and PubMed databases from January 2005 to May 2022. We found a total of 291 publications, from which we selected suitable ones for data extraction. We conducted descriptive and variation analyses as the main statistical analyses. We determined mean values, standard deviation, minimum, maximum, and 95% confidence intervals. The PICOS tool was used to evaluate the results. The analyzed population includes patients with rheumatologic and oncologic diseases. There is a significant interest in the drug safety of kinase inhibitors, as they represent a rapidly evolving and reliable pharmacological class. Clarifying the safety profile of their representatives remains important. In-depth review of full-text publications shows that the high frequency of reported serious ADRs is rather due to increased interest in reporting and publishing these cases than to their high frequency of occurrence.

Background/Objectives: Small cell lung cancer (SCLC) is a highly metastatic and lethal malignancy. Doublet chemotherapy consisting of a platinum compound and etoposide had remained the standard first-line regimen for decades, particularly for the majority of patients, who are diagnosed with extensive-stage disease. Over the past 5 years, results from the IMpower133 trial led to the approval of anti-PD-L1 agent atezolizumab as part of the first-line regimen for extensive-stage SCLC. The accumulation of real-world evidence on atezolizumab efficacy in this context is essential for corroborating trial results and further improving patient outcomes. Herein, we present real-world evidence from a Bulgarian cohort receiving atezolizumab as part of first-line extensive-stage SCLC treatment, comparing these data to the results of IMpower133. Methods: Data were extracted from the electronic health records of patients receiving atezolizumab plus chemotherapy as first-line treatment for extensive-stage SCLC in the period between 1 January 2022 and 31 December 2024. Analysis was conducted via the Danny Platform, an analytic platform for the integration of real-world evidence using embedded machine learning and LLM algorithms. Patients matching IMpower133 inclusion criteria were included in a group for comparison with trial results. Results: A total of 302 patients were included in the analysis. The real-world progression-free survival (PFS) in our study surpassed that in IMpower133 (7.6 versus 5.2 months), in addition to higher PFS rates beyond six months. A lower Objective Response Rate (ORR) (38.7% versus 65.4%) was noted in our real-world cohort, which we attribute to real-world documentation practices. Conclusions: Real-world evidence regarding PFS and treatment response generally align with the efficacy of adding atezolizumab to first-line extensive-stage SCLC treatment reported in the IMpower133 trial, while reflecting differences that may arise in routine clinical practice.

Small intestine cancer encompasses a group of malignant diseases originating in the duodenum, jejunum, or ileum. Although they account for only 3-5% of all gas-trointestinal carcinomas, their incidence is increasing, unlike more common malignant diseases, such as colorectal carcinoma, which makes their study increasingly important. Objective: to analyze the main malignant histological subtypes – adenocarcinomas, neuroendocrine neoplasms, gastrointestinal stromal tumors, and lymphomas – and to summarize and systematize the available literature data. Materials and Methods: We applied a narrative review study design involving the summarization and interpretation of existing literature data on the given topic and objective in order to create a structured, comprehensive scientific product on malignant diseases of the small intestine. We analyzed 20 literature sources. Results and Discussion: The etiology of small intestine cancer is multifactorial and can be divided into well-defined hereditary cancer syndromes and acquired chronic inflammatory conditions. Malignant tumors of the small intestine are a rare but increasingly common group of diseases that are difficult to manage due to their heterogeneity. This biological heterogeneity requires highly specific diagnostic, surgical, and systemic (e.g., targeted therapy for GIST, immunotherapy for MSI-H SBA, PRRT with 177Lu-DOTATATE for NETs) management strategies. Optimal results for the treatment of these rare tumors require a specialized, multidisciplinary approach, concentrated in high-tech centers and institutions.

The analysis included 466 patients with myelofibrosis on treatment with ruxolitinib. The PFS at 12 ^th , 20 ^th , 30 ^th , 40 ^th , and 50 ^th month was 88%, 83%, 75%, 65%, and 61% respectively. Median for PFS was reached at 73.5 months. OS median was reached at 48.2 months. OS at month 12 ^th , 20 ^th , 30 ^th , and 40 ^th month was 87%, 78%, 70%, and 56% respectively. Eligible patients for comparison with COMFORT-II trial after application of inclusion and exclusion criteria were 68, while the clinical trial included 146 patients. The estimated value for PFS at 12 ^th month was 84% and the median PFS was reached at 35.3 months. The values for OS was estimated to be 74% at 12 ^th month and the median of OS was reached at 30 ^th month. The clinical benefit rate from real-world population was estimated at 98%, and objective response rate was estimated at 79.2%, based on 53 patients.

Globally, pancreatic cancer continues to be a significant health problem. The number of new cases has been increasing by an average of 0.8% per year over the last decade. The prognosis remains extremely poor, with a five-year survival rate of 7.2%, confirming its reputation as one of the deadliest malignant diseases. Objective: to ana-lyze recent developments in the management of the diagnostic and treatment process for pancreatic cancer. Materials and Methods: systematic review of scientific publications through documentary analysis and analysis of the content of scientific publications selected by predefined key words. Results and Discussion: pancreatic cancer is one of the greatest clinical challenges in modern oncology, characterized by an extremely high mortality rate. Due to the lack of specific early manifestations and the biological aggressiveness of the disease, diagnosis is delayed in more than 80% of cases. Pancreatic disease should always be considered in the differential diagnosis of any acute or chronic pain. Successful management of these complex tumors requires a nuanced, multidisciplinary approach that integrates precise diagnosis, staging, and individualized therapeutic strategies.

Tofacitinib has raised cardiovascular safety concerns despite its proven therapeutic value in inflammatory diseases. This study evaluated its preclinical cardiovascular effects in a mouse model after 28 days of treatment with three different doses. Tofacitinib induced dose-dependent reductions in systolic and diastolic blood pressure, with significant effects evident by day 14 and more pronounced by day 28. Heart rate showed only minor, non-significant fluctuations, while serum creatine kinase and creatine kinase-MB decreased. Body weight gain was inhibited in treated animals, and mortality occurred only in the low- and medium-dose groups. The cardiac troponin I assay showed negative results in the control and tofacitinib-treated groups, and an increase in isolated rat basilar artery tone was induced by tofacitinib. Overall, tofacitinib produced measurable cardiovascular and systemic effects, supporting the need for further mechanistic studies and careful cardiovascular risk assessment.