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Abstract This is a single arm prospective phase II study conducted to assess the efficacy of fractionated weekly cisplatin-based neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer (MIBC) who are unfit for the standard 21-days chemotherapy regimen due to impaired renal function. Twenty-five patients were recruited between February 2015 and July 2017. Inclusion criteria were; age ≥18 years old, histopathologically-proven urothelial bladder cancer, stage T2-T4a, calculated glomerular filtration rate (GFR) of 40-60 ml/min, no metastasis and with adequate organ function. Chemotherapy given was cisplatin (35 mg/m2 d1, d8, and q21) plus gemcitabine (1,000 mg/m2 d1, d8, and q21) for three cycles followed by local therapy. Median age was 63 years (Mean±SD; 60.76 ±1.67 years). Most patients (21/25; 84%) were males. Almost half of the patients (13/25; 52%) had T3.Treatment was well-tolerated. All patients completed the scheduled 3 Cycles. 3 (12%) patients developed complete response, 10 (40%) partial response, 6 (24%) stable disease, while 6 (24%) developed progression. Median survival was 23 months (95% CI; 18.1-27.89). Fifteen (60%) patients underwent surgery, while 5 (20%) patients underwent bladder preservation. Four (16%) patients were shifted to palliative care and 1(4%) patient declined any further treatment. In conclusion, fractionated weekly cispaltin-gemcitabine neoadjuvant chemotherapy in MIBC patients with impaired renal function is feasible and safe with good clinical response. Further larger studies are warranted.

Abstract This is a single arm prospective phase II study conducted to assess the efficacy of fractionated weekly cisplatin-based neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer (MIBC) who are unfit for the standard 21-days chemotherapy regimen due to impaired renal function. Twenty-five patients were recruited between February 2015 and July 2017. Inclusion criteria were; age ≥18 years old, histopathologically-proven urothelial bladder cancer, stage T2-T4a, calculated glomerular filtration rate (GFR) of 40-60 ml/min, no metastasis and with adequate organ function. Chemotherapy given was cisplatin (35 mg/m2 d1, d8, and q21) plus gemcitabine (1,000 mg/m2 d1, d8, and q21) for three cycles followed by local therapy. Median age was 63 years (Mean±SD; 60.76 ±1.67 years). Most patients (21/25; 84%) were males. Almost half of the patients (13/25; 52%) had T3.Treatment was well-tolerated. All patients completed the scheduled 3 Cycles. 3 (12%) patients developed complete response, 10 (40%) partial response, 6 (24%) stable disease, while 6 (24%) developed progression. Median survival was 23 months (95% CI; 18.1-27.89). Fifteen (60%) patients underwent surgery, while 5 (20%) patients underwent bladder preservation. Four (16%) patients were shifted to palliative care and 1(4%) patient declined any further treatment. In conclusion, fractionated weekly cispaltin-gemcitabine neoadjuvant chemotherapy in MIBC patients with impaired renal function is feasible and safe with good clinical response. Further larger studies are warranted.

Abstract This is a single arm prospective phase II study conducted to assess the efficacy of fractionated weekly cisplatin-based neoadjuvant chemotherapy in patients with muscle-invasive bladder cancer (MIBC) who are unfit for the standard 21-days chemotherapy regimen due to impaired renal function. Twenty-five patients were recruited between February 2015 and July 2017. Inclusion criteria were; age ≥18 years old, histopathologically-proven urothelial bladder cancer, stage T2-T4a, calculated glomerular filtration rate (GFR) of 40-60 ml/min, no metastasis and with adequate organ function. Chemotherapy given was cisplatin (35 mg/m2 d1, d8, and q21) plus gemcitabine (1,000 mg/m2 d1, d8, and q21) for three cycles followed by local therapy. Median age was 63 years (Mean±SD; 60.76 ±1.67 years). Most patients (21/25; 84%) were males. Almost half of the patients (13/25; 52%) had T3.Treatment was well-tolerated. All patients completed the scheduled 3 Cycles. 3 (12%) patients developed complete response, 10 (40%) partial response, 6 (24%) stable disease, while 6 (24%) developed progression. Median survival was 23 months (95% CI; 18.1-27.89). Fifteen (60%) patients underwent surgery, while 5 (20%) patients underwent bladder preservation. Four (16%) patients were shifted to palliative care and 1(4%) patient declined any further treatment. In conclusion, fractionated weekly cispaltin-gemcitabine neoadjuvant chemotherapy in MIBC patients with impaired renal function is feasible and safe with good clinical response. Further larger studies are warranted.

Chinese medicine formulas used against SARS-CoV-2 in China. Significant data are showing that glycyrrhizin and licorice extract have multiple beneficial activities in combating most features of SARS-CoV-2. Purpose: The aim of current review was to highlight recent progresses in research that showed the evidence of the potential use of glycyrrhizin and licorice extract against COVID-19. Methodology: We have reviewed the information published from 1979 to October 2020. These studies demon- strated the effects , use and safety of glycyrrhizin and icorice extract against viral infections,bacterial infections, inflammatory disorders of lung ( in vitro and in vivo). These studies were collated through online electronic databases research (Academic libraries as PubMed, Scopus, Web of Science and Egyptian Knowledge Bank). Results: Pooled effect size of articles provides information about the rationale for using glycyrrhizin and licorice extract to treat COVID-19. Fifty studies demonstrate antiviral activity of glycyrrhizin and licorice extract. The most frequent mechanism of the antiviral activity is due to disrupting viral uptake into the host cells and dis- rupting the interaction between receptor- binding domain (RBD) of SARS-COV2 and ACE2 in recent articles. Fifty studies indicate that glycyrrhizin and licorice extract have significant antioxidant, anti-inflammatory and immunomodulatory effects. Twenty five studies provide evidence for the protective effect of glycyrrhizin and licorice extract against inflammation-induced acute lung injury and cardiovascular disorders. Conclusion: The current study showed several evidence regarding the beneficial effects of glycyrrhizin and licorice extract in combating COVID-19. More randomized clinical trials are needed to obtain a precise conclusion

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