Combined modality therapy for pancreatic carcinoma: An Australian Pancreatic Cancer Group study of the addition of gemcitabine (G) to concurrent infusional 5-fluorouracil (CI 5FU) and 3D conformal radiotherapy (RT)—Final outcomes

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Background: This open-label Phase II study (B9E-AY-S168) examined whether CI 5FU plus 3D conformal planning RT is well tolerated and may be combined with G pre and post chemoradiotherapy in patients (pts) with pancreatic cancer (PC). Methods: Eligible pts were enrolled in two strata: (1) inoperable PC in head or body without metastases (LAD) or (2) resected PC at high risk of relapse (Surg). G was given at 1000 mg/m2 weekly for 3 wks followed by 1 wk rest and a 5–6 wk period of RT and concurrent CI 5FU (200 mg/m2/day). The defined target volume was treated to 54Gy in 30# of 1.8Gy (LAD) or 45Gy in 25# (Surg). After 4 wks rest, G was given for 12 wks. Results: 63 pts were enrolled: 39 females, 24 males; mean age 61 yr, range 31–79; 43% ECOG PS 0, 51% PS 1, 5% PS 2. Follow-up was 2 yr. 1- and 2-yr survival (KM) were 46% and 10% (LAD) and 59% and 27% (Surg). 1- and 2-yr local control (KM) were 48% and 21% (LAD) and 80% and 80% (Surg). The % planned dose delivered was (i) G pre RT: 87.6% (LAD)/94.6% (Surg); (ii) 5FU: 100.7%/96.4%; (iii) RT: 96.2%/99.5%; (iv) G post RT: 67.4%/65.3%. The baseline CA 19.9 level was significantly associated with a shorter TTPD (p=0.0002) and a shorter survival time (p=0.0071). Using Time Dependent Covariate analysis, CA 19.9 levels were strongly associated with TTPD and survival (both p < 0.0001); a person with a 10-fold higher level has a 1.95-fold higher risk of death over the next time period than their counterpart (95% CI: 1.53–2.49-fold). In 22 pts we found no statistically significant associations between outcome and mutations in K-RAS or TP53 or with microsatellite instability. Grade 3/4 hematological and non-hematological toxicity was reported by 29 (46%) and 42 pts (67%), respectively. There was one treatment-related death. Conclusions: This approach to treatment is safe and promising, with good local control for a substantial proportion of patients, and merits testing in a randomized trial.

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Measurement of bottom-quark hadron masses in exclusive J/psi decays with the CDF detector

We measure the masses of b hadrons in exclusively reconstructed final states containing a J/psi --> mu-mu+ decay using 220 pb(-1) of data collected by the CDF II experiment. We find: m(B+) = 5279.10 +/- 0.41(stat.) +/- 0.36(sys.) MeV/c2, m(B0) = 5279.63 +/- 0.53(stat.) +/- 0.33(sys.) MeV/c2, m(B(s)0) = 5366.01 +/- 0.73(stat.) +/- 0.33(sys.) MeV/c2, m(lambda(b)0) = 5619.7 +/- 1.2(stat.) +/- 1.2(sys.) MeV/c2. m(B+) - m(B0) = -0.53 +/- 0.67(stat.) +/- 0.14(sys.) MeV/c2, m(B(s)0) - m(B0) = 86.38 +/- 0.90(stat.) +/- 0.06(sys.) MeV/c2, m(lambda(b)0) - m(B0) = 339.2 +/- 1.4(stat.) +/- 0.1(sys.) MeV/c2. The measurements of the B(s)0, lambda(b)0 mass, m(B(s)0) - m(B0) and m(lambda(b)0) - m(B0) mass difference are of better precision than the current world averages.

Constraints on cosmic neutrino fluxes from the Antarctic Impulsive Transient Antenna experiment

We report new limits on cosmic neutrino fluxes from the test flight of the Antarctic Impulsive Transient Antenna (ANITA) experiment, which completed an 18.4 day flight of a prototype long-duration balloon payload, called ANITA-lite, in early 2004. We search for impulsive events that could be associated with ultrahigh energy neutrino interactions in the ice and derive limits that constrain several models for ultrahigh energy neutrino fluxes and rule out the long-standing -burst model.

Phase II study of vinflunine in patients with metastatic renal cell carcinoma

PURPOSE

An open-label, multicentre, non-comparative phase II trial to determine the response rate of intravenous vinflunine as first line chemotherapy in patients with metastatic renal cell carcinoma (RCC).

PATIENTS AND METHODS

Patients with metastatic RCC were treated with vinflunine 350 mg/m2 (n = 11) or 320 mg/m2 (n = 22) administered intravenously every 21 days.

RESULTS

Out of 33 patients included in this study, one partial response was observed in the group treated at 350 mg/m2 and none in the group receiving 320 mg/m2 resulting in a response rate in this population of 9.1% (95% CI: 0.2-41.3). Median progression free survival was 5.6 months (95% CI: 2.8-14.4) for patients treated at 350 mg/m2, and 3.3 months (95% CI: 1.6-6.4) for those treated at 320 mg/m2.The median survival time was 10.4 months (95% CI: 6.8-12.4) for the whole study population. The principal toxicities were grade 3/4 neutropaenia -90.9% at 350 mg/m2 and 68.1% at 320 mg/m2, febrile neutropaenia was recorded in 3 patients (27.3%) at 350 mg/m2 and in 5 patients (22.7%) at 320 mg/m2. One episode of thromboembolic event was reported in 1 patient at each dose level.

CONCLUSION

Vinflunine given intravenously once every 3 weeks has not shown any clinically relevant activity in the management of patients with metastatic renal cell carcinoma; tolerance of the treatment was better at a dose of 320 mg/m2 than at 350 mg/m2.

Intraoperative explantation of two single-piece hydrophobic acrylic intraocular lenses due to surface deposits

PURPOSE

To report clinical, pathological, and laboratory analyses of two cases of single-piece hydrophobic acrylic intraocular lenses (IOLs), which presented with significant surface deposits during implantation.

METHODS

The lenses were implanted with the manufacturer's recommended injector (loaded with Viscoat and Healon GV, respectively). Immediately after injection into the anterior chamber, areas on the lenses' surfaces were covered by deposits, which could not be entirely removed by irrigation/aspiration. The lenses were explanted and replaced with lenses of the same design. They underwent gross analyses, light microscopy, scanning electron microscopy, and energy dispersive X-ray spectroscopy for analysis of the elemental composition of the deposits. Liquid chromatography/mass spectroscopy was also performed to identify the presence of proteins.

RESULTS

The deposits on the first lens had a granular appearance, forming a homogeneous layer mostly on the posterior lens surface. Larger crystal-like deposits were present mostly on the anterior surface of the second lens. Elemental analyses of the deposits in both cases revealed the presence of peaks of sodium, chloride, phosphate, and potassium, in addition to the peaks of carbon and oxygen (normal constituents of the lens material). Only protein components normally found in the anterior chamber during surgery, such as haemoglobin and albumin, were identified.

CONCLUSIONS

The results obtained suggest that the deposits in both cases may have resulted from crystallization of the ophthalmic viscosurgical device normally used during the loading of the IOLs into the cartridges.

Search for new physics using high-mass tau pairs from 1.96 TeV pp collisions

We present the results of a search for anomalous resonant production of tau lepton pairs with large invariant mass, the first such search using the CDF II Detector in Run II of the Tevatron pp collider. Such anomalous production could arise from various new physics processes. In a data sample corresponding to 195 pb(-1) of integrated luminosity we predict 2.8+/-0.5 events from standard model background processes and observe 4. We use this result to set limits on the production of heavy scalar and vector particles decaying to tau lepton pairs.

Fertility- and menopause-related information needs of younger women with a diagnosis of early breast cancer

PURPOSE

The use of chemotherapy and endocrine therapies in the treatment of premenopausal women carries with it reproductive and gynecologic implications that young women may find distressing and discordant with plans for childbearing. This multicenter study aimed to investigate fertility- and menopause-related information needs among young women with a diagnosis of early-stage breast cancer.

PATIENTS AND METHODS

Two hundred twenty-eight women with a diagnosis of early-stage breast cancer who were aged 40 years or younger at diagnosis and who were 6 to 60 months after diagnosis were entered onto the trial. Participants completed a mailed self-report questionnaire that included a purposely designed fertility- and menopause-related information needs survey and standardized measures of distress, anxiety, quality of life, menopausal symptoms, and information-seeking style.

RESULTS

Seventy-one percent of participants discussed fertility-related issues with a health professional as part of their breast cancer treatment, and 86% discussed menopause-related issues. Consultation with a fertility or menopause specialist was the most preferred method of obtaining this information. Receiving fertility-related information was rated as being significantly more important than receiving menopause-related information at time of diagnosis (P < .001) and at treatment decision making (P = .058). Receiving menopause-related information was rated as being significantly more important than receiving fertility-related information during adjuvant treatment (P < .05), at completion of adjuvant treatment (P < .001), and during follow-up (P < .001). Common questions, sources of information, and correlates of perceived importance were identified.

CONCLUSION

The results of this study suggest that younger women have unmet needs for fertility- and menopause-related information and provide preliminary empirical data to guide the development of better fertility- and menopause-related patient education materials for younger women with a diagnosis of early breast cancer.

Measurement of B(t --> Wb)/B(t--> Wq) at the collider detector at fermilab

We present a measurement of the ratio of top-quark branching fractions R = B(t --> Wb)/B(t --> Wq), where q can be a b, s, or a d quark, using lepton-plus-jets and dilepton data sets with an integrated luminosity of approximately 162 pb(-1) collected with the Collider Detector at Fermilab during Run II of the Tevatron. The measurement is derived from the relative numbers of tt events with different multiplicity of identified secondary vertices. We set a lower limit of R > 0.61 at 95% confidence level.

Search for long-lived doubly charged Higgs bosons in pp collisions at sqrt[s] = 1.96 TeV

We present a search for long-lived doubly charged Higgs bosons (H(+/- +/-)), with signatures of high ionization energy loss and muonlike penetration. We use 292 pb(-1) of data collected in pp collisions at sqrt[s] = 1.96 TeV by the CDF II detector at the Fermilab Tevatron. Observing no evidence of long-lived doubly charged particle production, we exclude H(+/- +/-)(L) and H(+/- +/-)(R) bosons with masses below 133 GeV/c(2) and 109 GeV/c(2), respectively. In the degenerate case we exclude H(+/- +/-) mass below 146 GeV/c(2). All limits are quoted at the 95% confidence level.

Effect of nebulized albuterol on blood glucose in patients with diabetes mellitus with and without cystic fibrosis

Over 90% of cystic fibrosis (CF) patients are treated with bronchodilators, and 6% have diabetes. Some with asthma also have diabetes, and most are treated with bronchodilators. Systemic administration of adrenergic agents can cause increases in blood glucose, but the effect of inhaled agents is unclear. A double-blind study was performed on 10 patients with type 1 diabetes mellitus (DM) without CF (3 male, 7 female, mean age 25.5 years) and 9 patients with insulin-dependent CF-related diabetes (CFRD) (8 male, 1 female, mean age 21.9 years). On 2 separate days before 9 AM fasting and the morning dose of insulin, 2.5 mg of albuterol or nebulized placebo were given. Blood glucose was measured by finger stick with a glucose reflectance meter before and 15, 30, 45, and 60 min after treatment. No significant changes from baseline or differences between placebo and albuterol occurred in either group. The mean maximum increase from baseline in DM was 20 mg/dl on placebo, and 38 mg/dl on albuterol; in the CFRD, the respective changes were 7 and 7 mg/dl. Two DM patients had a > 50 mg/dl increase on albuterol vs. placebo; no CFRD patients had differences of such magnitude. DM patients had greater increases from baseline than CFRD patients on placebo and albuterol. Differences reached statistical significance at 30 and 45 min on placebo, and 45 min on albuterol. Albuterol 2.5 mg by nebulizer causes no clinically significant increases in blood glucose in DM or CFRD patients. Diabetes patients without CF have a significantly greater increase of glucose with time (placebo or albuterol) than CFRD patients.

Evidence for B0 s-->phiphi decay and measurements of branching ratio and A(CP) for B+ -->phiK+

We present the first evidence of charmless decays of the B(0)(s) meson, the decay B(0)(s)--> phiphi, and a measurement of the branching ratio BR(B(0)(s)--> phiphi) using 180 pb(-1) of data collected by the CDF II experiment at the Fermilab Tevatron collider. In addition, the BR and direct CP asymmetry for the B+-->phiK+ decay are measured. We obtain BR(B(0)(s)--> phiphi)=[14(+6)(-5)(stat)+/-6(syst)] x 10(-6), BR(B+-->phiK+)=[7.6+/-1.3(stat)+/-0.6(syst)] x 10(-6), and A(CP)(B+-->phiK+)= -0.07+/-0.17(stat)+0.03 / -0.02(syst). Both decays are governed in the standard model by second order (penguin) b-->s(-)ss amplitudes.

Search for anomalous kinematics in tt dilepton events at CDF II

We report on a search for anomalous kinematics of tt dilepton events in pp collisions at square root of s=1.96 TeV using 193 pb(-1) of data collected with the CDF II detector. We developed a new a priori technique designed to isolate the subset in a data sample revealing the largest deviation from standard model (SM) expectations and to quantify the significance of this departure. In the four-variable space considered, no particular subset shows a significant discrepancy, and we find that the probability of obtaining a data sample less consistent with the SM than what is observed is 1.0%-4.5%.

Measurement of the cross section for prompt diphoton production in pp collisions at square root of s=1.96 TeV

We report a measurement of the rate of prompt diphoton production in pp collisions at square root of s=1.96 TeV using a data sample of 207 pb(-1) collected with the upgraded Collider Detector at Fermilab. The background from nonprompt sources is determined using a statistical method based on differences in the electromagnetic showers. The cross section is measured as a function of the diphoton mass, the transverse momentum of the diphoton system, and the azimuthal angle between the two photons and is found to be consistent with perturbative QCD predictions.

Measurement of the W(+)W(-) production cross section in pp collisions at square root[s]=1.96 TeV using dilepton events

We present a measurement of the W(+)W(-) production cross section using 184 pb(-1) of p(p) collisions at a center-of-mass energy of 1.96 TeV collected with the Collider Detector at Fermilab. Using the dilepton decay channel W(+)W(-)-->l(+)nul(-), where the charged leptons can be either electrons or muons, we find 17 candidate events compared to an expected background of 5.0(+2.2)(-0.8) events. The resulting W(+)W(-) production cross-section measurement of sigma(pp-->W(+)W(-))=14.6(+5.8)(-5.1)(stat)(+1.8)(-3.0)(syst) +/- 0.9(lum) pb agrees well with the standard model expectation.

Australian experience of a modified schedule of FOLFOX with high activity and tolerability and improved convenience in untreated metastatic colorectal cancer patients

This study determined the efficacy and safety of a modified FOLFOX regimen that improved patient convenience without compromising oxaliplatin dose intensity. A total of 62 patients with previously untreated metastatic colorectal cancer were enrolled to receive, entirely as outpatients, 2-weekly cycles of oxaliplatin 100 mg m⁻² i.v. over 2 h, together with leucovorin 400 mg m⁻² over 2 h, 5-fluorouracil (5-FU) 400 mg m⁻², bolus, followed by a 46-h infusion of 5-FU at 2.4 g m⁻². Treatment was given until progression or unmanageable toxicity. In all, 61 patients received ⩾one oxaliplatin dose and a median of 11 treatment cycles (range 1–20 cycles); 22 (36%) reported grade 3/4 neutropenia and 13 patients (21%) experienced grade 3 neurotoxicity; 16 patients (26%) discontinued treatment due to disease progression or death, 15 (25%) due to neurotoxicity and six (10%) due to haematological toxicity. Of the 56 eligible patients, complete or partial responses were observed in 29 or 52% (95% confidence interval 38–65%). Median progression-free survival was 8.2 months (7.1–9.9) and median overall survival was 18.7 months (14.0–23.4). In our experience, a modified schedule of FOLFOX improves convenience without compromising efficacy or toxicity.

Measurement of partial widths and search for direct CP violation in D0 meson decays to K-K+ and pi-pi+

We present a measurement of relative partial widths and decay rate CP asymmetries in K-K+ and pi(-)pi(+) decays of D0 mesons produced in pp collisions at sqrt[s]=1.96 TeV. We use a sample of 2x10(5) D(*+)-->D0pi(+) (and charge conjugate) decays with the D0 decaying to K-pi(+), K-K+, and pi(-)pi(+), corresponding to 123 pb(-1) of data collected by the Collider Detector at Fermilab II experiment at the Fermilab Tevatron collider. No significant direct CP violation is observed. We measure Gamma(D0-->K-K+)/Gamma(D0-->K-pi(+))=0.0992+/-0.0011+/-0.0012, Gamma(D0-->pi(-)pi(+))/Gamma(D0-->K-pi(+))=0.035 94+/-0.000 54+/-0.000 40, A(CP)(K-K+)=(2.0+/-1.2+/-0.6)%, and A(CP)(pi(-)pi(+))=(1.0+/-1.3+/-0.6)%, where, in all cases, the first uncertainty is statistical and the second is systematic.

Measurement of the lifetime difference between Bs mass eigenstates

We present measurements of the lifetimes and polarization amplitudes for B(0)(s)-->J/psiphi and B(0)(d)-->J/psiK(*0) decays. Lifetimes of the heavy and light mass eigenstates in the B(0)(s) system are separately measured for the first time by determining the relative contributions of amplitudes with definite CP as a function of the decay time. Using 203+/-15 B(0)(s) decays we obtain tau(L) = (1.05(+0.16)(-0.13) +/- 0.02) ps and tau(H) = (2.07(+0.58)(-0.46) +/- 0.03) ps. Expressed in terms of the difference DeltaGamma(s) and average Gamma(s), of the decay rates of the two eigenstates, the results are DeltaGamma(s)/Gamma(s) = (65(+25)(-33) +/- 1)% and DeltaGamma(s) = (0.47(+0.19)(-0.24) +/- 0.01) ps(-1).

Search for excited and exotic electrons in the egamma decay channel in pp collisions at sqrt[s] = 1.96 TeV

We present a search for excited and exotic electrons (e(*)) decaying to an electron and a photon, both with high transverse momentum. We use 202 pb(-1) of data collected in pp collisions at sqrt[s] = 1.96 TeV with the Collider Detector at Fermilab II detector. No signal above standard model expectation is seen for associated ee(*) production. We discuss the e(*) sensitivity in the parameter space of the excited electron mass M(e(*)) and the compositeness energy scale Lambda. In the contact interaction model, we exclude 132 GeV/c(2)<M(e(*))<879 GeV/c(2) for Lambda = M(e(*)) at 95% confidence level (C.L.). In the gauge-mediated model, we exclude 126 GeV/c(2) < M(e(*)) < 430 GeV/c(2) at 95% C.L. for the phenomenological coupling f/Lambda approximately 10(-2) GeV-1.

First measurements of inclusive W and Z cross sections from run II of the fermilab tevatron collider

We report the first measurements of inclusive W and Z cross sections times leptonic branching ratios for pp collisions at square root[s]=1.96 TeV, based on their decays to electrons and muons. The data correspond to an integrated luminosity of 72 pb(-1) recorded with the CDF detector at the Fermilab Tevatron. We test e-mu universality in W decays, and we measure the ratio of leptonic W and Z rates from which the leptonic branching fraction B(W-->lnu) can be extracted as well as an indirect value for the total width of the W and the Cabibbo-Kobayashi-Maskawa matrix element, |V(cs)|.