A randomized phase 2 trial of combretatstatin A4 phosphate (CA4P) in combination with paclitaxel and carboplatin to evaluate safety and efficacy in subjects with advanced imageable malignancies

14060

Background: CA4P is the lead compound in a class of agents termed Vascular Disrupting Agents. Phase I studies of CA4P demonstrated toxicities that do not overlap those of chemotherapy. In vitro studies show synergistic cytotoxicity for CA4P and chemotherapy. This study was designed to assess safety, toxicity and tumor perfusion of CA4P at 2 doses when combined with paclitaxel and carboplatin at fixed doses. Methods: A one stage, randomized trial for subjects with imageable tumors by DCE-MRI for perfusion. Subjects received either 45 or 63 mg/m2 CA4P IV on Days 1, 8, and 15, then 200 mg/m2 paclitaxel and AUC 6 carboplatin on Day 2 of each 21 day cycle. After completion of 6 cycles, subjects could continue with CA4P alone. DCE-MRI was measured prior and 24 hours after the first dose of CA4P. Results: 13 subjects were accrued from 3/05–11/05. 78 cycles were administered and 1 subject continues active therapy on cycle 19. The median number of cycles administered was 6. Both 45 and 63 CA4P with paclitaxel/carboplatin were well tolerated. The most frequent adverse events are listed in Table 1 . Grade 3–4 AEs were similar between the two dose groups. Table 1 : Most Frequent AEs by CA4P Dose DCE-MRI data showed a mean reduction in blood flow for both dose groups (46% vs. 19% respectively) confirming CA4P’s tumor vascular disrupting capabilities. Tumor responses were observed and were similar between both dose groups. Best overall response through cycle 6 was 3 PR, and 6 SD. Two subjects with thyroid cancer were randomized to the low dose group and completed cycle 6. The 1st had SD and progressed after cycle 6. The 2nd achieved PR and progressed after 8 cycles. These subjects also had the greatest reduction in tumor blood flow. Ktrans was reduced by 73 and 79% 24 hours post CA4P. Conclusion: These doses of CA4P in combination with paclitaxel and carboplatin were well tolerated, demonstrated anti-tumor activity and reduction of tumor blood flow.

[Table: see text]

No significant financial relationships to disclose.

Pemetrexed plus cetuximab in patients (pts) with recurrent non-small cell lung cancer (NSCLC): A phase I-IIa dose-ranging study from the Hoosier Oncology Group

7698

Background: Both pemetrexed (P) and cetuximab (C) have single agent activity in NSCLC, non-overlapping toxicities and different mechanisms of action, making the combination of P and C an attractive option to evaluate. This study evaluates the feasibility of combining these agents, and tests the activity and toxicity of this regimen in pts with recurrent NSCLC. Methods: Eligible pts had stage IIIB/IV NSCLC, previously treated ≥ 1 prior platinum containing regimen, PS 0–1. Prior use of EGFR tyrosine kinase inhibitors was permitted. The phase I portion determined the MTD (Bedano Proc ASCO et al., 2006). The primary endpoint of the phase II portion was to estimate TTP using Kaplan-Meier analysis (5% alpha, 80% beta), requiring 25 pts to demonstrate a TTP of ≥ 24 weeks vs. historical control of 12 weeks. Following a loading dose of C at 400 mg/m2 on week 1, pts received P at 750 mg/m2 iv q3wks and C at 250 mg/m2 iv weekly. Cycles were repeated every 21 days. After completing at least 4 cycles, pts with non-progressive disease (PD) were allowed to continue C alone until PD. Results: Eligible and treated phase II pts (n=23) received a median of 4 cycles (range 1–12). Pt characteristics: M:F 57%:43%; median age 64 (range 43–80), stage IIIB: IV 17%:83%; adeno:squamous cell 61%:30%; smoking status: current/former/never: 29%/62%/10%. Prior regimens, median 2 (range 1–6). G3/4/5 toxicities included: 4.3% neutropenia, 13% infection, 4.3% hemorrhage, 22% skin. There were no G3/4 episodes of anemia, TCP, febrile neutropenia, liver toxicity or diarrhea. Response data was available for 18 patients. Partial responses were seen in 2 pts (8.7 %), SD in 8 patients (34.8%). Median TTP was 25 weeks. Conclusion: It is feasible and safe to combine P at 750 mg/m2 every 21 days and C at 400 mg/m2 week 1 and 250 mg/m2 weekly thereafter. This combination resulted in longer TTP when compared with historical controls of P at 500 mg/m2 alone.

No significant financial relationships to disclose.

Randomized phase II study of biweekly gemcitabine (gem)-paclitaxel (pac), gem-carboplatin (carb) and gem-cisplatin (cis) as first-line treatments in metastatic breast cancer (MBC) after anthracycline failure

1099

Background: Biweekly gem-pac and gem-cis regimens have shown promising activity and safety in different tumor types. In MBC biweekly gem-pac is active and well tolerated. The aim of this multi-country study is to evaluate the efficacy and safety of gem in combination with pac, carb or cis on a biweekly schedule in patients (pts) with MBC. Methods: Major eligibility criteria included: tissue diagnosis of stage IV breast carcinoma; prior anthracycline therapy; ECOG performance status (PS) of 0 or 1; and written informed consent. Pts were randomized to receive gem 2500 mg/m2 in combination with pac 150 mg/m2 (Arm A), carb AUC 2.5 (Arm B) or cis 50 mg/m2 (Arm C) on day 1 of 2-week cycles. The primary endpoint was response rate, with safety a secondary endpoint. Results: This interim analysis was planned to occur when patient enrollment had reached 50% (75/150 pts), at which point there were 26 pts in Arm A, 25 in Arm B and 24 in Arm C, with 12 pts still on treatment. The baseline characteristics were similar in the three arms, including mean age (Arm A 50.2 yr, Arm B 46.1, Arm C 47.3); ECOG PS (PS 0: 50.0%, 64.0%, 54.2%); mean number of sites of tumor involvement (2.9, 2.6, 2.7); dominant type of metastasis (visceral: 73.1%, 80.0%, 79.2%); and disease-free interval (<24 mo: 53.8%, 60.0%, 41.7%). The mean number of cycles was 6.4, 6.0 and 5.8. There was a partial response in 5/26 efficacy qualified pts (19.2%), 5/25 pts (20.0%) and 2/23 pts (8.7%) in Arms A, B and C, respectively, stable disease in 10 pts (38.5%), 9 pts (36.0%) and 9 pts (39.1%), and progressive disease in 5 pts (19.2%), 6 pts (24.0%) and 6 pts (26.1%). There were no treatment-related deaths. Conclusions: The three regimens appear to show activity and have manageable toxicity when given on a biweekly schedule.

[Table: see text]

No significant financial relationships to disclose.

Characterisation of the anti-apoptotic function of survivin-DeltaEx3 during TNFalpha-mediated cell death

Survivin is an oncogenic protein involved in cell division and acts as an anti-apoptotic factor. It is highly expressed in most cancers and is associated with chemotherapy resistance, increased tumour recurrence, and shorter patient survival. This makes anti-survivin therapy an attractive cancer treatment strategy. These functions are mediated by several survivin spliced variants, whose expression may correlate with cancer progression. One of the spliced variants, survivin-ΔEx3, is known to inhibit apoptosis, through undefined mechanisms. Here, we characterised these mechanisms upon TNFα−mediated apoptosis, and showed that survivin-ΔEx3 acts as an adaptor, allowing the formation of a complex between Bcl-2 and activated caspase-3. The Bcl-2/survivin-ΔEx3 complex, but not survivin-ΔEx3 itself, inhibits the activity of caspase-3. Bcl-2 is therefore linked to the postmitochondrial apoptotic machinery by survivin-ΔEx3. Thus, survivin-ΔEx3 plays a key role in the inhibition of caspase-3 activity, and in the control of the mitochondrial checkpoint of apoptosis. This study suggests that targeting survivin-ΔEx3, rather than survivin alone, could be relevant for treating human cancers.

BM stem cell transplantation rescues pathophysiologic features of aged dystrophic mdx muscle

BACKGROUND

The value of transplantation of BM stem cells in aged (12-month-old) mdx was evaluated because it is thought to be a more ideal model for studying the praxiology of Duchenne muscular dystrophy (DMD). The possible mechanisms of stem cell differentiation were then discussed.

METHODS

BM was isolated from 8-10-week-old male C57 BL/10 mice. After injecting BM cells into 12-month-old female mdx mice through the tail vein, the expression of dystrophin and MyoD was detected at different time points by immunofluorescence staining, RT-PCR and Western blot.

RESULTS

The C57 male mice donor-specific and Y-chromosome-specific sequence could be detected in all female aged mdx mice, implying the success of the transplantation. Expression of dystrophin and MyoD was detected and increased over time.

DISCUSSION

BM cells were recruited to the muscle and partially restored specific pathophysiologic features of the dystrophic muscle in aged mdx mice. Muscle differentiation of BM cells recapitulated embryonic myogenesis.

Triterpene constituents from the seedling of Aronia melanocarpa

Two new triterpene saponins, 16-O-acetyl-21-O-angeloyltheasapogenol A 3-O-[beta-D-galactopyranosyl(1 --> 2)][beta-D-xylopyranosyl(1 --> 2)-alpha-L-arabinopyranosyl (1 --> 3)]-beta-D-glucopyranosiduronic acid (1) and 16,28-O-diacetyl-21-O-tigloyltheasapogenol A 3-O-[beta-D-galactopyranosyl(1 --> 2)][beta-D-xylopyranosyl(1 --> 2)-alpha-L-arabinopyranosyl (1 --> 3)]-beta-D-glucopyranosiduronic acid (2), together with four known triterpenenes, have been isolated from the dried seedling of Aronia melanocarpa, and their structures established by spectroscopic and chemical evidence.

Full-length genome sequence and genetic relationship of two paramyxoviruses isolated from bat and pigs in the Americas

Mapuera virus (MPRV) was isolated from a fruit bat in Brazil in 1979, but its host range and disease-causing potential are unknown. Porcine rubulavirus (PoRV) was identified as the aetiological agent of disease outbreaks in pigs in Mexico during early 1980s, but the origin of PoRV remains elusive. In this study, the completed genome sequence of MPRV was determined, and the complete genome sequence of PoRV was assembled from previously published protein-coding genes and the non-coding genome regions determined from this study. Comparison of sequence and genome organization indicated that PoRV is more closely related to MPRV than to any other members of the genus Rubulavirus. In the P gene coding region of both viruses, there is an ORF located at the 5' end of the P gene overlapping with the P protein coding region, similar to the C protein ORF present in most viruses of the subfamily Paramyxovirinae, but absent in other known rubulaviruses. Based on these findings, we hypothesise that PoRV may also originate from bats, and spillover events from bats to pigs, either directly or via an intermediate host, were responsible for the sporadic disease outbreaks observed in Mexico.

Ketamine inhibits polymorphonuclear leucocyte CD11b expression and respiratory burst activity in endotoxemic rats

OBJECTIVE AND DESIGN

To observe the effect of ketamine on polymorphonuclear leucocytes (PMN) adhesion and respiratory burst activity in endotoxemia rats.

MATERIALS

30 rats were randomly allocated to five groups: rats challenged with intraperitoneal injection of saline (saline group); challenged with intraperitoneal injection of LPS 10 mg/kg (LPS group); challenged with intraperitoneal injection of LPS 10 mg/kg and treated by intraperitoneal injection of ketamine 5, 25, 50 mg/kg at 0, 1, 2, 3, 4, 5 h after the injection of LPS, respectively (three ketamine treatment groups).

METHODS

PMN respiratory burst and CD11b expression were measured with flow cytometry at the end of 1 h, 4 h, and 6 h.

RESULTS

LPS challenge significantly increased PMN respiratory burst activity and CD11b expression when compared with the saline group (p < 0.01). There was a significant decrease in LPS-induced PMN respiratory burst activity and CD11b expression in three ketamine treatment groups when compared with LPS group (p < 0.01).

CONCLUSIONS

Ketamine significantly inhibits PMN CD11b expression and respiratory burst activity in endotoxemic rats.

Comparison between ozone and ferrate in oxidising geosmin and 2-MIB in water

Among the chemicals causing taste and odour (T&O) in drinking water, the most commonly identified and problematic ones are geosmin and 2-MIB (2-methylisoborneol). Since the reported odour thresholds of geosmin and 2-MIB are as low as 4 and 8.5 ng/L, respectively, they are not readily removed by conventional water treatment processes. In this study, ozone (O3) and ferrate (Fe(VI)) were applied to oxidise geosmin and 2-MIB. Their performances were compared in terms of removal efficiency of geosmin and 2-MIB. In the case of O3, removal efficiency of geosmin and 2-MIB ozonation at different initial O3 doses, H2O2/O3 ratios and water temperatures were evaluated. The oxidation rates of geosmin and 2-MIB by Fe(VI) were measured within pH 6-8. The effect of H2O2 addition was also evaluated. In summary, O3, especially with H2O2, could almost completely oxidise geosmin and 2-MIB, while Fe(VI) could not oxidise them more than 25% at any pH that was considered in this study. This was attributed to the structure of the organics and high reaction selectivity of Fe(VI). Further study should be conducted to find the reason of inhibition of oxidation by Fe(VI).

SNP analysis of Molting related genes in <i>Penaeus monodon</i> and <i>Litopenaeus vannamei</i> shrimp (Brief report)

Abstract. Molting is a very important growth period in shrimp. During the intermolt cycle, the accumulations of carbohydrate protein provide steady growth. The molt-inhibiting hormone (MIH) and the crustacean hyperglycemic hormone (CHH) belong to a large neuropeptide family, which are involved in the regulation of the length of the intermolt period, keeping shrimp in the intermolt stage (GU et al., 2000; YODMUANG et al., 2004). There are two kinds of MIH (MIH1 and MIH2) and one CHH. Therefore, the MIH1, MIH2 and CHH genes are candidate genes for detecting polymorphisms associated with the molting pathway and growth

Partial molecular characterization, polymorphism and chromosomal localization of the porcine PSMD4 gene

The complete coding sequence of porcine PSMD4 gene encoding proteasome 26S non-ATPase subunit 4 was obtained by the reverse transcriptase-polymerase chain reaction (RT-PCR) and deposited in GenBank nucleotide database (AY704418). The nucleotide sequence and the predicted protein sequence shared the high sequence identity with their mammalian counterparts. A G/A single nucleotide polymorphism in intron 9 detected as Hin6I PCR-restriction fragment length polymorphism (PCR-RFLP) shows allele frequency differences between Meishan, Erhualian, Tibetan, Large White and Duroc breeds. Analyses of somatic cell hybrid panel (SCHP) and radiation hybrid (IMpRH) panel revealed that PSMD4 gene maps to SSC 4q21-q23 and closely linked the SW512 (14 cR, LOD = 19.47).

Skin cancer after nonmyeloablative hematopoietic cell transplantation

Squamous cell carcinoma (SCC) is the most common skin cancer in patients receiving immunosuppressive therapy, and is well documented to occur in patients that have undergone either solid organ transplantation or conventional myeloablative bone marrow transplantation. Nonmyeloablative hematopoietic cell transplantation (NMAT) provides transient, intensive immunosuppression, permitting allogeneic engraftment without ablating the marrow. The purpose of this report is to describe six patients that developed SCC (n=3), basal cell carcinoma (n=2), or malignant melanoma (n=2) over a period of 2-26 months following NMAT. All patients had myelodysplasia or acute myelogenous leukemia prior to transplantation. The authors demonstrate for the first time that patients who undergo NMAT are at risk for developing skin cancers and emphasize the need for close surveillance in the post transplantation period.

Molecular cloning and characterization of pig, cow and sheep MAdCAM-1 cDNA and the demonstration of cross-reactive epitopes amongst mammalian homologues

Full-length cDNA clones for the pig, cow and sheep mucosal addressin cellular adhesion molecule (MAdCAM)-1 homologues were isolated from Peyer's patches by a combination of reverse transcription (RT)-polymerase chain reaction and 5' and 3' RACE strategies. Degenerate primers based on conserved amino acid (aa) sequences within the N-terminal immunoglobulin (Ig)-like domains of the human and rodent MAdCAM-1 molecules were used for initial sequencing of the Ig-like domains. MAdCAM-1 transcripts of 1425 bp, 1525 bp and 1510 bp obtained for the pig, cow and sheep contained an open-reading frame for proteins of 390, 424 and 418 aa, respectively. The pig and ruminant MAdCAM-1 had two N-terminal Ig-like domains, a mucin-like region and a third Ig-like domain found in rodent but not human MAdCAM-1. Antibodies raised against bacterially expressed N-terminal Ig-like domains of pig, human and sheep MAdCAM-1 demonstrated the existence of cross-reactive epitopes, raising the possibility of producing monoclonal antibodies which can be used as multi-species MAdCAM-1-targeting reagent for the development of mucosal vaccines.

A phase II trial of olanzapine and palonosetron for the prevention of chemotherapy induced nausea and vomiting (CINV)

8608

Background: Olanzapine has been shown to be a safe and effective agent for the prevention of CINV in chemotherapy naïve cancer patients. Palonosetron has been approved for the prevention of acute CINV and for the prevention of delayed CINV in patients receiving moderately emetogenic chemotherapy (MEC). Methods: A phase II trial was performed for the prevention of CINV in chemotherapy naïve patients using the combination of olanzapine and palonosetron. The regimen was 10 mg of oral olanzapine, 0.25 mg of intravenous palonosetron, and dexamethasone (20 mg for highly emetogenic and 8 mg for moderately emetogenic chemotherapy) on the day of chemotherapy, day 1, and 10 mg/day of oral olanzapine alone on days 2–4 after chemotherapy. Forty patients (median age 60 yrs, range 38–84; 22 females; ECOG PS 0,1) consented to the protocol and all were evaluable. Results: The percentage of patients with a complete response (CR) (no emesis, no rescue) was 100% for the acute period (24 h post chemotherapy), 75% for the delayed period (days 2–5 post chemotherapy), and 75% for the overall period (0–120 h) for eight patients receiving highly emetogenic chemotherapy (HEC) (cisplatin > 70 mg/m2). CR was 97% for the acute period, 75% for the delayed period, and 72% for the overall period in 32 patients receiving MEC (doxorubicin, >50mg/m2). In the patients receiving HEC, the percentage of patients without nausea (0, scale 0–10, M. D. Anderson Symptom Inventory) was 100% in the acute period, 50% in the delayed period, and 50% in the overall period. In patients receiving MEC, the percentage without nausea was 100% in the acute period, 78% in the delayed period, and 78% in the overall period. There were no Grade 3 or 4 toxicities and no significant pain, fatigue, disturbed sleep, memory changes, dyspnea, lack of appetite, drowsiness, dry mouth, mood changes or restlessness experienced by the patients. CR and control of nausea in subsequent cycles of chemotherapy (35 patients, cycle 2; 31 patients cycle 3; 23 patients, cycle 4) were equal to or greater than cycle one. Conclusions: The combination of olanzapine and palonosetron with dexamethasone given only on the day of chemotherapy was safe and highly effective in controlling acute and delayed CINV in patients receiving HEC and MEC.

No significant financial relationships to disclose.

Sequence identification, tissue distribution, mapping and polymorphism of the porcine sar1b gene

The predicted full-length cDNA sequence of the porcine Sar1b gene was characterized by assembling pig ESTs from GenBank. The coding sequence (CDS) shares high sequence identity with the corresponding sequences of human (93%) and mouse (91%). The reverse transcription-polymerase chain reaction (RT-PCR) displayed that porcine Sar1b gene is expressed in all eight tissues (liver, small intestine, stomach, heart, lung, spleen, muscle and fat). Analysis of the somatic cell hybrid panel (SCHP) and the INRA-University of Minnesota porcine radiation hybrid (IMpRH) panel indicated the gene maps to SSC2 (1/2 q24)-q29 and most closely links to the interleukin-4 (IL4) gene. One base-pair deletion polymorphism in the 3' untranslated region (UTR) detected by PCR-single strand conformational polymorphism (PCR-SSCP) analysis shows allele frequency differences between Meishan, Yushan Black, Dahuabai, Qingping, Tibetan, Landrace, Large White and Duroc. The association analysis using pigs of Tongcheng, Landrace x (Large White x Tongcheng) and Large White x (Landrace x Tongcheng) suggested that the deletion polymorphism was associated with the porcine muscle pH value.