A phase I trial of weekly combination KOS-862 (Epothilone D) and trastuzumab in HER-2 overexpressing malignancies

2028

Background: KOS-862 (Epothilone D) (K) has shown single agent activity against metastatic breast cancer (MBC) and NSCLC. Trastuzumab (H) is standard therapy for HER-2 overexpressing MBC. This phase IB trial determined the safety and PK profile of KOS-862 in a weekly schedule with H. Methods: Eligibility: pts with HER-2 overexpressing (IHC 3+ or FISH +) chemo-refractory tumors, ECOG ≤ 2, neuropathy ≤ gr 1, no CNS metastases, and no H ≤ 6 mo. prestudy. H given as a 4 mg/kg loading dose, then 2 mg/kg wkly. K given as a 90 min iv infusion wkly × 3 Q 4 wks after H. K dose escalation cohorts: 70, 85 & 100 mg/m2. H1 + H2 antagonists + corticosteroid prophylaxis given 30–60 min prior to K. DLT: gr 4 hematologic or gr 3 other toxicity, or toxicity requiring >4 wk treatment delay. Cycle 1 + 2 PK samples obtained for K + H. Results: 13 pts treated from 9/04 - 8/05. Median age 51 yrs (36–65). All pts had MBC. Prior H therapy n = 9, prior taxane n = 11. Enrollment: 70 mg/m2 (4), 85 mg/m2 (3), and 100 mg/m2 (6). Mean number cycles 3.9 (1–6). The 100 mg/m2 cohort was expanded to 6 pts per study design; no DLTs were noted. Toxicity: Principal neurotoxicities (gr 3 noted, if present): parasthesias (10 pts, 1 gr3), neuropathic pain (5 pts, 2 gr3), dizziness (4 pts), dysguesia (4 pts), ataxia (3 pts), transient confusion (3 pts), dysesthesias (2 pts), insomnia (2 pts). No gr 4 neurotoxicities reported. Non-neurologic toxicities were limited to gr 1/2 and included diarrhea, pyrexia, abdominal and back pain, arthralgias. PK (n = 13): KOS-862 CL 21 ± 10 L/hr, Vz 260 ± 110 L, T1/2 9.8 ± 3.9 hr. Seco-metabolite was 67% ± 35% of K. At 100 mg/m2 K dose (n = 6): Cmax 3.3 ± 1.1 μg/mL and AUCinf 11.0 ± 7.5 h*(g/mL). Neither K nor its seco-metabolite PK were affected by H. Responses: An 85 mg/m2 K pt (no prior H or taxane) had confirmed PR and a 100 mg/m2 K pt (prior taxane) had an unconfirmed PR. A 2nd 100 mg/m2 pt (no prior H or taxane, bone only disease) had > 90% CEA reduction. Conclusions: This phase I study demonstrates feasibility of full dose wkly KOS-862 coadministration with wkly H. Treatment-related toxicities were all gr 1 / 2, except for 3 cases gr 3 paresthesias and neuropathic pain. PK of K and its principal metabolite were not affected by H. Three clinical responses were observed; a phase II trial of this combination is ongoing in minimally-pretreated MBC.

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Phase III study of gemcitabine plus vinorelbine (VG) versus vinorelbine (V) in patients (pts) with metastatic breast cancer (MBC) previously treated with anthracyclines (A) and taxanes (T). Final results of GEICAM 2000–04 study

575

Background: VG has shown to be efficacious and safe in MBC in pts previously treated with AT. This study compared treatment (TT) V with the combination of VG. Primary objective was progression free survival (PFS). Methods: pts previously treated with AT, aged ≥18, ECOG ≤ 2, were randomized to V: 30 mg/m2 day (d) 1, d8, or VG 30/1200 mg/m2 d1, d8, both every 21 days until disease progression. Stratification criteria were previous lines of TT for MBC (0 vs.1 vs.2) and visceral disease (yes vs. no). 126 pts per arm were needed to demonstrate a prolongation in PFS of 2 months (m) (from 3 to 5; HR = 1.67; α and β errors 0.05 and 10). Results: 252 pts (127 V and 125 VG) were recruited between 2001 and 2005. Arms were well balanced: median age was 57 years; median number of metastatic sites 2; visceral disease was present in 75% of pts; 17%, 53% and 29% of pts received study TT as first, second and third line respectively. Median number of cycles were 4 (1–21) in V and 6 (1–26) in VG. Median PFS was 6.3 m (95% CI, 5.3–7.3) for VG and 4.1 m (95% CI, 3.3–4.9) for V (p=0.0011). Objective response rate was 37% (CI 95% 29–46) for VG and 25% (CI 95%: 17–33) for V (p= 0.035). CTC grade 3–4 hematologic toxicity was significantly higher with VG vs. V (65% vs. 43% neutropenia, 33% vs. 17% leucopenia, and 11% vs. 2% thrombocytopenia); febrile neutropenia was present in 10.5% of pts on VG and 6% of pts in V (p=ns). Non-hematological toxicity was low and manageable in both arms. Conclusions: VG demonstrated significant efficacy advantages over V in pts with MBC previously treated with AT, with manageable toxicity. This favorable risk-benefit profile supports the use of this combination in this patient population.

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Observation of B(0)(s)-->Psi(2S)Phi and measurement of the ratio of branching fractions Beta(B(0)(s)-->Psi(2S)Phi)/Beta(B(0)(s)-->J/PsiPhi)

We report the first observation of B(0)(s)-->Psi(2S)Phi decay in p(p_) collisions at square root of 8=1.96 TeV using 360 pb(-1) of data collected by the CDF II detector at the Fermilab Tevatron. We observe 20.2 +/- 5.0 and 12.3 +/- 4.1 B(0)(s)-->Psi(2S)Phi candidates, in Psi(2S)-->mu(+)mu(-) and Phi(2S)-->J/Phipi(+)pi(-) decay modes, respectively. We present a measurement of the relative branching fraction Beta(B(0)(s)-->Psi(2S)Phi)/Beta(B(0)(s)-->J/PsiPhi)=0.52 +/- 0.13(stat) +/- 0.04(syst) +/- 0.06(BR) using the Psi(2S)-->mu(+)mu(-) decay mode.

Toxicity and health-related quality of life in breast cancer patients receiving adjuvant docetaxel, doxorubicin, cyclophosphamide (TAC) or 5-fluorouracil, doxorubicin and cyclophosphamide (FAC): impact of adding primary prophylactic granulocyte-colony stimulating factor to the TAC regimen

BACKGROUND

The aim of the study was to analyse the toxicity and health related quality of life (HRQoL) of breast cancer patients treated with FAC (5-fluorouracil, doxorubicin, cyclophosphamide) and TAC (docetaxel, doxorubicin, cyclophosphamide) with and without primary prophylactic G-CSF (PPG).

PATIENTS AND METHODS

This was a phase III study to compare FAC and TAC as adjuvant treatment of high-risk node-negative breast cancer patients. After the entry of the first 237 patients, the protocol was amended to include PPG in the TAC arm due to the high incidence of febrile neutropenia. A total of 1047 evaluable patients from 49 centres in Spain, two in Poland and four in Germany were included in the trial. Side-effects and the scores of the EORTC QLQ-C30 and QLQ BR-23 questionnaires were compared in the three groups (FAC, TAC pre-amendment and TAC post-amendment).

RESULTS

The addition of PPG to TAC significantly reduced the incidence of neutropenic fever, grade 2-4 anaemia, asthenia, anorexia, nail disorders, stomatitis, myalgia and dysgeusia. Patient QoL decreased during chemotherapy, more with TAC than FAC, but returned to baseline values afterwards. The addition of PPG to TAC significantly reduced the percentage of patients with clinically relevant Global Health Status deterioration (10 or more points over baseline value) at the end of chemotherapy (64% versus 46%, P<0.03).

CONCLUSIONS

The addition of PPG significantly reduces the incidence of neutropenic fever associated with TAC chemotherapy as well as that of some TAC-induced haematological and extrahaematological side-effects. The HRQoL of patients treated with TAC is worse than that of those treated with FAC but improves with the addition of PPG, particularly in the final part of chemotherapy treatment.

Search for Z' --> e+ e- using dielectron mass and angular distribution

We search for Z' bosons in dielectron events produced in pp collisions at square root of s = 1.96 TeV, using 0.45 fb(-1) of data accumulated with the Collider Detector at Fermilab II detector at the Fermilab Tevatron. To identify the Z' --> e+ e- signal, both the dielectron invariant mass distribution and the angular distribution of the electron pair are used. No evidence of a signal is found, and 95% confidence level lower limits are set on the Z' mass for several models. Limits are also placed on the mass and gauge coupling of a generic Z', as well as on the contact-interaction mass scales for different helicity structure scenarios.

Search for high-mass resonances decaying to emu in pp collisions at square root = 1.69 TeV

We describe a general search for resonances decaying to a neutral emu final state in pp collisions at a center-of-mass energy of 1.96 TeV. Using a data sample representing 344 pb(-1) of integrated luminosity recorded by the Collider Detector at Fermilab II experiment, we compare standard model predictions with the number of observed events for invariant masses between 50 and 800 GeV/c2. Finding no significant excess (5 events observed vs 7.7 +/- 0.8 expected for M(emu) > 100 GeV/c2 ), we set limits on sneutrino and Z' masses as functions of lepton family number violating couplings.

Utilidad del análisis del líquido cefalorraquídeo para el estudio de las deficiencias del metabolismo de neurotransmisores y pterinas y del transporte de glucosa y folato a través de la barrera hematoencefálica

BACKGROUND AND OBJECTIVE

In the last few years, it has been described inborn errors of neurotransmitter and pterin metabolism and defects in folate and glucose transport across blood brain barrier. All these defects are classified as rare diseases and needs cerebrospinal fluid (CSF) sample analysis for diagnosis. Our aim was to evaluate the results of the application of a CSF analysis protocol in a pediatric population from Spain and Portugal presenting with neurological disorders of unknown origin.

PATIENTS AND METHOD

We studied CSF samples from and 283 patients with neurological disorders of unknown origin and 127 controls. Neurotransmitters were analysed by HPLC with electrochemical detection, and pterins and 5-methyltetrahydrofolate were determined by HPLC with fluorescence detection.

RESULTS

We diagnosed 3 patients with tyrosine hidroxylase deficiency, 2 with dopa responsive dystonia, 14 with GTP-ciclohydrolase deficiency, 2 with glucose transport deficiency and 43 with cerebral folate deficiency.

CONCLUSIONS

This study allowed us to diagnose new patients, and more importantly, the establishment in all of them of a pharmacological or nutritional treatment. The most frequent defect found was CSF 5-methyltetrahydrofolate deficiency, which was present in different groups of patients.

Measurement of the tt production cross section in pp collisions at square root s = 1.96 TeV using missing E(T) + jets events with secondary vertex b tagging

We present a measurement of the tt production cross section in pp collisions at square root s = 1.96 TeV which uses events with an inclusive signature of significant missing transverse energy and jets. This is the first measurement which makes no explicit lepton identification requirements, so that sensitivity to W --> tau nu decays is maintained. Heavy flavor jets from top quark decay are identified with a secondary vertex tagging algorithm. From 311 pb(-1) of data collected by the Collider Detector at Fermilab, we measure a production cross section of 5.8 +/- 1.2(stat)(-0.7)(+0.9)(syst) pb for a top quark mass of 178 GeV/c2, in agreement with previous determinations and standard model predictions.

Direct search for Dirac magnetic monopoles in pp collisions at square root s = 1.96 TeV

We search for pair-produced Dirac magnetic monopoles in 35.7 pb(-1) of proton-antiproton collisions at square root s = 1.96 TeV with the Collider Detector at Fermilab (CDF). We find no monopole candidates corresponding to a 95% confidence-level cross-section limit sigma < 0.2 pb for a monopole with mass between 200 and 700 GeV/c2. Assuming a Drell-Yan pair-production mechanism, we set a mass limit m > 360 GeV/c2.

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.

Measurement of the ratios of branching fractions and

We report an observation of the decay B(O)(S) --> D(-)(s)pi(+) in pp collisions at radical S = 1.96 TeV using 115 pb(-1) of data collected by the CDF II detector at the Fermilab Tevatron. We observe 83 +/- 11(stat) B(O)(s) --> D(-)(s)pi(+) candidates, representing a large increase in statistics over previous measurements and the first observation of this decay at a pp collider. We present the first measurement of the relative branching fraction Beta(B(O)(s) --> D(-)(s)pi(+))/Beta(B(0) --> D(-)(pi)(+)) = 1.32 +/- 0.18(stat) +/- 0.38(syst). We also measure Beta(B(+) --> D(0)pi(+))/Beta(B(0) -->D(-)pi(+)) = 1.97 +/- 0.10(stat) +/- 0.21(syst), which is consistent with previous measurements.

Search for scalar bottom quarks from gluino decays in collisions at

We searched for scalar bottom quarks 156 pb(-1) of pp collisions at radicalS = 1.96 recorded by the Collider Detector at Fermilab II experiment at the Tevatron. Scalar bottom quarks can be produced from gluino decays in -parity conserving models of supersymmetry when the mass of the gluino exceeds that of the scalar bottom quark. Then, a scalar bottom quark can decay into a bottom quark and a neutralino. To search for this scenario, we investigated events with large missing transverse energy and at least three jets, two or more of which were identified as containing a secondary vertex from the hadronization of quarks. We found four candidate events, where 2.6 +/- 0.7 are expected from standard model processes, and placed 95% confidence level lower limits on gluino and scalar bottom quark masses of up to 280 and 240 GeV/c(2), respectively.

Top-quark mass measurement from dilepton events at CDF II

We report a measurement of the top-quark mass using events collected by the CDF II detector from pp collisions at square root of s = 1.96 TeV at the Fermilab Tevatron. We calculate a likelihood function for the top-quark mass in events that are consistent with tt --> bl(-)nu(l)bl'+ nu'(l) decays. The likelihood is formed as the convolution of the leading-order matrix element and detector resolution functions. The joint likelihood is the product of likelihoods for each of 33 events collected in 340 pb(-1) of integrated luminosity, yielding a top-quark mass M(t) = 165.2 +/- 6.1(stat) +/- 3.4(syst) GeV/c2. This first application of a matrix-element technique to tt --> bl+ nu(l)bl'- nu(l') decays gives the most precise single measurement of M(t) in dilepton events. Combined with other CDF run II measurements using dilepton events, we measure M(t) = 167.9 +/- 5.2(stat) +/- 3.7(syst) GeV/c2.

Measurement of the inclusive jet cross section using the kT algorithm in pp collisions at (square root s)=1.96 TeV

We report on a measurement of the inclusive jet production cross section as a function of the jet transverse momentum in pp collisions at (square root s)=1.96 TeV using data collected with the upgraded Collider Detector at Fermilab in run II, corresponding to an integrated luminosity of 385 pb-1. The measurement is carried out for jets with rapidity 0.1</yjet/<0.7 and transverse momentum in the range 54<pjetT<700 GeV/c. Next-to-leading order perturbative QCD predictions are in good agreement with the measured cross section after the necessary nonperturbative parton-to-hadron corrections are included.

Measurement of the dipion mass spectrum in decays

We measure the dipion mass spectrum in X(3872)--> J/psipi(+) pi(-) decays using 360 pb(-1) of pp collisions at square root s= 1.96 TeV collected with the CDF II detector. The spectrum is fit with predictions for odd C-parity ((3)S(1), (1)P(1), and (3)D(J)) charmonia decaying to J/psipi(+) pi(-), as well as even C-parity states in which the pions are from rho(0) decay. The latter case also encompasses exotic interpretations, such as a D(0)D(*0) molecule. Only the (3)S(1) and J/psirho hypotheses are compatible with our data. Since (3)S(1) is untenable on other grounds, decay via J/psirho is favored, which implies C= +1 for the X(3872). Models for J/psi - rho different angular momenta L are considered. Flexibility in the models, especially the introduction of rho - omega interference, enables good descriptions of our data for both L = 0 and 1.

Seasonal effect on zebu embryo quality as determined by their degree of apoptosis and resistance to cryopreservation

In order to optimize the production of embryos under tropical conditions and to test a possible seasonal effect on embryo quality, 40 Zebu cows were superovulated during the dry season (April to May) and during the rainy season (July to August). A total of 116 (average 2.7/cow) and 83 embryos (3.5 average/cow) were obtained during the respective seasons. After classification as good, fair or poor quality, embryos were tested based on their ultrastructural differences (n = 53 dry season 16 good, 20 fair and 17 poor and n = 61 rainy season 21 good, 20 fair and 20 poor) and their degree of apoptosis using the TUNEL technique (n = 30 during the dry season and n = 55 in the rainy season). Structural characteristics determining embryo quality varied between good and fair quality embryos. No difference, however, was observed between good, fair and poor quality embryos from the two seasons. The number of TUNEL-positive cells was different among embryos (p < 0.001), being lower in labelled cells of good quality embryos regardless of the season. Fewer apoptotic cells were observed in embryos assigned in all three quality levels during the rainy season (p < 0.001). Ultrastructural evaluations confirmed the results obtained by TUNEL. Cryopreserved embryos of good (n = 25 in each season) and fair quality (n = 11 dry season; n = 17 rainy season) showed a significant decrease of TUNEL-positive cells during the rainy season (p < 0.05). Results suggest that embryos collected in the dry season have more cellular damage in contrast; embryos cryopreserved in the rainy season appeared morphologically better equipped to result in a pregnancy following transfer.

Search for Higgs bosons decaying to bb and produced in association with W bosons in pp collisions at square root of s = 1.96 TeV

We present a search for Higgs bosons decaying into bb and produced in association with W bosons in pp collisions at square root of s = 1.96 TeV. This search uses 320 pb(-1) of the data set accumulated by the upgraded Collider Detector at Fermilab. Events are selected that have a high-transverse momentum electron or muon, missing transverse energy, and two jets, at least one of which is consistent with the hadronization of a b quark. Both the number of events and the dijet mass distribution are consistent with standard model background expectations, and we set 95% confidence level upper limits on the production cross section times branching ratio for the Higgs boson or any new particle with similar decay kinematics. These upper limits range from 10 pb for mH = 110 GeV/c2 to 3 pb for mH = 150 GeV/c2.

Evidence for the exclusive decay B(c)+- --> J/psi pi+- and measurement of the mass of the B(c)+- meson

We report the first evidence for a fully reconstructed decay mode of the B(c)+- meson in the channel B(c)+- --> J/psi pi+-, with J/psi --> mu+ mu-. The analysis is based on an integrated luminosity of 360 pb(-1) in pp collisions at 1.96 TeV center of mass energy collected by the Collider Detector at Fermilab. We observe 14.6 +/- 4.6 signal events with a background of 7.1 +/- 0.9 events, and a fit to the J/psi pi+-mass spectrum yields a B(c)+- mass of 6285.7 +/- 5.3(stat) +/- 1.2(syst) MeV/c2. The probability of a peak of this magnitude occurring by random fluctuation in the search region is estimated as 0.012%.

Search for charged Higgs bosons from top quark decays in pp collisions at square root s=1.96 TeV

We report the results of a search for a charged Higgs boson in the decays of top quarks produced in pp collisions at a center-of-mass energy of 1.96 TeV. We use a data sample corresponding to an integrated luminosity of 193 pb-1 collected by the upgraded Collider Detector at Fermilab. No evidence for charged Higgs production is found, allowing 95% C.L. upper limits to be placed on BR(t-->H+b) for different charged Higgs decay scenarios. In addition, we present in the minimal supersymmetric standard model (mH+/-, tanbeta) plane the first exclusion regions with radiative and Yukawa coupling corrections.

Precision top-quark mass measurement in the lepton+jets topology in p p collisions at square root s=1.96 TeV

We report two measurements of the top-quark mass M(top) using the CDF II detector at the Fermilab Tevatron in a 318 pb(-1) data sample of tt events in the lepton+jets final state. One method uses an event-based likelihood technique resulting in M(top) = 173.2(-2.4)(+2.6)(stat) +/- 3.2(syst) GeV/c2 or 173.2(-4.0)(+4.1) GeV/c2. The second method reconstructs a top-quark mass in each event using the measured invariant mass of the hadronically decaying W boson to constrain the jet energy scale to obtain a value for M(top)of 173.5(-3.6)(+3.7)(stat) +/- 1.3(syst) GeV/c2 or 173.5(-3.8)(+3.9) GeV/c2 . We take the latter, which is more precise, as our result.

Search for neutral Higgs bosons of the minimal supersymmetric standard model decaying to tau pairs in pp collisions at square root of s = 1.96 TeV

We present a search for neutral supersymmetric Higgs bosons decaying to tau pairs produced in pp collisions at square root of s = 1.96 TeV. The data, corresponding to 310 pb(-1) integrated luminosity, were collected with the Collider Detector at Fermilab in run II of the Tevatron. No significant excess above the standard model backgrounds is observed. We set exclusion limits on the production cross section times branching fraction to tau pairs for Higgs boson masses in the range from 90 to 250 GeV/c2.