Non-platinum doublets were as effective as platinum-based doublets for chemotherapy-naïve advanced non-small-cell lung cancer in the era of third-generation agents

PURPOSE

The aim was to compare the efficacy between doublets of third-generation agents (non-platinum) and doublets of platinum plus a third-generation agent (platinum-based) for chemotherapy-naïve advanced non-small-cell lung cancer (NSCLC).

METHODS

We conducted a literature-based meta-analysis to compare the efficacy between doublets of third-generation agents and doublets of platinum plus a third-generation agent for chemotherapy-naïve advanced NSCLC. The primary end point was overall survival, and the secondary end points were progression-free survival (PFS) and response rate. Subgroup analyses were also conducted by different non-platinum doublet regimens or different platinum-based doublets. A descriptive review for toxicity was performed.

RESULTS

Sixteen randomized controlled trials were identified ultimately. Results demonstrated that the efficacy of non-platinum doublets was comparable with platinum-based doublets according to the overall survival (HR = 1.03, 95 % CI = 0.98-1.08, p = 0.29). Subgroup analyses by different non-platinum doublets also showed the efficacy of all the third-generation doublets, such as vinorelbine plus gemcitabine, vinorelbine plus paclitaxel, gemcitabine plus paclitaxel, and gemcitabine plus docetaxel, was comparable with platinum-based doublets (HR = 1.00, 95 % CI = 0.78-1.27, p = 0.98; HR = 0.97, 95 % CI = 0.80-1.18, p = 0.79; HR = 1.05, 95 % CI = 0.99-1.12, p = 0.11; HR = 1.01, 95 % CI = 0.92-1.10, p = 0.87; respectively). Subgroup analyses by different platinum-based doublets indicated that the efficacy of the third-generation doublets were equal to both cisplatin-based doublets and carboplatin-based doublets (HR = 1.08, 95 % CI = 1.00-1.17, p = 0.05; HR = 1.00, 95 % CI = 0.94-1.05, p = 0.94; respectively). The secondary end points indicated that platinum-based doublets might have an advantage in PFS but not in response rate (HR = 1.06, 95 % CI = 1.01-1.12, p = 0.03; RR = 0.99, 95 % CI = 0.90-1.08, p = 0.81; respectively).

CONCLUSIONS

Non-platinum doublets were as effective as platinum-based doublets with different toxicity profile for chemotherapy-naïve advanced NSCLC in the era of third-generation agents.

Morphology and volatile compounds of metathoracic scent gland in Tessaratoma papillosa (Drury) (Hemiptera: Tessaratomidae)

Tessaratoma papillosa (Drury) (Hemiptera: Tessaratomidae) is a serious insect pest of litchi and longan in South China. When disturbed, this insect could release large quantities of disagreeable odorous volatiles from its scent gland. Knowledge on the scent gland and its secretion is crucial for developing the semiochemical methods to manage this pest. Morphology and ultrastructure of the metathoracic scent glands (MTGs) were studied under stereo and scanning electron microscopy, and the volatile compounds of MTGs from both male and female T. papillosa were analyzed with coupled gas chromatography-mass spectrometry (GC-MS). The MTG complex is located between the metathorax and the first abdominal segment at the ventral surface of the insect, which has a well-developed single double valve cystic-shaped orange median reservoir, paired colorless lateral glands in both sides, and a long and wavy tubular accessory gland that inlays tightly into the ventral edge around the median reservoir. The MTG opens to the body surface through paired ostioles located between the meso- and metacoxae of the evaporatorium with mushroom bodies. The GC-MS analyses showed that female and male adults have nine major volatile components in common. Tridecane is the most abundant in both females and males, reaching up to 47.1% and 51.8% of relative amount, respectively. The minor component is benzophenone with only 0.28% and 0.14%. Furthermore, undecane, tetradecane, 3-methyl-tridecane, and cyclopentadecane were found only in males. The possible function of volatile compounds of MTG contents in T. papillosa is addressed.

Morphological characteristics and chromosome behaviour in F1, F2 and BC1 progenies between Chrysanthemum x morifolium and Ajania pacifica

The garden chrysanthemum (Chrysanthemum x morifolium) variety 'Aoyunhuoju' (2n = 6x = 54) was crossed as female with Ajania pacifica (2n = 10x = 90) to produce an intergeneric F1 hybrid, which was used both as a source ofF2 progeny and as a parent for a first back-cross with 'Aoyunhuoju'. The morphology of all of the F1 hybrids and hybrid derivatives was intermediate with respect to the two parents, although the BC1 progenies resembled 'Aoyunhuoju' more closely than any of the F1 and F2 progenies did. In the F1 hybrid, the density of silvery hairs on the lower leaf surface and along the margin of the leaf was lower than in A. pacifica, while that in the BC1 generation, this trait was less prominent than in the F1. The somatic chromosome number of the F1, F2 (with an exception of F2-6 of a mainly 63) and BC1 generations was 2n = 8x = 72, 2n = 8x = 72 and 2n = 7x = 63 respectively, as expected. The hybrids and their derivatives retained a variable degree of fertility. There was a low frequency of meiotic chromosome pairing failure in all three hybrid generations, with most of the chromosomes involved as bivalents. Some BC1 individuals show potential for commercialization thanks both to their flower shape and the inheritance of the silvery leaf trait from A. pacifica.

Effectiveness of fast-track rehabilitation vs conventional care in laparoscopic colorectal resection for elderly patients: a randomized trial

AIM

The aim of the study was to evaluate the efficacy and safety of fast-track rehabilitation in elderly patients over 65 years of age, following laparoscopic surgery to remove colorectal cancer.

METHOD

A total of 78 elderly patients with colorectal cancer who underwent laparoscopic colorectal resection were randomly assigned to receive either the fast-track care programme (n = 40) or the conventional perioperative care protocol (control group, n = 38). Medical personnel conducting the study were blinded to patients' clinical outcomes prior to statistical analysis. The fast-track protocol included no preoperative mechanical bowel irrigation, immediate oral alimentation and earlier postoperative ambulation exercise. The length of postoperative hospital stay, the length of time to regain bowel function and the rate of postoperative complications were compared between the two groups.

RESULTS

The length of time to regain bowel function, including the passage of flatus[31 (26-40) h vs 38 (32-51) h, P = 0.001], to the first bowel movement [55 (48-63) h vs 64 (48-71) h, P = 0.009] and to start a liquid diet (12 [11-16] h vs 47 [35-50] h, P = 0.000) were significantly shorter in patients receiving the fast-track care protocol compared with those receiving the conventional care protocol. A shorter duration of postoperative hospital stay was recorded in patients receiving the fast-track program than in those receiving conventional care (P = 0.0001). A reduced percentage of patients who developed general complications was also observed in the fast-track group (5.0%vs 21.1%, P = 0.045).

CONCLUSION

This randomized controlled trial has shown that in the elderly undergoing laparoscopic colorectal surgery, the fast-track recovery programme resulted in a more rapid postoperative recovery, earlier discharge from hospital and fewer general complications compared with a conventional postoperative protocol.

Endovascular treatment for the spontaneous rupture of a non-aneurysmal subdiaphragmatic aorta

The case of a patient who underwent an endovascular aortic repair for a spontaneous rupture of a non-aneurysmal subdiaphragmatic aorta without trauma, infection, or inflammation is reported. The patient is a 51-year-old male diagnosed with subdiaphragmatic aortic rupture and was in a state of hemorrhagic shock upon admission to the hospital. Intraoperative aortography revealed the abdominal aortic rupture site located above the celiac artery. A coated thoracic stent graft was used. Completion angiography showed a total exclusion with no endoleaks. After six months of follow-up, computed tomographic scans confirmed the absence of endoleaks or graft displacements.

Widely tunable midinfrared difference frequency generation in orientation-patterned GaAs pumped with a femtosecond Tm-fiber system

We demonstrate a midinfrared source tunable from 6.7 to 12.7 μm via difference frequency generation (DFG) in orientation-patterned GaAs, with 1.3 mW average output power. The input pulses are generated via Raman self-frequency shift of a femtosecond Tm-doped-fiber laser system in a fluoride fiber. We numerically model the DFG process and show good agreement between simulations and experiments. We use this numerical model to show an improved design using longer pump pulses.

Factors influencing the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography: correlation with biopsy and radical prostatectomy specimens

OBJECTIVES

This study was designed to identify factors that influenced the degree of enhancement of prostate cancer on contrast-enhanced transrectal ultrasonography (CETRUS).

METHODS

139 patients suspected of prostate cancer were evaluated with CETRUS followed by systematic and targeted transrectal ultrasound-guided biopsies. The degree of enhancement of the lesions was objectively measured using peak intensity with time-intensity curve analysis software. Ultrasound findings were correlated with clinical characteristics as well as biopsy and radical prostatectomy findings.

RESULTS

Prostate cancers were detected in 230 biopsy sites from 91 patients. The mean peak intensity value of prostate cancer was significantly higher than that of the benign lesions (9.82 ± 3.73 vs 7.51 ± 2.97; p<0.001), and the peak intensity value of the cancer foci varied across the prostate. The mixed model analysis revealed that the location and Gleason score of tumour foci were the influencing factors of the peak intensity value, and the former had a stronger influence upon peak intensity than the latter (p=0.000 and 0.040, respectively). However, age, prostate volume or serum prostate-specific antigen of the patient had no significant influence on the peak intensity value (p>0.05). Furthermore, the peak intensity value of tumours larger than 5 mm diameter was significantly higher than tumours of 5 mm or smaller diameter (9.28 ± 2.46 vs 6.69 ± 2.65; p<0.001).

CONCLUSIONS

The prostate cancer lesions with a higher Gleason score and larger tumour size which were located in the lateral peripheral zone (PZ) were more likely to show a marked enhancement. Lesions with lower peak intensity that are located in the medial PZ should also be treated as suspicious.

High intergrain critical current density in fine-grain (Ba0.6K0.4)Fe2As2 wires and bulks

The K- and Co-doped BaFe(2)As(2) (Ba-122) superconducting compounds are potentially useful for applications because they have upper critical fields (H(c2)) of well over 50 T, H(c2) anisotropy γ < 2and thin-film critical current densities J(c) exceeding 1 MA cm(-2) (refs 1-4) at 4.2 K. However, thin-film bicrystals of Co-doped Ba-122 clearly exhibit weak link behaviour for [001] tilt misorientations of more than about 5°, suggesting that textured substrates would be needed for applications, as in the cuprates. Here we present a contrary and very much more positive result in which untextured polycrystalline (Ba(0.6)K(0.4))Fe(2)As(2) bulks and round wires with high grain boundary density have transport critical current densities well over 0.1 MA cm(-2) (self-field, 4.2 K), more than 10 times higher than that of any other round untextured ferropnictide wire and 4-5 times higher than the best textured flat wire. The enhanced grain connectivity is ascribed to their much improved phase purity and to the enhanced vortex stiffness of this low-anisotropy compound (γ~1-2) when compared with YBa(2)Cu(3)O(7-x) (γ~5).

Cathepsin B may be a potential biomarker in cervical cancer

Cathepsin B is a protease which is able to digest extracellular matrix. It is currently unknown whether cathepsin B plays a role in cervical cancer development and progression. With Q-PCR and Western blotting, we observed cathepsin B expression in cervical cancer cell line Hela cells. After the gene was silenced in HeLa cells with SiRNA, we confirmed that cathepsin B expressions at both mRNA and protein levels were significantly reduced. At the same time, cell proliferation, migration and invasion of the HeLa cells were significantly decreased compared to control cells. In addition, a significant regression of tumor growth in nude mice which received the siRNA targeted cathepsin B HeLa cells was observed. We further studied the expression of cathepsin B in a series of 169 clinical samples, including 56 invasive cervical squamous carcinoma, 85 CINs and 28 normal cervical tissues. It was found that cathepsin B expression in invasive carcinomas was significantly higher than that in the CINs and normal tissues (P<0.01). In addition, cathepsin B expression in the invasive carcinomas was positively correlated to tumor invasion depth and lymphatic metastasis. Our results indicate that cathepsin B may be a potential biomarker for further strategical clinical studies in cervical cancer.

Proteomic differences in seed filling between yellow-seeded progeny of Brassica napus-Sinapis alba (Brassicaceae) and black-seeded parent B. napus

Comparative proteomics of seed filling between yellow-seeded progeny from somatic hybrids Brassica napus-Sinapis alba and black-seeded parent (B. napus) were taken out using two-dimensional electrophoresis (2-DE). The process indicated distinct differences in 2, 3, 4, 5, 6 weeks after fertilization (WAF) and mature seed. A total of 8 out of the 27 discriminate proteins were identified by mass spectrum analysis and MASCOT comparison, including protein kinase, enolase, triosephosphate isomerase, and dioxygenase. PCR primers contrived for the putative genes were applied for further identification of progenies and both parents, which indicated that spot A3-5 might be the novel protein of intergeneric hybrid, i.e., A5-2 derived from S. alba. Applying these specific primers, this study demonstrates that the new yellow-seeded germplasm is different from the existing yellow seed materials of rapeseed.

Continuous administration of recombinant human endostatin (Endostar): A pre-clinical safety study

The aim of this study was to evaluate the safety of the continuous administration of recombinant human endostatin (Endostar) in healthy mice. A total of 16 nude mice were randomly divided into four treatment groups: a continuous administration group injected intraperitoneally (i.p.) with 14 mg/kg Endostar over seven days, an intermittent administration group injected i.p. with 2 mg/kg Endostar daily for seven days, a saline injection group and an untreated control group. All mice were implanted with an intraperitoneal mini-osmotic drug pump filled with Endostar or saline. The serum concentration of Endostar, the cell fraction of CD11b(-)CD146(+)CD105(+) vascular endothelial cells in the peripheral blood, the injury of the myocardial, lung and kidney tissues and the density of microvessels within these organs were observed 24 h after the termination of drug or saline administration. Only trace amounts of Endostar were detected in the serum of the continuous administration and intermittent administration groups. Myocardial, lung and kidney tissues exhibited no detectable signs of injury and no differences in the density of microvessels were found in these organs among the four groups. Yet, the cell fraction (in %) of CD11b(-)CD146(+)CD105(+) vascular endothelial cells in the peripheral blood was higher in the continuous administration group compared with that in the other treatment groups (P=0.011). This suggests that intermittent Endostar delivery did not significantly impact the vascular endothelium, while continuous Endostar administration may promote injury of the endothelium. In conclusion, the continuous administration of Endostar does not appear to be a safe method by which to administer this antiangiogenic agent to healthy nude mice.

Optimization of factors affecting Agrobacterium-mediated transformation of Micro-Tom tomatoes

Micro-Tom is the smallest known variety of tomatoes. An orthogonal experimental design L(16) (4(5)) was used to optimize Agrobacterium-mediated transformation of cotyledon explants of Lycopersicon esculentum cv. Micro-Tom. Four parameters were investigated to determine their effect on transformation frequency: the concentration of bacterial suspension, time of dip in bacterial suspension, co-cultivation time, and concentration of carbenicillin. We also examined the effect of these parameters on contamination rate, necrosis rate, mortality, cut-surface browning rate, and undamaged explant rate. Both the bacterial and carbenicillin concentrations had a significant influence on the rate of infected explants. The time of co-cultivation also had a significant influence on the transformation parameters. The optimal transformation protocol consisted of an Agrobacterium suspension of 0.5 × 10(8) cells/mL (OD(600) = 0.5) and an infection time of 5 min, one day of co-cultivation and 500 mg/L carbenicillin. Under these conditions, the transformation efficiency of the shoots reached 5.1%; the mean transformation frequency was 3.9% (N = 838).