Analysis of oxaliplatin-induced sensory neurotoxicity (sNT) in patients receiving FIREFOX, alternating regimen of mFOLFOX-6 and FOLFIRI, with metastatic colorectal cancer (MCRC): Results from combined analysis of KSCC0501 and KSCC0701

492

Background: The Kyushu Study Group of Clinical Cancer (KSCC) conducted two phase II trials (KSCC0501 and KSCC0701, Akagi et al. J Clin Oncol. 28:15s, 2010, UMIN ID: 000001342) to evaluate the efficacy and safety of first-line oxaliplatin-based chemotherapy for MCRC. This combined analysis was performed to compare the incidence of oxaliplatin-induced sNT between the two trials.

Methods: Patients (pts) were accrued from 2005 to 2007 in KSCC0501 and from 2007 to 2008 in KSCC0701. Sixty pts received FOLFOX-4 in KSCC0501 and 47 pts received FIREFOX(4 cycles of mFOLFOX-6 alternating with 4 cycles of FOLFIRI) in KSCC0701. All pts were reviewed for efficacy and toxicity (NCI-CTCAEv3.0). Kaplan-Meier analysis was performed to assess the incidence of sNT.

Results: The incidence of sNT was 71.4% with FOLFOX-4 and 36.2% with FIREFOX (Table). The ORR was 34.5% (95% CI F22.5-48.1%) for FOLFOX4 and 58.7% (43.9-73.5%) for FIREFOX. Median PFS was 7.0 M (5.1-9.8 M) with FOLFOX-4 and 10.3 M (7.5-11.9 M) with FIREFOX. MST and 2-year survival were respectively 31.5 M (18.1-40.1 M) and 58.0% for FOLFOX4, versus not determined and 57.1% for FIREFOX. The median no. of treatment cycles was 9 for FOLFOX-4 and 12 for FIREFOX. After 4, 8, and 12 cumulative treatment cycles, the incidence of grade 2+sNT was respectively 24.0%, 30.7%, and 60.5% with FOLFOX-4 versus 6.5%, 6.5%, and 16.0% with FIREFOX.

Conclusions: As first-line oxaliplatin-based chemotherapy for MCRC, FIREFOX caused less oxaliplatin-induced sNT and prolonged the duration of treatment. We have now finished enrollment for study KSCC 0801 (KSCC 0701+bevacizumab) and are following the pts.

[Table: see text]

[Table: see text]

Matrix metalloprotease-9 activity in the cerebrospinal fluid and spinal injury severity in dogs with intervertebral disc herniation

We investigated whether matrix metalloproteinase (MMP)-9 expression in the cerebrospinal fluid (CSF) of dogs with intervertebral disc herniation (IVDH) is associated with the severity of neurological signs and prognosis. CSF from the cisterna magna (C-CSF) and the lumbar spine (L-CSF) of 34 dogs with IVDH was analyzed using zymography. Activity of MMP-9 in L-CSF was detected in 6 of 34 dogs with IVDH, often for more than 7 days after injury. MMP-9 activity was not detected from any of the C-CSF samples. Of the six cases that were MMP-9 positive, all four cases with grade V that had loss of deep pain were non-ambulatory 6 months after treatment. The remaining two cases with grade III and IV could recover mobility. In dogs with grade V thoracolumbar IVDH, MMP-9 expression in the CSF may indicate severe spinal cord injury with poor prognosis.

Safety and efficacy of gefitinib monotherapy for patients (pts) ≥80 years (yrs) with advanced non-small cell lung cancer (NSCLC): A phase II subset analysis

e19059

Background: Lung cancer is a disease of the elderly with median age at diagnosis of 70 yrs. The very elderly pts (age ≥80 yrs) with advanced NSCLC have not been well studied, even though this proportion is increasing over coming years. There are no data to evaluate the safety and efficacy of gefitinib treatment for pts ≥80 yrs with advanced NSCLC. Methods: We reported the phase II trial of gefitinib monotherapy in chemotherapy-naïve pts of 75 yrs or older with advanced NSCLC (J Thorac Oncol. 2008;3: 1166–1171). We analyzed data for pts ≥80 yrs, comparing with those <80 yrs in our trial. Results: A total of 28 pts were 80 yrs old and over in our trial. Patient characteristics: male/female = 12/16, median age = 82 (range 80–90), ECOG PS 0/1/2=7/13/8, stage IB/IIIA/IV=1/3/24, and adenocarcinoma (Ad)/non-Ad= 22/6. Five pts achieved partial response. The response rate was 18% (CI 95%, 6–39). The disease control rate was 50%. Median survival time was 9 months and 1-year survival rate was 39%. The most frequent adverse events were skin disorders (86%). Nine pts (32%) experienced toxicities ≥grade 3. There were two pts with possible interstitial lung disease including one treatment-related death. Tumor samples from 10 pts were analyzed for EGFR mutation status. EGFR mutations were detected in tumor tissues from 5 pts, of which 3 had partial responses (60%). Table shows the difference between the pts ≥80 yrs and those <80 yrs. Conclusions: Gefitinib monotherapy is effective and relatively well tolerated for pts ≥80 yrs with advanced NSCLC. Gefitinib has potential as a first-line therapeutic option even if elderly pts are more than 80 yrs old.

[Table: see text]

No significant financial relationships to disclose.

Modification of IkappaBalpha by taurine bromamine inhibits tumor necrosis factor alpha-induced NF-kappaB activation

OBJECTIVE AND DESIGN

Eosinophils play a prominent role in the pathogenesis of various common human allergic diseases, including asthma. Taurine chloramine (TauCl) and taurine bromamine (TauBr) are products of activated neutrophils and eosinophils. TauCl has strong anti-inflammatory properties. However, much less is known about TauBr. The aim of this study was to compare the anti-inflammatory capacity and membrane permeability of TauBr to those of TauCl.

MATERIALS AND METHODS

Jurkat cells (T-lymphocytes) and YJ cells (myeloid-committed eosinophils) were used throughout this in vitro study. Tumor necrosis factor (TNFalpha) was employed for activation of the cells. Degradation of the cytosolic NF-kappaB inhibitor protein (IkappaBalpha) was studied by Western blot analysis. Assessment of NF-kappaB DNA binding activity was performed by an electrophoretic mobility shift assay (EMSA).

RESULTS

TauBr inhibited degradation of IkappaBalpha and TNFalpha-induced NF-kappaB activation. TauBr exerted an anti-inflammatory effect by a similar process to that of TauCl. TauBr administered extracellularly in phosphate buffered saline (PBS) shifted the IkappaBalpha band at a relatively low concentration of 50 muM. In addition, TauBr was membrane-permeable as demonstrated by the inactivation of glyceraldehyde-3-phosphate dehydrogenase (GAPDH).

CONCLUSIONS

TauBr was found to be highly membrane-permeable. TauBr might be generated both extracellularly and intracellularly by eosinophils at inflammatory sites in allergic disease and play an anti-inflammatory role.

Removal of arsenic from contaminated soils using different salt extractants

This study presents an environmental-friendly and cost effective method for the extraction of arsenic from contaminated soils. Laboratory experiments using inorganic salts, potassium phosphate (KH2PO4), potassium chloride (KCl), potassium nitrate (KNO3), potassium sulfate (K2SO4), and sodium perchlorate (NaClO4) were evaluated as arsenic extractants. An Andosol soil was artificially contaminated with arsenite [As(III)] and arsenate [As(V)]. The soil was washed in a batch process with different salt solutions in the pH range 3-11 for 24 hours at 20 degrees C. Among the various potassium and sodium salts tested, KH2PO4 was found to be highly effective in extracting arsenic from As(III)-soil attaining more than 80% and 40% from As(V)-soil in neutral pH range. Other salts were particularly ineffective in extraction of arsenic from both soils. More arsenic was extracted more from the As(III)-soil than the As(V)-soil.

Pattern of dietary fiber intake among the Japanese general population

OBJECTIVES

To evaluate the dietary fiber (DF) intake pattern among the Japanese general population.

DESIGN

We performed a dietary survey among the general population in northern Japan to evaluate the intake patterns. DF intake was calculated by substituting the DF content of each food in the Dietary Fiber Table for the intake of each food from this dietary survey.

SUBJECTS

Five hundred and seventy-seven subjects participated in the study, 198 men and 379 women.

RESULTS

In subjects with higher DF intakes the origins of the DF that were from all food groups, but with the notable exception of rice. The contribution of the seaweed group was of particular interest. From multiple regression analysis, as for food group, seaweeds showed the highest positive correlation with DF intake in both genders, followed by vegetables, pulses, fruits. On the other hand, rice showed the negative correlation with DF intake in both genders. As for life factor, body mass index showed the negative correlation with DF intake in women.

CONCLUSION

Seaweed, a typical Japanese food, was most related to the increase in DF intake for the Japanese general population, whereas rice, the Japanese staple, had a small influence on decreased DF intake.

Effect of paroxetine on marble-burying behavior in mice

The present study was undertaken to investigate the effect of paroxetine, a selective serotonin reuptake inhibitor (SSRI), on marble-burying behavior in mice in comparison with those of fluvoxamine and clomipramine. Marble-burying test is extensively used as an animal model for obsessive/compulsive disorder. A significant inhibition in marble-burying behavior was observed with paroxetine, at a dose of 10 mg/kg. The earlier SSRI, fluvoxamine, also significantly inhibited marble-burying behavior at a dose of 30 mg/kg. Although clomipramine, a tricyclic antidepressant, caused an inhibition in marble-burying behavior, a high dose of 100 mg/kg was needed to show a significant effect. On the other hand, all the drugs used in the present study showed no significant changes in spontaneous locomotor activity at doses inhibiting marble-burying behavior. In conclusion, it was confirmed that paroxetine has a potent inhibitory effect on marble-burying behavior in mice, and could have a similar antiobsessive/anticompulsive activity in human beings.

Chemical extraction of arsenic from contaminated soil

A series of batch extraction experiments were conducted using a fortified soil with different extracting solutions such as inorganic acids (hydrochloric acid (HCl), sulfuric acid (H2SO4), phosphoric acid (H3PO4), perchloric acid (HClO4), or nitric acid (HNO3)), organic acids (acetic acid (C2H4O2), citric acid (C6H8O7)) and alkaline agent (NaOH). Various concentrations were used to investigate the removal efficiency and to optimise the concentration of each extractant. In the present investigation a Kuroboku soil contaminated with arsenite (As(III)) was used as a model soil. Arsenic was extracted most efficiently by 5% H3PO4 with a maximum of more than 99% from the model soil. Sulfuric acid also showed high percentage extraction efficiency. On the other hand, C2H4O2 and oxidizing acids such as HNO3 and HClO4 showed low efficiency of As extraction compared with C6H8O7. Although, NaOH also showed higher extraction efficiencies compared with organic and oxidizing acids but mainly arsenate (As(V)) was found to be the major component. A significant fraction of the As(III) was oxidized to As(V) during mineral acid and alkaline extraction and extraction efficiency also varied with the concentration of the acid and alkali solution.

Extraction behavior of metallic contaminants and soil constituents from contaminated soils

With an aim of developing an effective remediation technology for soils contaminated by heavy metals and metalloids, the extraction behavior of metallic contaminants as well as those of soil constituents was studied on a laboratory scale. Three contaminated soils collected from a former metal recycling plant were examined. These three soils were found to be contaminated by As, Cu, Pb, Sb, Se and Zn as compared to the non-contaminated soil. The pH-dependent extraction behavior of various elements from the soils was measured in a wide pH range and categorized into three groups. Hydrochloric acid (HCl), H2SO4, H3PO4, HNO3, sodium citrate, sodium tartrate, disodium dihydrogen ethylenediaminetetraacetate and diethylenetriaminepentaacetic acid were evaluated as extractants for removing contaminants from the soils. Extraction behavior of the soil constituents was also studied. The efficiency of the extraction was evaluated by the Japanese content and leaching tests. The stabilization of Pb remaining in the soil after the extraction process was conducted by the addition of iron(III) and calcium chloride.

An objective method to evaluate the risk of recurrence and extension of Dupuytren's disease

This study was undertaken to assess the influence of the factors related to Dupuytren's diathesis on the rates of recurrence and extension of Dupuytren's disease after surgery. The records of 65 patients who underwent surgery for Dupuytren's disease were retrospectively studied and the presence of factors related to diathesis were recorded. The sensitivity and specificity of each factor for predicting recurrence and extension were calculated. Odds ratios and 95% confidence intervals were also calculated and a discriminant analysis was performed to explore correlations between recurrence and extension and the significant variables. Our results confirmed the prognostic value of diathesis. The results have been used to develop a new scoring system for evaluating the risk of recurrence and extension.

Surgery for Dupuytren's disease in Japanese patients and a new preoperative classification

The surgical outcome of Dupuytren's disease was evaluated in 73 hands of 57 patients in a Japanese population. Subtotal fasciectomy was performed in all cases. Surgical results were evaluated using the percentage improvement of extension in each finger joint. Statistical analyses were performed on the risk factors associated with recurrence and extension. The surgical outcome depended on the degree of contracture of the proximal interphalangeal joint. Recurrence of disease occurred in eight patients (14%) and extension occurred in nine (16%). Recurrence and extension frequently occurred in those who had ectopic lesions or involvement of the radial side of the hand. The present results suggested that the Dupuytren's diathesis had an influence on recurrence and extension. We proposed a new classification of Dupuytren's disease that might help to predict the surgical outcome and facilitate surgical planning.

Comparison of diagnostic methods for diabetes mellitus based on prevalence of retinopathy in a Japanese population: the Hisayama Study

AIMS/HYPOTHESIS

The aims of this study were to compare the ability of tests measuring fasting plasma glucose, 2-h plasma glucose and HbA1c levels in predicting specific diabetic retinopathy, and to determine the cut-off level of each measurement for diagnosing diabetes in a Japanese population.

METHODS

In a total of 1637 subjects, fasting plasma glucose, 2-h plasma glucose and HbA1c levels were measured in a 75-g oral glucose tolerance test, and diabetic retinopathy was assessed by ophthalmic examination. We calculated receiver operating characteristic (ROC) curves as well as the prevalence of diabetic retinopathy by deciles of the distribution of these glycaemic measurements.

RESULTS

Of the subjects, 37 (2.3%) had diabetic retinopathy. The prevalence of retinopathy dramatically increased in the tenth decile of each variable. Analysis with ROC curves showed that the optimal cut-off levels for diagnosis of diabetes were 6.4 mmol/l for fasting plasma glucose, 11.1 mmol/l for 2-h plasma glucose, and 5.7% for HbA1c. The sensitivities for the cut-off point of the three measurements were identical (86.5%), and the specificities were similar (fasting plasma glucose 87.3%; 2-h plasma glucose 89.6%; HbA1c 90.1%). The area under the ROC curve for 2-h plasma glucose (96.1%) was slightly but not significantly larger than that for fasting plasma glucose (90.0%) and that for HbA1c (94.5%).

CONCLUSIONS/INTERPRETATION

. Our findings suggest that measuring fasting plasma glucose or HbA1c is just as useful as measuring 2-h plasma glucose for the diagnosis of diabetes, and that the cut-off point for diagnostic fasting plasma glucose level is lower than that of the current diagnostic criteria.

Expression of Dmrt1 protein in developing and in sex-reversed gonads of amphibians

Many genes are known to be involved in gonadal differentiation in vertebrates. Dmrt1, a gene that encodes a transcription factor with a DM-domain, is considered to be one of the essential genes controlling testicular differentiation in mammals, birds, reptiles, amphibians and fish. However, it still remains unknown which testicular cells of animals other than mice and chicks express Dmrt1 protein. For an explanation of its role(s) in testicular differentiation in vertebrates, the expression of the Dmrt1 protein needs to be studied. For this purpose, we conducted an immunohistochemical study of this protein in an amphibian by using an antibody specific for Dmrt1. No positive signal was found in the indifferent gonad of tadpoles of Rana rugosa at early stages. However, in the testis of tadpoles at later stages (XV-XXV) and in frogs one month after metamorphosis, this protein was expressed in interstitial cells and Sertoli cells. In the testis of adult frogs, germ cells also expressed Dmrt1 protein. RT-PCR analysis revealed that the gene for this protein was not transcribed at any time during ovarian development, but was expressed in the female to male sex-reversed gonad. This was true when immunohistological studies were performed. In addition, Southern blot analysis showed DMRT1 to be an autosomal gene. Taken together, our findings indicate that Dmrt1 protein is expressed by interstitial cells, Seroli cells and germ cells in the testis of R. rugosa. Dmrt1 may thus be very involved in the testicular differentiation of amphibians.

Xanthogranulomatous cholecystitis mimicking gallbladder cancer: report of a case

A 61-year-old woman was admitted to our hospital with abnormal findings of abdominal computed tomography. Whereas she had neither fever nor abdominal pain, a cholecystitis was suspected. Ultrasonography showed a mass in the gallbladder with several stones, and an unclear border between the gallbladder and liver. Computed tomography showed a large-mass in the gallbladder with findings that seemed to indicate hepatic invasion and para-aortic lymph node metastasis. On the basis of these findings, we made a diagnosis of gallbladder cancer associated with hepatic invasion and lymph node metastasis. We treated this gallbladder tumor by hepatic arterial infusion chemotherapy via catheter with cisplatin and 5-fluorouracil. Four weeks after administration of the anti-cancer drugs, the tumorous lesion of the gallbladder could not be detected by abdominal imagings, and the gallbladder wall revealed no irregular findings. During laparotomy, the gallbladder showed signs of chronic cholecystitis, and a cholecystectomy was performed. Findings of the resected specimens showed severe inflammation, fibrosis, and bleeding in the gallbladder wall with infiltration by many foamy cells. Histopathological diagnosis was xanthogranulomatous cholecystitis. We report here a case of xanthogranulomatous cholecystitis mimicking gallbladder cancer and review the literature.