Evidence for a pseudogap in underdoped Bi{2}Sr_{2}CaCu{2}O{8+delta} and YBa2Cu3O6.50 from in-plane optical conductivity measurements

The real part of the in-plane optical self-energy data in underdoped Bi_{2}Sr_{2}CaCu_{2}O_{8+delta} (Bi-2212) and ortho II YBa2Cu3O6.5 contains new and important information on the pseudogap. Using a theoretical model approach, a major new finding is that states lost below the pseudogap Delta_{pg} are accompanied by a pileup of states just above this energy. The pileup along with a sharp mode in the bosonic spectral function leads to an unusually rapid increase in the optical scattering rate as a function of frequency and a characteristically sloped peak in the real part of the optical self-energy. These features are not found in optimally doped and overdoped samples and represent the clearest signature so far in the in-plane optical conductivity of the opening of a pseudogap.

Bosonic spectral density of epitaxial thin-film La1.83Sr0.17CuO4 superconductors from infrared conductivity measurements

We use optical spectroscopy to investigate the excitations responsible for the structure in the optical self-energy of thin epitaxial films of La(1.83)Sr(0.17)CuO(4). Using Eliashberg's formalism to invert the optical spectra we extract the electron-boson spectral function and find that at low temperature it has a two component structure closely matching the spin excitation spectrum recently measured by magnetic neutron scattering. We contrast the temperature evolution of the spectral density and the two-peak behavior in La(2-Sr(x)CuO(4) with another high temperature superconductor Bi(2)Sr(2)CaCu(2)O(8+delta). The bosonic spectral functions of the two materials account for the low T(c) of LSCO as compared to Bi-2212.

Phytophthora Blight and Dieback in North Carolina Nurseries During a 2003 Survey

A survey of 14 nurseries growing hybrid rhododendron, Pieris spp., or Viburnum spp. was conducted as part of the 2003 Sudden Oak Death Pilot National Survey to determine if Phytophthora ramorum, the causal agent of sudden oak death, had been introduced to nurseries in North Carolina. Over 220,000 hybrid rhododendrons, 1,700 plants of Pieris spp., and 2,800 plants of Viburnum spp. were surveyed. Across nurseries, blight and dieback incidence averaged 2.4% for Pieris spp. and 10% for rhododendron. P. ramorum was not recovered by isolation or detected by polymerase chain reaction in the 347 plant samples collected. Three species of Phytophthora were isolated from hybrid rhododendron and Pieris spp., but no Phytophthora isolates were recovered from Viburnum spp. P. citricola and P. cambivora were isolated most frequently (61 and 39 isolates, respectively), while 2 isolates of P. cactorum were recovered. Occasionally, two Phytophthora spp. were found in the same block of rhododendrons within a nursery, but only one species was recovered from an individual plant. Most cultivars of rhododendron surveyed, including 'English Roseum,' 'Nova Zembla,' and 'Roseum Elegans,' had less than 0.5% incidence of Phytophthora blight and dieback, whereas 'Lee's Dark Purple' had 3.8% disease incidence across all nurseries surveyed.

Lab-scale test of a ventilation system including a dielectric barrier discharger and UV-photocatalyst filters for simultaneous removal of gaseous and particulate contaminants

A ventilation system including a dielectric barrier discharger (DBD) and UV-photocatalyst (UVP) filters was designed and tested for simultaneous removal of gaseous and particulate contaminants in a test chamber. The DBD was used in the first stage of electrostatic precipitator (ESP) for particle charging and gas decomposition. An applied DC electric field was used in the second stage of ESP to collect the charged particles. UVP filters were then used to decompose gaseous species, such as formaldehyde (HCHO) and benzene, toluene, and xylene (BTX) including O3, which was inherently produced by the DBD. %Reductions in mass concentration of PM2.5 and number concentration of submicron particles were approximately 79.5% and 76.3%, respectively, after the ventilation with air cleaning system was operated for 5 h. Both HCHO and BTX were completely removed when the initial concentration of each gas was 1 ppm.

PRACTICAL IMPLICATIONS

Indoor air quality (IAQ) problems, such as sick building syndrome (SBS), are caused by limited ventilation in high-rise buildings. To overcome these problems, DBD and UVP filters were applied into a lab-scale ventilation system for simultaneous removal of pollutant particles and gases. The data supplied in this study will be useful for designing any actual ventilation system after further research, including scale-up experiments.

Bond cutting in Cs-doped tris(8-hydroxyquinoline) aluminium

A series of Cs 4d and Al 2p spectra associated with valence-band and cut-off spectra have been used to characterize the interaction between caesium and tris(8-hydroxyquinoline) aluminium (Alq(3)) molecules in a Cs-doped Alq(3) layer. The Cs 4d and Al 2p spectra were tuned to be very surface sensitive by selecting a photon energy of 120 eV at the National Synchrotron Radiation Research Center, Taiwan. A critical Cs concentration exists, above which a new Al 2p signal appears next to the Al 2p peak of Alq(3) in the lower binding-energy side. The Al 2p signal was analyzed and assigned as being contributed from a mixture of Alq(2), Alq and Al. Experimental data supported the observation that bond cutting of Alq(3) by the doped Cs atoms occurred at high Cs doping concentration.

Structural studies of the final enzyme in the alpha-aminoadipate pathway-saccharopine dehydrogenase from Saccharomyces cerevisiae

The 1.64 A structure of the apoenzyme form of saccharopine dehydrogenase (SDH) from Saccharomyces cerevisiae shows the enzyme to be composed of two domains with similar dinucleotide binding folds with a deep cleft at the interface. The structure reveals homology to alanine dehydrogenase, despite low primary sequence similarity. A model of the ternary complex of SDH, NAD, and saccharopine identifies residues Lys77 and Glu122 as potentially important for substrate binding and/or catalysis, consistent with a proton shuttle mechanism. Furthermore, the model suggests that a conformational change is required for catalysis and that residues Lys99 and Asp281 may be instrumental in mediating this change. Analysis of the crystal structure in the context of other homologous enzymes from pathogenic fungi and human sources sheds light into the suitability of SDH as a target for antimicrobial drug development.

First-in-human phase I trial of a cyclodextrin-containing polymer-camptothecin nanoparticle in patients with solid tumors

14078

Background: IT-101 is a de novo designed experimental therapeutic comprised of linear, cyclodextrin(CD)-containing polymer conjugates of camptothecin(CPT) that assemble into ca. 40 nm diameter nanoparticles via polymer-polymer interactions that involve inclusion complex formation between the CPT and the CD. Particle size, near neutral surface charge and CPT release rate were specifically designed into IT-101. Published pre-clinical animal studies show extended circulation times (t1/2 of ca. 20 h in rodents), tumor accumulation, slow release of the CPT and anti-tumor efficacy that directly correlate to the properties of the nanoparticle. Release of CPT can disassemble the nanoparticle into individual polymer chains that have size ca. 10 nm that are capable of renal clearance (t1/2 of several minutes in rodents). Methods: Patients with relapsed or refractory cancer were evaluated every two cycles of therapy (90 minute IV infusions of IT- 101 in D5W on days 1, 8 and 15 of a 28 day cycle). Three dose levels of 6, 12 and 18 mg CPT eq./m2 have been tested. Results: At the time of this interim analysis, eight patients have been enrolled and five evaluated. In general, IT-101 is well tolerated and pancytopenia is the DLT. The expected MTD is 12 mg/ m2.Three out of five patients demonstrated stable disease on CT scan evaluation. One pancreatic cancer patient remains stable for 6 months. PK data are available from the first 5 patients. Total and free CPT display biphasic elimination from plasma with mean terminal elimination half lives of 38±3.7 and 61±43 hours, respectively. The mean Vd and CLsys of total CPT are 6.1±1.4 L and 0.1±0.03 L/h and are unrelated to dose over the range tested, with a mean total-to-free AUC ratio of 10.7±3.7. Conclusions: These first in human PK data for IT-101 confirm that 40 nm particles with near neutral surface charge provide favorable PK properties. The stable disease rate, although not yet conclusive, is consistent with promising efficacy. The preliminary results of this phase I study warrant continued enrollment that is ongoing.

No significant financial relationships to disclose.

Phase II study of induction chemotherapy with fixed dose rate (FDR) gemcitabine and cisplatin followed by concurrent chemoradiation with capecitabine for locally advanced pancreatic cancer (LAPC)

15122

Background: Despite the use of 5-FU based chemoradiotherapy (CRT) over the past decades, prognosis of patients with LAPC remains dismal. To deliver more efficient systemic treatment earlier and reduce toxicity of CRT, we designed a treatment protocol consisting of induction (IND) chemotherapy with FDR gemcitabine (GEM) and cisplatin (CDDP), followed by CRT with capecitabine (CAP) in LAPC. Methods: Eligible patients had unresectable, histologically confirmed adenocarcinoma of pancreas, ECOG PS of 0–2, and no prior chemo- or radiotherapy for this phase II study. Patients received FDR GEM 1000 mg/m2 (D1,8) and CDDP 60 mg/m2 (D1) every 3 weeks for 3 cycles. Patients without disease progression subsequently received CRT of 55.8 Gy in 31 fractions concurrently with CAP, 650 mg/m2 given twice daily without drug holidays. Four weeks after CRT, FDR GEM 1000 mg/m2 was given on day 1, 8 every 3 weeks for 3 cycles. Time to progression was the primary endpoint. Results: Between Jan 2005 and Nov 2006, 21 patients were enrolled (median age 59, M/F: 13/8, ECOG PS 0/1: 3/18). Two patients withdrew consent after 1st and 2nd cycle and remaining 19 patients completed all three cycles of IND chemotherapy, with three (15.8%) out of 19 evaluable patients achieving partial response (0 CR, 3 PR, 14 SD, 2 PD). All 17 patients completed CRT with mean radiation dose of 55.4 Gy. Further four patients progressed during CRT, while one additional patient achieved partial response. As of Jan 2007, 5 patients died and 12 patients showed tumor progression. Median TTP was 12.5 mo (95% CI: 4.2–20.8) and median survival was not reached with median follow up duration of 9.7 months. Grade III/IV toxicities included neutropenia (38.1%/9.5%), thrombocytopenia (4.8%/0%), and anemia (14.3%/0%) during IND phase. Toxicites were generally mild during CRT phase with grade III neutropenia and diarrhea occurring in one and two patients, respectively. One patient died of neutropenic sepsis after 3rd cycle of IND chemotherapy. Conclusions: FDR GEM-CDDP induction chemotherapy followed by CAP-RT and maintenance FDR GEM is feasible and active with promising TTP of 12.5 months. Enrollment continues till reaching target accrual of 37 patients.

No significant financial relationships to disclose.

Pharmacokinetic (PK) and phase I study of sorafenib (S) for solid tumors and hematologic malignancies in patients with hepatic or renal dysfunction (HD or RD): CALGB 60301

3538

Background: We sought to characterize the PK and determine a tolerable dose of S in patients with HD or RD. Methods: Patients with performance status 0–2 and pathologically proven solid tumors, multiple myeloma, or non-Hodgkin’s lymphoma, for whom standard therapy was exhausted, were assigned to one of 9 cohorts: [1] Bilirubin (B) =ULN and SGOT =ULN and creatinine clearance (CC) =60 ml/min; [2] B > ULN but = 1.5 x ULN and/or SGOT > ULN; [3] CC between 40 and 59 mL/min; [4] B > 1.5 x ULN to = 3 x ULN (any SGOT); [5] CC between 20 and 39 mL/min; [6] B > 3 x ULN to 10 x ULN (any SGOT); [7] CC < 20 mL/min; [8] albumin < 2.5 mg/dL (any B/ SGOT); and [9] hemodialysis. S was administered po as a 400 mg test dose on day 1 with blood sampled before and 1, 2, 3, 4, 6, 24, and 168 hrs afterwards for PK. Total S concentrations were fit to a 2-compartment model and population parameters from previous studies were utilized. On day 8, continuous daily po S started with dose escalation in groups of at least 3 evaluable patients. Dose-limiting toxicity (DLT) by day 29 was defined as: grade 4 neutrophils or platelets; B = 1.5 x baseline in HD and = 2.5 x ULN in RD; CC reduction by > 20 mL/min in RD and >10 mL/min in HD; grade = 3 nausea/vomiting/diarrhea despite optimal supportive care; or any other grade = 3 non-hematologic toxicity. Results: Between 1/05 and 12/06, 146 patients (target 150) were registered but 12 never started therapy. With the exception of cohorts 6 and 7, at least 12 patients per cohort were evaluable. The dose level in each cohort with DLT in less than one third of patients was: [1] 400 mg bid; [2] 400 mg bid; [3] 400 mg bid; [4] 200 mg bid; [5] 200 mg bid; [6] not even 200 mg every third day tolerable; [7] n/a; [8] 200 mg qd; and [9] 200 mg qd. All DLT was non-hematologic: 9 of 12 events in patients with HD were increase in B; other DLT included abdominal pain, rash, fatigue, nausea/vomiting, hand-foot syndrome, congestive heart failure, diarrhea, hemorrhage, and hypertension. PK data are available for 51 patients. Apparent S clearance was: highly variable, median 5.69 (range 1.27 - 19.98) L/hr; not related to age, body weight, or sex; and not different among cohorts. Conclusions: Apparent S clearance does not depend on cohort. We propose the above empiric starting doses by cohort.

No significant financial relationships to disclose.

A phase I trial of RX-0201 (AKT anti-sense) in patients with an advanced cancer

3564

Background: Akt-1, a proto-oncogene, plays a vital role in cancer progression by stimulating proliferation and inhibiting apoptosis of cancer cells. RX-0201, a 20-mer oligonucleotide with sequence complementary to Akt-1 mRNA, is designed to inhibit the expression of Akt-1 within cancer cells in cancer patients (pts). Non-clinical studies conducted on RX-0201 demonstrated that RX-0201 bears significant in vitro and in vivo anti-cancer activities with favorable safety. Purposes: The aims of the current phase I trial were to determine the maximum tolerated dose (MTD) and to establish pharmacokinetic (PK) and safety profiles of RX-0201 in pts with an advanced cancer. Methods: RX-0201 was administered to pts with an advanced cancer by up to 2 cycles of continuous infusion; each cycle of infusion lasted for 14 days which was followed by a 7-day rest. Rapid dose escalation had been used until at least a grade (G) 2 toxicity was observed, and then a traditional dose escalation followed. Entry criteria included Karnofsky Performance Status score =70, advanced cancer, tumor accessible for paired biopsy, and signed informed consent. 17 pts were enrolled and treated at a dose level ranging from 6 to 315 mg/m2/d on D1–14, repeated q 21 d. Results: G 3 fatigue was observed in two pts at the 315 mg/m2/d dose; three pts dosed at 250 mg/m2/d were not noted with any G 3 toxicity, which make this dose (250 mg/m2/d) the recommended phase II trial dose. No other significant, compound-related, adverse events were observed in those 17 pts participated. Pts PK profiles of RX-0201 and AKT-1 immunohistochemistry results on pts’ tumor biopsy samples will also be presented. Conclusion: MTD of RX-0201 is 315 mg/m2/d in pts with an advanced cancer when the compound is administered in the current continuous infusion regimen.

No significant financial relationships to disclose.

CyberKnife high-dose fractionated stereotactic radiosurgery with tumor tracking: An effective non-surgical treatment alternative for single small peripheral lung tumors

18125

Background: We report preliminary outcomes using CyberKnife radiosurgery with tumor tracking to treat small (<4 cm) peripheral inoperable stage I lung cancers and single pulmonary metastases. Methods: Enrollment of eligible pts began in July 2004. Prior conventional thoracic irradiation and the incorporation of systemic therapy were permitted. Fiducials (3–5) were placed near tumors under CT guidance. Pts received 45–60 Gy in 3 equal 1–2 hour fractions delivered over a 5–9 day period. Results: The median follow-up period of survivors was 12 months (range = 3–24 months). A total of 24 lesions were treated, 15 clinical stage I lung cancers and 9 single lung metastases. Four patients had prior conventional thoracic radiation (17%) and 6 patients received systemic therapy in conjunction with radiosurgery (25%). Two received systemic doses of platinum based doublet chemotherapy, 3 received gefitinib and 1 received sunitinib. Pneumothorax was a complication of fiducial placement in 7 pts, requiring tube thoracostomy in 4. All pts completed treatment with few acute side effects. No unexpected additional toxicities were noted with systemic therapy except for one pt who developed Grade III radiation pneumonitis while receiving gefitinib. A second pt with Grade III radiation pneumonitis had prior extensive conventional thoracic radiation. All tumors responded to treatment at 3 months as seen by a decrease in gross tumor volume. At 12 months 14 CT scans were evaluable. Four lesions responded completely (33%), 2 exhibited a partial response and the remaining 8 were obscured by radiation fibrosis corresponding to the high-dose irradiated volume (57%). Local progression was seen in only 2 single lung metastases at 10 and 12 months. There have been no regional lymph node failures. Four patients have died, 1 of progressive metastatic disease and 3 of comorbid illnesses. Conclusion: CyberKnife high-dose fractionated stereotactic radiosurgery with tumor tracking is an effective well-tolerated treatment option for small peripheral lung tumors, both primary and metastatic. The integration of systemic therapy appears feasible but needs to be further evaluated in clinical trials.

No significant financial relationships to disclose.

Phase II study of weekly docetaxel in combination with capecitabine (C) in advanced gastric (AGA) and gastro-esophageal adenocarcionma (AGEA)

15139

Background: Chemotherapy regimens for AGA and AGEA have shown considerable toxicity and most require continuous IV administration. Both D and C are active agents in AGA. D upregulates thymidine phosphorylase, the enzyme which catalyzes the conversion of C to 5-FU, with preclinical evidence of synergy for the combination. A phase I study of D and C showed acceptable tolerability and activity in patients (pts) with AGA (Ramanathan et al., 2005). This multi-institutional phase II trial evaluates the combination of D and C in 1st or 2nd line treatment of AGA and AGEA. Methods: Pts with AGA/AGEA who received ≤ 1 prior chemotherapy regimen were eligible. D 30 mg/m2 on d 1, 8 and C 825 mg/ m2 BID were administered on days 1–14 of a 21 day cycle. The one stage study design had an accrual goal of 40 pts. The primary endpoint was to detect a 50% improvement in median survival in previously untreated pts to 10 months (mo), by one-sided log-rank test at level a = 0.05. Results: Enrollment is complete with 40 pts, all are evaluable for response and toxicity. Pt characteristics: 79% male; 94% with ECOG performance status 0/1; median age 60 yrs (34–84), 32 pts (80%) were previously untreated. Overall response rate is 25% with 1CR and 9 PR. The projected median time to progression (TTP) and survival are 6.2 and 7.8 mo respectively. Dose modifications were required in 9%. Median cycles administered 4 (range 1–10). Grade 3/4 adverse events include: diarrhea (13%), hand-foot syndrome (13%), dehydration (6%), abd pain, anorexia, fatigue, febrile neutropenia, gastric ulcer, hyperglycemia, vertigo, and vomiting (3% each). Conclusion: The combination of D and C is well tolerated and active. The preliminary TTP (6.2 mo) and survival (7.8 mo) compare favorably with published regimens for 1st line therapy, but did not meet study endpoint. The combination of D and C is an easily administered outpatient regimen for AGA and AGEA and may be worthy of further investigation with a targeted agent. (Funded by Sanofi-Aventis and Roche Pharmaceuticals).

No significant financial relationships to disclose.

Design and development of virtual reality based perceptual-motor rehabilitation scenarios

Virtual reality technology may provide new options for conducting perceptual-motor assessment within simulated 3D environments for persons with a wide range of disabilities. This paper outlines our work developing a series of game-like VR scenarios to assess and rehabilitate eye-hand coordination, range of motion and other relevant perceptual-motor activities. Our efforts have focused on building engaging game-based stereoscopic graphic scenarios that allow clients to participate in perceptual-motor rehabilitation by interacting with 3D stimuli within a full 360-degree space using a head mounted display or by way of a "face-forward" format using 3D projection displays. Exploratory work using multiple video sensors to detect and track 3D body motion, identify body postures and quantify motor performance is also described.

High energy scales in the optical self-energy of the cuprate superconductors

Using optical spectroscopy with a derivative technique, we find for the high Tc cuprate Bi2Sr2CaCu2O8+delta (Bi-2212) evidence for a new high energy scale at 900 meV beyond the two previously well-known ones at roughly 50 and 400 meV. The intermediate scale at 400 meV has recently been seen in angle-resolved photoemission spectroscopy experiments along the nodal direction as a large kink. In YBa2Cu3O6.50, the three energy scales are shifted to lower energy relative to Bi-2212 and we observe the emergence of a possible new high energy feature at 600 meV.

Treatment of primary CNS lymphoma with induction high-dose methotrexate, temozolomide, rituximab followed by consolidation cytarabine/etoposide: A pilot study with biomarker analysis

7595

Background: There is currently no consensus on the optimal treatment for patients diagnosed with primary CNS lymphoma (PCNSL). Between 2001–2004, UCSF PCNSL patients were treated with combination high-dose methotrexate, temozolomide, rituximab (MTR) as induction therapy. Patients in CR with this regimen were treated with high-dose cytarabine plus etoposide as consolidation. The purposes of this study were: (1) Pilot analysis to determine the safety and efficacy of intensive methotrexate-based induction therapy followed by high-dose consolidation with elimination of whole brain irradiation; (2) Analysis of molecular markers in PCNSL which predict sensitivity to chemotherapy and outcome. Methods: 21 untreated, CD20 +, immunocompetent PCNSL patients were treated with combination methotrexate (8 gm/m²), temozolomide (150 mg/m²/day)and rituximab (375 mg/m²). Patients in CR received consolidation cytarabine (2 g/ m² x 8 doses) plus etoposide (40 mg/kg over 96 hours). IHC analysis of potential biomarkers predictive of outcome was performed on paraffin sections from these patients. Candidate markers for validation were selected by gene expression analysis of an independent, multicenter dataset of 20 cases. Results: Mean age was 58.6 y (range 40–81). Median KPS was 60. MTR and cytarabine/etoposide consolidation was well-tolerated with no treatment-related mortality or evidence for neurotoxicity. One case of post-remission cytopenia occurred after consolidation and resolved spontaneously. Eleven patients (52.4%) attained CR with induction; eight received consolidation; three patients in CR deferred consolidation. Median PFS was 11.5 months. Median OS for all 21 patients has not yet been reached with median follow-up of 27.5 months. Expression of the apoptotic regulator DAP-1 by lymphoma cells as determined by IHC was associated with improved PFS (p<0.028) and OS (p<0.021). Conclusions: Combination MTR followed by intensive consolidation appears to be well tolerated in PCNSL. PFS appears at least similar to regimens that contain whole brain irradiation. A larger phase II study has been initiated to evaluate this regimen in a multicenter setting.

[Table: see text]

Randomized single institute pilot study of vaccinia-CEA(6D)-tricom and fowlpox-CEA (6D)-tricom with GM-CSF (V) in combination with docetaxel (D) in patients with colorectal cancer (CC)

13538

Background: Our previous study demonstrated 40% patients with CC achieved stable disease at 4 months with V (JCO, 23(4):720–31, 2005.). Preclinical studies showed taxene enhanced tumor vaccine in delaying tumor growth and increasing the antigen-specific T cells. We report the results of a Randomized phase II pilot study of V in combination with docetaxel (D) in CC patients. Methods: 27 patients with metastatic CC were randomly assigned to 3 arms, stratified for HLA-A2. All patients received a ‘prime’ dose of vaccinia-Tricom on Day 0, followed by ‘boost’ doses of fowlpox-Tricom on Days 21 and q 21 days for 4 months; all vaccinations were followed by local GM-CSF (100 μg) for 4 days. Arm 1 received V; Arm II and III received V and D on D1, D8 during each fowlpox vaccination at 10mg/m2 and 30mg/m2, respectively. Patients with stable disease continued vaccinations monthly after study completed. Safety data was evaluated. Primary endpoints included the impact of varying doses of D on CEA-specific T cell immune responses (CTL) using the ELISPOT assay, the recommended dose for further study as defined by the best immune response with acceptable toxicity, and objective clinical response. Results: The most common AE related to the vaccines was grade (g) 1 injection site reactions. Other common AEs were g1 fatigue, nausea, vomiting, fever, headache, and myalgia. There were 1 g3 fever and 1 g3 abdominal pain. The AE from the combination arm were contributed by D as expected, included g3: hyperglycemia (1), fatigue (1), elevation of liver function tests (2), pulmonary infection (1), abdominal pain (1), vomiting (1) or diarrhea (1). 6/ 27 patients have died 17 months after starting V. Patients received 2 to 12 cycles of therapy before disease progression. Observed clinical benefit was significantly lower than the 40% previously documented with V alone. The immune data is to be presented. Conclusions: Inferior clinical benefit as compared to our previous experiment could be explained by more heavily pretreated patients in this trial or negative impact of D on V. CTL data should explain this observation.

No significant financial relationships to disclose.

First-in-human phase-I pharmacokinetic trial of NS-9, a liposomal poly(I):poly(C), in patients with liver metastases from various primary cancers

13016

Background: NS-9 is a complex of poly-inosinate [poly(I)] and poly-cytidylate [poly(C)] in a cationic liposome and is active in vitro and in vivo. Objectives: to determine the tolerability, safety, and maximal tolerated dose (MTD), and pharmacokinetics of NS-9 by 1 hr IV infusion, given daily x5 q 28 days. Methods: A phase I dose escalation study was undertaken in patients with liver metastases from solid tumors. Eligible patients were adults with ECOG PS 0–1 and no recent chemotherapy (≥ 4 wks prior). Dose cohorts studied were 0.1, 0.15, 0.2, 0.3 and 0.4mg/m2. Results: 18 patients were enrolled (13M:5F) median age 58 (range 21 to 77 yrs). Tumor types included neuroendocrine (8), and ocular melanoma (1), gastric (1), GE junction (1), esophageal (2), and colorectal (5) carcinomas. Two of three patients treated at the first dose level (0.4 mg/m2) had grade 3/4 reversible lipase elevation with or without acute pancreatitis, a dose limiting toxicity (DLT). De-escalation to doses ranging from 0.1 to 0.2 mg/m2/day was with no DLT. At 0.3 mg/m2 two of three patients treated had a DLT (neutropenia and thrombocytopenia). The MTD was determined at 0.2 mg/m2. Common toxicities included pyrexia, chills, nausea, fatigue, abdominal pain, myalgia, anorexia, sweating, neutropenia, thrombocytopenia, and elevated glucose, amylase, and LFTs. Pharmacokinetics showed rapid elimination (T1/2 ranged from 2.4 to 5.0 hours) without accumulation after multiple doses. 1 patient (esophageal Ca) had a PR in the target lesions in the liver. Conclusions: The MTD is 0.2 mg/m2/day with a hint of antitumor activity. NS-9 should be pursued in phase-II studies.

No significant financial relationships to disclose.

Phase I study of RX-0201 in patients with advanced or metastatic solid tumors

13102

Background: RX-0201 is a 20-mer oligonucleotide that is complementary to Akt-1 mRNA. Strong evidence exists that Akt plays a very important role in cancer progression by stimulating cell proliferation and inhibiting apoptosis. Over-expression of constitutively activated Akt in many cell types promotes cellular transformation. In addition to reducing Akt mRNA levels and inhibiting the expression of Akt protein, in vitro pharmacology studies have demonstrated that RX-0201 suppressed cell proliferation in carcinomas of the brain, breast, cervix, colon, head & neck, kidney, liver, lung, ovary, pancreas, prostate, stomach and melanoma. In vivo studies have also shown that RX-0201 significantly inhibits the growth of tumor in human prostate and brain cancer of nude mice models. This study is designed to determine the maximum tolerated RX-0201 dose in patients with advanced malignancies. Methods: Patients with solid tumors for whom no standard therapies exist, Karnofsky PS>70, adequate hepatic and renal function and normal coagulation parameters were eligible. Eligible patients were scheduled to receive 2 treatment cycles with RX-0201 via continuous infusion for 14 days with 7 days off q 21 days. Dose escalation was based on observed treatment-related toxicities. One patient was enrolled at each dose level (6 mg/m2/day - 315mg/m2/day). Tumor measurements were performed at screening and at the completion of treatment cycle 2. Tumor biopsies were obtained at screening and at the completion of treatment cycle 2 to look for inhibition of AKT in tumor cells. Plasma samples for pharmacokinetic analyses were collected. Results: To date 9 patients have been enrolled, 4 with GI malignancies, 1 with small cell lung cancer, 2 with breast cancer and 1 with locally advanced Basal Cell carcinoma. 6/9 patients were able to complete the 2 cycles.1/9 patients were taken off study because of withdrawal of consent due to grade 1 vomiting. 8 patients were taken off for disease progression. Drug related toxicities were Grade 1 and included fatigue, dizziness, cough vomiting and myalgia. Conclusions: While enrolment is still ongoing, the RX-0201 has been well tolerated upto 315mg/m2 in this previously heavily treated patient population. Once MTD is reached phase II trials will be planned. PK and PD data will be presented.

[Table: see text]

A phase I study of the pan-Bcl2 family inhibitor GX15–070, administered as a 3-hour weekly infusion in patients with refractory solid tumors or lymphomas

3081

Background: GX15–070 is an antagonist of the BH3-binding groove of the bcl-2 family of anti apoptotic proteins. GX15–070 activates apoptosis in vitro and exhibits clinical activity in chronic lymphocytic leukemia (O’Brien et al, ASH 2005) with a recommended phase II dose of 28 mg/m2 every 3 weeks with DLT of grade 3 infusional CNS toxicities. Methods: In a standard titration design, 4 cohorts of 3 patients (pt) were treated with 5mg/m2 - 14 mg/m2 IV infused over 3 hours, weekly. Each cycle of therapy consisted of 4 weekly infusions. Pharmacokinetics (PK) and pharmacodynamic (PD) response based on plasma oligonucleosomal DNA levels were evaluated. Results: N=15 pts were treated. Median age was 58 (range 24–71). Median number of prior regimens was 4 (range 1–11). A total of 105 infusions (26 cycles) was administered. GX15–070 underwent first order elimination kinetics with a short initial distribution phase (α t1/2=0.6 h), followed by a longer elimination γphase (t1/2=43.8 h). At the 14 mg/m2 dose level, median C max and AUC values were 98 ng/ml and 276 ng.hr/ml, respectively. The coefficient of variation was low at 38%. Adverse events have mostly been observed during or shortly after the infusion and have been transient. The most common pertain to the central nervous and gastro-intestinal system (drowsiness, euphoria, ataxia, and abdominal pain). Most toxicities were mild to moderate, with the exception of grade 3 pain experienced by 2/2 pts with Hodgkin’s disease, that resolved rapidly but resulted in treatment discontinuation in 1 patient. One episode of Grade 3 infusional CNS toxicity was reported at 14 mg/m2 requiring the inclusion of 6 patients with no further DLT. No neutropenia, thrombocytopenia or lymphopenia have been reported. The MTD has not been reached. Mean increase in plasma oligonucleosomal DNA was 36 fold (range 0–182 fold) over baseline. Best response to treatment to date : SD ≥ 8 weeks (4); PD (5); too early (6). Conclusion: Weekly GX15–070 as been well tolerated at doses showing biological activity. Dose escalation will be pursued up to 28 mg/m2 weekly.

No significant financial relationships to disclose.

A phase I dose escalation study of BIBW 2992, an irreversible dual EGFR/HER2 receptor tyrosine kinase inhibitor, in a 3 week on 1 week off schedule in patients with advanced solid tumors

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Background: BIBW 2992 is a highly potent irreversible dual EGFR /HER2 receptor tyrosine kinase inhibitor. This is the first trial performed in the United States with this compound. Methods: Patients with refractory solid tumors (historically known to express EGFR and/or HER2) with normal end-organ function and PS 0–1 were enrolled into a phase I dose-escalation clinical trial. After completion of eligibility and informed consent, BIBW 2992 was administered orally, once daily, for 21 days followed by a 7-day rest. Three patients were accrued in each cohort using a traditional dose escalation 3+3 trial design. After reaching DLT, the MTD dose group was expanded to 18 patients. PK sampling and skin biopsies were performed at baseline and day 21. Tumor biopsies in appropriate patients were obtained pre- and post-treatment in the final cohort to analyze inhibition of the EGFR pathway. Results: Forty-three patients were enrolled. Dose levels ranged from 10 to 65 mg daily. Tumor types included colon (10), breast (8), pancreas and ovarian (4), thyroid and esophageal (3), prostate and NSCLC (2), gastric, cholangiocarcinoma, basal cell, parotid, NPC, HCC, and mesothelioma (1 ). An interim PK analysis showed that BIBW 2992 exposure and peak plasma concentrations increased with increasing dose on day 1 and at steady state. Steady state was reached at day 8. Adverse events were diarrhea, skin rash, pruritus, mucositis, nausea, and vomiting. Doses were escalated to 65 mg/day, with two DLTs noted (skin rash and mucositis). The 40-mg dose was chosen as the recommended phase II dose based on acceptable toxicity when administered chronically. No objective responses have been observed; however, 15 of 35 evaluable patients (43%) experienced stable disease and have been on treatment for > 3 mos. Four patients have continued in an extension study. Two of these patients are still active and one has been taking BIBW 2992 for approximately 1 year. Conclusion: BIBW 2992 is well tolerated at 40 mg per day using a 21-day, 7-day off-treatment schedule. The adverse events observed were typical of receptor tyrosine kinases, including skin rash, pruritis, mucositis and GI disturbance.

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Magnetic resonance spectroscopy for measuring the biodistribution and in situ in vivo pharmacokinetics of fluorinated compounds: validation using an investigation of liver and heart disposition of tecastemizole

BACKGROUND AND OBJECTIVE

The study of biodistribution and in situ pharmacokinetics is a challenging, but sometimes very important, aspect of premarketing characterization of drugs. We aimed to develop a non-invasive fluorine magnetic resonance (MR) spectroscopic method for the absolute quantitation of a mono-fluorinated compound and of its metabolites in the heart and liver of healthy subjects for this purpose.

METHOD

We used fluorine MR spectroscopy (MRS) at 4 T (Tesla) and external standardization in an open label multiple-dose study. Twenty-three healthy adult subjects were enrolled in the study. The surface coil localized fluorine MR spectrum was monitored in the heart and liver at baseline and after oral administration of multiple doses of tecastemizole. Steady-state measurements were made at set time points that depended upon dose, and washout measurements were made only on subjects in which in vivo fluorine signal was observed.

RESULTS AND DISCUSSION

At 4 T, under the given experimental conditions, the method had a lower limit of quantitation (LLOQ) of about 2.6 microm and a limit of detection (LOD) of about 0.3 microm for solution state samples (linewidth approximately 15 Hz). The measurement reproducibility was 6.4% using a 50 microm phantom. The effect of MR operator and spectral analyst on the calculated calibration curve slope was small, with inter-rater correlation coefficients of 0.999 and 0.998 respectively. MR signal from fluorine-containing tecastemizole-related moieties was observed in situ only at day 8 in the liver of three of five subjects dosed at 270 mg/day. The average in situ concentration was estimated to be 58+/-22 microm, with an average test-retest reproducibility of 216%. Extrapolating the in vitro results to human measurements, with an approximate linewidth of 250 Hz, predicts in situ LOD and LLOQ values of approximately 6 and 44 microm respectively. However, the human study had a fluorine MRS LOD of approximately 20 microm. The decrease in sensitivity and the increase in variability of the in vivo, in situ measurements compared with the validation study most likely arose from coil placement and incomplete rephasing of the MR signal by the respiratory phase compensation method.

CONCLUSION

The measured concentrations were the lowest ever recorded for a multi-dose exogenous mono-fluorinated compound in the human liver using a validated fluorine MR quantitation method. The proposed non-invasive MR method for studying the biodistribution and in situ pharmacokinetics of mono-fluorinated compounds in the liver and heart should have broader application to the development of non-invasive biomarkers.

Comparison of alfetanil and ketamine in combination with propofol for patient-controlled sedation during fiberoptic bronchoscopy

BACKGROUND

During fiberoptic bronchoscopy, propofol, ketamine, benzodiazepines, and opiates are most commonly used, alone or in combination for sedation. The aim of this study was to compare the clinical efficacy of propofol/ketamine with propofol/alfentanil for patient-controlled sedation (PCS) during fiberoptic bronchoscopy.

METHOD

Patients undergoing fiberoptic bronchoscopy were randomly assigned to receive either propofol/alfentanil (PA group; n = 138) or propofol/ketamine (PK group; n = 138) via a patient-controlled analgesia (PCA) device for sedation and analgesia. Changes in blood pressure, heart rate (HR), and oxygen saturation were monitored. Degree of patient and bronchoscopist satisfaction was evaluated using a 10-cm visual analog scale (VAS) (0 = extremely uncomfortable to 10 = extremely comfortable).

RESULTS

After sedation, systolic arterial pressure (SAP) decreased in the PA group, but SAP was stable in the PK group. Compared with values immediately before starting bronchoscopy, SAP and HR increased during the procedure in both groups (P < 0.05). Patients in the PK group showed more satisfaction [(9.5 (6-10) vs. 9.0 (6-10)), P < 0.05] and amnesia (82% vs. 61%, P < 0.01). Despite these differences, the majority (greater than 90%) of the patients in both groups stated that they were comfortable during the procedure.

CONCLUSION

Our results show that although both techniques proved effective for sedation in patients undergoing fiberoptic bronchoscopy, ketamine is superior to alfentanil when used in combination with propofol because of the high patient satisfaction and amnesia.

Serum CA19-9 response as a surrogate for clinical outcome in patients receiving fixed-dose rate gemcitabine for advanced pancreatic cancer

The use of serial serum measurements of the carbohydrate antigen 19-9 (CA19-9) to guide treatment decisions and serve as a surrogate end point in clinical trial design requires further validation. We investigated whether CA19-9 decline represents an accurate surrogate for survival and time to treatment failure (TTF) in a cohort of 76 patients with advanced pancreatic cancer receiving fixed-dose rate gemcitabine in three separate studies. Statistically significant correlations between percentage CA19-9 decline and both overall survival and TTF were found, with median survival ranging from 12.0 months for patients with the greatest degree of biomarker decline (>75%) compared with 4.3 months in those whose CA19-9 did not decline during therapy (P<0.001). Using specific thresholds, patients with ⩾25% decline in CA19-9 during treatment had significantly better outcomes than those who did not (median survival and TTF of 9.6 and 4.6 months vs 4.4 and 1.5 months; P<0.001). Similar results were seen using both 50 and 75% as cutoff points. We conclude that serial CA19-9 measurements correlate well with clinical outcomes in this patient population, and that decline in this biomarker should be entertained for possible use as a surrogate end point in clinical trials for the selection of new treatments in this disease.

Effects of epidural naloxone on pruritus induced by epidural morphine: a randomized controlled trial

BACKGROUND

Epidural morphine produces prolonged analgesia but has many side effects including pruritus. Naloxone is an antagonist that can reverse the side effects of morphine.

METHOD

We studied the effects of continuously administered epidural naloxone mixed with morphine on side effects and analgesia in a randomized, double blind, two-armed study. Fifty-eight pregnant women undergoing cesarean section were enrolled. All patients received a 4-mg epidural bolus of morphine in the post-anesthetic care unit. After this, patients in group M (n=28) received continuous epidural morphine (6 mg over 48 h) in 0.1% bupivacaine; patients in group N (n=30) received an epidural infusion containing naloxone (1.2 mg over 48 h) and morphine (6 mg over 48 h) in 0.1% bupivacaine. The infusion rate was 2 mL/h.

RESULTS

The incidence (82% versus 47%) and severity of pruritus were lower in group N than group M (P=0.001). There were no significant differences in pain score or in the incidence of nausea, vomiting or urinary disturbance between groups.

CONCLUSION

Continuous epidural infusion of naloxone combined with morphine is effective in reducing the incidence and severity of pruritus induced by epidural morphine.

Identification, Mefenoxam Sensitivity, and Compatibility Type of Phytophthora spp. Attacking Floriculture Crops in North Carolina

Phytophthora isolates were collected from floriculture crops grown in commercial greenhouses in North Carolina for species identification, compatibility type determination, and mefenoxam sensitivity tests. Isolation from 41 symptomatic plant species at 29 production locations resulted in 483 isolates from eight crops at seven locations. Phytophthora cryptogea (184 isolates) was recovered from dusty miller and gerbera daisy. All isolates of P. cryptogea were insensitive or intermediate in sensitivity to mefenoxam at 1 μg a.i./ml and were A1 compatibility type. P. nicotianae (273 isolates) was isolated from African violet, lavender, pansy, petunia, and vinca. Of these isolates, 21% were insensitive to mefenoxam at either 1 or 100 μg a.i./ml. Isolates of P. nicotianae from five locations were A2 compatibility type, whereas isolates on pansy at one location were A1 compatibility type. English ivy grown at two locations was infected with P. palmivora. All 26 isolates of P. palmivora were sensitive to mefenoxam and were A1 compatibility type. Mating type and mefenoxam sensitivity were uniform among isolates of P. nicotianae and P. palmivora from a given crop at a given location, suggesting that epidemics within a location may have originated from a single source of inoculum.

Optical phonon sidebands of electronic intersubband absorption in strongly polar semiconductor heterostructures

We present the first evidence for a distinct optical phonon progression in the linear and nonlinear intersubband absorption spectra of electrons in a GaN/Al(0.8)Ga(0.2)N heterostructure. Femtosecond two-color pump-probe experiments in the midinfrared reveal spectral holes on different vibronic transitions separated by the LO-phonon frequency. These features wash out with a decay time of 80 fs due to spectral diffusion. The remaining nonlinear transmission changes decay with a time constant of 380 fs. All results observed are described by the independent boson model.

Combustion characteristics of paper mill sludge in a lab-scale combustor with internally cycloned circulating fluidized bed

After performing a series of batch type experiments using a lab-scale combustor, consideration was given to the use of an internally cycloned circulating fluidized bed combustor (ICCFBC) for a paper mill sludge. Operation parameters including water content, feeding mass of the sludge, and secondary air injection ratio were varied to understand their effects on combustion performance, which was examined in terms of carbon conversion rate (CCR) and the emission rates of CO, C(x)H(y) and NO(x). The combustion of paper mill sludge in the ICCFBC was compared to the reaction mechanisms of a conventional solid fuel combustion, characterized by kinetics limited reaction zone, diffusion limited reaction zone, and transition zone. The results of the parametric study showed that a 35% water content and 60 g feeding mass generated the best condition for combustion. Meanwhile, areal mass burning rate, which is an important design and operation parameter at an industrial scale plant, was estimated by a conceptual equation. The areal mass burning rate corresponding to the best combustion condition was approximately 400 kg/hm(2) for 35% water content. The secondary air injection generating swirling flow enhanced the mixing between the gas phase components as well as the solid phase components, and improved the combustion efficiency by increasing the carbon conversion rate and reducing pollutant emissions.

An unusual cause of pulmonary haemorrhage in a patient with rheumatoid arthritis

INTRODUCTION

Pulmonary haemorrhage is a rare presentation of strongyloides hyperinfection.

CLINICAL PICTURE

A 69-year-old female patient with rheumatoid arthritis on methotrexate and prednisolone presented with severe community acquired pneumonia. Intravenous trimethoprim/ sulfamethoxazole (bactrim) and high dose hydrocortisone for Pneumocystis carinii pneumonia were commenced. She developed pulmonary haemorrhage 2 weeks later and bronchoalveolar lavage cytology revealed helminthic larvae identified as strongyloides.

TREATMENT AND OUTCOME

Despite treatment with ivermectin and albendazole with rapid tailing down of hydrocortisone, she succumbed to her illness.

CONCLUSIONS

Strongyloides hyperinfection should be considered in an immunocompromised patient on high dose corticosteroid presenting with pulmonary haemorrhage. Prognosis remains dismal as supported by our case report and current literature.

High-transition-temperature superconductivity in the absence of the magnetic-resonance mode

The fundamental mechanism that gives rise to high-transition-temperature (high-T(c)) superconductivity in the copper oxide materials has been debated since the discovery of the phenomenon. Recent work has focused on a sharp 'kink' in the kinetic energy spectra of the electrons as a possible signature of the force that creates the superconducting state. The kink has been related to a magnetic resonance and also to phonons. Here we report that infrared spectra of Bi2Sr2CaCu2O8+delta (Bi-2212), shows that this sharp feature can be separated from a broad background and, interestingly, weakens with doping before disappearing completely at a critical doping level of 0.23 holes per copper atom. Superconductivity is still strong in terms of the transition temperature at this doping (T(c) approximately 55 K), so our results rule out both the magnetic resonance peak and phonons as the principal cause of high-T(c) superconductivity. The broad background, on the other hand, is a universal property of the copper-oxygen plane and provides a good candidate signature of the 'glue' that binds the electrons.

Analysis of aptamer binding site for HCV-NS3 protease by alanine scanning mutagenesis

Nonstructural protein 3 (NS3) of Hepatitis C virus (HCV) is a multifunctional protein and possesses protease, nucleotide triphosphatase and helicase activities. The N-terminal domain of NS3 (amino acids 1027-1218; delta NS3) has a trypsin-like protease activity and is essential for processing of viral polyprotein. Accordingly it is a potential target for anti-HCV drugs and we isolated RNA aptamers (Kd = 10 nM, Ki = 100 nM) using in vitro selection strategy. To study the interaction between delta NS3 and its aptamer, we applied alanine scanning mutagenesis and constructed seven mutant proteins at positive amino acid residues on the surface of delta NS3. Binding and inhibitory activities of the NS3 aptamer against mutant proteins were kinetically analyzed. These results clarified that especially Arg161 and Arg130 are important for interaction with the NS3 aptamer.

Analysis of interaction between RNA aptamer and protein using nucleotide analogs

Non-structural protein 3 (NS3) derived from Hepatitis C virus (HCV) is essential for viral proliferation and has two functional domains; trypsin-like serine protease and helicase. Recently we obtained three types of RNA aptamers (G9-I, -II and -III) bound to NS3 protease domain (delta NS3) by in vitro selection and confirmed their strong inhibition for protease activity. These aptamers have a common sequence, 5'-GA(A/U)UGGGAC-3', forming a loop structure by Mulfold secondary structure modeling. G9-I shows a three-way junction and G9-II and -III have four-way junction structures. To characterize the active structure of these aptamers, we applied modification interference analysis using nucleotide analogs and identified common important nucleotides in these three aptamers.

Etiology of Phytophthora drechsleri and P. nicotianae (=P. parasitica) Diseases Affecting Floriculture Crops

Phytophthora nicotianae and P. drechsleri isolates (n = 413) recovered from eight floricultural hosts at 11 different production sites were described according to compatibility type, resistance to mefenoxam, and amplified fragment length polymorphism (AFLP) profiles. Sample sizes ranged from 2 to 120. In all cases, isolates recovered from a single facility had the same compatibility type and resistance to mefenoxam. AFLP analysis indicated that six clonal lineages of P. nicotianae and two clonal lineages of P. drechsleri were responsible for the 11 epidemics and that isolates recovered from the same facility were identical. A single clone of P. nicotianae was recovered from snapdragons at two field production sites in the southeastern United States receiving seedlings from the same source. This clone persisted at one site from 2000 to 2001. Another clone was recovered from verbena at three separate greenhouse facilities where one facility was supplying verbena to the other two. These results suggest that asexual reproduction of these pathogens plays an important role in epidemics and spread may occur between distant facilities via movement of plants.