Long-duration, weekly treatment with gemcitabine plus vinorelbine for non-small cell lung cancer: A multicenter phase II study

In this phase II study, gemcitabine and vinorelbine were combined at suboptimal doses for weekly administration in advanced non-small cell lung cancer (NSCLC). The primary objectives were to determine objective response rate (ORR) and time to progression (TTP). Secondary endpoints were safety and overall survival. Chemonaive patients with histologically or cytologically confirmed stage IIIB or IV NSCLC received vinorelbine (25 mg/m2) immediately followed by gemcitabine (800 mg/m2) once each week (on day 1) for 6 months without rest. From May 1998 to May 1999, 40 patients were enrolled (85% males; 70% stage IV) with a median age of 65.5. A total of 478 doses were administered, with a median of 9 per patient (range 2-72). The ORR was 27.5% (95% CI, 15.1-44.1%). The median TTP was 3.5 months (95% CI, 2.9-4.4 months). At a median follow-up of 6.5 months, the median survival was 11.6 months, and survival rates at 1 and 2 year(s) were 47.5% and 15.8%, respectively. The most common grade 3/4 hematologic toxicity was neutropenia, in 70% of patients, with febrile neutropenia in 28%. The most common grade 3/4 non-hematologic toxicity was transaminase elevation, in 22.5% of patients, which was transient and reversible. The other most prominent toxicities were, unexpectedly, pulmonary and cardiac toxicities. Based on these results, weekly, long-term administration of gemcitabine-vinorelbine appears to be an active regimen in NSCLC that warrants further investigation.

Wirksamkeit und Verträglichkeit von topisch appliziertem Foscarnet-Natrium bei der Behandlung von Herpes labialis

BACKGROUND AND OBJECTIVE

Aim of this post-marketing surveillance study was to generate further data on efficacy and tolerability of foscarnet sodium cream 2% in patients with recurrent herpes labialis in daily routine practice.

DESIGN AND METHODS

90 outpatients with recurrent herpes labialis were instructed to apply the antiviral cream to the lesions according to package insert for up to 10 days. Symptoms were recorded before beginning of treatment, after three days, and at the end of treatment.

RESULTS

Paresthesia and swelling as well as the number of vesicles were reduced after three days of observation, and were improved by about 90% at the end of treatment. Erosions and crust formation also improved markedly. Efficacy as well as tolerability were evaluated as positive by the majority of physicians and patients. No adverse reactions were reported.

CONCLUSIONS

Foscarnet sodium 2% cream is an effective and safe medication for the treatment of recurrent labial herpes in daily routine practice of dermatologists.

Gemcitabine–docetaxel versus cisplatin–vinorelbine in advanced or metastatic non-small-cell lung cancer: a phase III study addressing the case for cisplatin

BACKGROUND

This multicenter, randomized, phase III study compared the efficacy, including progression-free survival (PFS), and safety of gemcitabine-docetaxel (GD) combination versus cisplatin-vinorelbine (CV) in the treatment of advanced non-small-cell lung cancer (NSCLC).

PATIENTS AND METHODS

Chemonaive patients with stage IIIB or IV NSCLC were treated with GD (gemcitabine 1000 mg/m(2) days 1 and 8 plus docetaxel 85 mg/m(2) day 8, every 3 weeks for eight cycles) or CV (cisplatin 100 mg/m(2) day 1 plus vinorelbine 30 mg/m(2), days 1, 8, 15 and 22, every 4 weeks for six cycles).

RESULTS

A total of 311 patients were enrolled (155 GD and 156 CV). Neither PFS nor overall survival differed significantly between the two arms (median PFS 4.2 and 4 months; median survival 11.1 and 9.6 months; 1-year survival 46% and 42%, for GD and CV, respectively). For the GD arm compared with the CV arm, the hazard ratio for PFS was 1.04 [95% confidence interval (CI) 0.83-1.32], and for overall survival, it was 0.90 (95% CI 0.70-1.16). Objective response rates did not differ significantly (31% for GD, 35.9% for CV). Myelosupression, emesis and frequency of febrile neutropenia were less pronounced on the GD arm, whereas fluid retention and pulmonary events were more pronounced. The CV arm experienced a higher number of serious adverse events and a lower compliance with the protocol. There was no quality of life (QoL) difference between arms. Median time to definite impairment of health-related QoL was 153 and 168 days in GD and CV arms, respectively.

CONCLUSIONS

There was no advantage in PFS with GD compared with CV; however, the CV regimen had higher rate of toxic events, mainly myelosuppression. The herein, non-platinum-containing regimen could be considered as a rational alternative to the cisplatin-based doublet.

Phase II randomised trial comparing docetaxel given every 3 weeks with weekly schedule as second-line therapy in patients with advanced non-small-cell lung cancer (NSCLC)

BACKGROUND

Taxotere (docetaxel) at the dose of 75 mg/m(2) every 3 weeks is a standard therapy for pretreated non-small-cell lung cancer (NSCLC). The aim of this study was to evaluate the safety profile of two schedules of docetaxel administration (every 3 weeks versus weekly) in patients with pretreated NSCLC.

PATIENTS AND METHODS

From February 2000 to February 2001, 125 patients with locally advanced or metastatic NSCLC were randomised after failure of a previous platinum-based regimen to receive either docetaxel 75 mg/m(2) administered every 3 weeks (Dq3w) or docetaxel 40 mg/m(2) given weekly for 6 weeks followed by 2 weeks of rest (Dqw). Safety evaluations focused on grade 3-4 neutropenia, febrile neutropenia, nausea-vomiting and asthenia.

RESULTS

Patients' characteristics were well balanced between arms. The most common National Cancer Institute Common Toxicity Criteria (NCI-CTC) grade 3-4 toxicity was neutropenia, which occurred in 48.4% of Dq3w patients versus 15.9% of Dqw patients (P=0.001). In addition, febrile neutropenia were observed in 6.5% of patients in Dq3w versus 0% in Dqw. Grade 3-4 asthenia was more frequent in Dqw. Other non-haematological toxicities were very rare. Regarding efficacy, there was a trend towards a better disease control rate in Dq3w: 32.2% versus 25.4% in Dqw. Median time to progression and survival were rather similar in both arms, respectively: 2.1 months (range 2-3.2) and 5.8 months (range 4.0-7.0) in Dq3w and 1.8 months (range 1.6-2.3) and 5.5 months (range 3.7-6.6) in Dqw.

CONCLUSIONS

While both schedules had a favourable safety profile, a significant lower rate of severe neutropenia was observed in the weekly arm. Both regimens had similar efficacy. The weekly regimen could be considered as a good alternative for patients at risk of severe neutropenia.

Thermophoresis of DNA determined by microfluidic fluorescence

We describe a microfluidic all-optical technique to measure the thermophoresis of molecules. Within micrometer-thick chambers, we heat aqueous solutions with a micrometer-sized focus of infrared light. The temperature increase of about 1 K is monitored with temperature-sensitive fluorescent dyes. We test the approach in measuring the thermophoresis of DNA. We image the concentration of DNA in a second fluorescence-color channel. DNA is depleted away from the heated spot. The profile of depletion is fitted by the thermophoretic theory to reveal the Soret coefficient. We evaluate the method with numerical 3D calculations of temperature profiles, drift, convection and thermophoretic depletion using finite element methods. The approach opens new ways to monitor thermophoresis at the single molecule level, near boundaries and in complex mixtures. The flexible microfluidic setting is a good step towards microfluidic applications of thermophoresis in biotechnology.

[Primary lung cancer in elderly subjects in France]

INTRODUCTION

There are few data on primary bronchial carcinoma in France. We report here the results of the study KBP 2000-CPHG in which there were 1868 patients aged 70 or more and 338 aged 80 or more.

METHODS

We compared the patients under 70 (Group I) with those aged 70 or more (Group II) as well as with the details of the over 80's.

RESULTS

Group II included significantly more women (17.4% vs 15.2%; p = 0.04), non-smokers (11.2% vs 5.3%; p<0.0001), patients of poor performance status (24.2% vs 14.5%; p<0.0001) and squamous carcinomas (44.5% vs 37.8%; p<0.001) than Group I, but fewer adenocarcinomas (27.2% vs 31.5%; p = 0.009) and as many small cell carcinomas (15.9% vs 16.9%; p = 0.32). In Group II there were less stage III and IV tumours (75.1% vs 78.1%; p = 0.0005) more symptomatic treatment (23.2% vs 6.1%) and radiotherapy alone (12.8% vs 3.8%; p < 0.0001). The results were similar beyond 80 years. On multivariate analysis age, performance status and stage appeared to be independent variables in the choice of curative or symptomatic treatment.

CONCLUSIONS

Age alone is not therefore a limiting factor in the choice of treatment.

Laser-driven plasma loader for shockless compression and acceleration of samples in the solid state

A new method for shockless compression and acceleration of solid materials is presented. A plasma reservoir pressurized by a laser-driven shock unloads across a vacuum gap and piles up against an Al sample thus providing the drive. The rear surface velocity of the Al was measured with a line VISAR, and used to infer load histories. These peaked between approximately 0.14 and 0.5 Mbar with strain rates approximately 10(6)-10(8) s(-1). Detailed simulations suggest that apart from surface layers the samples can remain close to the room temperature isentrope. The experiments, analysis, and future prospects are discussed.

[Primary bronchial carcinoma in elderly subjects in France]

INTRODUCTION

There are few data on primary bronchial carcinoma in France. We report here the results of the study KBP 2000-CPHG in which there were 1868 patients aged 70 or more and 338 aged 80 or more.

METHODS

We compared the patients under 70 (Group I) with those aged 70 or more (Group II) as well as with the details of the over 80's.

RESULTS

Group II included significantly more women (17.4% vs 15.2%; p=0.04), non-smokers (11.2% vs 5.3%; p<0.0001), patients of poor performance status (24.2% vs 14.5%; p<0.0001) and squamous carcinomas (44.5% vs 37.8%; p<0.001) than Group I, but fewer adenocarcinomas (27.2% vs 31.5%; p=0.009) and as many small cell carcinomas (15.9% vs 16.9%; p=0.32). In Group II there were less stage III and IV tumours (75.1% vs 78.1%; p=0.0005) more symptomatic treatment (23.2% vs 6.1%) and radiotherapy alone (12.8% vs 3.8%; p<0.0001). The results were similar beyond 80 years. On multivariate analysis age, performance status and stage appeared to be independent variables in the choice of curative or symptomatic treatment.

CONCLUSIONS

Age alone is not therefore a limiting factor in the choice of treatment.

Dissection of heteronuclear NMR experiments for studies of magnetization transfer efficiencies

Modern NMR experiments for applications with biological macromolecules in solution typically include multiple magnetization transfer steps. When working with large structures, a significant fraction of the magnetization is lost during these transfers. For the design and optimization of complex experimental schemes, the magnetization transfer efficiencies have therefore commonly been calculated from the spin relaxation times. This paper now suggests a new method for measurement of individual transfer efficiencies directly with the system of interest, using short, reliable experiments. Initial applications of this approach with a 110,000 Da protein indicate that there is a wide range of transfer efficiencies among individual spin pairs in a structure of this size, which leads to a correspondingly large variation of the individual signal intensities and the need for techniques to enhance the weak signals.

Lipoblastoma-lipoblastomatosis associated with unilateral limb hypertrophy: a case report in a newborn

Lipoblastoma is a benign mesenchymal tumor of embryonic adipose tissue, uncommon in infancy. Multicentricity, absence of a capsule and histopathology best defines a lipoblastoma. Synonyms for this lesion are embryonic lipoma, fetal lipoma, lipoblastic tumor, and congenital lipomatoid tumor. Lipoblastoma is more common in males (approximately 80%), is usually located in the subcutaneous soft tissue (benign lipoblastoma) or in the deep interstitium (benign lipoblastomatosis), or sometimes in all corporeal segments. Primary treatment is complete excision. Relapse is between 14-25%, many of which are more "mature," and difficult to differentiate from lipoma. The differential diagnosis includes liposarcoma, which is rare under ten years. Radical excision in children is recommended with relapses, especially with lipoblastomatosis. Chromosomal markers help discriminate between liposarcoma and lipoblastoma.

Klippel-Trenaunay-Servelle Syndrome in Pediatrics

The aim of this report is to explain the historical differences between Klippel-Trenaunay (KT), Klippel-Trenaunay-Weber (KTW), and Klippel-Trenaunay-Servelle (KTS) syndromes. Furthermore, an attempt will be made to describe the different causes, symptoms, and consequences of the pathology, largely as a consequence of venous hypertension. The significance of these syndromes within the pediatric population is highlighted.

Disabling disturbance of olfaction in a dental technician following exposure to methyl methacrylate

It is often difficult to diagnose dysosmia due to occupational olfactotoxic substances. The authors present a case of disabling disturbance of olfaction in a dental technician. This is very likely to have been caused by exposure to methyl methacrylate. From 1988-1992, the dental technician had very extensive and sustained contact with a self-polymerizing acrylic resin based on methyl methacrylate. Her perception of smell was still normal in 1988, but it deteriorated up to 1992. The olfactory disorders have persisted and impede social life and occupational rehabilitation.

The Caenorhabditis elegans autosomal dominant polycystic kidney disease gene homologs lov-1 and pkd-2 act in the same pathway

Autosomal dominant polycystic kidney disease (ADPKD) strikes 1 in 1000 individuals and often results in end-stage renal failure. Mutations in either PKD1 or PKD2 account for 95% of all cases [1-3]. It has recently been demonstrated that polycystin-1 and polycystin-2 (encoded by PKD1 and PKD2, respectively) assemble to form a cation channel in vitro [4]. Here we determine that the Caenorhabditis elegans PKD1 and PKD2 homologs, lov-1 [5] and pkd-2, act in the same pathway in vivo. Mutations in either lov-1 or pkd-2 result in identical male sensory behavioral defects. Also, pkd-2;lov-1 double mutants are no more severe than either of the single mutants, indicating that lov-1 and pkd-2 act together. LOV-1::GFP and PKD-2::GFP are expressed in the same male-specific sensory neurons and are concentrated in cilia and cell bodies. Cytoplasmic, nonnuclear staining in cell bodies is punctate, suggesting that one pool of PKD-2 is localized to intracellular membranes while another is found in sensory cilia. In contrast to defects in the C. elegans autosomal recessive PKD gene osm-5 [6-8], the cilia of lov-1 and pkd-2 single mutants and of lov-1;pkd-2 double mutants are normal as judged by electron microscopy, demonstrating that lov-1 and pkd-2 are not required for ultrastructural development of male-specific sensory cilia.

Sociodemographic and clinical factors associated with low quality of life one year after coronary bypass operations: the Israeli coronary artery bypass study (ISCAB)

OBJECTIVES

We sought to examine the effect of sociodemographic characteristics and perioperative clinical factors 1 year after coronary bypass operations on low health-related quality of life. We also sought to assess the usefulness of an additional single question on overall health for identifying patients with low health-related quality of life.

METHODS

This report is part of the Israeli coronary artery bypass study of 1994, in which every patient undergoing isolated coronary bypass grafting in Israel was included. The target population for this report comprised all survivors beyond 1 year who were 45 to 65 years of age. Patients were interviewed before the operations. Self-administered questionnaires regarding health-related quality of life (SF-36) were sent to 1724 patients who were successfully located 1 year postoperatively, and 1270 questionnaires were completed. Low health-related quality of life was defined as the lowest tertile of the distribution of scores for the 2 summary components of the SF-36 and the single question on overall health. Logistic models were constructed for each of the 3 outcomes.

RESULTS

Female sex and low socioeconomic background were associated with low health-related quality of life in the logistic models. Other significant factors were symptoms of angina, sleep disturbances, hypertension, high severity of illness scores, hospital readmission, no rehabilitation, and hospitals with high perioperative mortality. Of the 3 study outcomes, the model for the single question on overall health was the most discriminating (C statistic = 0.76 vs 0.70 and 0.70, respectively).

CONCLUSIONS

The study identifies patients who would most benefit from posthospitalization community support after bypass operations. Under circumstances of limited resources, these disadvantaged groups should be targeted as a priority. Encouraging participation in existing rehabilitation programs or introducing telephone hotlines could improve health-related quality of life after coronary bypass grafting without large investments.

No correlation of focal contacts and close adhesion by comparing GFP-vinculin and fluorescence interference of DiI

In regions of focal adhesion, cells adhere to a substrate through the interaction of extracellular matrix proteins and transmembrane integrins which are coupled to the cell skeleton. It is generally assumed that the plasma membrane is brought to close proximity to the substrate there. We used the novel method of fluorescence interference contrast (FLIC) microscopy to measure the distance of the plasma membrane of GD25 fibroblasts on silica coated with fibronectin. We correlated the distance map with the distribution of vinculin tagged with green fluorescent protein. We found that the major part of the membrane was separated by 50 nm from the substrate. With respect to this plateau, we found spots of upward deformation and of close adhesion as well as a general ruffling of the membrane. There was no correlation between the areas of close adhesion and the distribution of vinculin. We conclude that focal adhesion does not imply a close attachment of membrane and substrate.

Universality of decoherence

We consider environment induced decoherence of quantum superpositions to mixtures in the limit in which that process is much faster than any competing one generated by the Hamiltonian H(sys) of the isolated system. While the golden rule then does not apply we can discard H(sys). By allowing for couplings to different reservoirs, we reveal decoherence as a universal short-time phenomenon independent of the character of the system as well as the bath and of the basis the superimposed states are taken from. We discuss consequences for the classical behavior of the macroworld and quantum measurement: For decoherence of superpositions of macroscopically distinct states H(sys) is always negligible.

Fast voltage transients in capacitive silicon-to-cell stimulation detected with a luminescent molecular electronic probe

The capacitive stimulation of nerve cells from semiconductor chips is a prerequisite for the development of neuroelectronic devices. We report on the primary response of a cell membrane to a voltage step applied to oxidized silicon. It is observed with a luminescent voltage-sensitive dye. We find exponential voltage transients with a time constant of 1-5 micros. We assign the short response to an electrical decoupling by a thin film of electrolyte between oxide and membrane. The high-pass filtering of stimulation is a crucial constraint for the development of silicon-to-neuron interfaces.