Solutions of Gallium Trichloride in Ethers: A 71Ga NMR Study and the X-Ray Structure of GaCl3 · Monoglyme

Solutions of GaCl3 in various ethers have been studied by 71Ga NMR spectroscopy. σ71Ga data indicate that the predominant species in diethylether and tetrahydrofuran solutions are GaCl3 · O(C2H5)2 and GaCl3. 2OC4H8, respectively. However, in monoglyme solution dissociation occurs and the product crystallizing from the solution is [cis-GaCl2(monoglyme)2]GaCl4 as demonstrated by an X-ray structure determination of the solvate GaCl3 · monoglyme.

Gemcitabine-based combinations (gem+x) vs gemcitabine (gem) alone in the treatment of advanced pancreatic cancer: a meta- analysis of sixteen randomized trials

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Background: Sixteen randomised trials have compared Gem-based combination chemotherapy to Gem alone in advanced and metastatic pancreatic cancer. This analysis was performed to better define the role of combination chemotherapy in pancreatic cancer. Methods: The meta-analysis included 16 studies comparing Gem vs. Gem+X. Fifteen trials were evaluable for survival, the primary end-point of the investigation. Overall, 4465 patients (pts) were included, 2222 pts in the Gem+X arm, and 2243 pts in the Gem arm). The analysis was predominantly based on published summary data. Results: Three groups were formed: combinations with platinum analogs, fluoropyrimidines, or other cytotoxic agents. Five trials evaluated platinum-based combinations (3 cisplatin, 2 oxaliplatin). The combined analysis indicated a hazard ratio (HR) of 0.85 (95% CI: 0.76–0.96) demonstrating a significant (p=0.010) superiority of the combination. Further 6 trials investigated the combination of Gem with fluoropyrimidines (3 5-FU, 3 capecitabine). Again, a significant superiority of the combination therapy was observed with a HR of 0.90 (95% CI: 0.81–0.99; p=0.030). Among the fluoropyrimidine combinations greatest homogeneity of results was observed in trials combining gemcitabine with capecitabine. In four randomised trials no improvement of survival was observed when Gem was combined with other cytotoxic agents such as pemetrexed, exatecan or irinotecan (HR=0.99; 95% CI: 0.88–1.10; p=0.80). When all 15 evaluable trials are taken together, an overall hazard ratio of HR=0.91 (95% CI: 0.85–0.97; p=0.004) was achieved. Five trials including 1682 pts provided adequate information on baseline performance status (PS). Combination chemotherapy had a marked benefit on survival in pts with a good PS (HR=0.76; 95%CI: 0.67 - 0.87; p<0.0001), while it was not more effective than Gem alone in pts with an initially poor PS (HR=1.08; 95% CI: 0.90 - 1.29). Conclusions: A meta-analysis of fifteen randomised trials indicated a significant survival benefit for Gem+X as compared to Gem alone when Gem was combined with either a platinum analog or capecitabine. This benefit was greatest in pts with a good PS, while no benefit was evident in poor PS pts.

No significant financial relationships to disclose.

[Current standards and novel developments in the treatment of neuroendocrine tumors of the gastroenteropancreatic system]

Current guidelines have been published for the diagnosis and therapy of neuroendocrine neoplasms of the gastroenteropancreatic (GEP) system 1. Systemic therapy of inoperable advanced neuroendocrine tumors includes biotherapy with somatostatin analogas, peptid receptor radionuclide therapy (PRRT) with 177Lutetium-DOTA-TATE, chemotherapy with steptozotocin/5-fluorouracil or capecitabine/temozolomide and molecular targeted therapy with everolimus or sunitinib 1 2. For symptom control in patients with carcinoid syndrome biotherapy with somatostatin analogs, PRRT, loco-regional and local-ablative interventional procedures of liver metastases as well as the peripheral serotonin synthesis inhibitor telotristat Ethyl 1 2 3 4 are highly effective. Novel aspects and developments in the diagnosis and treatment of neuroendocrine tumors will be discussed in this review.

19-jährige Patientin mit akuter Promyelozytenleukämie und Knieschwellung

We report on a case of a 19-year-old female patient with acute promyelocytic leukemia suffering from febrile monarthitis of the right knee during neutropenia after consolidation chemotherapy caused by Geotrichum capitatum. Apparently this infection occurred due to a hematological reactivation since the patient had already developed Geotrichum capitatum fungemia during induction therapy. Under antimycotic therapy with voriconazole, flucytosine, and caspofungin as well as after two arthroscopic synovectomies with cleansing of the right knee, the infection could be controlled and the full clinical function of the knee joint could be preserved.