FOLFOXIRI plus bevacizumab has demonstrated benefits for metastatic colorectal cancer (mCRC) patients. However, challenges arise in its clinical implementation due to expected side effects and a lack ...of stratification criteria.
The AIO "CHARTA" trial randomised mCRC patients into clinical Group 1 (potentially resectable), 2 (unresectable/risk of rapid progression), or 3 (asymptomatic). They received FOLFOX/bevacizumab +/- irinotecan. The primary endpoint was the 9-month progression-free survival rate (PFSR@9). Secondary endpoints included efficacy in stratified groups, QoL, PFS, OS, ORR, secondary resection rate, and toxicity.
The addition of irinotecan to FOLFOX/bevacizumab increased PFSR@9 from 56 to 67%, meeting the primary endpoint. The objective response rate was 61% vs. 69% (P = 0.21) and median PFS was 10.3 vs. 12 months (HR 0.83; P = 0.17). The PFS was (11.4 vs. 12.9 months; HR 0.83; P = 0.46) in potentially resectable patients, with a secondary resection rate of 37% vs. 51%. Moreover, Group 3 (asymptomatic) patients had a PFS of 11.1 vs. 16.1 months (HR 0.6; P = 0.14). The addition of irinotecan did not diminish QoL.
The CHARTA trial, along with other studies, confirms the efficacy and tolerability of FOLFOXIRI/bevacizumab as a first-line treatment for mCRC. Importantly, clinical stratification may lead to its implementation.
The trial was registered as NCT01321957.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Stellate sturgeon (Acipenser stellatus) is a species of great conservation concern throughout its range. Over the past century, it has experienced a dramatic decline in abundance and distribution in ...the Black Sea basin. Information regarding the genetic structure of the species is very limited in the region, despite its crucial importance for developing adequate management plans for the species’ conservation and recovery.
Samples from 163 A. stellatus were analysed using mitochondrial and microsatellite DNA markers to investigate the species’ genetic characteristics in the north‐western and southern Black Sea.
Both genetic markers revealed high genetic diversity (153 haplotypes and 264 alleles) and low genetic differentiation of marine and freshwater catches. The north‐western Black Sea population is undergoing a slight demographic expansion after a bottleneck event induced by overfishing and dam constructions.
The genetic population structure indicates a single genetic cluster in the north‐western Black Sea region and signs of admixture of two genetic clusters in the southern region. It also provides the first evidence for a remnant reproductive stellate sturgeon micro‐population in rivers of Turkey and Georgia.
A sturgeon fishing ban and stocking activities carried out during the last decades, largely without any prior genetic assessment of the sturgeon populations, added little conservation value. Outreach initiatives and urgent actions are required to foster the recovery of this Critically Endangered species in the region.
Reconstruction of the connectivity of the rivers and the enhancement of habitats and spawning grounds are beneficial to all sturgeon species. An ex‐situ conservation programme for Turkish rivers which flow into the Black Sea would be beneficial to help conserve the genetic resources until the habitats and migration routes become functional. Moreover, genetic screening and recruitment programmes must be functional for all rivers flowing into the Black Sea.
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FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The stellate sturgeon,
Acipenser stellatus
, is a critically endangered fish species. Knowledge on its genetic diversity and population structure is urgently needed to enable the identification of ...management units in order to prevent extinction. Therefore, 18 species-specific, polymorphic microsatellite loci have been isolated using GS-FLX Titanium pyrosequencing, arranged into 6 multiplex PCR sets, and characterized in 52 individuals (20 farmed and 32 wild). The total number of alleles per locus varied between 3 and 36 with an average of 8.44. The wild individuals were more diverse with an average number of 8.17 alleles per locus than the farmed ones with 3.28 alleles per locus. Observed heterozygosities ranged from 0.050 to 0.950 in the farmed and from 0.094 to 0.969 in the wild individuals. Significant deviations from Hardy-Weinberg equilibrium were found at 3 loci of the farmed and 5 loci of the wild individuals. The two sturgeon groups were significantly differentiated (
F
ST
= 0.118). The high sensitivity and discriminatory power of the 18 loci were proven by a very low overall probability of identity for siblings (PIsib = 8.73 × 10
−6
) and a high accuracy of self-classification (98%). Thus, these newly developed markers represent a valuable genetic toolbox to identify management units for species conservation and sustainable fisheries.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Longitudinally extensive transverse myelitis is characteristic but not pathognomonic for neuromyelitis optica spectrum disorders (NMOSDs) and may mimic local tumors. In this retrospective study based ...on a cohort of 175 NMOSD patients we identified seven patients who initially presented with a longitudinally extensive spinal cord lesion and underwent spinal cord biopsy due to magnetic resonance imaging (MRI)-suspected malignancies. Remarkably, routine neuropathology was inconclusive and did not guide the diagnostic process to anti-aquaporin-4 (AQP4)-seropositive NMOSD. Serious postoperative complications occurred in 5/7 patients and persisted during follow-up in 2/7 patients (29%). Considering these sequelae, AQP4-antibody testing should be mandatory in patients with inconclusive longitudinally extensive spinal cord lesions prior to biopsy.
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NUK, OILJ, SAZU, UKNU, UL, UM, UPUK
Background: The diagnostic and pathophysiological relevance of antibodies to aquaporin-4 (AQP4-Ab) in patients with neuromyelitis optica spectrum disorders (NMOSD) has been intensively studied. ...However, little is known so far about the clinical impact of AQP4-Ab seropositivity. Objective: To analyse systematically the clinical and paraclinical features associated with NMO spectrum disorders in Caucasians in a stratified fashion according to the patients' AQP4-Ab serostatus. Methods: Retrospective study of 175 Caucasian patients (AQP4-Ab positive in 78.3%). Results: Seropositive patients were found to be predominantly female (p < 0.0003), to more often have signs of co-existing autoimmunity (p < 0.00001), and to experience more severe clinical attacks. A visual acuity of <= 0.1 during acute optic neuritis (ON) attacks was more frequent among seropositives (p < 0.002). Similarly, motor symptoms were more common in seropositive patients, the median Medical Research Council scale (MRC) grade worse, and MRC grades <= 2 more frequent, in particular if patients met the 2006 revised criteria (p < 0.005, p < 0.006 and p < 0.01, respectively), the total spinal cord lesion load was higher (p < 0.006), and lesions >= 6 vertebral segments as well as entire spinal cord involvement more frequent (p < 0.003 and p < 0.043). By contrast, bilateral ON at onset was more common in seronegatives (p < 0.007), as was simultaneous ON and myelitis (p < 0.001); accordingly, the time to diagnosis of NMO was shorter in the seronegative group (p < 0.029). The course of disease was more often monophasic in seronegatives (p < 0.008). Seropositives and seronegatives did not differ significantly with regard to age at onset, time to relapse, annualized relapse rates, outcome from relapse (complete, partial, no recovery), annualized EDSS increase, mortality rate, supratentorial brain lesions, brainstem lesions, history of carcinoma, frequency of preceding infections, oligoclonal bands, or CSF pleocytosis. Both the time to relapse and the time to diagnosis was longer if the disease started with ON (p < 0.002 and p < 0.013). Motor symptoms or tetraparesis at first myelitis and > 1 myelitis attacks in the first year were identified as possible predictors of a worse outcome.
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