Purpose
To evaluate the association in the change of circulating tumor cell (CTC) levels and clinical outcomes (PFS and OS) in patients with advanced non-small cell lung cancer (NSCLC) treated ...homogenously with docetaxel and gemcitabine administered every 2 weeks.
Methods
We prospectively evaluated 37 patients for CTC levels at baseline and after 2 months of chemotherapy (before third cycle). Detection was carried out with the CellSearch system.
Results
Nine of the 37 patients (24 %) had ≥2 CTCs at the baseline determination. Median progression-free survival (PFS) was 4.3 months (95 % CI 2.5–8.3) for patients with CTC 0–1 as compared to 9.4 months (95 % CI 1.2–12.2) for those with CTC ≥2 (
p
= 0.3506). Median overall survival (OS) was 8.1 (95 % CI 2.8–16.3) and 12.2 (95 % CI 1.4–12.2) months for patients with 0–1 CTCs and ≥2 CTCs, respectively (
p
= 0.7639). Patients with a second CTC quantification were classified as: group 1, CTC = 0–1 at baseline and CTC = 0–1 after second chemotherapy cycle (18 patients); group 2, CTC ≥2 at baseline and CTC = 0–1 after second determination (5 patients). Median PFS was 7.7 and 9.9 months for group 1 and group 2, respectively (
p
= 0.4467).
Conclusions
CTCs ≥2 at baseline were detected only in 24 % of this group of patients with advanced NSCLC and poor performance status. No significant differences in PFS and OS between patients with or without CTCs at baseline were observed.
Despite the advent of immunotherapy in urothelial cancer, there is still a need to find effective cytotoxic agents beyond first and second lines. Vinflunine is the only treatment approved in this ...setting by the European Medicines Agency and taxanes are also widely used in second line. Cabazitaxel is a taxane with activity in docetaxel-refractory cancers. A randomized study was conducted to compare its efficacy versus vinflunine.
This is a multicenter, randomized, open-label, phase II/III study, following a Simon’s optimal method with stopping rules based on an interim futility analysis and a formal efficacy analysis at the end of the phase II. ECOG Performance Status, anaemia and liver metastases were stratification factors. Primary objectives were overall response rate for the phase II and overall survival for the phase III.
Seventy patients were included in the phase II across 19 institutions in Europe. Baseline characteristics were well balanced between the two arms. Three patients (13%) obtained a partial response on cabazitaxel (95% CI 2.7–32.4) and six patients (30%) in the vinflunine arm (95% CI 11.9–54.3). Median progression-free survival for cabazitaxel was 1.9 versus 2.9months for vinflunine (P=0.039). The study did not proceed to phase III since the futility analysis showed a lack of efficacy of cabazitaxel. A trend for overall survival benefit was found favouring vinflunine (median 7.6 versus 5.5months). Grade 3- to 4-related adverse events were seen in 41% patients with no difference between the two arms.
This phase II/III second line bladder study comparing cabazitaxel with vinflunine was closed when the phase II showed a lack of efficacy of the cabazitaxel arm. Vinflunine results were consistent with those known previously.
NCT01830231.
Background
This article describes and compares approved targeted therapies and the newer immunotherapy agents.
Materials and methods
This article especially performs an in-depth review of currently ...available data for tivozanib, explaining its mechanism of action, its safety profile and its role as an efficacy drug in the management of renal cancer.
Results
Despite the fact that the treatment of advanced RCC has been dramatically modified in recent years, durable remissions are scarce and it remains a lethal disease. For first- and second-line therapy, there is now growing evidence to guide the selection of the appropriate treatment.
Conclusions
Several TKIs are standard of care at different settings. Among those approved TKIs, tivozanib has similar efficacy than others with a better safety profile. The use of prognostic factors is critical to the selection of optimal therapy.
Traditional analyses of feeding experiments that test consumer preference for an array of foods suffer from several defects. We have modified the experimental design to incorporate into a ...multivariate analysis the variance due to autogenic change in control replicates. Our design allows the multiple foods to be physically paired with their control counterparts. This physical proximity of the multiple food choices in control/experimental pairs ensures that the variance attributable to external environmental factors jointly affects all combinations within each replicate. Our variance term, therefore, is not a contrived estimate as is the case for the random pairing strategy proposed by previous studies. The statistical analysis then proceeds using standard multivariate statistical tests. We conducted a multiple choice feeding experiment using our experimental design and utilized a Monte Carlo analysis to compare our results with those obtained from an experimental design that employed the random pairing strategy. Our experimental design allowed detection of moderate differences among feeding means when the random design did not.
Objective: In a recent trial, moral reconation therapy (MRT)-a cognitive-behavioral intervention for criminal recidivism-was not more effective than usual care (UC) for veterans in behavioral health ...treatment. To determine for whom treatments of recidivism are most effective, we tested if recency of criminal history or psychopathic traits moderated MRT's effects on outcomes. Method: In a multisite trial, 341 veterans (95.3% male; 57.8% White/Non-Hispanic) with a criminal history who were admitted to behavioral health treatment programs were randomly assigned to UC or UC + MRT and followed at 6- and 12-months. Incarceration (yes/no) or criminal conviction (yes/no) in the year prior to enrollment and psychopathic traits at baseline (median split) were prespecified as moderators of treatment effects on primary (criminal thinking, criminal associations) and secondary outcomes (legal, employment, and family/social problems; substance use problems and days of use). Results: Among veterans incarcerated in the year prior to enrollment, MRT (vs. UC) was associated with greater reductions in criminal associations (6 months) and days drinking or using drugs (12 months). Among those convicted in the year prior to enrollment, MRT (vs. UC) was associated with greater reductions in employment problems (12 months) and days drinking or using drugs at each follow-up. For those high in psychopathic traits, MRT (vs. UC) was associated with greater reductions in days drinking or using drugs at each follow-up. Conclusions: For veterans in behavioral health treatment with recent criminal histories and high in psychopathic traits, MRT may be effective for reducing risk for criminal recidivism.
What is the public health significance of this article?
This study found that for veterans in behavioral health treatment programs with a criminal history, a group treatment aimed at reducing risk for criminal recidivism is effective for those with more recent criminal histories and those with greater psychopathic tendencies.
Habitat heterogeneity, particularly patchiness in seagrass cover, greatly affects the community dynamics of seagrass ecosystems. Heterogeneity in seagrass habitats can also be caused by unvegetated ...patches within the otherwise continuous seagrass cover. Blowouts are bare areas with an eroding edge that forms a vertical wall, often with overhanging seagrass roots and rhizomes. Fishes, including parrotfishes, aggregate in these blowouts. These aggregations of herbivorous fishes might influence the structure of the adjacent seagrass habitat. We compared parrotfishSparisomaspp. grazing patterns at different distances from the edge of blowouts in seagrass beds (mainlyThalassia testudinum) at St. Ann’s Bay, Jamaica, by counting and measuring the number of bite marks on the seagrass blades. The percentage of grazed blades, number of bites per blade, and total area of seagrass removed by grazing all increased with increasing distance from the edge of the blowout. However, the size of the bite marks, which is indicative of the size of the fish that made them, was significantly larger near the blowout than at further distances. Few large bites were found at distances greater than 4 m from the blowout, while small bites were more abundant at distances further from the edge. These data suggest that larger fishes feed in closer proximity to the shelter of the blowouts, while smaller fishes avoid the blowout edge. Both seagrass morphology and parrotfish grazing characteristics were significantly different among the blowouts used in the study, indicating that blowouts in and of themselves increase the structural heterogeneity of seagrass beds. Thus, blowouts affect the structure of seagrass ecosystems directly and indirectly (via their effects on the grazing behavior of parrotfishes).
•An extensive and varied criminal history is the norm for veterans in SUD treatment.•Many veterans are rearrested or reincarcerated one year after discharge.•Personality changes predict recidivism ...above and beyond other known predictors.•Services focused on recidivism risk management may benefit veterans in treatment.
Veterans in treatment for substance use disorders (SUD) often report past criminal offending. However, the rate of criminal recidivism in this population is unknown. Further, prior research in veterans has not examined personality factors as predictors of recidivism, despite the prominence of such factors in leading models of recidivism risk management. We examined these issues in a secondary data analysis of 197 military veterans with a history of criminal offending who were enrolled in an SUD residential treatment program. Participants were interviewed using several measurement instruments at treatment entry, one month into treatment, treatment discharge, and 12 months post-discharge. Most veterans (94%) had a history of multiple charges, and 53% had recent involvement in the criminal justice system at the time of treatment entry. In the 12 months post-discharge, 22% reported reoffending. In addition, 30% of patients who had been recently involved in the criminal justice system at treatment entry reoffended during follow-up. Higher friend relationship quality (OR = 2.32, 95% CI 1.03, 5.21) at treatment entry and higher staff ratings of patients’ relationship quality with other residents during treatment (OR = 2.76, 95% CI 1.40, 5.41) predicted lower odds of recidivism post-discharge. After accounting for these factors, smaller reductions during treatment in the personality trait of Negative Emotionality predicted an increased risk for criminal recidivism post-discharge (OR = 1.13, 95% CI 1.01, 1.26). Results support augmenting the curriculum of SUD programs for veterans with services aimed at reducing risk for criminal recidivism, with a focus on interventions that directly target patients’ social support networks and tendencies towards negative emotionality.
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