Initially, unresectable colorectal liver metastases can be resected after response to chemotherapy. While cetuximab has been shown to increase response and resection rates, the survival outcome for ...this conversion strategy needs further evaluation.
Patients with technically unresectable and/or ≥5 liver metastases were treated with FOLFOX/cetuximab (arm A) or FOLFIRI/cetuximab (arm B) and evaluated with regard to resectability every 2 months. Tumour response and secondary resection data have been reported previously. A final analysis of overall survival (OS) and progression-free survival (PFS) was carried out in December 2012.
Between December 2004 and March 2008, 56 patients were randomised to arm A, 55 to arm B. The median OS was 35.7 95% confidence interval (CI) 27.2–44.2 months arm A: 35.8 (95% CI 28.1–43.6), arm B: 29.0 (95% CI 16.0–41.9) months, HR 1.03 (95% CI 0.66–1.61), P = 0.9. The median PFS was 10.8 (95% CI 9.3–12.2) months arm A: 11.2 (95% CI 7.2–15.3), arm B: 10.5 (95% CI 8.9–12.2) months, HR 1.18 (95% CI 0.79–1.74), P = 0.4. Patients who underwent R0 resection (n = 36) achieved a better median OS 53.9 (95% CI 35.9–71.9) months than those who did not 21.9 (95% CI 17.1–26.7) months, P < 0.001. The median disease-free survival for R0 resected patients was 9.9 (95% CI 5.8–14.0) months, and the 5-year OS rate was 46.2% (95% CI 29.5% to 62.9%).
This study confirms a favourable long-term survival for patients with initially sub-optimal or unresectable colorectal liver metastases who respond to conversion therapy and undergo secondary resection. Both FOLFOX/FOLFIRI plus cetuximab, appear to be appropriate regimens for ‘conversion’ treatment in patients with K-RAS codon 12/13/61 wild-type tumours. Thus, liver surgery can be considered curative or alternatively as an additional ‘line of therapy’ in those patients who are not cured.
NCT00153998, www.clinicaltrials.gov.
GeSn alloys are the most promising direct band gap semiconductors to demonstrate full CMOS-compatible laser integration with a manufacturing from Group-IV materials. Here, we show that room ...temperature lasing, up to 300 K, can be obtained with GeSn. This is achieved in microdisk resonators fabricated on a GeSn-On-Insulator platform by combining strain engineering with a thick layer of high Sn content GeSn.
A systematic review, meta‐analysis and meta‐regression were conducted to evaluate the effectiveness of behavioural weight management programmes and examine how programme characteristics affect mean ...weight loss. Randomized controlled trials of multicomponent behavioural weight management programmes in overweight and obese adults were included. References were obtained through systematic searches of electronic databases (conducted November 2012), screening reference lists and contacting experts. Two reviewers extracted data and evaluated risk of bias. Thirty‐seven studies, representing over 16,000 participants, were included. The pooled mean difference in weight loss at 12 months was −2.8 kg (95% confidence interval CI −3.6 to −2.1, P < 0.001). I² indicated that 93% of the variability in outcome was due to differences in programme effectiveness. Meta‐analysis showed no evidence that supervised physical activity sessions (mean difference 1.1 kg, 95% CI −2.65 to 4.79, P = 0.08), more frequent contact (mean difference −0.3 kg, 95% CI −0.7 to 0.2, P = 0.25) or in‐person contact (mean difference 0.0 kg, 95% CI −1.8 to 1.8, P = 0.06) were related to programme effectiveness at 12 months. In meta‐regression, calorie counting (−3.3 kg, 95% CI −4.6 to −2.0, P = 0.027), contact with a dietitian (−1.5 kg, 95% CI −2.9 to −0.2, P < 0.001) and use of behaviour change techniques that compare participants' behaviour with others (−1.5 kg, 95% CI −2.9 to −0.1, P = 0.032) were associated with greater weight loss. There was no evidence that other programme characteristics were associated with programme effectiveness. Most but not all behavioural weight management programmes are effective. Programmes that support participants to count calories or include a dietitian may be more effective, but the programme characteristics explaining success are mainly unknown.
Single-cell barcoding enables the combined processing and acquisition of multiple individual samples as one. This maximizes assay efficiency and eliminates technical variability in both sample ...preparation and analysis. Remaining challenges are the barcoding of live, unprocessed cells to increase downstream assay performance combined with the flexibility of the approach towards a broad range of cell types. To that end, we developed a novel antibody-based platform that allows the robust barcoding of live human cells for mass cytometry (CyTOF). By targeting both the MHC class I complex (beta-2-microglobulin) and a broadly expressed sodium-potassium ATPase-subunit (CD298) with platinum-conjugated antibodies, human immune cells, stem cells as well as tumor cells could be multiplexed in the same single-cell assay. In addition, we present a novel palladium-based covalent viability reagent compatible with this barcoding strategy. Altogether, this platform enables mass cytometry-based, live-cell barcoding across a multitude of human sample types and provides a scheme for multiplexed barcoding of human single-cell assays in general.
One of the main advantages of fuel cell based mobility over other sustainable mobility concepts is the flexible production of hydrogen via electrolysis. To date, it is unclear how electrolysis at ...hydrogen refueling stations should be operated in order to achieve the lowest possible costs despite the constraints of hydrogen demand. This study proposes and evaluates an intelligent operating strategy for electrolysis capable of exploiting times of low electricity prices while participating in the spot market and maximizing wind energy utilization when combined with a wind farm. This strategy is based on a simulation model considering imperfect forecasts (e.g. of wind availability or energy prices) and non-linear electrolyzer behavior. Results show that this approach reduces hydrogen production costs by up to 9.2% and increases wind energy utilization by up to 19%, respectively.
•Electrolysis can be operated flexibly and complement renewables.•Operating strategies of electrolysis should take forecasts into account.•Predictive operation is most effective in combination with renewables.•The presented strategy reduces hydrogen production costs by up to 9%.•The presented strategy increases wind energy utilization by 19%.
In this letter, the electrostatic and the performance of cylindrical silicon nanowire (NW) MOSFETs with an omega-shaped gate and diameters down to 8 nm are investigated. The impact of silicon nitride ...(SiN) spacer thickness (7, 10, or 15 nm) on short-channel performance is examined. The tradeoff between superior electrostatic confinement and electrical performance, which will be an essential consideration for the design of future NW devices, is clearly observed. Finally, a comparison with trigate NWs shows an improved electrostatic control for a cylindrical-shaped gate, as theoretically expected.
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