Phase III study of afatinib or cisplatin plus pemetrexed in patients with metastatic lung adenocarcinoma with EGFR mutations

Purpose The LUX-Lung 3 study investigated the efficacy of chemotherapy compared with afatinib, a selective, orally bioavailable ErbB family blocker that irreversibly blocks signaling from epidermal growth factor receptor (EGFR/ErbB1), human epidermal growth factor receptor 2 (HER2/ErbB2), and ErbB4 and has wide-spectrum preclinical activity against EGFR mutations. A phase II study of afatinib in EGFR mutation-positive lung adenocarcinoma demonstrated high response rates and progression-free survival (PFS). Patients and Methods In this phase III study, eligible patients with stage IIIB/IV lung adenocarcinoma were screened for EGFR mutations. Mutation-positive patients were stratified by mutation type (exon 19 deletion, L858R, or other) and race (Asian or non-Asian) before two-to-one random assignment to 40 mg afatinib per day or up to six cycles of cisplatin plus pemetrexed chemotherapy at standard doses every 21 days. The primary end point was PFS by independent review. Secondary end points included tumor response, overall survival, adverse events, and patient-reported outcomes (PROs). Results A total of 1,269 patients were screened, and 345 were randomly assigned to treatment. Median PFS was 11.1 months for afatinib and 6.9 months for chemotherapy (hazard ratio [HR], 0.58; 95% CI, 0.43 to 0.78; P = .001). Median PFS among those with exon 19 deletions and L858R EGFR mutations (n = 308) was 13.6 months for afatinib and 6.9 months for chemotherapy (HR, 0.47; 95% CI, 0.34 to 0.65; P = .001). The most common treatmentrelated adverse events were diarrhea, rash/acne, and stomatitis for afatinib and nausea, fatigue, and decreased appetite for chemotherapy. PROs favored afatinib, with better control of cough, dyspnea, and pain. Conclusion Afatinib is associated with prolongation of PFS when compared with standard doublet chemotherapy in patients with advanced lung adenocarcinoma and EGFR mutations.

Symptom control and quality of life in lux-lung 3 : a phase III study of afatinib or cisplatin/pemetrexed in patients with advanced lung adenocarcinoma with EGFR mutations

Purpose Patient-reported symptoms and health-related quality of life (QoL) benefits were investigated in a randomized, phase III trial of afatinib or cisplatin/pemetrexed. Patients and Methods Three hundred forty-five patients with advanced epidermal growth factor receptor (EGFR) mutation-positive lung adenocarcinoma were randomly assigned 2:1 to afatinib 40 mg per day or up to six cycles of cisplatin/pemetrexed. Lung cancer symptoms and health-related QoL were assessed every 21 days until progression using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30 and Lung Cancer-13 questionnaires. Analyses of cough, dyspnea, and pain were preplanned, including percentage of patients who improved on therapy, time to deterioration of symptoms, and change in symptoms over time. Results Questionnaire compliance was high. Compared with chemotherapy, afatinib significantly delayed the time to deterioration for cough (hazard ratio [HR], 0.60; 95% CI, 0.41 to 0.87; P = .007) and dyspnea (HR, 0.68; 95% CI, 0.50 to 0.93; P = .015), but not pain (HR, 0.83; 95% CI, 0.62 to 1.10; P = .19). More patients on afatinib (64%) versus chemotherapy (50%) experienced improvements in dyspnea scores (P lt; .010). Differences in mean scores over time significantly favored afatinib over chemotherapy for cough (P lt; .001) and dyspnea (P = .001). Afatinib showed significantly better mean scores over time in global health status/QoL (P = .015) and physical (P = .001), role (P = .004), and cognitive (P lt; .007) functioning compared with chemotherapy. Fatigue and nausea were worse with chemotherapy, whereas diarrhea, dysphagia, and sore mouth were worse with afatinib (all P = .01). Conclusion In patients with lung adenocarcinoma with EGFR mutations, first-line afatinib was associated with better control of cough and dyspnea compared with chemotherapy, although diarrhea, dysphagia, and sore mouth were worse. Global health status/QoL was also improved over time with afatinib compared with chemotherapy.

Efficient selective identity-based encryption without random oracles

We construct two efficient Identity-Based Encryption (IBE) systems that admit selective-identity security reductions without random oracles in groups equipped with a bilinear map. Selective-identity secure IBE is a slightly weaker security model than the standard security model for IBE. In this model the adversary must commit ahead of time to the identity that it intends to attack, whereas in an adaptive-identity attack the adversary is allowed to choose this identity adaptively. Our first system—BB1—is based on the well studied decisional bilinear Diffie–Hellman assumption, and extends naturally to systems with hierarchical identities, or HIBE. Our second system—BB2—is based on a stronger assumption which we call the Bilinear Diffie–Hellman Inversion assumption and provides another approach to building IBE systems. Our first system, BB1, is very versatile and well suited for practical applications: the basic hierarchical construction can be efficiently secured against chosen-ciphertext attacks, and further extended to support efficient non-interactive threshold decryption, among others, all without using random oracles. Both systems, BB1 and BB2, can be modified generically to provide “full” IBE security (i.e., against adaptive-identity attacks), either using random oracles, or in the standard model at the expense of a non-polynomial but easy-to-compensate security reduction.

Kamouflage : loss-resistant password management

We introduce Kamouflage: a new architecture for building theft-resistant password managers. An attacker who steals a laptop or cell phone with a Kamouflage-based password manager is forced to carry out a considerable amount of online work before obtaining any user credentials. We implemented our proposal as a replacement for the built-in Firefox password manager, and provide performance measurements and the results from experiments with large real-world password sets to evaluate the feasibility and effectiveness of our approach. Kamouflage is well suited to become a standard architecture for password managers on mobile devices.

Lattice basis delegation in fixed dimension and shorter-ciphertext hierarchical IBE

We present a technique for delegating a short lattice basis that has the advantage of keeping the lattice dimension unchanged upon delegation. Building on this result, we construct two new hierarchical identity-based encryption (HIBE) schemes, with and without random oracles. The resulting systems are very different from earlier lattice-based HIBEs and in some cases result in shorter ciphertexts and private keys. We prove security from classic lattice hardness assumptions.

Efficient lattice (H)IBE in the standard model

We construct an efficient identity based encryption system based on the standard learning with errors (LWE) problem. Our security proof holds in the standard model. The key step in the construction is a family of lattices for which there are two distinct trapdoors for finding short vectors. One trapdoor enables the real system to generate short vectors in all lattices in the family. The other trapdoor enables the simulator to generate short vectors for all lattices in the family except for one. We extend this basic technique to an adaptively-secure IBE and a Hierarchical IBE.

Preventing pollution attacks in multi-source network coding

Network coding is a method for achieving channel capacity in networks. The key idea is to allow network routers to linearly mix packets as they traverse the network so that recipients receive linear combinations of packets. Network coded systems are vulnerable to pollution attacks where a single malicious node floods the network with bad packets and prevents the receiver from decoding correctly. Cryptographic defenses to these problems are based on homomorphic signatures and MACs. These proposals, however, cannot handle mixing of packets from multiple sources, which is needed to achieve the full benefits of network coding. In this paper we address integrity of multi-source mixing. We propose a security model for this setting and provide a generic construction.

Short signature without random oracles and the SDH assumption in bilinear groups

We describe a short signature scheme that is strongly existentially unforgeable under an adaptive chosen message attack in the standard security model. Our construction works in groups equipped with an efficient bilinear map, or, more generally, an algorithm for the Decision Diffie-Hellman problem. The security of our scheme depends on a new intractability assumption we call Strong Diffie-Hellman (SDH), by analogy to the Strong RSA assumption with which it shares many properties. Signature generation in our system is fast and the resulting signatures are as short as DSA signatures for comparable security. We give a tight reduction proving that our scheme is secure in any group in which the SDH assumption holds, without relying on the random oracle model.

Artful surfaces in design practices

A largely overlooked aspect of innovative design practices is how workplace surfaces play a role in supporting designers' everyday work. In this paper we introduce the idea of artful surfaces. Artful surfaces (Figure 1) are full of informative, inspirational and creative artefacts that help designers accomplish their everyday design practices. The way these surfaces are created and used could provide information about how designers work. We identify four types of artful surfaces: personal, shared, project-specific and live surfaces; and describe them using examples.

Amateur Media : Social, Cultural and Legal Perspectives

The rise of Web 2.0 has pushed the amateur to the forefront of public discourse, public policy and media scholarship. Typically non-salaried, non-specialist and untrained in media production, amateur producers are now seen as key drivers of the creative economy. But how do the activities of citizen journalists, fan fiction writers and bedroom musicians connect with longer traditions of extra-institutional media production? This edited collection provides a much-needed interdisciplinary contextualisation of amateur media before and after Web 2.0. Surveying the institutional, economic and legal construction of the amateur media producer via a series of case studies, it features contributions from experts in the fields of law, economics and media studies based in the UK, Europe and Singapore. Each section of the book contains a detailed case study on a selected topic, followed by two further pieces providing additional analysis and commentary. Using an extraordinary array of case studies and examples, from YouTube to online games, from subtitling communities to reality TV, the book is neither a celebration of amateur production nor a denunciation of the demise of professional media industries. Rather, this book presents a critical dialogue across law and the humanities, exploring the dynamic tensions and interdependencies between amateur and professional creative production. This book will appeal to both academics and students of intellectual property and media law, as well as to scholars and students of economics, media, cultural and internet studies.

For the Win : How Game Thinking Can Revolutionize Your Business

Millions flock to their computers, consoles, mobile phones, tablets, and social networks each day to play World of Warcraft, Farmville, Scrabble, and countless other games, generating billions in sales each year. The careful and skillful construction of these games is built on decades of research into human motivation and psychology: A well-designed game goes right to the motivational heart of the human psyche. In For the Win, authors Kevin Werbach and Dan Hunter argue persuasively that gamemakers need not be the only ones benefiting from game design. Werbach and Hunter are lawyers and World of Warcraft players who created the world’s first course on gamification at the Wharton School of the University of Pennsylvania. In their book, they reveal how game thinking—addressing problems like a game designer—can motivate employees and customers and create engaging experiences that can transform your business. For the Win reveals how a wide range of companies are successfully using game thinking. It also offers an explanation of when gamifying makes the most sense and a 6-step framework for using games for marketing, productivity enhancement, innovation, employee motivation, customer engagement, and more. In this informative guide, Werbach and Hunter reveal how game thinking can yield winning solutions to real-world business problems. Let the games begin!