Regorafenib as second-line therapy for intermediate or advanced hepatocellular carcinoma: Multicentre, open-label, phase II safety study

PURPOSE: We assessed the safety of the multikinase inhibitor regorafenib in patients with hepatocellular carcinoma (HCC) that had progressed following first-line sorafenib. PATIENTS AND METHODS: Thirty-six patients with Barcelona Clinic Liver Cancer stage B or C HCC and preserved to mildly impaired liver function (Child-Pugh class A) received regorafenib 160 mg once daily in cycles of 3 weeks on/1 week off treatment until disease progression, unacceptable toxicity, death or patient/physician decision to discontinue. The primary end-point was safety; secondary end-points included efficacy (including time to progression and overall survival). RESULTS: The median treatment duration was 19.5 weeks (range 2-103). At data cutoff, three patients remained on treatment. Reasons for discontinuation were adverse events (n=20), disease progression (n=10), consent withdrawal (n=2) and death (n=1). Seventeen patients required dose reductions (mostly for adverse events [n=15]); 35 patients had treatment interruption (mostly for adverse events [n=32] or patient error [n=11]). The most frequent treatment-related adverse events were hand-foot skin reaction (any grade n=19; grade ≥3 n=5), diarrhoea (n=19; n=2), fatigue (n=19; n=6), hypothyroidism (n=15; n=0), anorexia (n=13; n=0), hypertension (n=13; n=1), nausea (n=12; n=0) and voice changes (n=10; n=0). Disease control was achieved in 26 patients (partial response n=1; stable disease n=25). Median time to progression was 4.3 months. Median overall survival was 13.8 months. CONCLUSION: Regorafenib had acceptable tolerability and evidence of antitumour activity in patients with intermediate or advanced HCC that progressed following first-line sorafenib.

n-Alkane analyses from an transect of marine surface sediments off southwest Africa

An isobathic transect of marine surface sediments from 1°N to 28°S off southwest Africa was used to further evaluate the potential of the chain length distribution and carbon stable isotope composition of higher plant n-alkanes as proxies for continental vegetation and climate conditions. We found a strong increase in the n-C29-33 weighted mean average d13C values from -33 per mil near the equator to around -26 per mil further south. Additionally, C25-35n-alkanes reveal a southward trend of increasing average chain length from 30.0 to 30.5. The data reflect the changing contribution of plants employing different photosynthetic pathways (C3 and C4) and/or being differently influenced by the environmental conditions of their habitat. The C4 plant proportions calculated from the data (ca. 20% for rivers draining the rainforest, to ca. 70% at higher latitude) correspond to the C4 plant abundance in continental catchment areas postulated by considering prevailing wind systems and river outflows. Furthermore, the C4 plant contribution to the sediments correlates with the mean annual precipitation and aridity at selected continental locations in the postulated catchment areas, suggesting that the C4 plant fraction in marine sediments can be used to assess these environmental parameters.

Mid-Cretaceous planktonic foraminifera off central Morocco

Sites 545 and 547 collectively penetrated 629 m of mid-Cretaceous strata (upper Aptian to upper Cenomanian) off central Morocco during Leg 79 of the Deep Sea Drilling Project. Site 545, at the base of the steep Mazagan Escarpment, records a virtually complete succession of hemipelagic sediments of early late Aptian to middle Cenomanian age. Minor faunal recycling occurred throughout much of the upper Aptian to middle Albian part of the sequence (Cores 55 through 41), reflecting bottom currents along the Mazagan Escarpment. This may be related to the strong upwelling regime and high surface water productivity over Site 545 during the latest Aptian through middle Albian. The upwelling system ceased rather abruptly in this area in late middle Albian time. Recycling of older strata by bottom currents also ceased in the late middle Albian and resulted in a slower average accumulation rate in the upper Albian to middle Cenomanian section of Site 545 (Cores 40 through 28). However, intervals of pebbly claystone conglomerates in Cores 40 and 34 record sporadic instability in the slope adjacent to Site 545. Site 547, located only about 15 km seaward, is situated in a small sub-basin adjacent to the basement block drilled by Site 544. It contains an expanded upper Albian to upper Cenomanian sequence as a result of the numerous conglomeratic intervals throughout much of the section. In contrast to Site 545, the conglomerates were not derived from older strata cropping out on the Mazagan Escarpment; rather, they originated penecontemporaneously from a local unstable slope. A detailed biostratigraphic framework based on planktonic foraminifers is established for the mid-Cretaceous sections of Sites 545 and 547 and a new composite zonal scheme is proposed for the early late Aptian through early late Cenomanian interval. Fifty-five species are recognized and illustrated

A four-year record of UK'37- and TEX86-derived sea surface temperature estimates from sinking particles in the filamentous upwelling region off Cape Blanc, Mauritania

Lipid biomarker records from sinking particles collected by sediment traps are excellent tools to study the seasonality of biomarker production as well as processes of particle formation and settling, ultimately leading to the preservation of the biomarkers in sediments. Here we present records of the biomarker indices UK'37 based on alkenones and TEX86 based on isoprenoid glycerol dialkyl glycerol tetraethers (GDGTs), both used for the reconstruction of sea surface temperatures (SST). These records were obtained from sinking particles collected using a sediment trap moored in the filamentous upwelling zone off Cape Blanc, Mauritania, at approximately 1300 water depth during a four-year time interval between 2003 and 2007. Mass and lipid fluxes are highest during peak upwelling periods between October and June. The alkenone and GDGT records both display pronounced seasonal variability. Sinking velocities calculated from the time lag between measured SST maxima and minima and corresponding index maxima and minima in the trap samples are higher for particles containing alkenones (14-59 m/d) than for GDGTs (9-17 m/d). It is suggested that GDGTs are predominantly exported from shallow waters by incorporation in opal-rich particles. SST estimates based on the UK'37 index faithfully record observed fluctuations in SST during the study period. Temperature estimates based on TEX86 show smaller seasonal amplitudes, which can be explained with either predominant production of GDGTs during the warm season, or a contribution of GDGTs exported from deep waters carrying GDGTs in a distribution that translates to a high TEX86 signal.

Recent distribution and accumulation of organic carbon on the continental margin west off Spitsbergen

The study compiles the controlling factors for organic matter sedimentation patterns from a suite of organogeochemical parameters in surface sediments off Spitsbergen and direct seabed observations using a Remotely Operated Vehicle (ROV). In addition we assess its storage rates as well as the potential of carbon sinks on the northwestern margin of the Barents Sea with short sediment cores from a selected fjord environment (Storfjord). While sedimentation in the fjords is mainly controlled by river/meltwater discharge and coastal erosion by sea ice/glaciers resulting in high supply of terrigenous organic matter, Atlantic water inflow, and thus enhanced marine organic matter supply, characterizes the environment on the outer shelf and slope. Local deviations from this pattern, particularly on the shelf, are due to erosion and out washing of fine-grained material by bottom currents. Spots dominated by marine productivity close to the island have been found at the outer Isfjord and west off Prins Karls Forland as well as off the Kongsfjord/Krossfjord area and probably reflect local upwelling of nutrient-rich Atlantic water-derived water masses. Accumulation rates of marine organic carbon as well as reconstructed primary productivities decreased since the middle of the last century. Negative correlation of the Isfjord temperature record with reconstructed productivities in the Storfjord could be explained by a reduced annual duration of the marginal ice zone in the area due to global warming. Extremely high accumulation rates of marine organic carbon between 5.4 and 17.2 g/m**2/yr mark the Storfjord area, and probably high-latitude fjord environments in general, as a sink for carbon dioxide.

(Table 1) Water column biogenic silica concentrations and Si isotopic composition during Marion Dufresne cruise MD166 off South Africa

Southern Ocean biogeochemical processes have an impact on global marine primary production and global elemental cycling, e.g. by likely controlling glacial-interglacial pCO2 variation. In this context, the natural silicon isotopic composition (d30Si) of sedimentary biogenic silica has been used to reconstruct past Si-consumption:supply ratios in the surface waters. We present a new dataset in the Southern Ocean from a IPY-GEOTRACES transect (Bonus-GoodHope) which includes for the first time summer d30Si signatures of suspended biogenic silica (i) for the whole water column at three stations and (ii) in the mixed layer at seven stations from the subtropical zone up to the Weddell Gyre. In general, the isotopic composition of biogenic opal exported to depth was comparable to the opal leaving the mixed layer and did not seem to be affected by any diagenetic processes during settling, even if an effect of biogenic silica dissolution cannot be ruled out in the northern part of the Weddell Gyre. We develop a mechanistic understanding of the processes involved in the modern Si-isotopic balance, by implementing a mixed layer model. We observe that the accumulated biogenic silica (sensu Rayleigh distillation) should satisfactorily describe the d30Si composition of biogenic silica exported out of the mixed layer, within the limit of the current analytical precision on the d30Si. The failures of previous models (Rayleigh and steady state) become apparent especially at the end of the productive period in the mixed layer, when biogenic silica production and export are low. This results from (1) a higher biogenic silica dissolution:production ratio imposing a lower net fractionation factor and (2) a higher Si-supply:Si-uptake ratio supplying light Si-isotopes into the mixed layer. The latter effect is especially expressed when the summer mixed layer becomes strongly Si-depleted, together with a large vertical silicic acid gradient, e.g. in the Polar Front Zone and at the Polar Front.

Age determination of sediment cores off western Spitsbergen

The Late Weichselian glacial history of the continental shelf off western Spitsbergen is discussed, based on acoustic sub-bottom records and sediment cores. The outer part of Isfjorden and the inner shelf to the west of this fjord are characterized by a thin veneer (10-20 m) of glacigenic sediments and absence of ice-marginal features. Towards the outer shelf the sediment thickness increases significantly, and exceeds 500 m at the shelf edge. Possible moraine complexes were identified in this outer part. Sediment cores from the inner shelf sampled a firm diamicton, interpreted as till, beneath soft glaciomarine sediments. Radiocarbon dates on shells from the clay resting directly on the till, suggest an age of around 12,500 yrs B.P. for the base of the marine sequence. We argue that grounded ice covered the sites shortly before. In contrast to suggestions that the fjords and coast were partly ice free during the Late Weischselian, we conclude that the ice must have reached out onto the continental shelf.

Fundamentos biológicos para el uso de la mucosa oral como vía de aplicación de métodos inmunoterápicos

El transporte de medicamentos a través de la mucosa oral ha sido objeto de particular atención, especialmente en las ultimas dos décadas. Entre las distintas regiones de la mucosa oral, la mucosa sublingual es el sitio primario utilizado para la administración de diferentes sustancias incluidos algunos tipos de antígenos. La estructura histológica de esta área muestra la existencia de numerosas células inmunocompetentes capaces de activar el sistema inmunológico. Previo a la descripción de las diferentes rutas de absorción de fármacos y experiencias sobre permeabilidad de la región sublingual, se realiza una breve reseña de la histología y anatomía del área sublingual. En este trabajo también se tratan las ventajas y desventajas de la vía sublingual y el potencial aprovechamiento de la inmunoterapia sublingual para el tratamiento de patologías sistémicas y orales.