Docetaxel and gemcitabine combination in 133 advanced soft-tissue sarcomas: a retrospective analysis.

Advanced soft-tissue sarcomas are usually resistant to cytotoxic agents such as doxorubicin and ifosfamide. Antitumor activity has been observed for gemcitabine and docetaxel combination. We conducted a retrospective study on 133 patients (58 males/75 females) with unresectable or metastatic soft-tissue sarcoma. The median age at diagnosis was 51.7 (18-82), with 76 patients with leiomoyosarcoma and 57 patients with other histological subtypes. The initial localizations were limb (44), uterine (32), retroperitoneal (23) and organs or bone (34). Patients received 900 mg/m2 of gemcitabine (days 1 and 8) over 90 min plus 100 mg/m2 of docetaxel (day 8), intravenously every 21 days. Gemcitabine/docetaxel combination was well tolerated with an overall response of 18.4% and with no clear statistical difference between leiomyosarcomas and other histological subtypes (24.2% versus 10.4% (p=0.06)). No difference was found between uterine soft-tissue sarcomas versus others. The median overall survival was 12.1 months (1-28). Better overall survival was correlated with leiomyosarcoma (p=0.01) and with the quality of the response, even for patients with stable disease (p<10(-4)). No statistical difference was found for the initial localization. Response to treatment and overall survival were better for patients in World Health Organization (WHO) performance status classification (PS) 0 at baseline versus patients in WHO PS-1, 2 or 3 (p=0.023 and p<10(-4), respectively). Gemcitabine/docetaxel combination was tolerable and demonstrated better response and survival for leiomyosarcoma, especially for patients in WHO PS-0 at baseline. For the other histological subtypes, the response was not encouraging, but the survival for patients in response or stable suggests further investigation.

Carboplatin and weekly paclitaxel doublet chemotherapy compared with monotherapy in elderly patients with advanced non-small-cell lung cancer: IFCT-0501 randomised, phase 3 trial.

BACKGROUND: Platinum-based doublet chemotherapy is recommended to treat advanced non-small-cell lung cancer (NSCLC) in fit, non-elderly adults, but monotherapy is recommended for patients older than 70 years. We compared a carboplatin and paclitaxel doublet chemotherapy regimen with monotherapy in elderly patients with advanced NSCLC. METHODS: In this multicentre, open-label, phase 3, randomised trial we recruited patients aged 70-89 years with locally advanced or metastatic NSCLC and WHO performance status scores of 0-2. Patients received either four cycles (3 weeks on treatment, 1 week off treatment) of carboplatin (on day 1) plus paclitaxel (on days 1, 8, and 15) or five cycles (2 weeks on treatment, 1 week off treatment) of vinorelbine or gemcitabine monotherapy. Randomisation was done centrally with the minimisation method. The primary endpoint was overall survival, and analysis was done by intention to treat. This trial is registered, number NCT00298415. FINDINGS: 451 patients were enrolled. 226 were randomly assigned monotherapy and 225 doublet chemotherapy. Median age was 77 years and median follow-up was 30.3 months (range 8.6-45.2). Median overall survival was 10.3 months for doublet chemotherapy and 6.2 months for monotherapy (hazard ratio 0.64, 95% CI 0.52-0.78; p<0.0001); 1-year survival was 44.5% (95% CI 37.9-50.9) and 25.4% (19.9-31.3), respectively. Toxic effects were more frequent in the doublet chemotherapy group than in the monotherapy group (most frequent, decreased neutrophil count (108 [48.4%] vs 28 [12.4%]; asthenia 23 [10.3%] vs 13 [5.8%]). INTERPRETATION: Despite increased toxic effects, platinum-based doublet chemotherapy was associated with survival benefits compared with vinorelbine or gemcitabine monotherapy in elderly patients with NSCLC. We feel that the current treatment paradigm for these patients should be reconsidered. FUNDING: Intergroupe Francophone de Cancérologie Thoracique, Institut National du Cancer.

Iowa Infrastructure Investment Program: Report of the Governor on the Status of the I-Jobs Program, January 7, 2011

Department of Management reporting on the status of the Iowa Infrastructure Investment Program, known as the I-JOBS Program, as of September 30, 2010 with additional survey information from departments on the number of positions supported through October 31, 2010.

ALK inhibitors in the treatment of advanced NSCLC.

Pharmacologic agents that target protein products of oncogenes in tumors are playing an increasing clinical role in the treatment of cancer. Currently, the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) represent the standard of care for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) harboring activating EGFR mutations. Subsequently other genetic abnormalities with "driver" characteristics - implying transforming and tumor maintenance capabilities have been extensively reported in several small distinct subsets of NSCLC. Among these rare genetic changes, anaplastic lymphoma kinase (ALK) gene rearrangements, most often consisting in a chromosome 2 inversion leading to a fusion with the echinoderm microtubule-associated protein like 4 (EML4) gene, results in the abnormal expression and activation of this tyrosine kinase in the cytoplasm of cancer cells. This rearrangement occurs in 2-5% of NSCLC, predominantly in young (50 years or younger), never- or former-smokers with adenocarcinoma. This aberration most commonly occurs a independently of EGFR and KRAS gene mutations. A fluorescent in situ hybridization assay was approved by the US Food and Drug Administration (FDA) as the standard method for the detection of ALK gene rearrangement in clinical practice and is considered the gold standard. Crizotinib, a first-in-class dual ALK and c-MET inhibitor, has been shown to be particularly effective against ALK positive NSCLC, showing dramatic and prolonged responses with low toxicity, predominantly restricted to the gastro-intestinal and visual systems, and generally self-limiting or easily managed. However, resistance to crizotinib inevitably emerges. The molecular mechanisms of resistance are currently under investigation, as are therapeutic approaches including crizotinib-based combination therapy and novel agents such as Hsp90 inhibitors. This review aims to present the current knowledge on this fusion gene, the clinic-pathological profile of ALK rearranged NSCLC, and to review the existing literature on ALK inhibitors, focusing on their role in the treatment of NSCLC.

Annual Infrastructure Status Report 2014

This is the Iowa Department of Transportation’s summary of project status for infrastructure projects that have been appropriated revenue from various funds including Rebuild Iowa Infrastructure, Health Restricted Capitals, Revenue Bonds Capitals and Revenue Bonds Capitals II.

Annual Infrastructure Report 2009, January 25, 2010

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2010 January 28, 2011

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2012, January 15, 2012

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

Annual Infrastructure Report 2013, January 15, 2014

Major maintenance; health, safety, loss of use; and Americans with Disabilities Act deficiencies at the Capitol Complex and statewide for twelve agencies and divisions participating in the Vertical Infrastructure Program in collaboration with the Governor's Vertical Infrastructure Advisory Committee, including the Department of Administrative Services; the Department of Commerce, Alcoholic Beverages Division; the Department of Corrections; the Department of Cultural Affairs; the Department of Education, including Iowa Public Television and Iowa Vocational Rehabilitation Services; the Department of Human Services; Iowa Law Enforcement Academy; the Department of Public Safety; Terrace Hill; Iowa Veterans Home and Iowa Workforce Development. The advisory committee meets on a monthly basis to review the progress of the work and to make recommendations on procedures and priorities. Additional information on major maintenance projects is available in the advisory committee's Tenth Annual Report to the Governor, dated December 15, 2008.

2011 Annual Report for Appropriations from the Rebuild Iowa Infrastructure Fund and Revenue Bonds Capitals II Fund to the Watershed Improvement Fund

The Watershed Improvement Fund and the Watershed Improvement Review Board (WIRB) were created in 2005. This statute is now codified in Iowa Code Chapter 466A. The pmpose of the Watershed Improvement Fund is to enhance the water quality and flood prevention efforts in the state through a variety of impairment-based, locally­ directed watershed improvement projects. These projects are awarded grants through a competitive application process directed by the WIRB. Appropriations to the Fund do not revert. Interest earned on the moneys on the Fund are also retained in the Fund and are used to fund projects or pay per diem and expenses of the WIRB members. In state fiscal years 2009 (SFY2009) and 2010 (SFY2010), the Watershed Improvement Fund was appropriated $5,000,000 from the Rebuild Iowa Infrastructure Fund (RIIF). In SFY2011, the Watershed Improvement Fund was appropriated $2,000,000 from the Revenue Bonds Capitals II Fund (RBC2).

2012 Annual Report for Appropriations from the Rebuild Iowa Infrastructure Fund and Revenue Bonds Capitals II Fund to the Watershed Improvement Fund

The Watershed Improvement Fund and the Watershed Improvement Review Board (WIRB) were created in 2005. This statute is now codified in Iowa Code Chapter 466A. The purpose of the Watershed Improvement Fund is to enlmnce the water quality and flood prevention efforts in the state through a variety of impairment-based, locally­ directed watershed improvement projects. These projects are awarded grants through a competitive application process directed by the WIRB. Appropriations to the Fund do not revert except for the Capital Revenue Bonds II (RCB2) appropriation. Interest eamed on the moneys on the Fund are also retained in the Fund and are used to fund projects or pay per diem and expenses of the WIRB members. Starting July 1, 2012, the Fund is also receiving Animal Agriculture Compliance Fund Penalties. In state fiscal years 2009 (SFY2009) and 2010 (SFY2010), the Watershed Improvement Fund was appropriated $5,000,000 from the Rebuild Iowa Infrastructure Fund (RIIF). In SFY2011, the Watershed Improvement Fund was appropriated $2,000,000 from the Revenue Bonds Capitals II Fund (RBC2). No appropriation was received in fiscal year 2012. In SFY 2013, the Watershed Improvement Fund was appropriated $1,000,000 from the RIIF.

2013 Annual Report for Appropriations from the Rebuild Iowa Infrastructure Fund and Revenue Bonds Capitals II Fund to the Watershed Improvement Fund

The Watershed Improvement Fund and the Watershed Improvement Review Board (WIRB) were created in 2005. This statute is now codified in Iowa Code Chapter 466A. The purpose of the Watershed Improvement Fund is to enhance the water quality in the state through a variety of impairment-based, locally-directed watershed improvement projects. These projects are awarded grants through a competitive application process directed by the WIRB. Appropriations to the Fund do not revert except for the Capital Revenue Bonds II (RCB2) appropriation. Interest earned on the moneys on the Fund are also retained in the Fund and are used to fund projects or pay per diem and expenses of the WIRB members. Starting July 1, 2012, the Fund is also receiving Animal Agriculture Compliance Fund Penalties. In state fiscal years 2009 (SFY2009) and 2010 (SFY2010), the Watershed Improvement Fund was appropriated $5,000,000 from the Rebuild Iowa Infrastructure Fund (RIIF). In SFY2011, the Watershed Improvement Fund was appropriated $2,000,000 from the Revenue Bonds Capitals II Fund (RBC2). No appropriation was received in fiscal year 2012. In SFY 2013, the Watershed Improvement Fund was appropriated $1,000,000 from the RIIF.

2014 Annual Report for Appropriations from the Rebuild Iowa Infrastructure Fund and Revenue Bonds Capitals II Fund to the Watershed Improvement Fund

The Watershed Improvement Fund and the Watershed Improvement Review Board (WIRB) were created in 2005. This statute is now codified in Iowa Code Chapter 466A. The purpose of the Watershed Improvement Fund is to enhance the water quality in the state through a variety of impairment-based, locally-directed watershed improvement projects. These projects are awarded grants through a competitive application process directed by the WIRB. Appropriations to the Fund do not revert except for the Capital Revenue Bonds II (RCB2) appropriation. Interest earned on the moneys on the Fund are also retained in the Fund and are used to fund projects or pay per diem and expenses of the WIRB members. Starting July 1, 2012, the Fund is also receiving Animal Agriculture Compliance Fund Penalties. In state fiscal years 2009 (SFY2009) and 2010 (SFY2010), the Watershed Improvement Fund was appropriated $5,000,000 from the Rebuild Iowa Infrastructure Fund (RIIF). In SFY2011, the Watershed Improvement Fund was appropriated $2,000,000 from the Revenue Bonds Capitals II Fund (RBC2). No appropriation was received in fiscal year 2012. In SFY 2013, the Watershed Improvement Fund was appropriated $1,000,000 from the RIIF.

Ruin and related quantities in some advanced insurance risk models

Risk theory has been a very active research area over the last decades. The main objectives of the theory are to find adequate stochastic processes which can model the surplus of a (non-life) insurance company and to analyze the risk related quantities such as ruin time, ruin probability, expected discounted penalty function and expected discounted dividend/tax payments. The study of these ruin related quantities provides crucial information for actuaries and decision makers. This thesis consists of the study of four different insurance risk models which are essentially related. The ruin and related quantities are investigated by using different techniques, resulting in explicit or asymptotic expressions for the ruin time, the ruin probability, the expected discounted penalty function and the expected discounted tax payments. - La recherche en théorie du risque a été très dynamique au cours des dernières décennies. D'un point de vue théorique, les principaux objectifs sont de trouver des processus stochastiques adéquats permettant de modéliser le surplus d'une compagnie d'assurance non vie et d'analyser les mesures de risque, notamment le temps de ruine, la probabilité de ruine, l'espérance de la valeur actuelle de la fonction de pénalité et l'espérance de la valeur actuelle des dividendes et taxes. L'étude de ces mesures associées à la ruine fournit des informations cruciales pour les actuaires et les décideurs. Cette thèse consiste en l'étude des quatre différents modèles de risque d'assurance qui sont essentiellement liés. La ruine et les mesures qui y sont associées sont examinées à l'aide de différentes techniques, ce qui permet d'induire des expressions explicites ou asymptotiques du temps de ruine, de la probabilité de ruine, de l'espérance de la valeur actuelle de la fonction de pénalité et l'espérance de la valeur actuelle des dividendes et taxes.