Phase II Low Intensity Chemical Dosing (LICD): Development of Management Practices

(pdf contains 265 pages)

Radiotherapy plus nimotuzumab or placebo in the treatment of high grade glioma patients: results from a randomized, double blind trial

Background The prognosis of patients bearing high grade glioma remains dismal. Epidermal Growth Factor Receptor (EGFR) is well validated as a primary contributor of glioma initiation and progression. Nimotuzumab is a humanized monoclonal antibody that recognizes the EGFR extracellular domain and reaches Central Nervous System tumors, in nonclinical and clinical setting. While it has similar activity when compared to other anti-EGFR antibodies, it does not induce skin toxicity or hypomagnesemia. Methods A randomized, double blind, multicentric clinical trial was conducted in high grade glioma patients (41 anaplastic astrocytoma and 29 glioblastoma multiforme) that received radiotherapy plus nimotuzumab or placebo. Treatment and placebo groups were well-balanced for the most important prognostic variables. Patients received 6 weekly doses of 200 mg nimotuzumab or placebo together with irradiation as induction therapy. Maintenance treatment was given for 1 year with subsequent doses administered every 3 weeks. The objectives of this study were to assess the comparative overall survival, progression free survival, response rate, immunogenicity and safety. Results The median cumulative dose was 3200 mg of nimotuzumab given over a median number of 16 doses. The combination of nimotuzumab and RT was well-tolerated. The most prevalent related adverse reactions included nausea, fever, tremors, anorexia and hepatic test alteration. No anti-idiotypic response was detected, confirming the antibody low immunogenicity. The mean and median survival time for subjects treated with nimotuzumab was 31.06 and 17.76 vs. 21.07 and 12.63 months for the control group. Conclusions In this randomized trial, nimotuzumab showed an excellent safety profile and significant survival benefit in combination with irradiation.

Prevalence, intensity, longevity, and persistence of Anisakis sp. larvae and Lacistorhynchus tenuis metacestodes in San Francisco striped bass

Thirteen hundred and seventy-three striped bass, Marone saxatilis, were collected from the San Francisco Bay-Delta area to correlate host diet with parasitic infections and to determine the prevalence, intensity, longevity, and persistence of larval Anisakis sp. nematodes and the metacestode Lacistorhynchus tenuis. There is an increase in the prevalence and intensity of Anisakis sp. and in the intensity of L. tenuis with increase of age of the host. These increases are probably related to the diet and the persistence of tbe parasites. The infections of both species are overdispersed. San Francisco Bay striped bass are an incompatible host for both species of parasites. Degenerated Anisakis sp. will remain in lhe host for at least 8 months and L. tenuis metacestodes for 22 months. The occurrence of several other species of parasites and a tumor are also reported. (PDF file contains 10 pages.)