Cediranib Plus FOLFOX/CAPOX Versus Placebo Plus FOLFOX/CAPOX in Patients With Previously Untreated Metastatic Colorectal Cancer: A Randomized, Double-Blind, Phase III Study (HORIZON II)

Purpose Cediranib is a highly potent inhibitor of vascular endothelial growth factor (VEGF) signaling with activity against all three VEGF receptors. HORIZON II [Cediranib (AZD2171, RECENTIN) in Addition to Chemotherapy Versus Placebo Plus Chemotherapy in Patients With Untreated Metastatic Colorectal Cancer] assessed infusional fluorouracil, leucovorin, and oxaliplatin/capecitabine and oxaliplatin (FOLFOX/CAPOX) with or without cediranib in patients with previously untreated metastatic colorectal cancer (mCRC). Patients and Methods Eligible patients were initially randomly assigned 1:1:1 to receive cediranib (20 or 30 mg per day) or placebo plus FOLFOX/CAPOX. In an early analysis of this and two other cediranib studies (HORIZON I [Cediranib Plus FOLFOX6 Versus Bevacizumab Plus FOLFOX6 in Patients With Previously Treated Metastatic Colorectal Cancer] and HORIZON III [Cediranib Plus FOLFOX6 Versus Bevacizumab Plus FOLFOX6 in Patients With Untreated Metastatic Colorectal Cancer]), the 20-mg dose met the predefined criteria for continuation. Subsequent patients were randomly assigned 2: 1 to the cediranib 20 mg or placebo arms. Progression-free survival (PFS) and overall survival (OS) were coprimary end points. Results In all, 860 patients received cediranib 20 mg (n = 502) or placebo (n = 358). The addition of cediranib to FOLFOX/CAPOX resulted in PFS prolongation (hazard ratio [HR], 0.84; 95% CI, 0.73 to 0.98; P = .0121; median PFS, 8.6 months for cediranib v 8.3 months for placebo) but had no impact on OS (HR, 0.94; 95% CI, 0.79 to 1.12; P = .5707; median OS, 19.7 months for cediranib v 18.9 months for placebo). There were no significant differences in the secondary end points of objective response rate, duration of response, or liver resection rate. Median chemotherapy dose-intensity was decreased by approximately 10% in patients treated with cediranib. Adverse events (AEs) associated with cediranib were manageable. Conclusion Addition of cediranib 20 mg to FOLFOX/CAPOX resulted in a modest PFS prolongation, but no significant difference in OS. The cediranib AE profile was consistent with those from previous studies. Because of the lack of improvement in OS, cediranib plus an oxaliplatin-based regimen cannot be recommended as a treatment for patients with mCRC. J Clin Oncol 30:3596-3603. (C) 2012 by American Society of Clinical Oncology

Liquid-Liquid Equilibrium Data for the System Lard plus Oleic Acid plus Ethanol + Water at 318.2 K: Cholesterol Distribution Coefficients

This research reports liquid liquid equilibrium data for the system lard (swine fat), cis-9-octadecenoic acid (oleic acid), ethanol, and water at 318.2 K, as well as their correlation with the nonrandom two-liquid (NRTL) and universal quasichemical activity coefficient (UNIQUAC) thermodynamic equations, which have provided global deviations of 0.41 % and 0.53 %, respectively. Additional equilibrium experiments were also performed to obtain cholesterol partition (or distribution) coefficients to verify the availability of the use of ethanol plus water to reduce the cholesterol content in lard. The partition experiments were performed with concentrations of free fatty acids (commercial oleic acid) that varied from (0 to 20) mass % and of water in the solvent that varied from (0 to 18) mass %. The percentage of free fatty acids initially present in lard had a slight effect on the distribution of cholesterol between the phases. Furthermore, the distribution coefficients decreased by adding water in the ethanol; specifically, it resulted in a diminution of the capability of the solvent to remove the cholesterol.

Ground and excited state charmonium production in p plus p collisions at root s=200 GeV

We report on charmonium measurements [J/psi (1S), psi' (2S), and chi(c) (1P)] in p + p collisions at root s = 200 GeV. We find that the fraction of J/psi coming from the feed-down decay of psi' and chi(c) in the midrapidity region (vertical bar y vertical bar < 0: 35) is 9.6 +/- 2.4% and 32 +/- 9%, respectively. We also present the p(T) and rapidity dependencies of the J/psi yield measured via dielectron decay at midrapidity (vertical bar y vertical bar < 0.35) and via dimuon decay at forward rapidity (1.2 < vertical bar y vertical bar < 2.2). The statistical precision greatly exceeds that reported in our previous publication [Phys. Rev. Lett. 98, 232002 (2007)]. The new results are compared with other experiments and discussed in the context of current charmonium production models.

Central, but not basolateral, amygdala involvement in the anxiolytic-like effects of midazolam in rats in the elevated plus maze

The role of the amygdala in the mediation of fear and anxiety has been extensively investigated. However, how the amygdala functions during the organization of the anxiety-like behaviors generated in the elevated plus maze (EPM) is still under investigation. The basolateral (BLA) and the central (CeA) nuclei are the main input and output stations of the amygdala. In the present study, we ethopharmacologically analyzed the behavior of rats subjected to the EPM and the tissue content of the monoamines dopamine (DA) and serotonin (5-HT) and their metabolites in the nucleus accumbens (NAc), dorsal hippocampus (DH), and dorsal striatum (DS) of animals injected with saline or midazolam (20 and 30 nmol/0.2 mu L) into the BLA or CeA. Injections of midazolam into the CeA, but not BLA, caused clear anxiolytic-like effects in the EPM. These treatments did not cause significant changes in 5-HT or DA contents in the NAc, DH, or DS of animals tested in the EPM. The data suggest that the anxiolytic-like effects of midazolam in the EPM also appear to rely on GABA-benzodiazepine mechanisms in the CeA, but not BLA, and do not appear to depend on 5-HT and DA mechanisms prevalent in limbic structures.

Observation of Direct-Photon Collective Flow in Au plus Au Collisions at root s(NN)=200 GeV

The second Fourier component v(2) of the azimuthal anisotropy with respect to the reaction plane is measured for direct photons at midrapidity and transverse momentum (p(T)) of 1-12 GeV/c in Au + Au collisions at root s(NN) = 200 GeV. Previous measurements of this quantity for hadrons with p(T) < 6 GeV/c indicate that the medium behaves like a nearly perfect fluid, while for p(T) > 6 GeV/c a reduced anisotropy is interpreted in terms of a path-length dependence for parton energy loss. In this measurement with the PHENIX detector at the Relativistic Heavy Ion Collider we find that for p(T) > 4 GeV/c the anisotropy for direct photons is consistent with zero, which is as expected if the dominant source of direct photons is initial hard scattering. However, in the p(T) < 4 GeV/c region dominated by thermal photons, we find a substantial direct-photon v(2) comparable to that of hadrons, whereas model calculations for thermal photons in this kinematic region underpredict the observed v(2).

Wh plus missing-E-T signature from gaugino pair production at the LHC

In SUSY models with heavy squarks and gaugino mass unification, the gaugino pair production reaction pp -> (W) over tilde (+/-)(1)(Z) over tilde (2) dominates gluino pair production for m (g) over tilde less than or similar to 1 TeV at LHC with root s = 14 TeV (LHC14). For this mass range, the two-body decays (W) over tilde (1) -> W (Z) over tilde (1) and (Z) over tilde (2) -> h (Z) over tilde (1) are expected to dominate the chargino and neutralino branching fractions. By searching for lb (b) over tilde + is not an element of(T) events from (W) over tilde (+/-)(1)Z(2) production, we show that LHC14 with 100 fb(-1) of integrated luminosity becomes sensitive to chargino masses in the range m((W) over tilde1) similar to 450-550 GeV corresponding to m (g) over tilde similar to 1.5-2 TeV in models with gaugino mass unification. For 10(3) fb(-1), LHC14 is sensitive to the Wh channel for m((W) over tilde1) similar to 300-800 GeV, corresponding to m (g) over tilde similar to 1-2.8 TeV, which is comparable to the reach for gluino pair production followed by cascade decays. The Wh + is not an element of(T) search channel opens up a new complementary avenue for SUSY searches at LHC, and serves to point to SUSYas the origin of any new physics discovered via multijet and multilepton + is not an element of(T) channels.

W Z plus missing-E-T signal from gaugino pair production at LHC7

LHC searches for supersymmetry currently focus on strongly produced sparticles, which are copiously produced if gluinos and squarks have masses of a few hundred GeV. However, in supersymmetric models with heavy scalars, as favored by the decoupling solution to the SUSY flavor and CP problems, and m((g) over tilde) greater than or similar to 500 GeV as indicated by recent LHC results, chargino-neutralino ((W) over tilde (+/-)(1)(Z) over tilde (2)) production is the dominant cross section for m((W) over tilde1) similar to m((Z) over tilde2) < m(<(g)over tilde>)/3 at LHC with root s = 7 TeV (LHC7). Furthermore, if m((Z) over tilde1) + (m (Z) over tilde) less than or similar to m((Z) over tilde2) less than or similar to m((Z) over tilde1) + m(h), then (Z) over tilde (2) dominantly decays via (Z) over tilde (2) -> (Z) over tilde (1)Z, while (W) over tilde (1) decays via (W) over tilde (1) -> (Z) over tilde W-1. We investigate the LHC7 reach in the W Z + (sic)T channel (for both leptonic and hadronic decays of the W boson) in models with and without the assumption of gaugino mass universality. In the case of the mSUGRA/CMSSM model with heavy squark masses, the LHC7 discovery reach in the W Z+ (sic)T channel becomes competetive with the reach in the canonical (sic)T + jets channel for integrated luminosities similar to 30 fb(-1). We also present the LHC7 reach for a simplified model with arbitrary m((Z) over tilde1) and m((W) over tilde1) similar to m((Z) over tilde2). Here, we find a reach of up to m((W) over tilde1) similar to 200 (250) GeV for 10 (30) fb(-1).

Differential Gene Expression Profiles May Differentiate Responder and Nonresponder Patients with Rheumatoid Arthritis for Methotrexate (MTX) Monotherapy and MTX plus Tumor Necrosis Factor Inhibitor Combined Therapy

Objective. We aimed to evaluate whether the differential gene expression profiles of patients with rheumatoid arthritis (RA) could distinguish responders from nonresponders to methotrexate (MTX) and, in the case of MTX nonresponders, responsiveness to MTX plus anti-tumor necrosis factor-alpha (anti-TNF) combined therapy. Methods. We evaluated 25 patients with RA taking MTX 15-20 mg/week as a monotherapy (8 responders and 17 nonresponders). All MTX nonresponders received intliximab and were reassessed after 20 weeks to evaluate their anti-TNF responsiveness using the European League Against Rheumatism response criteria. A differential gene expression analysis from peripheral blood mononuclear cells was performed in terms of hierarchical gene clustering, and an evaluation of differentially expressed genes was performed using the significance analysis of microarrays program. Results. Hierarchical gene expression clustering discriminated MTX responders from nonresponders, and MTX plus anti-TNF responders from nonresponders. The evaluation of only highly modulated genes (fold change > 1.3 or < 0.7) yielded 5 induced (4 antiapoptotic and CCL4) and 4 repressed (4 proapoptotic) genes in MTX nonresponders compared to responders. In MTX plus anti-TNF nonresponders, the CCL4, CD83, and BCL2A1 genes were induced in relation to responders. Conclusion. Study of the gene expression profiles of RA peripheral blood cells permitted differentiation of responders from nonresponders to MTX and anti-TNF. Several candidate genes in MTX non-responders (CCL4, HTRA2, PRKCD, BCL2A1, CAV1, TNIP1 CASP8AP2, MXD1, and BTG2) and 3 genes in MTX plus anti-TNF nonresponders (CCL4, CD83, and BCL2A1) were identified for further study. (First Release July 1 2012; J Rheumatol 2012;39:1524-32; doi:10.3899/jrheum.120092)

Direct photon production in p plus p collisions at root s=200 GeV at midrapidity

The differential cross section for the production of direct photons in p + p collisions at root s = 200 GeV at midrapidity was measured in the PHENIX detector at the Relativistic Heavy Ion Collider. Inclusive direct photons were measured in the transverse momentum range from 5: 5-25 GeV/c, extending the range beyond previous measurements. Event structure was studied with an isolation criterion. Next-to-leading-order perturbative-quantum-chromodynamics calculations give a good description of the spectrum. When the cross section is expressed versus x(T), the PHENIX data are seen to be in agreement with measurements from other experiments at different center-of-mass energies.

Directed Flow of Identified Particles in Au plus Au Collisions at root S-NN=200 GeV at RHIC

STAR's measurements of directed flow (v(1)) around midrapidity for pi(+/-), K-+/-, K-S(0), p, and (p) over bar in Au + Au collisions at root s(NN) = 200 GeV are presented. A negative v(1) (y) slope is observed for most of produced particles (pi(+/-), K-+/-, K-S(0), p, and (p) over bar). In 5%-30% central collisions, a sizable difference is present between the v(1)(y) slope of protons and antiprotons, with the former being consistent with zero within errors. The v(1) excitation function is presented. Comparisons to model calculations (RQMD, UrQMD, AMPT, QGSM with parton recombination, and a hydrodynamics model with a tilted source) are made. For those models which have calculations of v(1) for both pions and protons, none of them can describe v(1()y) forpions and protons simultaneously. The hydrodynamics model with a tilted source as currently implemented cannot explain the centrality dependence of the difference between the v(1)(y) slopes of protons and antiprotons.

Cross sections and double-helicity asymmetries of midrapidity inclusive charged hadrons in p plus p collisions at root s = 62.4 GeV

Unpolarized cross sections and double-helicity asymmetries of single-inclusive positive and negative charged hadrons at midrapidity from p + p collisions at root s = 62.4 GeV are presented. The PHENIX measurement of the cross sections for 1.0 < p(T) < 4.5 GeV/c are consistent with perturbative QCD calculations at next-to-leading order in the strong-coupling constant, alpha(s). Resummed pQCD calculations including terms with next-to-leading-log accuracy, yielding reduced theoretical uncertainties, also agree with the data. The double-helicity asymmetry, sensitive at leading order to the gluon polarization in a momentum-fraction range of 0.05 less than or similar to x(gluon) less than or similar to 0.2, is consistent with recent global parametrizations disfavoring large gluon polarization.

Mutations in CTC1, encoding conserved telomere maintenance component 1, cause Coats plus

Coats plus is a highly pleiotropic disorder particularly affecting the eye, brain, bone and gastrointestinal tract. Here, we show that Coats plus results from mutations in CTC1, encoding conserved telomere maintenance component 1, a member of the mammalian homolog of the yeast heterotrimeric CST telomeric capping complex. Consistent with the observation of shortened telomeres in an Arabidopsis CTC1 mutant and the phenotypic overlap of Coats plus with the telomeric maintenance disorders comprising dyskeratosis congenita, we observed shortened telomeres in three individuals with Coats plus and an increase in spontaneous gamma H2AX-positive cells in cell lines derived from two affected individuals. CTC1 is also a subunit of the alpha-accessory factor (AAF) complex, stimulating the activity of DNA polymerase-alpha primase, the only enzyme known to initiate DNA replication in eukaryotic cells. Thus, CTC1 may have a function in DNA metabolism that is necessary for but not specific to telomeric integrity.

Bevacizumab plus oxaliplatin-based chemotherapy as adjuvant treatment for colon cancer (AVANT): a phase 3 randomised controlled trial

Background: Bevacizumab improves the efficacy of oxaliplatin-based chemotherapy in metastatic colorectal cancer. Our aim was to assess the use of bevacizumab in combination with oxaliplatin-based chemotherapy in the adjuvant treatment of patients with resected stage III or high-risk stage II colon carcinoma. Methods: Patients from 330 centres in 34 countries were enrolled into this phase 3, open-label randomised trial. Patients with curatively resected stage III or high-risk stage II colon carcinoma were randomly assigned (1: 1: 1) to receive FOLFOX4 (oxaliplatin 85 mg/m(2), leucovorin 200 mg/m(2), and fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 1; leucovorin 200 mg/m(2) plus fluorouracil 400 mg/m(2) bolus plus 600 mg/m(2) 22-h continuous infusion on day 2) every 2 weeks for 12 cycles; bevacizumab 5 mg/kg plus FOLFOX4 (every 2 weeks for 12 cycles) followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks); or bevacizumab 7.5 mg/kg plus XELOX (oxaliplatin 130 mg/m(2) on day 1 every 2 weeks plus oral capecitabine 1000 mg/m(2) twice daily on days 1-15) every 3 weeks for eight cycles followed by bevacizumab monotherapy 7.5 mg/kg every 3 weeks (eight cycles over 24 weeks). Block randomisation was done with a central interactive computerised system, stratified by geographic region and disease stage. Surgery with curative intent occurred 4-8 weeks before randomisation. The primary endpoint was disease-free survival, analysed for all randomised patients with stage III disease. This study is registered with ClinicalTrials.gov, number NCT00112918. Findings: Of the total intention-to-treat population (n=3451), 2867 patients had stage III disease, of whom 955 were randomly assigned to receive FOLFOX4, 960 to receive bevacizumab-FOLFOX4, and 952 to receive bevacizumab-XELOX. After a median follow-up of 48 months (range 0-66 months), 237 patients (25%) in the FOLFOX4 group, 280 (29%) in the bevacizumab-FOLFOX4 group, and 253 (27%) in the bevacizumab-XELOX group had relapsed, developed a new colon cancer, or died. The disease-free survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.17 (95% CI 0.98-1.39; p=0.07), and for bevacizumab-XELOX versus FOLFOX4 was 1.07 (0.90-1.28; p=0.44). After a minimum follow-up of 60 months, the overall survival hazard ratio for bevacizumab-FOLFOX4 versus FOLFOX4 was 1.27 (1.03-1.57; p=0.02), and for bevacizumab-XELOX versus FOLFOX4 was 1.15 (0.93-1.42; p=0.21). The 573 patients with high-risk stage II cancer were included in the safety analysis. The most common grade 3-5 adverse events were neutropenia (FOLFOX4: 477 [42%] of 1126 patients, bevacizumab-FOLFOX4: 416 [36%] of 1145 patients, and bevacizumab-XELOX: 74 [7%] of 1135 patients), diarrhoea (110 [10%], 135 [12%], and 181 [16%], respectively), and hypertension (12 [1%], 122 [11%], and 116 [10%], respectively). Serious adverse events were more common in the bevacizumab groups (bevacizumab-FOLFOX4: 297 [26%]; bevacizumab-XELOX: 284 [25%]) than in the FOLFOX4 group (226 [20%]). Treatment-related deaths were reported in one patient receiving FOLFOX4, two receiving bevacizumab-FOLFOX4, and five receiving bevacizumab-XELOX. Interpretation: Bevacizumab does not prolong disease-free survival when added to adjuvant chemotherapy in resected stage III colon cancer. Overall survival data suggest a potential detrimental effect with bevacizumab plus oxaliplatin-based adjuvant therapy in these patients. On the basis of these and other data, we do not recommend the use of bevacizumab in the adjuvant treatment of patients with curatively resected stage III colon cancer.

A model for the rat exploratory behavior in the elevated plus-maze

We would like to thank FAPESP for funding this work.

HER-2, p53, p21 and hormonal receptors proteins expression as predictive factors of response and prognosis in locally advanced breast cancer treated with neoadjuvant docetaxel plus epirubicin combination

Abstract Background Neoadjuvant chemotherapy has been considered the standard care in locally advanced breast cancer. However, about 20% of the patients do not benefit from this clinical treatment and, predictive factors of response were not defined yet. This study was designed to evaluate the importance of biological markers to predict response and prognosis in stage II and III breast cancer patients treated with taxane and anthracycline combination as neoadjuvant setting. Methods Sixty patients received preoperative docetaxel (75 mg/m2) in combination with epirubicin (50 mg/m2) in i.v. infusion in D1 every 3 weeks after incisional biopsy. They received adjuvant chemotherapy with CMF or FEC, attaining axillary status following definitive breast surgery. Clinical and pathologic response rates were measured after preoperative therapy. We evaluated the response rate to neoadjuvant chemotherapy and the prognostic significance of clinicopathological and immunohistochemical parameters (ER, PR, p51, p21 and HER-2 protein expression). The median patient age was 50.5 years with a median follow up time 48 months after the time of diagnosis. Results Preoperative treatment achieved clinical response in 76.6% of patients and complete pathologic response in 5%. The clinical, pathological and immunohistochemical parameters were not able to predict response to therapy and, only HER2 protein overexpression was associated with a decrease in disease free and overall survival (P = 0.0007 and P = 0.003) as shown by multivariate analysis. Conclusion Immunohistochemical phenotypes were not able to predict response to neoadjuvant chemotherapy. Clinical response is inversely correlated with a risk of death in patients submitted to neoadjuvant chemotherapy and HER2 overexpression is the major prognostic factor in stage II and III breast cancer patients treated with a neoadjuvant docetaxel and epirubicin combination.