A randomized phase III trial in patients with recurrent platinum sensitive ovarian cancer comparing efficacy and safety of paclitaxel micellar and Cremophor EL-paclitaxel

OBJECTIVE

Paclitaxel micellar was developed to avoid Cremophor-EL (Cr-EL) associated dose limiting toxicity and to allow a shorter infusion time. The efficacy and safety of paclitaxel micellar (+carboplatin) was compared to Cr-EL paclitaxel (+carboplatin) in recurrent platinum-sensitive ovarian, fallopian tube or peritoneal carcinoma.

METHODS

This was a multicentre, open-label, randomized phase III trial. Adult patients with recurrent disease was assigned to six 3-week cycles of paclitaxel micellar (250 mg/m²) administered as 1-h infusion or Cr-EL paclitaxel (175 mg/m²) as 3-h infusion. Both arms received carboplatin (AUC 5-6). Primary objective was non-inferiority for progression free survival (PFS) using computed tomography scans. Overall survival (OS) was included as secondary endpoint.

RESULTS

Between 2009 and 2013, 789 patients were randomized to receive experimental (N = 397) or control (N = 392) treatment. PFS for paclitaxel micellar was non-inferior to Cr-EL paclitaxel with a hazard ratio of 0.86 (95% CI: 0.72;1.03) in the per protocol population (PP), favouring paclitaxel micellar (non-inferiority margin was 1.2). Non-inferiority of OS was shown in the PP population with a hazard ratio of 0.95 (95% CI: 0.78; 1.16), favouring paclitaxel micellar (non-inferiority margin was 1.185). The most common adverse event was neutropenia (grade ≥ 3); 245 patients (79%) for paclitaxel micellar vs 213 patients (66%) for Cr-EL paclitaxel. The frequency of peripheral sensory neuropathy (any grade) was similar between the arms; 16% for paclitaxel micellar and 20% for Cr-EL paclitaxel.

CONCLUSION

Paclitaxel micellar (+ carboplatin) is non-inferior to Cr-EL paclitaxel (+ carboplatin) in terms of PFS and OS in the studied population. It provides a treatment option of a higher paclitaxel dose with a shorter infusion time without mandatory premedication.

TRIAL REGISTRATION NUMBER

2008-002668-32 (EudraCT), NCT00989131 (ClinicalTrials.gov).

Direct imaging and manipulation of ionic diffusion in mixed electronic-ionic conductors

Next generation Li-ion batteries require improved energy densities, power output and safety to satisfy the demands of emerging technologies. All solid state 3D thin-film batteries (ASB) based on nanoionics are considered as frontrunners to enable all this. In order to facilitate the introduction of this new architecture, a homogeneous electrochemical activity and a high ionic diffusivity of the electrodes is key. However, nanometer-resolved techniques to probe structural, electrical and electrochemical properties of the battery components are still limited. Here we propose a study that combines conductive atomic force microscopy (C-AFM) and secondary ion mass spectrometry (SIMS) for structural and electrical characterization. In addition, a novel concept called ion-modulated C-AFM (imC-AFM) is introduced to also sense the electrochemical activity of ions in confined volumes. Using the aforementioned methodologies, LixMn2O4 thin film cathodes are studied observing: (1) a direct correlation between electrical conductivity and local chemistry. (2) A non-uniform Li-ion electrochemical activity (i.e. ionic conductivity) on the cathode's surface with a clear enhancement in grain boundaries (GBs). Finally, (3) imC-AFM observes a high volume expansion associated with high Li incorporation. This work introduces a novel pathway for the rapid analysis of materials to be used in ASB.

Wet-chemical etching of atom probe tips for artefact free analyses of nanoscaled semiconductor structures

We introduce an innovative specimen preparation method employing the selectivity of a wet-chemical etching step to improve data quality and success rates in the atom probe analysis of contemporary semiconductor devices. Firstly, on the example of an SiGe fin embedded in SiO₂ we demonstrate how the selective removal of SiO₂ from the final APT specimen significantly improves accuracy and reliability of the reconstructed data. With the oxide removal, we eliminate the origin of shape artefacts, i.e. the formation of a non-hemispherical tip shape, that are typically observed in the reconstructed volume of complex systems. Secondly, using the same approach, we increase success rates to ∼90% for the damage-free, 3D site-specific localization of short (250 nm), vertical Si nanowires at the specimen apex. The impact of the abrupt emitter radius change that is introduced by this specimen preparation method is evaluated as being minor using field evaporation simulation and comparison of different reconstruction schemes. The Ge content within the SiGe fin as well as the 3D boron distribution in the Si NW as resolved by atom probe analysis are in good agreement with TEM/EDS and ToF-SIMS analysis, respectively.

[Sandhoff disease]

A new case of Sandhoff disease is presented (gangliosidosis GM2 type II or variant O) with enzymatic study in serum and leukocytes from the patient, as well as in serum from the newborn's, father and mother. The clinical expression, enzymatic study and evolution are discussed comparing them with Tay-Sachs disease (gangliosidosis GM2 type I o variant B).