A propensity score-weighted study comparing a two- versus four-weekly pegylated liposomal doxorubicin regimen in metastatic breast cancer

PURPOSE

A 4-weekly schedule of pegylated liposomal doxorubicin (PLD) has been approved for the treatment of metastatic breast cancer (MBC). Phase II trials have suggested interest in a 2-weekly regimen. This study aimed to compare the efficacy and safety of these two schedules.

METHODS

Data from MBC patients treated with PLD between 2011 and 2021 were retrospectively collected. The objective was to demonstrate the noninferiority of the 2-weekly versus the 4-weekly schedule in terms of 6-month progression-free survival (PFS). The prespecified noninferiority margin was calculated as 1.20. A propensity score to receive either schedule was estimated using a gradient boosting algorithm. Survival analyses using Cox regression models weighted by the propensity score were performed to compare the schedules.

RESULTS

Among the 192 patients included, 96 (50%) underwent each schedule. The median number of previous systemic therapies was 4 (IQR, 3 to 6). Anthracyclines were previously given in early breast cancer in 63.9% of patients. The median follow-up was 10.0 months (IQR, 5.0 to 20.1). A comparable distribution of adverse events was observed. The median PFS was 3.2 months (95% CI, 2.9 to 3.9), and the median overall survival was 12.1 months (95% CI, 10.8 to 14.9). The weighted hazard ratio for PFS was 1.12 (90% CI, 0.82 to 1.54), including the noninferiority boundaries.

CONCLUSION

PLD appeared to be a well-tolerated drug in this heavily pretreated MBC population. The efficacy and safety of the 2-weekly schedule did not provide any advantage, suggesting no interest in changing the registered regimen.

[Mite sensitization in children followed for respiratory allergy in a tropical African environment in Cotonou, Benin]

INTRODUCTION

In tropical Africa, allergies are not well documented. The objective of this work was to evaluate, by two methods, the sensitization to mites in children followed for respiratory allergy.

METHODS

Skin prick-test and IgE assay by REAST test with 3 mites: Dermatophagoides pteronyssinus (D. pteronyssinus), Dermatophagoides farinae (D. farinae) and Blomia tropicalis (B. tropicalis) were carried out in children from 3 to 15 years followed up for asthma and/or allergic rhinitis. The positive results of the two tests were compared.

RESULTS

Of the 130 (100%) children included, all eligible for the assay, 119 (91.5%) had the prick-test. The mean age and sex ratio (M/F) were 7±1 year, and 1.6. The association of rhinitis and asthma was the most frequent and found in 66 (55.6%). The sensitivity frequencies for the prick-test and assay were respectively 79% versus 36.1% for B. tropicalis, 71.4% versus 33.4% for D. pteronyssinus and 38.7% versus 37.8% for D. farinae. A moderate correlation between mean papule diameter and mean IgE concentration was observed.

CONCLUSION

In African tropical environments, dust mite sensitization in children followed for respiratory allergy is frequent, with the order of frequency being: B. tropicalis, D. pteronyssinus, and D. farinae. The prick-test had better sensitivity than the assay for its evaluation.

Synthesis, structure-activity relationships, and pharmacological profile of 9-amino-4-oxo-1-phenyl-3,4,6,7-tetrahydro[1,4]diazepino[6, 7,1-hi]indoles: discovery of potent, selective phosphodiesterase type 4 inhibitors

The synthesis, structure-activity relationships, and biological properties of a novel series of potent and selective phosphodiesterase type 4 (PDE4) inhibitors are described. These new aminodiazepinoindoles displayed in vitro PDE4 activity with submicromolar IC(50) values and PDE4 selectivity vs PDE1, -3, and -5. Specifically, one compound (CI-1044, 10e) provided efficient in vitro inhibition of TNFalpha release from hPBMC and hWB with IC(50) values of 0.34 and 0.84 microM, respectively. This compound was found to exhibit potent in vivo activity in antigen-induced eosinophil recruitment in Brown-Norway rats (ED(50) = 3.2 mg/kg po) and in production of TNFalpha in Wistar rats (ED(50) = 2.8 mg/kg po). No emetic side effects at therapeutic doses were observed in ferrets.

Levofloxacin: serum bactericidal activity against methicillin-resistant Staphylococcus aureus isolates

The aim of this study was to assess the serum bactericidal activity (SBA) of levofloxacin compared with that of ofloxacin against methicillin-resistant Staphylococcus aureus (MRSA) isolates. Serum from 10 healthy volunteers (seven females, three males) was collected after a single oral dose of either levofloxacin (500 mg) or ofloxacin (400 mg). Subjects were allocated randomly to treatment after at least a 1 week interval between antibiotic regimens. Three well-defined MRSA strains were tested, each susceptible to levofloxacin and ofloxacin, with different levels of resistance to methicillin (HBD 456, HBD 3 and HBD 2; class 1, 2 and 3 Tomasz heterogeneous resistance, respectively) together with a methicillin-susceptible (MSSA) reference strain (S. aureus ATCC 25,923). SBA was tested in vitro by a microtitration method 15 min before dosing and at 1, 4, 8 and 12 h after drug absorption. Levofloxacin was significantly more bactericidal than ofloxacin against all strains of S. aureus tested (SBA > or = 1:2). An SBA was recorded for only a short period with ofloxacin, and thereafter only bacteriostatic activity remained. This study, therefore, confirms the superior activity of levofloxacin over that of ofloxacin against MSSA and MRSA.

[Bleeding on probing. Significance--consequences]

Bleeding on probing is one of the techniques for evaluation of the periodontal pocket tissues condition. Bleeding, leading sign of inflammation inside the connective tissue, is a critical factor for pocket depth measurements, and with other variable factors prevents making reproducible measurements. With the concept of periodontal disease with asynchronous bursts of activity and period of remission, has appeared the necessity to determine and even to predict the presence of destructive activity just as it occurs in a particular site in order to set up a selective therapy. Many authors investigated for a correlation between destructive activity and bleeding on probing. At the present time, the development of manual or electronic probes provides a useful diagnostic aid for the clinician in daily practice as well as the researcher in longitudinal studies.

[Radiographic evaluation in periodontology: development of technics]

The recent development of digital imaging techniques for the analysis of dental radiographs provides an improved method for quantifying subtle changes in alveolar bone. The major application of this methodology appears to be in clinical trials.

Embryogenèse somatique a partir de cultures issues de protoplastes foliaires de Ranunculus sceleratus

Following preliminary experiments, studies on isolation and culture of Ranunculus sceleratus L. leaf protoplasts were performed to specify conditions inducing embryogenesis. The best developmental stage for obtaining protoplasts was the second unfolded leaf; protoplasts were incubated in cellulase Onozuka R 10 (0.1%), Driselase (0.05%), Macerozyme R 10 (0.02%), glucose (8.9%), and Murashige and Skoog major salts (×0.5) or calcium chloride (220 mg/L), yielding 8 × 105 viable protoplasts per leaf; the best inoculum has 35 × 103 protoplasts/mL, protoplasts were cultured in 1-naphthaleneacetic acid (NAA) (3 mg/L), 6-benzylaminopurine (1 mg/L), modified Heller's micronutrients, Morel's vitamins, calcium nitrate (400 mg/L), and glutamine (100 mg/L). Although survival of protoplasts was as high as 80%, only 3% of the cells divide after 3 weeks. After subculturing the suspensions embryogenesis proceeded rapidly. Use of NAA (3 mg/L) or spreading cell cultures on solid medium delays the process. Following induction, cultures become habituated; continuous embryogenesis results from the differentiation of secondary embryos arising directly from primary embryo epidermis. The capacity for embryogenesis, however, diminishes after several subcultures, particularly if media are supplemented with growth regulators. Although growth of many embryos is inhibited, most plantlets subsequently develop normally. Thus, while we have demonstrated embryogenic capacity in suspension cultures derived from mesophyll protoplasts, direct development of somatic embryos from protoplasts remains to be shown.

Bourgeonnement in vitro a partir d'épiderme séparé de feuille de Bryophyllum Daigremontianum (Crassulacées)

The lower epidermis from leaves of Bryophyllum Daigremontianum Berger has been mechanically separated and cultured in liquid or solid medium; cytokinin and auxin in combination have been necessary to obtain a lamellar callus, with the Murashige and Skoog's macroelements being more efficient than White's, Knop's, or Lin and Staba's. Numerous buds have been initiated after 3 or 4 weeks, especially with naphthaleneacetic acid (1 mg/litre) in combination with 6-benzylaminopurine (0.2 mg/litre). The best results for bud formation have been obtained with the epidermis of the first and second well developed leaves. The buds, rooted in vitro, developed into normal plants. The histological study has showed that the callus was originated only from the banal epidermal cells. The stomatic cells have not been activated and died. The other tissues of the leaf have never produced any bud in the same culture conditions; then, as for other species, the epidermis has a greater ability to initiate a budding programme.