Male patients commencing FOLFOX / FOLFIRI chemotherapy in 2014, descriptive statistics

Background: Metastatic colorectal cancer is an incurable illness; however the advent of chemotherapy has significantly improved survival and symptom control. FOLFOX and FOLFIRI are used at SPBOH as the standard of care for patients with metastatic disease. No statistical data is available on that cohort of patients; this study aims to establish a population data-set for patients on FOLFOX/FOLFIRI. Methods: This retrospective cross-sectional study included all patients on FOLFOX and FOLFIRI in 2014. Only male patients were included, data was retrospectively extracted from the ward’s logbook and ISOFT clinical manager. Cycle 1, 6 and 12 dates were documented. Data was analysed using clinically reliable statistical tools, all reported p-values were statistically significant at <0.05. Results: From a total of 108 patients, 4 patients were excluded from the analysis. The average age of patients was 65.2 years. The average length of 12 cycles was 24.5 weeks. 19% of patients had cycles longer than 7 months whereas only 10% lasted more than 8 months on treatment. 41% of patients dropped out before completing the full course with a complication and mortality rate of 17%. Patients on FOLFIRI were more likely to have their chemotherapy changed and were also more likely to have received previous treatment. Conclusion: Although chemotherapy increases survival in metastatic colorectal cancer we have to appreciate that many patients do not proceed smoothly with their treatment. Many of those patients are middle aged independent individuals, after-all the physician must draw the line at the appropriate time and focus on palliative care rather than continuing ineffectively with chemotherapy.peer-reviewe

Neoadjuvant Trastuzumab Emtansine and Pertuzumab in Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer: Three-Year Outcomes From the Phase III KRISTINE Study.

PurposeThe KRISTINE study compared neoadjuvant trastuzumab emtansine plus pertuzumab (T-DM1+P) with docetaxel, carboplatin, trastuzumab plus P (TCH+P) for the treatment human epidermal growth factor receptor 2-positive stage II to III breast cancer. T-DM1+P led to a lower pathologic complete response rate (44.4% v 55.7%; P = .016), but fewer grade 3 or greater and serious adverse events (AEs). Here, we present 3-year outcomes from KRISTINE.MethodsPatients were randomly assigned to neoadjuvant T-DM1+P or TCH+P every 3 weeks for six cycles. Patients who received T-DM1+P continued adjuvant T-DM1+P, and patients who received TCH+P received adjuvant trastuzumab plus pertuzumab. Secondary end points included event-free survival (EFS), overall survival, patient-reported outcomes (measured from random assignment), and invasive disease-free survival (IDFS; measured from surgery).ResultsOf patients, 444 were randomly assigned (T-DM1+P, n = 223; TCH+P, n = 221). Median follow-up was 37 months. Risk of an EFS event was higher with TDM-1+P (hazard ratio [HR], 2.61 [95% CI, 1.36 to 4.98]) with more locoregional progression events before surgery (15 [6.7%] v 0). Risk of an IDFS event after surgery was similar between arms (HR, 1.11 [95% CI, 0.52 to 2.40]). Pathologic complete response was associated with a reduced risk of an IDFS event (HR, 0.24 [95% CI, 0.09 to 0.60]) regardless of treatment arm. Overall, grade 3 or greater AEs (31.8% v 67.7%) were less common with T-DM1+P. During adjuvant treatment, grade 3 or greater AEs (24.5% v 9.9%) and AEs leading to treatment discontinuation (18.4% v 3.8%) were more common with T-DM1+P. Patient-reported outcomes favored T-DM1+P during neoadjuvant treatment and were similar to trastuzumab plus pertuzumab during adjuvant treatment.ConclusionCompared with TCH+P, T-DM1+P resulted in a higher risk of an EFS event owing to locoregional progression events before surgery, a similar risk of an IDFS event, fewer grade 3 or greater AEs during neoadjuvant treatment, and more AEs leading to treatment discontinuation during adjuvant treatment

The space density of Compton-thick AGN at z~0.8 in the zCOSMOS-Bright Survey

The obscured accretion phase in BH growth is a key ingredient in many models linking the AGN activity with the evolution of their host galaxy. At present, a complete census of obscured AGN is still missing. The purpose of this work is to assess the reliability of the [NeV] emission line at 3426 A to pick up obscured AGN up to z~1 by assuming that [NeV] is a reliable proxy of the intrinsic AGN luminosity and using moderately deep X-ray data to characterize the amount of obscuration. A sample of 69 narrow-line (Type 2) AGN at z=0.65-1.20 were selected from the 20k-zCOSMOS Bright galaxy sample on the basis of the presence of the [NeV] emission. The X-ray properties of these galaxies were then derived using the Chandra-COSMOS coverage of the field; the X-ray-to-[NeV] flux ratio, coupled with X-ray spectral and stacking analyses, was then used to infer whether Compton-thin or Compton-thick absorption were present in these sources. Then the [NeV] luminosity function was computed to estimate the space density of Compton-thick (CT) AGN at z~0.8. Twenty-three sources were detected by Chandra, and their properties are consistent with moderate obscuration (on average, ~a few 10^{22} cm^-2). The X-ray properties of the remaining 46 X-ray undetected Type 2 AGN were derived using X-ray stacking analysis. Current data indicate that a fraction as high as ~40% of the present sample is likely to be CT. The space density of CT AGN with logL_2-10keV>43.5 at z=0.83 is (9.1+/-2.1) 10^{-6} Mpc^{-3}, in good agreement with both XRB model expectations and the previously measured space density for objects in a similar redshift and luminosity range. We regard our selection technique for CT AGN as clean but not complete, since even a mild extinction in the NLR can suppress [NeV] emission. Therefore, our estimate of their space density should be considered as a lower limit.Comment: 10 pages, 7 figures, 2 tables, A&A, in pres