Response to imatinib rechallenge in a patient with a recurrent gastrointestinal stromal tumor after adjuvant therapy: a case report

<p>Abstract</p> <p>Introduction</p> <p>Adjuvant imatinib improves recurrence-free survival of patients following resection of primary KIT-positive gastrointestinal stromal tumors. However, it is unknown whether patients who previously received adjuvant imatinib therapy will respond to imatinib rechallenge as treatment for recurrent disease. Here we present the first report documenting the benefits of imatinib rechallenge in a patient previously exposed to imatinib during adjuvant treatment.</p> <p>Case presentation</p> <p>A 51-year-old Asian woman with a wedge-resected primary gastric gastrointestinal stromal tumor at high risk of relapse underwent two years of adjuvant treatment with imatinib. Only 10 months after the completion of adjuvant imatinib treatment, a computed tomography scan revealed gastrointestinal stromal tumor recurrence in this patient, with multiple peritoneal nodules in the upper abdomen being detected. Our patient was rechallenged with imatinib 400 mg/day and had a partial response after one month of treatment. Imatinib rechallenge was well tolerated by our patient; the only adverse events she experienced were grade 1 edema, anemia and fatigue. Our patient maintained a partial response two years and six months after the imatinib rechallenge. However, computed tomography scans three months later showed that our patient had disease progression.</p> <p>Conclusions</p> <p>This case report demonstrates that a patient with a gastrointestinal stromal tumor who had previously received adjuvant imatinib therapy responded to imatinib rechallenge as treatment for her recurrent disease. These results indicate that imatinib sensitivity can be maintained in a patient with previous exposure to adjuvant imatinib therapy.</p

RNA profiling of cyclooxygenases 1 and 2 in colorectal cancer

Cyclooxygenases (particularily Cox-2) are involved in carcinogenesis and metastatic cancer progression. The expression profiles of the cyclooxygenases and the roles they play in established tumours of similar stage remains unclear. We report that Cox-1 and Cox-2 expression is highly variable in Dukes' C tumours, and changes in Cox-1 expression may be of importance

The role of the right temporoparietal junction in perceptual conflict: detection or resolution?

The right temporoparietal junction (rTPJ) is a polysensory cortical area that plays a key role in perception and awareness. Neuroimaging evidence shows activation of rTPJ in intersensory and sensorimotor conflict situations, but it remains unclear whether this activity reflects detection or resolution of such conflicts. To address this question, we manipulated the relationship between touch and vision using the so-called mirror-box illusion. Participants' hands lay on either side of a mirror, which occluded their left hand and reflected their right hand, but created the illusion that they were looking directly at their left hand. The experimenter simultaneously touched either the middle (D3) or the ring finger (D4) of each hand. Participants judged, which finger was touched on their occluded left hand. The visual stimulus corresponding to the touch on the right hand was therefore either congruent (same finger as touch) or incongruent (different finger from touch) with the task-relevant touch on the left hand. Single-pulse transcranial magnetic stimulation (TMS) was delivered to the rTPJ immediately after touch. Accuracy in localizing the left touch was worse for D4 than for D3, particularly when visual stimulation was incongruent. However, following TMS, accuracy improved selectively for D4 in incongruent trials, suggesting that the effects of the conflicting visual information were reduced. These findings suggest a role of rTPJ in detecting, rather than resolving, intersensory conflict

FCNC Effects in a Minimal Theory of Fermion Masses

As a minimal theory of fermion masses we extend the SM by heavy vectorlike fermions, with flavor-anarchical Yukawa couplings, that mix with chiral fermions such that small SM Yukawa couplings arise from small mixing angles. This model can be regarded as an effective description of the fermionic sector of a large class of existing flavor models and thus might serve as a useful reference frame for a further understanding of flavor hierarchies in the SM. Already such a minimal framework gives rise to FCNC effects through exchange of massive SM bosons whose couplings to the light fermions get modified by the mixing. We derive general formulae for these corrections and discuss the bounds on the heavy fermion masses. Particularly stringent bounds, in a few TeV range, come from the corrections to the Z couplings.Comment: 19 pages, 1 figur

Treatment of gastrointestinal stromal tumours in paediatric and young adult patients with sunitinib: a multicentre case series

Background: Gastrointestinal stromal tumours (GIST) are rarely encountered mesenchymal tumours of the gastrointestinal tract (1.5 people per 100,000/year) that are even more rarely seen in paediatric patients (1-2% of all cases). The standard treatment for advanced adult GIST is imatinib with sunitinib as a second-line option. Although the efficacy and tolerability of sunitinib in adults with GIST has been established, little is known of the profile of sunitinib in paediatric/young adult patients with GIST given the rarity of this disease. Methods: Paediatric/young adult patients aged up to 21 years with diagnosis of GIST who were treated with sunitinib were identified from retrospective records from three centres in Europe and the US. Most patients commenced sunitinib in a 6-week cycle, however, dosing could be reduced, delayed, changed to (or initiated with) a continuous schedule. Objective response (Response Evaluation Criteria In Solid Tumours [RECIST]) and adverse events were recorded. Results: We identified 9 paediatric/young adult patients (aged 11-21 years) with GIST who were treated with sunitinib de novo (n = 1) or following failure of imatinib (n = 8). Progressive disease was previously documented for all patients including 7 patients during imatinib therapy. Baseline patient and tumour profile characteristics showed a distinct profile (notably all were wild-type KIT/PDGFR) compared to that established for adults. Sunitinib treatment was associated with a best response of stable disease for 7 patients, with disease stabilisation lasting from 1 month to > 73 months and a median progression free survival time of 15 months. There was some evidence of better disease control for sunitinib when compared to prior imatinib. Most adverse events with sunitinib were manageable and all were consistent with the known profile of the agent. Conclusion: The ability to draw firm conclusions from this case series is limited by the small number of patients and the use of retrospective data which is largely reflective of the rarity of this condition. However, our findings provide initial evidence of clinical benefit and a generally manageable toxicity profile for sunitinib when administered to paediatric/young adult patients with GIST, most of whom had documented progressive disease during prior imatinib treatment

A Comparative Study of Contributions to ϵK\epsilon_K in the RS Model

We contrast the impact of Higgs mediated flavor changing neutral currents on epsilon_K in the framework of a warped extra dimension that was recently calculated by Azatov et al. with the older results for Kaluza-Klein gluon induced corrections to that observable. We find that the most stringent constraint on the KK scale for a Higgs field localized on the infrared brane for reasonable additional assumptions comes from KK gluon exchange. In the case of a bulk Higgs field we show that for certain scenarios the Higgs contribution can in fact exceed the KK gluon contribution. In the course of this analysis we also describe in detail the different renormalization procedures that have to be employed in the KK gluon and Higgs cases to relate the new physics at high energies to low energy observables.Comment: 13 pages, 5 figures. Extended discussion, references added, typos correcte

Primary omental Gastrointestinal stromal tumor (GIST)

This is an Open Access article distributed under the terms of the Creative Commons Attribution Licens

A fourth generation, anomalous like-sign dimuon charge asymmetry and the LHC

A fourth chiral generation, with $m_{t^\prime}$ in the range $\sim (300 - 500)$ GeV and a moderate value of the CP-violating phase can explain the anomalous like-sign dimuon charge asymmetry observed recently by the D0 collaboration. The required parameters are found to be consistent with constraints from other $B$ and $K$ decays. The presence of such quarks, apart from being detectable in the early stages of the LHC, would also have important consequences in the electroweak symmetry breaking sector.Comment: 18 pages, 9 figures, Figure 1 is modified, more discussions are added in section 2. new references adde