Metronomic Oral Vinorelbine: An Alternative Schedule in Elderly and Patients PS2 With Local/Advanced and Metastatic NSCLC Not Oncogene-addicted

The MILES and ELVIS studies showed that vinorelbine is one of the best options for elderly patients with advanced non-small-cell-lung cancer (NSCLC). Oral vinorelbine at standard schedule (60-80 mg/m2/weekly) has good activity in terms of response rates and progression-free survival. In recent years, a metronomic schedule of oral vinorelbine (40-50 mg/m2 three times a week, continuously) has been studied in phase II trials, especially in unfit and elderly patients. In the MOVE trial metronomic oral vinorelbine had a clinical benefit [partial response (PR)+stable disease (SD) >12 weeks] in 58.1% of patients with mild toxicity. On this basis, in 2017 we started a phase II study with metronomic oral vinorelbine in elderly (over 70 years) or unfit [Eastern Cooperative Oncology Group performance score (ECOG-PS) of 2] patients with locally/advanced and metastatic NSCLC. Primary aims were clinical benefit (PR+SD ≥6 months) and toxicity; secondary aims were progression-free survival and overall survival

Transport of Stratospheric Air Masses to the Nepal Climate Observatory–Pyramid (Himalaya; 5079 m MSL): A Synoptic-Scale Investigation

AbstractThis work analyzes and classifies stratospheric airmass transport events (ST) detected at the Nepal Climate Observatory–Pyramid (NCO-P; 27°57′N, 86°48′E, 5079 m MSL) Global Atmospheric Watch–World Meteorological Organization station from March 2006 to February 2008. For this purpose, in situ ozone (O3), meteorological parameters (atmospheric pressure and relative humidity), and black carbon (BC) are analyzed. The paper describes the synoptic-scale meteorological scenarios that are able to favor the development of ST over the southern Himalaya, by analyzing the meteorological fields provided by the ECMWF model (geopotential height, wind speed, and potential vorticity), satellite Ozone Monitoring Instrument data (total column ozone), and three-dimensional back trajectories calculated with the Lagrangian Analysis Tool (LAGRANTO) model. The study, which represents the first "continuous" classification of ST in the southern Himalaya, permitted classification of 94% of ST days within four synoptic-scale scenarios: stratospheric potential vorticity structures (PVS), subtropical jet stream (SJS), quasi-stationary ridges (QSR), and monsoon depressions (MD). SJS and PVS were the most frequent scenarios (48% and 30% of occurrences, respectively), QSR occurred for 12% of the ST days, and MD were detected only during the monsoon season (3%). SJS and PVS scenarios presented a peak frequency during the nonmonsoon seasons, when the jet stream and westerly disturbances influence atmospheric circulation over the southern Himalaya. During the identified ST, significant variations of O3 (+24%) and BC (−56%) were recorded relative to the averaged 2-yr mean values. On average, PVS and SJS were the most effective synoptic-scale scenarios in modifying the O3 and BC levels at NCO-P from postmonsoon to premonsoon seasons, and ST is one of the leading processes in defining the "background" BC variability at NCO-P

Characterization of snowfall estimated by in situ and ground-based remote-sensing observations at Terra Nova Bay, Victoria Land, Antarctica

AbstractKnowledge of the precipitation contribution to the Antarctic surface mass balance is essential for defining the ice-sheet contribution to sea-level rise. Observations of precipitation are sparse over Antarctica, due to harsh environmental conditions. Precipitation during the summer months (November–December–January) on four expeditions, 2015–16, 2016–17, 2017–18 and 2018–19, in the Terra Nova Bay area, were monitored using a vertically pointing radar, disdrometer, snow gauge, radiosounding and an automatic weather station installed at the Italian Mario Zucchelli Station. The relationship between radar reflectivity and precipitation rate at the site can be estimated using these instruments jointly. The error in calculated precipitation is up to 40%, mostly dependent on reflectivity variability and disdrometer inability to define the real particle fall velocity. Mean derived summer precipitation is ~55 mm water equivalent but with a large variability. During collocated measurements in 2018–19, corrected snow gauge amounts agree with those derived from the relationship, within the estimated errors. European Centre for the Medium-Range Weather Forecasts (ECMWF) and the Antarctic Mesoscale Prediction System (AMPS) analysis and operational outputs are able to forecast the precipitation timing but do not adequately reproduce quantities during the most intense events, with overestimation for ECMWF and underestimation for AMPS

Personalization of regorafenib treatment in metastatic gastrointestinal stromal tumours in real-life clinical practice

Background: Regorafenib (REG) has now been approved as the standard third-line therapy in metastatic gastrointestinal stromal tumour (GIST) patients at the recommended dose and schedule of 160 mg once daily for the first 3 weeks of each 4-week cycle. However, it has a relevant toxicity profile that mainly occurs within the first cycles of therapy, and dose and schedule adjustments are often required to reduce the frequency or severity of adverse events and to avoid early treatment discontinuation. To date, large amounts of data on the use of REG in metastatic GIST patients in daily clinical practice are not available, and we lack information about how this treatment personalization really affects the quality of life (QoL) of patients. The aim of the present retrospective study is to build a comprehensive picture of all alternative REG strategies adopted in daily clinical practice for use in metastatic GIST patients. Methods: Metastatic GIST patients treated with dose adjustment or alternative schedules of REG at seven reference Italian centres were retrospectively included. Results: For a total of 62 metastatic GIST patients, we confirmed that REG treatment adjustment is common in clinical practice and that it is very heterogeneous, with approximately 20 different strategies being adopted. Independent of which strategy is chosen, treatment personalization has led to a clinical benefit defined as complete or partial resolution of side effects in almost all patients, affecting the duration of REG treatment. Conclusions: The personalization of REG, even if it is heterogeneous, seems to be crucial to maximize the overall treatment duration

Hepatitis C and Non-Hodgkin Lymphoma Among 4784 Cases and 6269 Controls From the International Lymphoma Epidemiology Consortium

Background & Aims: increasing evidence points towards a role of hepatitis C virus (HCV) infection in causing malignant lymphomas. We pooled case-control study data to provide robust estimates of the risk of non-Hodgkin's lymphoma (NHL) subtypes after HCV infection. Methods: The analysis included 7 member studies from the International Lymphoma Epidemiology Consortium (InterLymph) based in Europe, North America, and Australia. Adult cases of NHL (n = 4784) were diagnosed between 1988 and 2004 and controls (n = 6269) were matched by age, sex, and study center. All studies used third-generation enzyme-linked immunosorbent assays to test for antibodies against HCV in serum samples. Participants who were human immunodeficiency virus positive or were organ-transplant recipients were excluded. Results: HCV infection was detected in 172 NHL cases (3.60%) and in 169 (2.70%) controls (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.40 -2.25). In subtype-specific analyses, HCV prevalence was associated with marginal zone lymphoma (OR, 2.47; 95% CI, 1.44-4.23), diffuse large B-cell lymphoma (OR, 2.24; 95% CI, 1.682.99), and lymphoplasmacytic lymphoma (OR, 2.57; 95% CI, 1.14-5.79). Notably, risk estimates were not increased for follicular lymphoma (OR, 1.02; 95% CI, 0.65-1.60). Conclusions: These results confirm the association between HCV infection and NHL and specific B-NHL subtypes (diffuse large B-cell lymphoma, marginal zone lymphoma, and lymphoplasmacytic lymphoma)