398 research outputs found
Dynamic effective anisotropy: Asymptotics, simulations, and microwave experiments with dielectric fibers
International audienceWe investigate dynamic effective anisotropy in photonic crystals (PCs) through a combination of an effective medium theory, which is a high-frequency homogenization (HFH) method explicitly developed to operate for short waves, as well as through numerical simulations and microwave experiments. The HFH yields accurate predictions of the effective anisotropic properties of periodic structures when the wavelength is of comparable order to the pitch of the array; specifically, we investigate a square array of pitch 2 cm consisting of dielectric rods of radius 0.5 cm and refractive index n=6√ within an air matrix. This behaves as an effective medium, with strong artificial anisotropy, at a frequency corresponding to a flat band emerging from a Dirac-like point in transverse magnetic (TM) polarization. At this frequency, highly directive emission is predicted for an electric source placed inside this PC, and this artificial anisotropy can be shown to coincide with a change of character of the underlying effective equation from isotropic to unidirective, with coefficients of markedly different magnitudes appearing in the effective equation tensor. In transverse electric (TE) polarization, we note a second radical change of character of the underlying effective equation, this time from elliptic to hyperbolic, near a frequency at which a saddle point occurs in the corresponding dispersion curves. Delicate microwave experiments are performed in both polarizations for such a PC consisting of 80 rods, and we demonstrate that a directive emission in the form of a + (respectively, an X) is indeed seen experimentally at the predicted frequency 9.5 GHz in TM polarization (respectively, 5.9 GHz in TE polarization). These are clearly dynamic effects since in the quasistatic regime the PC just behaves as an isotropic medium
Pemetrexed plus carboplatin in elderly patients with malignant pleural mesothelioma: combined analysis of two phase II trials
The incidence of malignant pleural mesothelioma (MPM) in elderly patients is increasing. In this study, pooled data from two phase II trials of pemetrexed and carboplatin (PC) as first-line therapy were retrospectively analysed for comparisons between age groups. Patients received pemetrexed 500 mg m−2 and carboplatin AUC 5 mg ml−1 min−1 intravenously every 21 days with standard vitamin supplementation. Elderly patients were defined as those ⩾70 years old. A total of 178 patients with an ECOG performance status of ⩽2 were included. Median age was 65 years (range 38–79), with 48 patients ⩾70 years (27%). Grade 3–4 haematological toxicity was slightly worse in ⩾70 vs <70-year-old patients, with neutropenia observed in 25.0 vs 13.8% (P=0.11), anaemia in 20.8 vs 6.9% (P=0.01) and thrombocytopenia in 14.6 vs 8.5% (P=0.26). Non-haematological toxicity was mild and similar in the two groups. No significant difference was observed in terms of overall disease control (60.4 vs 66.9%, P=0.47), time to progression (7.2 vs 7.5 months, P=0.42) and survival (10.7 vs 13.9 months, P=0.12). Apart from slightly worse haematological toxicity, there was no significant difference in outcome or toxicity between age groups. The PC regimen is effective and well tolerated in selected elderly patients with MPM
Metronomic oral vinorelbine in previously untreated advanced non-small-cell lung cancer patients unfit for platinum-based chemotherapy: results of the randomized phase II Tempo Lung trial
[Background] To assess the efficacy and safety of a metronomic schedule of oral vinorelbine (mVNR) in advanced non-small-cell lung cancer (NSCLC) in patients unfit for platinum-based combination chemotherapy.[Patients and methods] This was a multicenter, prospective, randomized, open-label phase II study in treatment-naive patients with TNM stage IIIB/IV NSCLC. Patients received mVNR at a fixed dose of 50 mg × 3 or standard schedule 60-80 mg/m2 weekly until disease progression or unacceptable toxicity. The primary endpoint was progression-free survival (PFS) without grade 4 toxicity (G4PFS; NCI-CTC v4). Main secondary objectives were safety, disease control rate (DCR) without grade 4 toxicity (G4DCR), DCR, PFS, overall survival (OS) and quality of life (QoL).[Results] A total of 167 patients were included, 83 and 84 patients in the mVNR and standard arms, respectively. The median G4PFS was 4.0 months [95% confidence interval (CI): 2.6-4.3] and 2.2 months (95% CI: 1.5-2.9), hazard ration (HR) = 0.63 (95% CI: 0.45-0.88), P = 0.0068 in favor of metronomic arm; G4DCR was 45.8% and 26.8% in the mVNR and standard arms, respectively. Grade 3-4 treatment-related adverse events were less frequent in the mVNR arm (25.3% versus 54.4%) mainly owing to a reduction in all grades (15.7% versus 51.9%) and grade 3-4 neutropenia (10.8% versus 42%). PFS was 4.3 (95% CI: 3.3-5.1) and 3.9 months (95% CI: 2.8-5.2) in mVNR and standard arms, respectively. No difference in median OS was observed. QoL was comparable between arms.[Conclusions] Metronomic oral vinorelbine significantly prolonged median G4PFS in advanced NSCLC patients unfit for platinum combinations as first-line treatment. It was associated with a clear reduction in toxicity and may be considered as an important option in this challenging population.Pierre Fabre Médicament was the Sponsor of the study. The study was funded by Pierre Fabre Médicament. Conduct of the study: Pierre Fabre Médicament with the support of Clinipace clinical research organization (CRO) for the monitoring, of C-Med (CRO) for the data management and statistical analyses.Peer reviewe
STELLAR: Final updated results of a phase II trial of TTFields with chemotherapy for unresectable malignant pleural mesothelioma
Background: Tumor Treating Fields (TTFields), an anti-mitotic, regional treatment
approved for glioblastoma utilizes low intensity, alternating electric fields delivered
non-invasively to the tumor using a portable medical device. In-vitro, human mesothelioma cells were highly susceptible to TTFields.
Methods: The trial accrued 80 patients with unresectable, previously untreated mesothelioma. Patients were treated with continuous 150 kHz TTFields (>18h/day) in combination with pemetrexed and cisplatin or carboplatin. Inclusion criteria included
ECOG PS of 0-1 and pathologically proven mesothelioma. The primary endpoint was
overall survival (OS). A visual analog scale was used to assess EOCG performance status
and cancer-related pain assessed until disease progression. The sample size provided
80% power with two-sided alpha of 0.05 to detect an increase in median OS of 5.5
months compared to historical controls (Vogelzang, JCO 2003).
Results: All 80 patients had a minimum follow up of 12 months. Median age was 67
(range 27-78), 84% were male and 44% (35 patients) had an ECOG PS of 1. 66% (53
patients) had epithelioid histology, similar to the Vogelzang study. Median OS was 18.2
months (95% CI 12.1-25.8) versus 12.1 months in the historical control. Median OS
for epithelioid patients was 21.2 months (95% CI 13.2-25.8). ECOG score was stable
during the first year of follow up. Median time to deterioration in performance status
was 13.1 months. Average score of pain was lower compared to baseline during the first
7 months of the treatment and was higher later on the study, with a median time to a
clinical significant 33% increase in pain of 8.4 months. No device-related serious
adverse events (AEs) were reported. Expected TTFields-related dermatitis was reported
in 46% (37 patients). Four patients (5%) had grade 3 dermatitis.
Conclusions: The study met primary endpoint of significant extension of overall survival in previously untreated mesothelioma patients. TTFields was not associated with
a decrease in performance status or an increase in pain for the duration of TTFields use.
TTFields in combinati
Long-term benefit of lurbinectedin as palliative chemotherapy in progressive malignant pleural mesothelioma (MPM): final efficacy and translational data of the SAKK 17/16 study.
BACKGROUND
The SAKK 17/16 study showed promising efficacy data with lurbinectedin as second- or third-line palliative therapy in malignant pleural mesothelioma. Here, we evaluated long-term outcome and analyzed the impact of lurbinectedin monotherapy on the tumor microenvironment at the cellular and molecular level to predict outcomes.
MATERIAL AND METHODS
Forty-two patients were treated with lurbinectedin in this single-arm study. Twenty-nine samples were available at baseline, and seven additional matched samples at day one of cycle two of treatment. Survival curves and rates between groups were compared using the log-rank test and Kaplan-Meier method. Statistical significance was set at P value <0.05.
RESULTS
Updated median overall survival (OS) was slightly increased to 11.5 months [95% confidence interval (CI) 8.8-13.8 months]. Thirty-six patients (85%) had died. The OS rate at 12 and 18 months was 47% (95% CI 32.1% to 61.6%) and 31% (95% CI 17.8% to 45.0%), respectively. Median progression-free survival was 4.1 months (95% CI 2.6-5.5 months). No new safety signals were observed. Patients with lower frequencies of regulatory T cells, as well as lower tumor-associated macrophages (TAMs) at baseline, had a better OS. Comparing matched biopsies, a decrease of M2 macrophages was observed in five out of seven patients after exposure to lurbinectedin, and two out of four patients showed increased CD8+ T-cell infiltrates in tumor.
DISCUSSION
Lurbinectedin continues to be active in patients with progressing malignant pleural mesothelioma. According to our very small sample size, we hypothesize that baseline TAMs and regulatory T cells are associated with survival. Lurbinectedin seems to inhibit conversion of TAMs to M2 phenotype in humans
Quantum ESPRESSO: a modular and open-source software project for quantum simulations of materials
Quantum ESPRESSO is an integrated suite of computer codes for
electronic-structure calculations and materials modeling, based on
density-functional theory, plane waves, and pseudopotentials (norm-conserving,
ultrasoft, and projector-augmented wave). Quantum ESPRESSO stands for "opEn
Source Package for Research in Electronic Structure, Simulation, and
Optimization". It is freely available to researchers around the world under the
terms of the GNU General Public License. Quantum ESPRESSO builds upon
newly-restructured electronic-structure codes that have been developed and
tested by some of the original authors of novel electronic-structure algorithms
and applied in the last twenty years by some of the leading materials modeling
groups worldwide. Innovation and efficiency are still its main focus, with
special attention paid to massively-parallel architectures, and a great effort
being devoted to user friendliness. Quantum ESPRESSO is evolving towards a
distribution of independent and inter-operable codes in the spirit of an
open-source project, where researchers active in the field of
electronic-structure calculations are encouraged to participate in the project
by contributing their own codes or by implementing their own ideas into
existing codes.Comment: 36 pages, 5 figures, resubmitted to J.Phys.: Condens. Matte
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