Underuse of Anthracyclines in Women with HER-2+ Advanced Breast Cancer

This article examines how discouraging the use of anthracyclines in combination with trastuzumab in patients with human epidermal growth factor receptor 2 positive metastatic breast cancer because of fears of cardiotoxicity has influenced the use of these agents in this patient setting

Vinorelbine-based salvage therapy in HER2-positive metastatic breast cancer patients progressing during trastuzumab-containing regimens: a retrospective study

<p>Abstract</p> <p>Background</p> <p>The vinka-alkaloyd vinorelbine is a potentially valuable treatment in patients with HER2-positive, trastuzumab-resistant advanced breast cancer. We sought to document the clinical activity of vinorelbine-based salvage treatments in this clinical setting.</p> <p>Methods</p> <p>We analyzed a cohort of 424 consecutive women receiving trastuzumab-based therapy for HER2-positive advanced breast cancer. Of these, 299 were identified as progressing during the initial trastuzumab-based treatment, and 77 received vinorelbine-based therapy as first salvage treatment. Central review of pathological specimens revealed that 70 patients had HER2-amplification detected by FISH. For these patients we determined overall response rate (ORR = complete-CR + partial-PR) and clinical benefit (CB = CR+PR+ Stable disease lasting at least 6 months), time to progression (TTP) and overall survival (OS) from the initiation of vinorelbine-based salvage therapy.</p> <p>Results</p> <p>In 60 patients who were evaluable for tumor response, ORR and CB rates were 28% (95% C.I. 18%-41%) and 50% (95% C.I. 38%-62%), respectively. Median follow-up from the initiation of salvage therapy was 15 months (range 1–63 months). Median TTP and OS were 7.1 months (95% C.I. 6.6–7.7 months) and 21 months (95% C.I. 14.3–27.7 months), respectively. No differences in clinical outcomes were observed according to whether vinorelbine was administered as a single agent or in combination with other cytostatics, or whether trastuzumab was stopped or continued beyond disease progression.</p> <p>Conclusion</p> <p>our findings suggests that vinorelbine-based combinations are active and should be further evaluated in studies conducted in trastuzumab-resistant patients, including those evaluating newer HER2-targeting agents.</p

Dati e percezioni sullo sviluppo di una comunità di pratica online di docenti: il caso della scuola "Don Milani"

Dal 2005 nella scuola secondaria di primo grado sperimentale “Don Milani” di Genova è presente un sistema di comunicazione - cooperazione professionale a distanza, sviluppato su una piattaforma di comunicazione online alla quale è tenuto ad accedere tutto il personale docente. L’ipotesi di questo studio è che il sistema di comunicazione online abbia, nel tempo, incrementato la costruzione di un’identità collettiva, culturale e professionale, attraverso l’osmosi di buone pratiche e saperi, qualificando i processi partecipativi, bilanciando l’attività in presenza e a distanza. Per valutare l’evoluzione della comunità Don Milani, abbiamo svolto una ricerca partecipata, realizzando un’analisi degli scambi di messaggi sui forum e un questionario ad hoc per i docenti. Dal confronto dei dati quantitativi e qualitativi, si rilevano sia il progressivo consolidamento della dimensione partecipativa, sia la graduale formazione di una comunità di pratica fondata sulla collaborazione

and Paolo ViarengoHerding and clustering in Economics: the

February 2005 The clustering of agents in the market is a typical problem discussed by the new approaches to macroeconomic modelling, that describe macroscopic variables in terms of the behavior of a large collection of microeconomic entities. Clustering is often described by Ewens Sampling Formula (ESF), that admits a very nice interpretation in terms of rational vs herding behavior. Focusing on the evergreen problem of the size of …rms, we discuss the incompatibility between empirical data and ESF. An alternative model is suggested, inspired to Simon’s approaches to the …rm size problem. It di¤ers from the Ewens model both in destruction and in creation. In particular the probability of herding is independent on the size of the herd. This very simple assumption destroys the exchangeability of the random partitions, and forbids an analytical solution. Simple computational simulations look to con…rm that actually the mean number of clusters of size i (the equilibrium distribution) follows the corresponding Yule distribution. Finally we introduce a Markov chain, that resembles the marginal dynamics of a cluster, which drives the cluster to the right-censored Yule distribution