Vinorelbine/carboplatin vs gemcitabine/carboplatin in advanced NSCLC shows similar efficacy, but different impact of toxicity

This randomised phase III study in advanced non-small cell lung cancer (NSCLC) patients was conducted to compare vinorelbine/carboplatin (VC) and gemcitabine/carboplatin (GC) regarding efficacy, health-related quality of life (HRQOL) and toxicity. Chemonaive patients with NSCLC stage IIIB/IV and WHO performance status 0–2 were eligible. No upper age limit was defined. Patients received vinorelbine 25 mg m−2 or gemcitabine 1000 mg m−2 on days 1 and 8 and carboplatin AUC4 on day 1 and three courses with 3-week cycles. HRQOL questionnaires were completed at baseline, before chemotherapy and every 8 weeks until 49 weeks. During 14 months, 432 patients were included (VC, n=218; GC, n=214). Median survival was 7.3 vs 6.4 months, 1-year survival 28 vs 30% and 2-year survival 7 vs 7% in the VC and GC arm, respectively (P=0.89). HRQOL, represented by global QOL, nausea/vomiting, dyspnoea and pain, showed no significant differences. More grade 3–4 anaemia (P<0.01), thrombocytopenia (P<0.01) and transfusions of blood (P<0.01) or platelets (P<0.01) were observed in the GC arm. There was more grade 3–4 leucopoenia (P<0.01) in the VC arm, but the rate of neutropenic infections was the same (P=0.87). In conclusion, overall survival and HRQOL are similar, while grade 3–4 toxicity requiring interventions are less frequent when VC is compared to GC in advanced NSCLC

Development of a risk-based environmental management tool for drilling discharges. Summary of a four-year project

This paper briefly summarizes the ERMS project and presents the developed model by showing results from environmental fates and risk calculations of a discharge from offshore drilling operations. The developed model calculates environmental risks for the water column and sediments resulting from exposure to toxic stressors (e.g., chemicals) and nontoxic stressors (e.g., suspended particles, sediment burial). The approach is based on existing risk assessment techniques described in the European Union technical guidance document on risk assessment and species sensitivity distributions. The model calculates an environmental impact factor, which characterizes the overall potential impact on the marine environment in terms of potentially impacted water volume and sediment area. The ERMS project started in 2003 and was finalized in 2007. In total, 28 scientific reports and 9 scientific papers have been delivered from the ERMS project (http://www.sintef.no/erms)