Phase III trial of infusional fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI) compared with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI) as first-line treatment for metastatic colorectal cancer: The gruppo oncologico nord ovest

Purpose: The Gruppo Oncologico Nord Ovest (GONO) conducted a phase III study comparing fluorouracil, leucovorin, oxaliplatin, and irinotecan (FOLFOXIRI [irinotecan 165 mg/m2 day 1, oxaliplatin 85 mg/m2 day 1, leucovorin 200 mg/m2 day 1, fluorouracil 3,200 mg/m2 48-hour continuous infusion starting on day 1, every 2 weeks]) with infusional fluorouracil, leucovorin, and irinotecan (FOLFIRI). Methods: Selection criteria included unresectable metastatic colorectal cancer, age 18 to 75 years, and no prior chemotherapy for advanced disease. The primary end point was response rate (RR). Results: A total of 244 patients were randomly assigned. An increase of grade 2 to 3 peripheral neurotoxicity (0% v 19%; P < .001), and grade 3 to 4 neutropenia (28% v 50%; P < .001) were observed in the FOLFOXIRI arm. The incidence of febrile neutropenia (3% v 5%) and grade 3 to 4 diarrhea (12% v 20%) were not significantly different. Responses, as assessed by investigators, were, for FOLFIRI and FOLFOXIRI, respectively, complete, 6% and 8%; and partial, 35% and 58%, (RR, 41% v 66%; P = .0002). RR confirmed by an external panel was 34% versus 60% (P < .0001). The RO secondary resection rate of metastases was greater in the FOLFOXIRI arm (6% v 15%; P = .033, among all 244 patients; and 12% v 36%; P = .017 among patients with liver metastases only). Progression-free survival (PFS) and overall survival (OS) were both significantly improved in the FOLFOXIRI arm (median PFS, 6.9 v 9.8 months; hazard ratio [HR], 0.63; P = .0006; median OS, 16.7 v 22.6 months; HR, 0.70; P = .032). Conclusion: The FOLFOXIRI regimen improves RR, PFS, and OS compared with FOLFIRI, with an increased, but manageable, toxicity in patients with metastatic colorectal cancer with favorable prognostic characteristics. Further studies of FOLFOXIRI in combination with targeted agents and in the neoadjuvant setting are warranted. © 2007 by American Society of Clinical Oncology

Transfer reaction studies with spectrometers

The revival of transfer reaction studies benefited from the construction of the new generation large solid angle spectrometers, coupled to large \u3b3arrays. The recent results of \u3b3-particle coincident measurements in 40Ca+96Zr and 40Ar+208Pb reactions demonstrate a strong interplay between single-particle and collective degrees of freedom that is pertinent to the reaction dynamics. The development of collectivity has been followed in odd Ar isotopes populated in the 40Ar+208Pb reaction through the excitation of the 11=2 states, understood as the coupling of single particle degrees of freedom to nuclear vibration quanta. Pair transfer modes is another important degree of freedom which is presently being studied with Prisma in inverse kinematics at energies far below the Coulomb barrier. First results from the 96Zr+40Ca reaction elucidate the role played by nucleon-nucleon correlation

Lifetime Measurements of the Neutron-Rich N=30 Isotones Ca-50 and Sc-51: Orbital Dependence of Effective Charges in the fp Shell

The lifetimes of the first excited states of the N=30 isotones 50Ca and 51Sc have been determined using the Recoil Distance Doppler Shift method in combination with the CLARA-PRISMA spectrometers. This is the first time such a method is applied to measure lifetimes of neutron-rich nuclei populated via a multinucleon transfer reaction. This extends the lifetime knowledge beyond the f7/2 shell closure and allows us to derive the effective proton and neutron charges in the fp shell near the doubly magic nucleus 48Ca, using large-scale, shell-model calculations. These results indicate an orbital dependence of the core polarization along the fp shell

Particle-core coupling in S 37

International audienceExcited states of the neutron-rich N=21 S37 nucleus have been studied using binary grazing reactions produced by the interaction of a 215-MeV beam of S36 ions with a thin Pb208 target. The magnetic spectrometer, PRISMA, and the γ-ray array, CLARA, were used in the measurements. The level scheme of S37 was established to an excitation energy of 4196 keV and a number of new transitions were observed, in particular that corresponding to the decay of the proposed Jπ=(11/2−) level at an excitation energy of 2776 keV. The structure of the state is discussed within the context of state-of-the-art shell-model calculations using the SDPF-U effective interaction; the main component of the wave function corresponds to the coupling of the odd 1f7/2 neutron to the first 2+ state of the S36 core. The electromagnetic decay properties of the state are discussed within the context of a particle-core coupling model and the shell model. The other members of the multiplet of states are also discussed