Opportunities and restrictions for the local-endogenous development in metropolitan areas of high industrial concentration: the case of Thriasio Pedio in Attica

This paper investigates the development pattern of the urban area of Thriasio Pedio in the metropolitan region of Attica, which is characterised by a high concentration of industrial activities. The local-endogenous development model is discussed in the theoretical review of the paper, in the sense of the local socioeconomic system’s capacity to transform, react to external challenges, promote awareness and import specific forms of social regulation at the local level.On this ground, the main question of the paper concerns the nature of the area’s development and more specifically, whether or not this is defined by endogenous factors (i.e. the operation of locally embedded production systems) along with predetermined exogenous factors (i.e. the allocation of central/metropolitan activities in Thriasio Pedio). The study is supported by the results of a sampling research in representative economic units of the Thriasio Pedio area. The analysis helped us to see whether the various applications of the local-endogenous development pattern, as defined in the paper, are incorporated into the overall productive system of the area. The prerequisites for the reinforcement of the local endogenous capacity were also identified in this analysis

A phase III trial of exemestane plus bevacizumab maintenance therapy in patients with metastatic breast cancer after first-line taxane and bevacizumab: a GINECO group study

International audienceBACKGROUND: Maintenance strategies beyond response or tumor stabilization with first-line chemotherapy in metastatic breast cancer (MBC) have not been extensively studied. Endocrine therapy combined with continued bevacizumab may be a helpful option for estrogen receptor (ER)-positive MBC. PATIENTS AND METHODS: In this prospective, open-label, phase III study, patients with histologically confirmed ER-positive, HER2-negative MBC and non-progressive disease after 16-24 weeks of taxane plus bevacizumab (T + BEV) were randomized to continuation of T + BEV or maintenance bevacizumab plus exemestane (E + BEV). The primary end point was progression-free survival (PFS) from randomization. To have 80% power to detect an improvement in the 6-month PFS rate (PFS6m) from 50% to 65%, 186 assessable patients were needed for a total of 141 PFS events. An interim analysis was planned after 40% of the required events. RESULTS: The interim analysis with 98 patients showed that the probability of reaching a statistically significant improvement in PFS by the end of the study was only 7%. This led the Independent Data and Monitoring Committee to recommend termination of patient enrollment. After a median of 21-month follow-up of all randomized patients (117 in total), PFS6m from randomization was 67.2% [95% confidence interval (CI) 53.6-77.7] with T + BEV and 55.2% (95% CI 41.5-66.9) with E + BEV [hazard ratio (HR): 1.0, 95% CI 0.7-1.5, P = 0.998]. Median PFS from BEV initiation was 12.5 and 12.3 months in the T + BEV and E + BEV arms, respectively. In the T + BEV arm, taxane was prematurely stopped for the majority of patients (94.9%), mainly due to toxicity (49.2%). Updated data after 35 months' median follow-up showed death rates of 44% and 55% in T + BEV and E + BEV arms, respectively. CONCLUSION: In this trial, maintenance therapy with E + BEV in ER-positive, HER2-negative MBC patients with no evidence of progression after first-line T + BEV did not achieve longer PFS compared with continuation of T + BEV. CLINICALTRIALSGOV: NCT0130367