Metastatic Colorectal Cancer Outcomes by Age Among ARCAD First- and Second-Line Clinical Trials

Metastatic Colorectal Cancer; OutcomesCáncer colorrectal metastásico; ResultadosCàncer colorrectal metastàtic; ResultatsBackground We evaluated the time to progression (TTP) and survival outcomes of second-line therapy for metastatic colorectal cancer among adults aged 70 years and older compared with younger adults following progression on first-line clinical trials. Methods Associations between clinical and disease characteristics, time to initial progression, and rate of receipt of second-line therapy were evaluated. TTP and overall survival (OS) were compared between older and younger adults in first- and second-line trials by Cox regression, adjusting for age, sex, Eastern Cooperative Oncology Group Performance Status, number of metastatic sites and presence of metastasis in the lung, liver, or peritoneum. All statistical tests were 2-sided. Results Older adults comprised 16.4% of patients on first-line trials (870 total older adults aged >70 years; 4419 total younger adults aged ≤70 years, on first-line trials). Older adults and those with Eastern Cooperative Oncology Group Performance Status >0 were less likely to receive second-line therapy than younger adults. Odds of receiving second-line therapy decreased by 11% for each additional decade of life in multivariable analysis (odds ratio = 1.11, 95% confidence interval = 1.02 to 1.21, P = .01). Older and younger adults enrolled in second-line trials experienced similar median TTP and median OS (median TTP = 5.1 vs 5.2 months, respectively; median OS = 11.6 vs 12.4 months, respectively). Conclusions Older adults were less likely to receive second-line therapy for metastatic colorectal cancer, though we did not observe a statistical difference in survival outcomes vs younger adults following second-line therapy. Further study should examine factors affecting decisions to treat older adults with second-line therapy. Inclusion of geriatric assessment may provide better criteria regarding the risks and benefits of second-line therapy.The National Cancer Institute Gastrointestinal Cancer Center Specialized Programs of Research Excellence (SPORE) Career Development Award (5P50CA127003-08) funded Dr McCleary’s effort. The ARCAD Foundation funded data collection and analysis

Risk Factors for Postcesarean Maternal Infection in a Trial of Extended-Spectrum Antibiotic Prophylaxis

To identify maternal clinical risk factors for postcesarean maternal infection in a randomized clinical trial of preincision extended-spectrum antibiotic prophylaxis

Technology developments for a large-format heterodyne MMIC array at W-band

We report on the development of W-band (75–110 GHz) heterodyne receiver technology for large-format astronomical arrays. The receiver system is designed to be both mass producible, so that the designs could be scaled to thousands of receiver elements, and modular. Most of the receiver functionality is integrated into compact monolithic microwave integrated circuit (MMIC) amplifier-based multichip modules. The MMIC modules include a chain of InP MMIC low-noise amplifiers, coupled-line bandpass filters, and sub-harmonic Schottky diode mixers. The receiver signals will be routed to and from the MMIC modules on a multilayer high-frequency laminate, which includes splitters, amplifiers, and frequency triplers. A prototype MMIC module has exhibited a band-averaged noise temperature of 41 K from 82 to 100 GHz and a gain of 29 dB at 15 K, which is the state-of-the-art for heterodyne multichip modules

Coupling instrumental and geological records of sea-level change : evidence from southern New England of an increase in the rate of sea-level rise in the late 19th century

Author Posting. © American Geophysical Union, 2004. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Geophysical Research Letters 31 (2004): L05203, doi:10.1029/2003GL018933.We construct a high-resolution relative sea-level record for the past 700 years by dating basal salt-marsh peat samples above a glacial erratic in an eastern Connecticut salt marsh, to test whether or not the apparent recent acceleration in the rate of sea-level rise (SLR) is coeval with climate warming. The data reveal an average SLR rate of 1.0 ± 0.2 mm/year from about 1300 to 1850 A.D. Coupling of the regional tide-gauge data (1856 to present) with this marsh-based record indicates that the nearly three-fold increase in the regional rate of SLR to modern levels likely occurred in the later half of the 19th century. Thus the timing of the observed SLR rate increase is coincident with the onset of climate warming, indicating a possible link between historic SLR increases and recent temperature increases.A Research Initiative Grant from the NOSAMS facility at WHOI funded the C-14 analysis. The Postdoctoral Scholar Program at WHOI (with funding provided by the U.S.G.S.), The John E. and Anne W. Sawyer Endowed Fund, and The J. Lamar Worzel Assistant Scientist Fund provided support to J. Donnelly