Factors affecting the local distribution of <i>Polystigma rubrum</i> stromata on <i>Prunus spinosa</i>

Background and aims – Polystigma rubrum forms orange-red stromata on the surface of living leaves of Prunus spinosa and P. domestica. Records suggests that this fungus now has a much more limited distribution in Britain than recorded in the 19th and early 20th century. Methods – We studied the local distribution of the fungus in the Burren Hills of western Ireland where it remains very common. Key results – Assessment of the local distribution of the fungus over two years found stromata to occur more frequently on P. spinosa leaves in hedgerows than woodlands. On individual trees in areas of open limestone pavement, the frequency of stromata was ten times higher in 2016 than 2015, possibly related to interannual rainfall differences. On hedgerow trees subjected to winter flooding, stromata were much less abundant, whereas stromata were more abundant on leaves also infected by the gall mite Eriophyes prunispinosae. The identity of Po. rubrum was confirmed by ITS sequencing.Conclusion – At a field location where Po. rubrum stromata are present in unusually high abundance, the distribution of stromata on trees in different habitats showed high levels of variation linked to both habitat and the presence of gall mites. Further work is required to determine whether variation in leaf surface and soil moisture are the key determinants of the observed distribution. Such investigations may reveal why Po. rubrum, once common in northern Europe is now restricted mainly to westerly, coastal locations

Factors affecting the local distribution of Polystigma rubrum stromata on Prunus spinosa.

Background and aims – Polystigma rubrum forms orange-red stromata on the surface of living leaves of Prunus spinosa and P. domestica. Records suggests that this fungus now has a much more limited distribution in Britain than recorded in the 19th and early 20th century. Methods – We studied the local distribution of the fungus in the Burren Hills of western Ireland where it remains very common. Key results – Assessment of the local distribution of the fungus over two years found stromata to occur more frequently on P. spinosa leaves in hedgerows than woodlands. On individual trees in areas of open limestone pavement, the frequency of stromata was ten times higher in 2016 than 2015, possibly related to interannual rainfall differences. On hedgerow trees subjected to winter flooding, stromata were much less abundant, whereas stromata were more abundant on leaves also infected by the gall mite Eriophyes prunispinosae. The identity of Po. rubrum was confirmed by ITS sequencing.Conclusion – At a field location where Po. rubrum stromata are present in unusually high abundance, the distribution of stromata on trees in different habitats showed high levels of variation linked to both habitat and the presence of gall mites. Further work is required to determine whether variation in leaf surface and soil moisture are the key determinants of the observed distribution. Such investigations may reveal why Po. rubrum, once common in northern Europe is now restricted mainly to westerly, coastal locations

The SystHERs registry: an observational cohort study of treatment patterns and outcomes in patients with human epidermal growth factor receptor 2–positive metastatic breast cancer

BACKGROUND: Amplification of the human epidermal growth factor receptor 2 (HER2) gene occurs in approximately 20% of invasive breast cancer cases and is associated with a more aggressive disease course than HER2-negative breast cancer. HER2-targeted therapies have altered the natural history of HER2-positive breast cancer, a trend that will likely further improve with the recent approval of new agents. A prospective, observational cohort study was designed and initiated to provide real-world insights into current treatment patterns, long-term survival, and patients’ experiences with initial and subsequent treatments for HER2-positive metastatic breast cancer (MBC). METHODS/DESIGN: The Systematic Therapies for HER2-positive Metastatic Breast Cancer Study (SystHERs) is a US-based prospective observational cohort study enrolling patients ≥18 years of age with recently diagnosed HER2-positive MBC not previously treated with systemic therapy in the metastatic setting. The primary objective of the study is to identify treatment patterns and clinical outcomes in recently diagnosed patients in a variety of practice settings. Secondary objectives include comparative efficacy, safety, and patient-reported outcomes (PROs). Healthcare resource utilization is an exploratory end point. Tumor tissue and blood sample collection is optional. The SystHERs registry will enroll approximately 1000 patients over a 3-year period, after which the study will continue for ≥5 years, allowing for a maximum follow-up of 8 years. The treating physician will determine all care and the frequency of visits. PRO measures will be completed at study enrollment and every 90 days. Clinical data will be abstracted quarterly from patient records. The first patient was enrolled in June 2012, and preliminary descriptive data based on 25% to 30% of the final study population are expected at the end of 2013, and as of April 25, 2014, 386 patients are enrolled. DISCUSSION: SystHERs is expected to provide in-depth data on demographic, clinicopathological, and treatment patterns and their associations with clinical outcomes, PROs, and healthcare resource utilization. Tumor tissue and DNA repositories will also be established for use in future translational research. TRIAL REGISTRATION NUMBER: NCT01615068 (ClinicalTrials.gov identifier)

Quality of life with ribociclib versus abemaciclib as first-line treatment of HR+/HER2− advanced breast cancer: a matching-adjusted indirect comparison

BackgroundA cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) + endocrine therapy is recommended as first-line treatment for hormone receptor-positive/human epidermal growth factor receptor 2-negative (HR+/HER2-) advanced breast cancer (ABC). Quality of life (QoL) is an important endpoint that affects treatment decisions. Understanding the relevance of CDK4/6i treatment on QoL is gaining importance given use in earlier treatment lines for ABC and an emerging role in treating early breast cancer in which QoL may be more impactful. In the absence of head-to-head trial data, a matching-adjusted indirect comparison (MAIC) permits comparative efficacy between trials.ObjectiveIn this analysis, patient-reported QoL for MONALEESA-2 [ribociclib + aromatase inhibitor (AI)] and MONARCH 3 (abemaciclib + AI) was compared using MAIC with a focus on individual domains.DesignAn anchored MAIC of QoL comparing ribociclib + AI versus abemaciclib + AI was performed using data from the European Organization for Research and Treatment of Cancer quality of life questionnaire (QLQ)-C30 and BR-23 questionnaires.MethodsIndividual patient data from MONALEESA-2 and published aggregated data from MONARCH 3 were included in this analysis. Time to sustained deterioration (TTSD) was calculated as the time from randomization to a ⩾10-point deterioration with no later improvement above this threshold.ResultsPatients from the ribociclib (n = 205) and placebo (n = 149) arms of MONALEESA-2 were matched with patients from the abemaciclib (n = 328) and placebo (n = 165) arms of MONARCH 3. After weighting, baseline patient characteristics were well balanced. TTSD significantly favored ribociclib versus abemaciclib in appetite loss [hazard ratio (HR), 0.46; 95% confidence interval (CI), 0.27-0.81], diarrhea (HR, 0.42; 95% CI, 0.23-0.79), fatigue (HR, 0.63; 95% CI, 0.41-0.96), and arm symptoms (HR, 0.49; 95% CI, 0.30-0.79). TTSD did not significantly favor abemaciclib compared with ribociclib in any functional or symptom scale of the QLQ-C30 or BR-23 questionnaires.ConclusionsThis MAIC indicates that ribociclib + AI is associated with better symptom-related QoL than abemaciclib + AI for postmenopausal patients with HR+/HER2- ABC treated in the first-line setting.Trial registrationNCT01958021 (MONALEESA-2) and NCT02246621 (MONARCH 3)