Long-Term Survival after High-Dose Chemotherapy Followed by Peripheral Stem Cell Rescue for High-Risk, Locally Advanced/Inflammatory, and Metastatic Breast Cancer

Patients with high-risk locally advanced/inflammatory and oligometastatic (≤3 sites) breast cancer frequently relapse or experience early progression. High-dose chemotherapy combined with peripheral stem cell rescue may prolong progression-free survival/relapse-free survival (PFS/RFS) and overall survival (OS). In this study, patients initiated high-dose chemotherapy with STAMP-V (carboplatin, thiotepa, and cyclophosphamide), ACT (doxorubicin, paclitaxel, and cyclophosphamide), or tandem melphalan and STAMP-V. Eighty-six patients were diagnosed with locally advanced/inflammatory (17 inflammatory) breast cancer, and 12 were diagnosed with oligometastatic breast cancer. Median follow-up was 84 months (range, 6-136 months) for patients with locally advanced cancer and 40 months (range, 24-62 months) for those with metastatic cancer. In the patients with locally advanced cancer, 5-year RFS and OS were 53% (95% CI, 41%-63%) and 71% (95% CI, 60%-80%), respectively, hormone receptors were positive in 74%, and HER2 overexpression was seen in 23%. In multivariate analysis, hormone receptor–positive disease and lower stage were associated with better 5-year RFS (60% for ER [estrogen receptor]/PR [progesterone receptor]-positive versus 30% for ER/PR-negative; P < .01) and OS (83% for ER/PR-positive versus 38% for ER/PR-negative; P < .001). In the patients with metastatic cancer, 3-year PFS and OS were 49% (95% CI, 19%-73%) and 73% (95% CI, 38%-91%), respectively. The favorable long-term RFS/PFS and OS for high-dose chemotherapy with peripheral stem cell rescue in this selected patient population reflect the relative safety of the procedure and warrant validation in defined subgroups through prospective, randomized, multi-institutional trials

CTW_Repeated_4Days

Repeated analysis over 4 days

Data from: Hiding behavior in Christmas tree worms on different time scales

Many animals escape predators by hiding. Hiding decisions are economic in that individuals trade off the physiological costs of hiding with the benefits of increased security. The number of conspecifics may increase competition, security, or attract predators, influencing predation risk. We studied hiding time in Christmas tree worms (Spirobranchus giganteus), sessile marine invertebrates, which lived with 0–17 other worms within 20cm. Competition and predation risk reduction both predict a shorter latency to re-emerge given the necessity to feed and potential for safety in numbers, respectively. In contrast, if grouped worms attract more predators, individuals should hide longer. We experimentally induced hiding in 174 worms and found a significant, positive relationship between hiding time and number of conspecifics. We repeated the test 4 consecutive times in 1 day on a subset of 30 worms that were either solitary or lived with one other untested worm. We found that worms with longer hiding times habituated more quickly than worms with shorter hiding times, and that the individual worm explained 55.8% of the variation in hiding time. When we conducted the trials for 4 days, we found that the individual worm explained 41.75% of the variation, but no evidence of behavioral plasticity. Worm antipredator responses were consistently individualistic, but behavioral plasticity was only evident over short time scales. For sessile marine invertebrates, higher densities may attract predators, enhancing rather than diluting predation risk. Worms that cannot move away from their neighbors, thus seemingly modify antipredator behavior in consistent ways

CTW_Repeated_1Day

Repeated analysis over 1 day