Gastrazole (JB95008), a novel CCK2/gastrin receptor antagonist, in the treatment of advanced pancreatic cancer: results from two randomised controlled trials

Gastrin has been shown to be a growth stimulant in pancreatic cancer cells. Gastrazole is a potent and selective gastrin receptor antagonist. Two randomised blinded trials were conducted to assess the effect of gastrazole in advanced pancreatic cancer. Patients with biopsy-proven, inoperable pancreatic carcinoma were recruited. Trial A compared protracted venous infusion (PVI) gastrazole with PVI placebo, whereas trial B compared PVI gastrazole with PVI fluorouracil (5-FU). Eighteen patients were randomised in trial A. Gastrazole produced significantly better survival compared to placebo (median 7.9 months vs 4.5 months; 1-year survival: 33 vs 11%, respectively; log rank P=0.02). No difference in toxicity was seen between gastrazole and placebo, except central venous catheter and pump complications. Ninety-eight patients were randomised in trial B. No significant survival difference was detected between gastrazole and 5-FU (median: 3.6 vs 4.2 months; 1-year survival: 13.2 vs 26.2%, respectively; log rank P=0.42). Toxicity of gastrazole was mild with significantly less diarrhoea (P=0.03), stomatitis (P<0.001) and hand– foot syndrome (P<0.001) compared to 5-FU. Quality of life (QoL) assessment showed similar QoL between gastrazole and 5-FU at baseline and no significant differences occurred with treatment either between arms or within arms. Compared to placebo, patients with advanced pancreatic cancer treated with gastrazole appeared to live longer, albeit in a very small trial and will require confirmation with large-scale randomised data. However, it did not produce survival advantage over PVI 5-FU. Lack of toxicity for gastrazole may allow its combination with cytotoxic drugs

The evolution of plant virus transmission pathways

International audienceThe evolution of plant virus transmission pathways is studied through transmission via seed, pollen, or a vector. We address the questions: under what circumstances does vector transmission make pollen transmission redundant? Can evolution lead to the coexistence of multiple virus transmission pathways? We restrict the analysis to an annual plant population in which reproduction through seed is obligatory. A semi-discrete model with pollen, seed, and vector transmission is formulated to investigate these questions. We assume vector and pollen transmission rates are frequency-dependent and density-dependent, respectively. An ecological stability analysis is performed for the semi-discrete model and used to inform an evolutionary study of trade-offs between pollen and seed versus vector transmission. Evolutionary dynamics critically depend on the shape of the trade-off functions. Assuming a trade-off between pollen and vector transmission, evolution either leads to an evolutionarily stable mix of pollen and vector transmission (concave trade-off) or there is evolutionary bi-stability (convex trade-off); the presence of pollen transmission may prevent evolution of vector transmission. Considering a trade-off between seed and vector transmission, evolutionary branching and the subsequent coexistence of pollen-borne and vector-borne strains is possible. This study contributes to the theory behind the diversity of plant–virus transmission patterns observed in nature

The evolution of parasitic and mutualistic plant–virus symbioses through transmission-virulence trade-offs

International audienceVirus–plant interactions range from parasitism to mutualism. Viruses have been shown to increase fecundity of infected plants in comparison with uninfected plants under certain environmental conditions. Increased fecundity of infected plants may benefit both the plant and the virus as seed transmission is one of the main virus transmission pathways, in addition to vector transmission. Trade-offs between vertical (seed) and horizontal (vector) transmission pathways may involve virulence, defined here as decreased fecundity in infected plants. To better understand plant–virus symbiosis evolution, we explore the ecological and evolutionary interplay of virus transmission modes when infection can lead to an increase in plant fecundity. We consider two possible trade-offs: vertical seed transmission vs infected plant fecundity, and horizontal vector transmission vs infected plant fecundity (virulence). Through mathematical models and numerical simulations, we show (1) that a trade-off between virulence and vertical transmission can lead to virus extinction during the course of evolution, (2) that evolutionary branching can occur with subsequent coexistence of mutualistic and parasitic virus strains, and (3) that mutualism can out-compete parasitism in the long-run. In passing, we show that ecological bi-stability is possible in a very simple discrete-time epidemic model. Possible extensions of this study include the evolution of conditional (environment-dependent) mutualism in plant viruses