Discrepancy between Knowledge and Perceptions of Dietary Omega-3 Fatty Acid Intake Compared with the Omega-3 Index

Little is known about the relationship between perceptions of nutrient adequacy and biomarkers of nutrition status. This cross-sectional study of U.S. and German adults (n = 200;18-80 years) compared dietary practices, knowledge, and beliefs of omega-3 fatty acids (O3-FA) with the omega-3 index (O3-I), an erythrocyte-based biomarker associated with cardiovascular disease (CVD) risk. More than half of adults believed that O3-FAs are beneficial for heart and brain health and could correctly identify the food sources of O3-FA. However, the mean O3-I in the U.S. (4.3%) and Germany (5.5%) puts the majority of adults sampled (99%) in intermediate or high CVD-risk categories. More Americans were considered at high CVD-risk (40%) when compared with Germans (10%). In the U.S., but not Germany, women had a significantly higher O3-I than men (4.8% vs. 3.8%, p < 0.001). In the intermediate CVD-risk group, about one-third of adults in both countries (30% in the U.S. and 27% in Germany) believed their diet was adequate in O3-FA. Notably, mean O3-I concentrations did not significantly differ with dietary perceptions of adequacy. More adults in Germany (26%) than in the U.S. (10%) believed that dietary supplements are needed to achieve a balanced diet. In spite of adequate knowledge about food sources and a consistent belief that O3-FA are important for health, very few participants had O3-I concentrations in the range for CVD protection

Bexarotene improves median survival (MS) in untreated, advanced NSCLC, when given in combination with carboplatin/paclitaxel

Background: Bexarotene (bex) is a subclass specific, synthetic rexinoid analogue, that preferentially binds and modulates the expression of RXR subclass of receptors α, β, and γ. It induces concentration-dependent repression of multiple genes (cyclin D1/D3, total EGFR, pEGFR) inhibiting cell growth, angiogenesis, invasion and metastasis, inducing differentiation, and apoptosis in tumor cells. Several phase-I/II trials suggested increased survival in patients with advanced NSCLC. Methods: Stage-IIIB with pleural effusion & Stage-IV chemo-naïve patients, ECOG 0–2, were enrolled and treated with carboplatin IV AUC-6 d-1 and paclitaxel IV 100 mg/m2 d-1, 8, 15, every 28-d for 4 cycles. Pts were randomized using a 1:1 design to bex PO 400 mg/m2/d either concurrent (C) from Day 1 or sequential (S) at the completion of chemo, for up to a year. Results: 56 patients were enrolled; median age 62.3 (range 41–86), 48 TNM Stage IV, 38 males, 50 ECOG PS 0–1. Of 51 pts evaluable for response, 30 (58%) achieved PR (C: 15 and S: 15); 16 (31%) showed SD (C: 8 and S: 8), and 5 (9.5%) had PD (C: 3 and S: 2). Thirty-two (63%) patients have expired as of 12/31/05. Based on ITT, 40 evaluable pts showed a median TTP of 169 days (C: 166.5 and S 172); The MS for the entire group is 342 days (11.42 mo (C: 12.8 and S: 10.53). Currently, 10 pts are still alive between 407 to 1036 days from registration on the trial. The treatment was well tolerated; overall, AEs were reported in 48% of pts in the S arm and 51% in the C arm. The incidence of Gr 3–4 AEs, regardless of the treatment arm, was \u3c 5%. There were no treatment-associated deaths. Conclusions: Our data suggests a better ORR, TTP, and improvement in MS, when bex is added to carboplatin/ paclitaxel, regardless of concurrent or sequential administration, compared with chemo alone. ORR was not compromised by bex administration and in fact it was above average reported for similar phase-II & -III studies. Toxicity is easily managed

Bexarotene improves TTP in untreated, advanced NSCLC, when given in combination with carboplatin/paclitaxel

Background: Bexarotene, a specific synthetic retinoid analogue, binds to the α, β, and γ subclass of RXR, providing therapeutic specificity and reduced toxicities in pts with RXR-expressing tumors. Initial phase-I/II clinical trials in NSCLC showed that bexarotene added to chemotherapy prolonged stabilization of disease (TTP) and 1, 2, and 3 yr survival. Methods: Stage IIIB with pleural effusion & Stage IV chemo-naïve patients, ECOG PS 0–2, were enrolled on study and treated with carboplatin IV AUC-6 d1 and paclitaxel IV 100mg/m2 d1, 8, and 15, every 28-d for 4 cycles. Pts were randomized using a 1:1 design to bexarotene PO 400mg/m2/d either concurrent (C) from Day 1 or sequential (S) at the completion of chemo, for up to a year. Results: From a planned total of 60 patients, 48 have been enrolled thus far; median age 62.3 (range 41–86), 43 Caucasian, 41 TNM Stage IV, 33 males, 34 ECOG PS 1. To date, 44 pts are evaluable for efficacy and toxicity based on ITT; 35 were evaluated for RR: 15 (42.8%) achieved PR (C: 7 and S: 8), 15 (42.8%) exhibited SD (C: 8 and S: 7), and 5 (14.3%) had PD (C: 2 and S: 3), during the first 112 days (C1–4 chemo). TTP analysis was done in 42 pts: 19 pts showed an overall TTP of 152 days (5.06 mo) (C=10: 148.3 days and S=9: 155.5 days); in 23 pts the TTP has not been reached after a median F/U of 79 days (range 10–203). The overall 1yr S was 58.8% with no significant difference between treatment arms (p=0.7). The treatment was well tolerated; overall, AEs were reported in 48% of pts in the S arm vs. 51% in the C arm. The incidence of Gr 3–4 AEs, regardless of the treatment arm, was \u3c 5%. There were no treatment-associated deaths. Conclusions: so far, data suggests a comparable ORR and a potential improvement in TTP, when bexarotene is added to carboplatin/paclitaxel, compared with chemo alone. Toxicity is easily managed. Updated efficacy and toxicity data will be presented at the meeting

Beyond antitrust populism: Towards robust antitrust

The populist use of competition policies is on the rise again, associated with the growth of big-tech companies in the era of digital platforms. This article sees antitrust populism as a re-emerging force in the United States and Europe via greater politicisation of competition law enforcement. It addresses the basic tenets of antitrust populism in order to expose the fundamental problems that populist use of competition law entails. I argue for a rethink of antitrust policy on the intellectual foundations laid down by what Mark Pennington describes as ‘robust political economy’. We need greater regulatory humility and antitrust enforcement which takes both innovation and welfare seriously