Activity of eribulin mesylate in brain metastasis from breast cancer. a stone in a pond?

Background: Brain metastases develop in approximately 10-25% of patients with metastatic breast cancer (MBC) and are associated with a very poor prognosis. Case Report: We report the case of a 40-year-old woman with MBC and associated lung, bone, liver, and brain metastases, who experienced a time to progression of several months with eribulin after whole-brain radiotherapy (WBRT), 2 lines of chemotherapy, and 1 line of hormonal therapy, maintaining a good toxicity profile. Discussion: Eribulin, in association with local treatment such as WBRT, can be well tolerated and effective in achieving a long progression-free survival and a good control of brain metastases in patients with MBC who have received multiple lines of treatment. The vascular remodeling properties of eribulin, combined with brain radiotherapy, might facilitate the passage of eribulin across the blood brain barrier, improving brain response. Conclusion: Our anecdotal experience suggests that eribulin may have a potentially beneficial effect on brain metastases while maintaining a good systemic control of the disease in patients with MBC

The course of cancer related fatigue up to ten years in early breast cancer patients. What impact in clinical practice?

Little is known about the cancer related fatigue (CRF) along cancer course and risk factors that could predict CRF development and persistence in breast cancer (BC) survivors. This prospective study detected incidence, timing of onset, duration of CRF, impact on QoL and psychological distress. Seventy-eight early BC patients, undergoing chemotherapy (CT) followed or not by hormonal therapy were assessed for QoL and psychological distress by EORTC QLQC30 and HADs questionnaires. Fatigue was investigated with mix methods, structured interview and psychometric measures. A qualitative analysis was added to assess the behavioral pattern of CRF. Low fatigue levels were identified after surgery (9%), increasing during (49%) and at the end of CT (47%), maintaining after 1 year (31%) and declining up to ten years of follow-up. Prevalence of CRF was higher at the end of CT and lower at follow-up. At the end and after 1 and 2 years from CT, persistence of CRF was associated to anxiety in 20%, 11% and 5% and to depression in 15%, 10% and 5% respectively. A relationship between CRF and psychological distress was observed; patients presenting depression and anxiety before CT were at higher risk for fatigue onset at a later period. A relationship between fatigue and QoL was noted at the end of CT. Our study shows the fatigue timely trend in early BC patients from surgery, CT and follow-up. Identification of biological, psychological, social predictor factors related to fatigue could be helpful for early interventions in patients at higher risk of developing fatigue

Impressive long-term response with pertuzumab and trastuzumab in HER2-positive breast cancer with brain metastasis

This is a case report of a 40-year-old woman who, after conservative breast cancer treatment, developed a HER2 positive solitary brain metastasis in the left temporal lobe, without extracranial disease. She underwent surgery resection followed by stereotactic radiotherapy and, because of early brain progression, she was submitted to the first line therapy with pertuzumab, trastuzumab and weekly paclitaxel. After six months of treatment, a brain magnetic resonance imaging revealed a complete disappearance of brain recurrence, which persisted for more than 24 months

Maintenance bevacizumab beyond first-line paclitaxel plus bevacizumab in patients with Her2-negative hormone receptor-positive metastatic breast cancer. Efficacy in combination with hormonal therapy

Background: Data on efficacy of bevacizumab (B) beyond first-line taxane -including regimen (BT) as first-line treatment are lacking. Although preclinical results that anti-angiogenic agents combined with hormonal therapy (HT) could be active, no clinical data exist about combination of maintenance Bevacizumab (mBev) with HT.Methods: Thirty-five patients who experienced a response after first-line BT, were given mBev at the dose of 15 mg/kg every 3 weeks. Among 30 pts with hormonal receptor-positive metastatic breast cancer (MBC), 20 (66.6%) received HT with mBev (mHTBev). Objective of the study was the outcome and safety of mBev and in two groups of patients receiving HT or not.Results: Complete response and partial response was achieved/maintained in 4 (11.4%) and 13 (37.1%) patients, respectively (overall response rate: 48.5%). Clinical benefit was obtained on 23 patients (65.7%). Median of mBev PFS and clinical benefit were 6.8 months (95% CI: 0.8-12.7) and 17.1 months (95% CI :12.2-21.9), respectively. Median PFS of patients who received mHTBev was longer than mBev without HT (13 months and 4.1 months, respectively, p = 0.05). The most common severe toxicities were proteinuria (11.4%) and hypertension (8.5%). No additional toxicity was observed with HTBev.Conclusion: Maintenance bevacizumab with or without anti-hormonal therapy in patients with hormone receptor positive breast cancer is tolerable and associated with long-term clinical outcome; these results encourage the strategy of prolonging bevacizumab until progression in combination with anti-hormonal agents

Decapod crustaceans associated with an artificial reef (Adriatic Sea)

The aim of this study is to increase the knowledge on the distribution of decapod crustaceans associated with an artificial reef positioned on sandy-mud bottoms in the central Adriatic Sea. The reef is constituted of concrete modules assembled in pyramids and concrete poles. Hard and soft bottom samples were collected from 2001, just after reef construction, to 2005 (4 surveys per year). Regarding the soft seabed, three sites close to a pyramid, three inside the reef area at a distance of 10-15 m from the structures, and three 200 m outside the reef (control sites) were randomly sampled during each survey. At the same time, three pyramids (vertical and horizontal walls) and three poles were also investigated. After taxonomical analysis, decapod crustaceans were analysed using abundance and species richness. Sites and years were compared using a balanced, fixed effect, 2-way ANOVA and PERMANOVA. In addition, SIMPER analysis was performed to identify those species typifying each community inhabiting both the soft bottom and the artificial substrates. The results showed that the artificial reef induced an increase in both abundance and diversity of the decapods of the natural habitat. In fact, man-made substrates may offer new available space for biological colonization and allow the settlement of new species usually living on hard bottoms, thus increasing the complexity of the original benthic communities

3D X-ray microscopy (XRM) investigation of exogenous materials inside mussels’ organs

The diffusion of pollutants in the marine environment is nowadays a well-recognized issue that is attracting growing interest from the scientific and social communities. One of the possible strategies to study the effect of pollutants is to quantify their presence inside marine organisms that are directly exposed for a certain period to the polluted environment. Among them, mussels, commonly considered as “biological water filters”, stand out as ideal candidates since they are stationary animals and their food intake comes only from the filtering of the surrounding water. Thus, the evaluation of the accumulation of exogenous pollutants, in particular high-density or metallic, inside the mussel's organs and specifically in its digestive glands, is of particular interest. In this paper we characterize the accumulation of exogenous materials in digestive glands of three different mussels by means of X-ray microscopy analysis. We provide evidence of how the unique capabilities of this technique allow reconstructing a full 3D image of an entire organ and how this image can provide valuable information to identify exogenous (non-biological) pollutants. Moreover, we take full advantage from the segmentation analysis of the images by discriminating different regions of the sample according to the density. With this experimental approach we measured the sizes of the exogenous pollutants and provided evidences that they accumulate preferentiality in the low-density regions of the organ, that are richer in ducts and secretive glands

Raja asterias population assessment in FAO GFCM GSA17 area

Population structure and distribution of the starry ray, Raja asterias, were described based on data collected during yearly rapido trawl surveys (SoleMon), between 2005 and 2014 in the Northern and Central Adriatic Sea. A total of 306 individuals were caught, sex ratio was 1.04:1 in favor of males and length-weight relationships were obtained for the whole sample. Following the MEDITS scale, maturity was estimated, observing a higher number of immature individuals. Relative abundance significantly increased during the recent period with the highest values recorded at 5-30 m depths. Such increase could be related to the response of R. asterias to climatic change or to the decrease  in fishing pressure in the area. Clear spatial segregation of individuals depending on their life stage was observed, with immature individuals inhabiting the coastal areas and adults more abundant at depths greater than 40 m. The comparison of the result of the present study with MEDITS survey outcomes in terms of  distribution patterns, persistence areas of adults and juveniles and abundances indices, evidences that SoleMon survey seems to be more suitable in defining such features of the stock, likely due to the greater catchability of the rapido trawl in respect to the MEDITS trawl net. However, further investigations are needed to identify factors affecting the increasing abundance of this species, and develop an action plan for spatial management of fishing activities

Prospective study on nanoparticle albumin-bound paclitaxel in advanced breast cancer. Clinical results and biological observations in taxane-pretreated patients

Background: There is a deep need to improve the care of metastatic breast cancer (MBC) patients, since even today it remains an incurable disease. Taxanes are considered the most effective cytotoxic drugs for the treatment of MBC, both in monotherapy and in combined schedules, but the need for synthetic solvents contributes to the severe toxicities and may have a negative impact on the efficacy. Nanoparticle albumin-bound paclitaxel (Nab-paclitaxel) is a colloidal suspension of paclitaxel and human serum albumin initially developed to avoid the toxicities associated with conventional taxanes. Patients and methods: The aim of this prospective, single-center open-label, noncomparative study was to evaluate the efficacy and safety of nab-paclitaxel in MBC patients pretreated with taxanes. The patients were treated with nab-paclitaxel as a single agent, 260 mg/m2 on day 1 of each 3-week cycle or 125 mg/m2 weekly. The primary endpoint was the overall response rate (ORR). Secondary objectives were duration of response, clinical benefit rate, progression-free survival (PFS), overall survival, and safety. Results: A total of 42 patients (median age 48 years, median Eastern Cooperative Oncology Group performance status 0, triple-negative MBC 19%, all pretreated with a taxane-based therapy, mainly in advanced disease) were enrolled in the study. The ORR was 23.8%, including one complete response (2.4%) and nine partial responses (21.4%); the disease control rate was 50%. The median duration of response was 7.2 months. After a median follow-up of 9 months, the median PFS was 4.6 months. ORR and PFS were similar irrespective of the previous chemotherapy lines, metastatic sites, and biomolecular expression. Nab-paclitaxel was well tolerated, and the most frequent treatment-related toxicities were mild to moderate (grades 1–2). Conclusion: This real-life study shows that nab-paclitaxel has a significant antitumor activity and a manageable safety profile in patients pretreated with taxanes and experiencing a treatment failure after at least one line of chemotherapy