Regorafenib therapy in metastatic colorectal cancer patients: markers and outcome in an actual clinical setting.

The oral multikinase inhibitor regorafenib had beneficial effects in randomized clinical phase III trials compared to the placebo in patients with metastatic colorectal cancer (mCRC) who progressed on standard therapies. The factors which influence regorafenib response and therapy sequence during treatment history are still highly discussed, and herein we analyzed the therapy algorithm, outcome and clinical markers following regorafenib application in a single center register study. Clinical data for 48 metastatic colorectal cancer patients were collected from 01.01.2013 to 31.12.2016. Treatment effects according to various patient and tumor characteristics were evaluated using univariate and multivariate Cox proportional hazard regression models. The 48 patients comprised 14 (29%) females and 34 (71%) males, with mean age 64.2±9 and ECOG 0-1. Progression free survival under regorafenib therapy was 2.9 months (quartiles 2.2; 4.4) and the overall response rate was 2 (4%) and disease control rate was 19 (40%). Overall survival (OS) and progression free survival (PFS) were investigated under regorafenib in the chemotherapy regimen given immediately before and afterthis treatment. Variables including tumor localization, Ras status, CEA and CA 19-9 plasma levels were analyzed for their impact on PFS, and the regorafenib-related adverse events were also observed. Our study confirms the efficacy of regorafenib in a real-life setting. We established that response rate and PFS in regorafenib treatment are independent of tumor localization, Ras status or biomarkers such as CEA and CA 19-9. Trifluridin/tripacil application or re-induction of chemotherapy +/- target therapy was effective following regorafenib therapy.

Combined effects of elevated CO2 and Cd-contaminated water on growth, photosynthetic response, Cd accumulation and thiolic components status in Lemna minor L.

The objective of this study was to investigate the combined effects of elevated CO2 and cadmium (Cd) treatments on growth, photosynthetic efficiency and phytoremediation ability in Lemna minor L. Plants of L. minor were exposed to different Cd concentrations (0, 1.5, 2.5 and 5 mg L(-1) Cd) for periods of 24, 48 and 72 h at ambient (AC) and at elevated (EC) CO2 (350 and 700 ppm, respectively). Cadmium concentration, bioconcentration factor, enzyme activities and thiols content enhanced in plants with the increase of Cd treatments, time of exposure and at both CO2 levels. Glutathione levels increased only at AC. Growth, photosynthetic and chlorophyll fluorescence parameters, and the reduced glutathione to oxidized glutathione ratio declined in plants with increasing exposure time, Cd treatments and at both CO2 levels. Our results suggested that the alleviation of toxicity, at low Cd doses, observed in L. minor grown at EC is dependent on both increased photosynthesis and an enhanced antioxidant capacity.