Phase II consolidation trial with anti-Lewis-Y monoclonal antibody (hu3S193) in platinum-sensitive ovarian cancer after a second remission.

OBJECTIVE: To investigate the efficacy and safety of hu3S193, a humanized anti-Lewis-Y monoclonal antibody, as a consolidation strategy in patients with platinum-sensitive recurrent epithelial ovarian cancer who achieved a second complete response after salvage platinum-doublet chemotherapy. METHODS: This single-arm phase II study accrued patients with recurrent epithelial ovarian cancer with Lewis-Y expression by immunohistochemistry who had achieved a second complete response after five to eight cycles of platinum-based chemotherapy. Patients received intravenous infusions of hu3S193, 30 mg/m2 every 2 weeks starting no more than 8 weeks after the last dose of chemotherapy and continuing for 12 doses, until disease progression, or unacceptable toxicity. The primary endpoint was progression-free survival of the second remission. Secondary objectives were safety and pharmacokinetics. RESULTS: Twenty-nine patients were enrolled. Most had a papillary/serous histology tumor (94%), stage III disease at diagnosis (75%), and five (17%) underwent secondary cytoreduction before salvage chemotherapy. Two patients were not eligible for efficacy but were considered for toxicity analysis. Eighteen patients (62%) completed the full consolidation treatment while nine patients progressed on treatment. At the time of analysis, 23 patients (85%) of the eligible population had progressed and seven of these patients (26%) had died. Median progression-free survival of the second remission was 12.1 months (95% CI: 10.6-13.9), with a 1-year progression-free survival of the second remission rate of 50.1%. The trial was terminated early since it was unlikely that the primary objective would be achieved. The most commonly reported treatment-related adverse events were nausea (55%) and vomiting (51%). CONCLUSIONS: Hu3S193 did not show sufficient clinical activity as consolidation therapy in patients with recurrent epithelial ovarian cancer who achieved a second complete response after platinum-based chemotherapy. TRIAL REGISTRATION: NCT01137071.

The Relationship between Coronary Artery Disease Risk Factors and Carotid Intima-Media Thickness in Children.

OBJECTIVE: To determine the number of coronary artery disease risk factors and the individual coronary artery disease risk factors that have a negative influence on carotid intima-media thickness in children. STUDY DESIGN: One hundred and nineteen children (mean age 10.51 ± 0.52 years; 51% female) participated. Each subject was assessed for carotid intima-media thickness, total cholesterol, high-density lipoprotein cholesterol (HDL-C), glucose, body mass index (BMI), and resting blood pressure. Surveys assessed family history of cardiovascular disease, and physical activity. Ultrasound assessment was completed on the right and left common carotid arteries. Statistical analyses included the t test, χ2 test, one-way ANOVA, and stepwise regression. RESULTS: An increase in carotid intima-media thickness was observed with 2 vs 0 coronary artery disease risk factors for left carotid intima-media thickness (P < .001). With 3+ vs 0 coronary artery disease risk factors, increases in left (P < .001) and combined left and right carotid intima-media thickness (P < .05) were observed. BMI independently predicted carotid intima-media thickness (r = 0.410; P < .01), but HDL-C did not. However, HDL-C was significantly inversely related to BMI (r = -0.534; P < .01). Combining BMI and HDL-C provided the strongest prediction of carotid intima-media thickness (r = 0.451; adjusted R2 = 0.190). Compared with children with a healthy and overweight BMI, children in the obese category had greater right (P < .00), left (P < .001), and combined right and left carotid intima-media thickness (P < .001). CONCLUSIONS: Carotid intima-media thickness is negatively influenced by 2+ coronary artery disease risk factors. Weight status appears to have the greatest negative impact on carotid intima-media thickness in children. These findings support the need for strategies to lower BMI in children.

Genetic structure provides insights into the geographic origins and temporal change in the invasive charru mussel (Sururu) in the southeastern United States.

In 2004, Mytella charruana (d'Orbigny, 1842) (Mollusca: Bivalvia: Mytilidae) became established along the coast of the southeastern United States (SE-US). Using mitochondrial DNA sequencing (cytochrome c oxidase subunit I), we compared genetic variation throughout its native range in South America to its invasive range in the SE-US. Samples from the SE-US were collected in 2006 and 2010 enabling a temporal comparison to evaluate possible genetic changes of the invasive population. We addressed two questions. First, what are the potential source populations (or geographic regions) for the SE-US invasion? Second, how has genetic diversity changed between the two sampling periods within the SE-US? We identified a total of 72 haplotypes, 64 of which were isolated to geographic sites and only 8 were shared among sites. The highly structured native range provides insight into the origin of invasive populations where our results suggest that the introduced SE-US population originated from multiple source populations with the Panama region as the primary source. Additionally, our results indicate that genetic composition of the non-native populations was unchanged between the two sampling periods. Mytella charruana exhibit a significant pattern of genetic structure among natural populations, owing to biogeographic barriers that limit natural dispersal, and an ability to persist in novel habitats, owing to a suite of life-history characters that favor survival under variable conditions. Overall, this study explains why M. charruana may become an increasing threat to locations founded by anthropogenic transportation.