Prevalencia de Fasciola hepatica y Paramphistomidae en bovinos de doble propósito en una hacienda del trópico bajo andino colombiano / Prevalence of Fasciola hepatica and Paramphistomidae in dual purpose cattle in a farm in the Colombian low Andean tropic

RESUMEN En muchos países la fasciolosis y la paramfistomosis representan un grave problema para la salud del sector pecuario. En Colombia hay registros de ambas distomatosis en bovinos, la mayoría en el trópico alto andino, las cuales generan pérdidas econômicas anuales cercanas a 40 000 000 000 COP. El objetivo de esta investigación fue determinar la prevalencia de fasciolosis y paramfistomosis en vacunos de la hacienda La Candelaria, Caucasia (Colombia), y la presencia de caracoles hospederos intermediarios. Para cumplirlo, se realizó un estudio descriptivo de corte transversal con muestreo no probabilístico por conveniencia. Se recolectaron heces de los animales y se hizo el diagnóstico mediante la técnica modificada de Dennis. Se establecieron las prevalencias de los digeneos de acuerdo con el sexo, peso, edad y raza. Se recolectaron caracoles dulciacuícolas en la zona estudiada y se identificaron por morfologia. Se analizaron 466 muestras fecales de 178 bovinos, de las razas Cebú (Bos indicus), BON (blanco orejinegro) y del cruce entre ellas. Se diagnosticaron F. hepatica y Paramphistomidae con prevalencias del 2,2% y 30,9%, respectivamente. En el 1,1% de los vacunos se diagnosticó coinfección. Ambas trematodosis prevalecieron en las hembras (p = 0,03). Se identificaron moluscos dulciacuícolas Ampullariidae, Physidae y Planorbidae sin estadios larvarios de digeneos. Se concluyó que los bovinos de doble propósito de la hacienda La Candelaria están expuestos a F. hepatica y Paramphistomidae, y, probablemente, se infectan en los predios de la hacienda. Paramphistomidae es más prevalente que F. hepatica, lo cual concuerda con lo descrito en algunos estudios realizados en hatos del trópico alto andino colombiano. Paramphistomidae se encontró en todos los grupos etarios.

ABSTRACT Fasciolosis and paramphistomosis are a major health problem for the livestock economy worldwide. In Colombia, both distomatosis are reported in cattle, particularly in high Andean tropics, with annual economic losses close to COP 40 billion. The goal of this study was to determine the prevalence of fasciolosis and paramphistomosis in cattle from La Candelaria farm, Caucasia (Colombia), and the presence of intermediate host snails. A descriptive cross-sectional study was carried out with non-probability convenience sampling. Stool samples were collected from the animals and the diagnosis was made using the modified Dennis technique. Digenea prevalence were determined according to sex, weight, age, and race. Freshwater snails were collected in the studied area and were identified by morphology. 400 and 66 fecal samples from 178 bovines of the Zebu (Bos indicus), BON (white-eared white) breeds and the cross between them were analyzed. Fasciola hepatica and Paramphistomidae were diagnosed with a prevalence of 2,2% and 30,9%, respectively. Coinfection was diagnosed in 1,1% of the cattle. Both trematodosis were most frequent in females (p = 0,03). Freshwater molluscs Ampullariidae, Physidae and Planorbidae without digenea larval stages were identified. It was concluded that dual-purpose cattle from La Candelaria farm are exposed to F. hepatica and Paramphistomidae and are probably infected on the farm grounds. Paramphistomidae was more prevalent than F. hepatica, which agrees with other studies in herds from the Colombian high Andean tropics. Paramphistomidae was found in all age groups.

Determination of the temperature causing a nociceptive response in the tail of albino BALB/c mice.

INTRODUCTION: Designs for determining nociceptive response in rodents are of great use in neurology and experimental neuroscience. Immersing mice's tails in warm water is one of the most widely used procedures to evaluate this response; however, a wide range of temperatures are used in different studies. Knowing the temperature that produces a powerful nociceptive response in the tail of BALB/c mice is extremely useful. METHODS: Eight 2-month-old male BALB/c mice were used. A 14-cm high beaker was filled with water up to 13cm. The animals' tails were immersed in the container with a starting temperature of 36°C. The water temperature was raised in 1°C increments until we identified the temperatures that produced nociceptive responses. That response was determined by counting the time taken before the mouse shook its tail to remove it from the water. RESULTS: Six of the 8 mice began shaking their tails at the temperature of 51°C. All animals removed their tails from the water at the temperatures of 54°C, 55°C, and 56°C, taking a mean time of 8.54, 7.99, and 5.33seconds, respectively. ANOVA applied to the response times for each of the 3 temperatures indicated revealed a value of F=2.8 (P=.123). CONCLUSIONS: The response time was statistically similar for the temperatures of 54°C, 55°C, and 56°C; however, the data were less dispersed for the latter temperature.

Determinación de la temperatura de respuesta nociceptiva sobre la cola de ratones albinos de la cepa Balb/c / Determination of the temperature causing a nociceptive response in the tail of albino BALB/c mice

Introducción: Los diseños para determinar la respuesta nociceptiva en roedores son de gran utilidad en neurología y en neurociencias experimentales. El paradigma de inmersión de la cola de ratón en agua temperada es uno de los más empleados para evaluar dicha respuesta; sin embargo, existe amplia variación en la temperatura utilizada en las diversas investigaciones. Resulta sumamente útil determinar la temperatura que produce una mejor respuesta nociceptiva sobre la cola de ratones de la cepa Balb/c.MétodosSe emplearon 8 ratones machos Balb/c de 2 meses de edad. Un beaker de 14 cm de alto se llenó de agua hasta 13 cm. Partiendo desde los 36 °C se empezó a sumergir la cola del animal dentro del recipiente. Se comenzó a elevar en 1 °C el agua hasta encontrar las temperaturas que produzcan las respuestas nociceptivas. Dicha respuesta se determinó contabilizando el tiempo que el ratón tardó en sacudir su cola retirándola del agua.ResultadosLos ratones empezaron a sacudir su cola a los 51 °C (6 de los 8 roedores). El total de la muestra retiró su cola del agua a los 54, 55 y 56 °C en el tiempo promedio de 8,54, 7,99 y 5,33 s, respectivamente. Al aplicar ANOVA a los tiempos de las 3 temperaturas señaladas se obtuvo el valor F = 2,8 y p = 0,123.ConclusionesEl tiempo de respuesta fue similar estadísticamente ante las temperaturas de 54, 55 y 56 °C; sin embargo se encontró menor dispersión de los datos ante esta última. (AU)

Introduction: Designs for determining nociceptive response in rodents are of great use in neurology and experimental neuroscience. Immersing mice's tails in warm water is one of the most widely used procedures to evaluate this response; however, a wide range of temperatures are used in different studies. Knowing the temperature that produces a powerful nociceptive response in the tail of BALB/c mice is extremely useful.MethodsEight 2-month-old male BALB/c mice were used. A 14-cm high beaker was filled with water up to 13 cm. The animals’ tails were immersed in the container with a starting temperature of 36 °C. The water temperature was raised in 1 °C increments until we identified the temperatures that produced nociceptive responses. That response was determined by counting the time taken before the mouse shook its tail to remove it from the water.ResultsSix of the 8 mice began shaking their tails at the temperature of 51 °C. All animals removed their tails from the water at the temperatures of 54 °C, 55 °C, and 56 °C, taking a mean time of 8.54, 7.99, and 5.33 seconds, respectively. ANOVA applied to the response times for each of the 3 temperatures indicated revealed a value of F=2.8 (P=.123).ConclusionsThe response time was statistically similar for the temperatures of 54 °C, 55 °C, and 56 °C; however, the data were less dispersed for the latter temperature. (AU)

HLA-G as a new tumor biomarker: detection of soluble isoforms of HLA-G in the serum and saliva of patients with colorectal cancer.

INTRODUCTION: Recent medical investigations suggest that HLA-G, due to its tolerogenic properties, can be used as a biomarker in the diagnosis, treatment, and prognosis of different neoplasms. This observational prospective pilot study aims at detecting sHLA-G in the serum and saliva of patients diagnosed with colorectal cancer (CRC). For this purpose, we compared the expression of sHLA-G from patients with a control sample from a healthy population. MATERIALS AND METHODS: Using the specific enzyme-linked immunosorbent assay (ELISA) method, the expression of sHLA-G in the serum and saliva samples from patients affected by CRC (n = 20) and in a control sample (n = 10) were analyzed. RESULTS: The data showed that in patients with CRC, salivary sHLA-G values were significantly higher than in the control group (18.84 U/ml versus 6.3 U/ml, p = 0.036). In addition, higher levels of sHLA-G were observed in the saliva of patients with CRC in more advanced stages, compared with patients in early stages (24.2 U/ml vs. 8.1 U/ml, p = 0.019). A significant correlation was observed between the concentration of sHLA-G in the serum and saliva of the analyzed samples (Spearman correlation 0.7, p = 0.004). CONCLUSIONS: This study demonstrates, for the first time, the possibility of detecting sHLA-G in the saliva of patients with CRC, resulting in a less invasive alternative to venipuncture. Likewise, we propose that sHLA-G could be an attractive molecular target based on its significant high levels in advanced stages.

Whole body PD-1 and PD-L1 positron emission tomography in patients with non-small-cell lung cancer.

PD-L1 immunohistochemistry correlates only moderately with patient survival and response to PD-(L)1 treatment. Heterogeneity of tumor PD-L1 expression might limit the predictive value of small biopsies. Here we show that tumor PD-L1 and PD-1 expression can be quantified non-invasively using PET-CT in patients with non-small-cell lung cancer. Whole body PD-(L)1 PET-CT reveals significant tumor tracer uptake heterogeneity both between patients, as well as within patients between different tumor lesions.

Experimental and theoretical structural/spectroscopical correlation of enterobactin and catecholamide.

Here we report the IR spectra of FeEnterobactin in catecholate conformations ([CatFeEB]3-) obtained by DFT calculations using PBE/QZVP and their correlation it with its experimental counterpart [SalH3FeEB]0. Fragments of FeEnterobactin and Enterobactin (H6EB) are elucidated from their MALDI-TOF mass spectrometry, and the dependence of the frontier orbitals (HOMO and LUMO) with the catecholamide dihedral angles of H6EB is reported. The frequency distribution of catecholamide dihedral angle of H6EB was carried-out using molecular dynamics (MD). The data presented enriches the understanding of [CatFeEB]3 - and H6EB frequency distribution and reactivity.

Mesorhizobium sanjuanii sp. nov., isolated from nodules of Lotus tenuis in the saline-alkaline lowlands of Flooding Pampa, Argentina.

Two rhizobial strains, BSA136T and BSA150, related to the genus Mesorhizobium were isolated from root nodules of Lotus tenuis grown in saline-alkaline lowlands soil from Argentina. These strains showed different repetitive element palindromic PCR fingerprinting patterns but shared more than 99 % sequence similarity for both 16S rRNA and recA genes. Despite the symbiotic nodC gene sequences of our strains being related to the canonical Lotus biovar species comprising Mesorhizobium loti and Mesorhizobium japonicum, the 16S rRNA phylogenetic marker suggests that their taxonomical identities are closely related to Mesorhizobium helmanticense, Mesorhizobium metallidurans, Mesorhizobium thianshanense, Mesorhizobium gobiense and Mesorhizobium tarimense. Multilocus sequence analysis performed with seven housekeeping genes confirmed that BSA136T belongs to a separate clade within the genus Mesorhizobium. The results of comparisons for in silico DNA-DNA hybridization and average nucleotide identity indexes between the genomes of BSA136T and closest-related Mesorhizobium species were below the threshold for species delineation. Phenotypic features differentiated BSA136T from its closest-related species. On the basis of our results, BSA136T and BSA150 can be considered to represent a novel species of the genus Mesorhizobium, for which the name Mesorhizobium sanjuanii sp. nov. is hereby proposed. The type strain of this species is BSA136T (=CECT 9305T=LMG 30060T), for which the draft genome sequence is available.

Determination of the temperature causing a nociceptive response in the tail of albino BALB/c mice. / Determinación de la temperatura de respuesta nociceptiva sobre la cola de ratones albinos de la cepa Balb/c.

INTRODUCTION: Designs for determining nociceptive response in rodents are of great use in neurology and experimental neuroscience. Immersing mice's tails in warm water is one of the most widely used procedures to evaluate this response; however, a wide range of temperatures are used in different studies. Knowing the temperature that produces a powerful nociceptive response in the tail of BALB/c mice is extremely useful. METHODS: Eight 2-month-old male BALB/c mice were used. A 14-cm high beaker was filled with water up to 13 cm. The animals' tails were immersed in the container with a starting temperature of 36°C. The water temperature was raised in 1°C increments until we identified the temperatures that produced nociceptive responses. That response was determined by counting the time taken before the mouse shook its tail to remove it from the water. RESULTS: Six of the 8 mice began shaking their tails at the temperature of 51°C. All animals removed their tails from the water at the temperatures of 54°C, 55°C, and 56°C, taking a mean time of 8.54, 7.99, and 5.33seconds, respectively. ANOVA applied to the response times for each of the 3 temperatures indicated revealed a value of F=2.8 (P=.123). CONCLUSIONS: The response time was statistically similar for the temperatures of 54°C, 55°C, and 56°C; however, the data were less dispersed for the latter temperature.

IR and NMR spectroscopic correlation of enterobactin by DFT.

Emerging and re-emerging epidemic diseases pose an ongoing threat to global health. Currently, Enterobactin and Enterobactin derivatives have gained interest, owing to their potential application in the pharmaceutical field. As it is known [J. Am. Chem. Soc (1979) 101, 20, 6097-6104], Enterobactin (H6EB) is an efficient iron carrier synthesized and secreted by many microbial species. In order to facilitate the elucidation of enterobactin and its analogues, here we propose the creation of a H6EB standard set using Density Functional Theory Infrared (IR) and NMR spectra. We used two exchange-correlation (xc) functionals (PBE including long-range corrections LC-PBE and mPW1), 2 basis sets (QZVP and 6-31G(d)) and 2 grids (fine and ultrafine) for most of the H6EB structures dependent of dihedral angles. The results show a significant difference between the OH and NH bands, while the CO amide and O(CO) IR bands are often found on top of each other. The NMR DFT calculations show a strong dependence on the xc functional, basis set, and grid used for the H6EB structure. Calculated 1H and 13C NMR spectra enable the effect of the solvent to be understood in the context of the experimental measurements. The good agreement between the experimental and the calculated spectra using LC-PBE/QZVP and ultrafine grid suggest the possibility of the systems reported here to be considered as a standard set. The dependence of electrostatic potential and frontier orbitals with the catecholamide dihedral angles of H6EB is described. The matrix-assisted laser desorption/ionization time of the flight mass spectrometry (MALDI-TOF MS) of H6EB is also reported of manner to enrich the knowledge about its reactivity.

Role of the spinal TrkB-NMDA receptor link in the BDNF-induced long-lasting mechanical hyperalgesia in the rat: A behavioural study.

BACKGROUND: Intrathecal/intracisternal BDNF in rodents produces long-lasting hyperalgesia/allodynia, which implies BDNF plays a role in the establishment and maintenance of central sensitization. Both self-regeneration of endogenous BDNF and neuroplastic modifications of spinal NMDA receptors downstream TrkB signalling could be involved in such enduring hyperalgesia. We investigated to what extent BDNF by itself could participate in the generation and maintenance of mechanical hyperalgesia using pharmacological tools. METHODS: We studied sensitivity of mechanical hyperalgesia induced by a single intrathecal (i.t.) injection of BDNF (3 ng/10 µL i.t.) administered at time zero, for: (1) chronic NMDA receptor inhibition with subcutaneously implanted 7-day delivery osmotic pumps loaded with ketamine; (2) TrkB receptor inhibition with intraperitoneal (i.p.) cyclotraxine-B; and (3) chronic glial inhibition with repeated propentofylline i.t. injections. Nociceptive threshold to paw pressure, tested on days -3, 0, 3, 7, 10 and 14, was used as the index of central sensitization. Locomotor patterns and food and water consumption were assessed with LABORAS. RESULTS: Chronic ketamine prevented the mechanical hyperalgesia induced by BDNF, without affecting locomotion and food and water consumption. After pump depletion, a late hyperalgesic response to paw pressure stimulation emerged, which can be lastingly antagonized by cyclotraxine-B. Chronic propentofylline treatment irreversibly suppressed BDNF-induced hyperalgesia. CONCLUSION: Activation of NMDA receptors downstream to TrkB signalling is essential for behavioural expression of the mechanical hyperalgesia induced by intrathecal BDNF. However, maintenance of the hyperalgesia depends mainly from self-regenerating glial BDNF rather than from a NMDA receptor-dependent form of neuroplasticity. SIGNIFICANCE: Intrathecal BDNF induces long-lasting central sensitization via a glial-likely BDNF self-regenerating mechanism, whose behavioural expression depends on downstream activation of NMDA receptors. This knowledge suggests that TrkB antagonists could represent an interesting lead for the development of novel therapeutic strategies for some chronic pain conditions.

Conventional versus modern abattoirs in Colombia: Impacts on welfare indicators and risk factors for high muscle pH in commercial Zebu young bulls.

The aim of the study was to determine the effects of abattoir type (conventional abattoir -CA- versus modern abattoir -MA-) on stress parameters and risk factors for high muscle pH in Colombia. A total of 522 Zebu young bulls were studied in two groups: 285 at CA, and 237 at MA. Blood samples were taken to measure cortisol, glucose, lactate, creatine kinase, ß-hydroxybutyrate, total protein, albumin, creatinine, urea, haematocrit, leukocytes and N/L ratio. Cattle were monitored during the unloading, lairage, handling and stunning. The logistic regression model showed that stocking density, transport time, abattoir type, and inefficient stunning were variables associated with the prevalence of dark cutting carcasses. This study demonstrated that modern improvements at abattoir level, proper infrastructure, and stunning equipment, do not always guarantee quality in terms of animal welfare. As a first attempt in the Colombian beef industry, this research suggested how handling practices could affect cattle welfare and the prevalence of high muscle pH even at MA.

Risk factors influencing bruising and high muscle pH in Colombian cattle carcasses due to transport and pre-slaughter operations.

The aim of this study was investigate risk factors as possible causes for bruising and high muscle pH under commercial operating conditions in Colombia. Data was recorded for 86 journeys referring to 1179 animals. Carcasses were analyzed in terms of muscle pH and bruises (site, size, severity and shape). Our results indicate that truck load density, stops during transportation of cattle and the lairage time at the plant increased the risk of bruises appearing on carcasses. A lairage time of 18 to 24h at the plant increased the prevalence of bruises 2.1 times compared to lairage periods of between 12 and 18 h. Furthermore, intermittent stops during transit are a risk factor for the increase in the incidence of bruises. However, the transport time (up to 4h) was not related to the presence of bruises and high muscle pH. Finally, steers were found to have less risk of presenting a high muscle pH.

Therapeutic strategies based on polymeric microparticles.

The development of the field of materials science, the ability to perform multidisciplinary scientific work, and the need for novel administration technologies that maximize therapeutic effects and minimize adverse reactions to readily available drugs have led to the development of delivery systems based on microencapsulation, which has taken one step closer to the target of personalized medicine. Drug delivery systems based on polymeric microparticles are generating a strong impact on preclinical and clinical drug development and have reached a broad development in different fields supporting a critical role in the near future of medical practice. This paper presents the foundations of polymeric microparticles based on their formulation, mechanisms of drug release and some of their innovative therapeutic strategies to board multiple diseases.

Análisis de la gestión territorial: Encuesta Nacional de Salud 2007, Colombia 2011 / Analysis of the local authorities: National Health Survey 2007, Colombia 2011

OBJETIVO: en este artículo se presentan los resultados de la Encuesta Nacional de Salud de 2007 (ENS), del módulo I sobre las administraciones territoriales de salud, en cuanto a la capacidad de gestionar la salud en los municipios y caracterizar la infraestructura sanitaria y la vigilancia en la salud pública. METODOLOGIA: se realizó un estudio descriptivo retrospectivo, en una muestra representativa de 238 municipios del país de todas las categorías, de los cuales respondieron 223. La fuente de información fue la ENS/2007, aplicada a los secretarios de salud de los municipios de la muestra. RESULTADOS: la oferta de instituciones públicas y privadas de salud y aseguradoras, tiene mayor presencia en los municipios de categoría 1 y especial. La infraestructura sanitaria es insuficiente pero es mayor en los municipios de categoría especial y principalmente en la zona urbana. La vigilancia en salud pública para la mortalidad materna, perinatal, Enfermedad Diarréica Aguda (EDA) e Infección Respiratoria Aguda (IRA) es mayor en los municipios de categorías 1 y especial. CONCLUSIONES: a pesar de los esfuerzos realizados por los actores municipales para mejorar la salud, los resultados muestran desigualdades importantes entre la zona urbana y rural, así como entre los municipios de categorías 1 y especial, al igual que en las otras categorías, situación que demanda inversiones mayores en infraestructura sanitaria, en el sistema de vigilancia de la salud pública y en los programas de los municipios de menor desarrollo, para que las desigualdades no sean progresivas y se obtengan mejores beneficios en salud para la población.

OBJECTIVE: this paper presents the results of the 2007 National Health Survey's (ENS) module I, which deals with territorial management of health regarding the capacity to manage health in the municipalities and to characterize their sanitary infrastructure and public health surveillance. METHODOLOGY: a descriptive retrospective study was conducted with a representative sample of 238 Colombian municipalities from all the categories, 223 of which answered the call. The source of information was the ENS/2007, which was applied to the health secretaries of the sample's municipalities. RESULTS: more public and private health providers and health insurance companies are available in the municipalities belonging to the special category and to category 1. The sanitary infrastructure is insufficient but larger in the municipalities from the special category, particularly in the urban area. Public health surveillance for maternal and perinatal mortality, and for add and ari is higher in the municipalities from the special category and from category 1. CONCLUSIONS: in spite of the efforts of the municipalities to improve health, the results show important inequalities between the rural and urban areas, and between the municipalities from the special category and the municipalities from other categories. This situation calls for larger investments for the sanitary infrastructure, the public health surveillance systems, and the programs of the less developed municipalities in order to prevent inequalities from becoming progressive and to obtain better profits in terms of the people's health.

Effect of single post-ovulatory administration of levonorgestrel on gene expression profile during the receptive period of the human endometrium.

The hypothesis that levonorgestrel (LNG) used as an emergency contraceptive interferes with endometrial receptivity remains unproven. We compared the endometrial gene expression profile during the receptive period after administering a single dose of LNG 1.5 mg or placebo on day 1 of the luteal phase. An endometrial biopsy was done on day LH+7 or LH+8 and samples were taken from seven volunteers, each one contributing with one cycle treated with placebo and another with LNG. The expression of 20 383 genes was determined using cDNA microarrays. Real-time RT-PCR was used 1) to confirm the differences found in DNA microarray analysis and 2) to determine the effect of LNG on transcript levels of C3, C4BPα, COX2, MAOA, S100A4, and SERPINB9, known to be upregulated during receptivity, and on cPLA2α, JAK1, JNK1, CTSL1, and GSTP1, known to respond to mifepristone. Additional endometrial biopsies were done during the pre-receptive (LH+3) and receptive (LH+7) period and samples were taken from eight untreated volunteers in order to determine the changes associated with acquisition of receptivity of 14 genes. Mean levels of PAEP, TGM2, CLU, IGF2, and IL6ST mRNAs increased after administering LNG while those of HGD, SAT1, EVA1, LOC90133, ANXA1, SLC25A29, CYB5A, CRIP1, and SLC39A14 decreased. Except for the level of ANXA1 transcript, all changes remained within the range observed in untreated controls, and none of the transcripts responding to mifepristone changed in response to LNG. Post-ovulatory administration of LNG caused minimal changes in gene expression profiling during the receptive period. Neither the magnitude nor the nature or direction of the changes endorses the hypothesis that LNG interferes with endometrial receptivity.

Phase I dose-escalation study to determine the safety, pharmacokinetics and pharmacodynamics of brivanib alaninate in combination with full-dose cetuximab in patients with advanced gastrointestinal malignancies who have failed prior therapy.

BACKGROUND: The objectives of this phase I study were to determine the safety, pharmacokinetics (PK), pharmacodynamics and efficacy of brivanib combined with full-dose cetuximab in patients with advanced gastrointestinal malignancies. METHODS: Patients with advanced gastrointestinal malignancies who had failed prior therapies received brivanib (320, 600 or 800 mg daily) plus cetuximab (400 mg m(-2) loading dose then 250 mg m(-2) weekly). Assessments included adverse events, PK, tumour response, 2[18F]fluoro-2-deoxyglucose positron-emitting tomography and K-Ras mutation analyses. RESULTS: Toxicities observed were manageable; the most common treatment-related toxicities (>10% of patients) were fatigue, diarrhoea, anorexia, increase in aspartate aminotransferase and alanine aminotransferase, acneiform dermatitis, headache, mucosal inflammation, nausea, dry skin, vomiting, hypertension, pruritus, proteinuria and weight loss. Of 62 patients, 6 (9.7%) had objective radiographic partial responses, with an overall response rate of 10%. Median duration of response was 9.2 months; median progression-free survival was 3.9 months. CONCLUSIONS: The acceptable toxicity profile and efficacy of brivanib observed in this study were promising. These findings are being further evaluated in a phase III study of brivanib plus cetuximab vs cetuximab alone in patients previously treated with combination chemotherapy for K-Ras wild-type advanced metastatic colorectal cancer.

A phase I study to determine the safety, pharmacokinetics and pharmacodynamics of a dual VEGFR and FGFR inhibitor, brivanib, in patients with advanced or metastatic solid tumors.

BACKGROUND: This study was designed to determine the safety, pharmacokinetics (PK) and pharmacodynamics (PD) of brivanib in patients with advanced/metastatic solid tumors. PATIENTS AND METHODS: Ninety patients enrolled in this two-part, phase I open-label study of oral brivanib alaninate. The primary objectives of this study were (in part A) dose-limiting toxicity, maximum tolerated dose (MTD) and the lowest biologically active dose level and (in part B) the optimal dose/dose range. The secondary objectives of this study were preliminary evidence of antitumor activity, PK and PD. RESULTS: Across part A (open-label dose escalation and MTD) and part B (open-label dose optimization), 68 patients received brivanib alaninate. Brivanib demonstrated a manageable toxicity profile at doses of 180-800 mg. Most toxic effects were mild. Systemic exposure of the active moiety brivanib increased linearly ≤1000 mg/day. The MTD was 800 mg/day. Forty-four patients were treated at the MTD: 20 with 800 mg continuously, 11 with 800 mg intermittently and 13 with 400 mg b.i.d. doses. Partial responses were confirmed in two patients receiving brivanib ≥600 mg. Dynamic contrast-enhanced magnetic resonance imaging demonstrated statistically significant decreases in parameters reflecting tumor vascularity and permeability after multiple doses in the 800-mg continuous q.d. and 400-mg b.i.d. dose cohorts. CONCLUSION: In patients with advanced/metastatic cancer, brivanib demonstrates promising antiangiogenic and antitumor activity and manageable toxicity at doses ≤800 mg orally q.d., the recommended phase II study dose.