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- Wilking, N., et al.
(författare)
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Long-term follow-up of the SBG 9401 study comparing tailored FEC-based therapy versus marrow-supported high-dose therapy
- 2007
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Ingår i: Annals of Oncology. - : Elsevier BV. - 0923-7534 .- 1569-8041. ; 18:4, s. 694-700
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Tidskriftsartikel (refereegranskat)abstract
- Background: The purpose was to investigate adjuvant marrow-supportive high-dose chemotherapy compared with an equitoxicity-tailored comparator arm. Patients and methods: Five hundred and twenty-five women below theage of 60 years with operated high-risk primary breast cancer were randomised to nine cycles of granulocyte colony-stimulating factor supported and individually tailored FEC (5-fluorouracil, epirubicin, cyclophosphamide), (n = 251) or standard FEC followed by marrow-supported high-dose therapy with CTCb (cyclophosphamide, thiotepa, carboplatin) therapy (n = 274), followed by locoregional radiotherapy and tamoxifen for 5 years. Results: There were 104 breast cancer relapses in the tailored FEC group versus 139 in the CTCb group (double triangular method by Whitehead, P = 0.046), with a median follow-up of all included patients of 60.8 months. The event-free survival demonstrated 121 and 150 events in the tailored FEC- and CTCb group, respectively [P = 0.074, hazard ratio (HR) 0.804, 95% confidence interval (CI) 0.633-1.022]. Ten patients in the tailored FEC regimen developed acute myeloid leukaemia (AML)/myelodysplasia (MDS). One hundred deaths occurred in the tailored FEC group and 121 in the CTCb group (P = 0.287, HR 0.866, 95% CI 0.665-1.129). Conclusion: The update of this study shows an improved outcome linked to the tailored FEC treatment in relation to breast cancer relapse, but also an increased incidence of AML/MDS. © 2007 Oxford University Press.
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- Lindman, Henrik, et al.
(författare)
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A randomised study of tailored toxicity-based dosage of fluorouracil-epirubicin-cyclophosphamide chemotherapy for early breast cancer (SBG 2000-1)
- 2018
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Ingår i: European Journal of Cancer. - : Elsevier BV. - 0959-8049 .- 1879-0852. ; 94, s. 79-86
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Tidskriftsartikel (refereegranskat)abstract
- Study aim: Retrospective studies have demonstrated a worse outcome in breast cancer patients not developing leukopenia during adjuvant chemotherapy. The SBG 2000-1 is the first randomised trial designed to compare individually dosed chemotherapy without G-CSF support based on grade of toxicity to standard-dosed chemotherapy based on body surface area (BSA). Methods: Patients with early breast cancer were included and received the first cycle of standard FEC (fluorouracil 600 mg/m2, epirubicin 60 mg/m2, cyclophosphamide 600 mg/m2). Patients with nadir leukopenia grade 0–2 after first cycle were randomised between either 6 additional courses of tailored FEC with increased doses (E 75–90 mg/m2, C 900–1200 mg/m2) or fixed treatment with 6 standard FEC. Patients with grade 3–4 leukopenia were registered and treated with 6 standard FEC. Primary end-point was distant disease-free survival (DDFS). Results: The study enrolled 1535 patients, of which 1052 patients were randomised to tailored FEC (N = 524) or standard FEC (N = 528), whereas 401 patients with leukopenia grade 3–4 continued standard FEC and formed the registered cohort. Dose escalation did not statistically significantly improve 10-year DDFS (79% and 77%, HR 0.87, CI 0.67–1.14, P = 0.32) or OS (82% and 78%, respectively, HR 0.89, CI 0.57–1.16, P = 0.38). Corresponding estimates for the registered group of patients were DDFS 79% and OS 82%, respectively. Conclusions: The SBG 2000-1 study failed to show a statistically significant improvement of escalated and tailored-dosed chemotherapy compared with standard BSA-based chemotherapy in patients with low haematological toxicity, although all efficacy parameters showed a numerical advantage for tailored treatment.
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- Andersson, J, et al.
(författare)
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A population-based study on the first forty-eight breast cancer patients receiving trastuzumab (Herceptin (R)) on a named patient basis in Sweden
- 2002
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Ingår i: Acta Oncologica. - : Informa UK Limited. - 1651-226X .- 0284-186X. ; 41:3, s. 276-281
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Tidskriftsartikel (refereegranskat)abstract
- Several studies have presented data on the efficacy and tolerability of trastuzumab within clinical trials. As a minority of patients is included in these trials, we undertook this retrospective study to describe trastuzumab therapy in clinical routine and its tolerability. We reviewed the medical records of the first 48 patients in Sweden who received treatment with trastuzumab on a named patient basis with (n = 29) and without (n = 19) chemotherapy. Forty-six patients had metastatic disease and had failed to respond to several prior regimens before starting antibody treatment. Two patients had locally advanced breast cancer failing on given neoadjuvant therapy. Patients with breast cancers with strong (3+) c-erbB-2 overexpression tended to have an improved survival from start of trastuzumab treatment versus those with a moderate (2+) overexpression (p=0.09). Adverse events were registered in 22 patients (46%). The most common and acute side effects were fever and chills (7 patients, 15%). The toxicity seemed reasonable but two patients (4%) suffered serious cardiac events, both of them having received previous treatment with antracyclines.
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- Antunes, FE, et al.
(författare)
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Ionization by pH and Anionic Surfactant Binding Gives the Same Thickening Effects of Crosslinked Polyacrylic Acid Derivatives
- 2012
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Ingår i: Journal of Dispersion Science and Technology. - : Informa UK Limited. - 0193-2691 .- 1532-2351. ; 33:9, s. 1368-1372
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Tidskriftsartikel (refereegranskat)abstract
- Physical properties of aqueous solutions of hydrophobically modified crosslinked polyacrylic acids change quite extensively as the polymer is charged up. A study is carried out concerning the similarities between two polymer ionization processes, that is, by pH increment and anionic surfactant addition. The two processes charge the polymer by distinctly different mechanisms. At sufficiently high pH the carboxylic groups of the polymer are virtually all ionized and the polymer is, therefore, fully charged. The effective repulsion among the charged groups due to the entropy of the counterions promotes an increased stiffness as well as an expansion of the polymer particles. We investigate here how the ionization and swelling will be if, instead of high pH, the polymer is at low pH conditions but associated to ionic surfactants. Surfactants associate to the polymer both in a noncooperative way by the binding of individual surfactant molecules and in a cooperative way as micelles since the polymer promotes surfactant self-assembly. This binding leads to a highly charged polymer-surfactant complex and leads to an osmotic swelling as well. The swelling and the gelation were monitored by rheology and dynamic light scattering, of polymer solutions by varying the pHs and adding ionic surfactants at low pH. The results show that ionization by surfactants and by pH lead to approximately the same gelation degree, as can be seen by similar viscosity values. Both processes result in dramatic viscosity increases, up to 8 orders of magnitude. More hydrophobic surfactants, with longer alkyl chain, are shown to be more efficient as enhancers of swelling and gelation. The network that is formed at high pH or at sufficiently high concentration of surfactant can be weakened or even disrupted if monovalent or divalent salts are added, demonstrating the role of counterion entropy.
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- Billsten, P, et al.
(författare)
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Adsorption of human carbonic anhydrase II onto silicon oxides surfaces : The effects of truncation in the N-terminal region
- 1998
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Ingår i: The Colloid Science of Lipids New Paradigms for Self-Assembly in Science and Technology. - 1435-1536 .- 0340-255X. - 9783798511125 - 9783798516557 ; 108, s. 161-165
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Konferensbidrag (refereegranskat)abstract
- The adsorption of human carbonic anhydrase II pseudo-wild type (HCAIIpwt) and an N-terminally truncated version thereof onto silica surfaces were studied. The amount adsorbed and the adsorption kinetics were measured using in situ ellipsometry. A substantial difference was seen between the two proteins. The adsorbed amount of the truncated version (2.53 mg/m2) indicates an end-on orientation, while the HCAIIpwt seems to adsorb side-on (1.84 mg/m2). It is suggested that the orientation effects arise from the truncation. The truncation is known to unfold the two most N-terminal helical segments, which could inhibit adsorption with the N-terminal region facing the surface, due to steric repulsion.
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| 8. |
- Lindman, Björn, et al.
(författare)
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Colloidal systems in DNA packaging
- 2003
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Ingår i: Meeting on Self-Assembly - the Future. - 1586033824 ; , s. 374-386
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Konferensbidrag (refereegranskat)abstract
- The interaction between DNA and cationic cosolutes- multivalent ions, cationic surfactants and cationic macromolecules- has direct biological implications and is also foreseen to have a number of applications, in particular for transfection and protection and purification of DNA. We have during the last few years established a broad physico-chemical research program on various mixed systems of DNA and cationic surfactants. This collaborative Lund-Coimbra project will be outlined, reporting recent findings as well as research plans. The research is largely based on our previous work on mixed polymer-surfactant systems and as a basis we will describe some important general features of those.
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