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- Dimopoulos, Meletios A., et al.
(author)
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Safety and efficacy of pomalidomide plus low-dose dexamethasone in STRATUS (MM-010) : A phase 3b study in refractory multiple myeloma
- 2016
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In: Blood. - : American Society of Hematology. - 0006-4971 .- 1528-0020. ; 128:4, s. 497-503
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Journal article (peer-reviewed)abstract
- Patients with relapsed and/or refractory multiple myeloma (RRMM) have poor prognosis. The STRATUS study assessed safety and efficacy of pomalidomide plus low-dose dexamethasone in the largest cohort to date of patients with RRMM. Patients who failed treatment with bortezomib and lenalidomide and had adequate prior alkylator therapy were eligible. Pomalidomide 4 mg was given on days 1-21 of 28-day cycles with low-dose dexamethasone 40 mg (20 mg for patients aged >75 years) on days 1, 8, 15, and 22 until progressive disease or unacceptable toxicity. Safety was the primary end point; secondary end points included overall response rate (ORR), duration of response (DOR), progression-free survival (PFS), and overall survival (OS). Among 682 patients enrolled, median age was 66 years, and median time since diagnosis was 5.3 years. Median number of prior regimens was 5. Most patients were refractory to both lenalidomide and bortezomib (80.2%). Median follow-up was 16.8 months; median duration of treatment was 4.9 months. Most frequent grade 3/4 treatment-emergent adverse events were hematologic (neutropenia [49.7%], anemia [33.0%], and thrombocytopenia [24.1%]). Most common grade 3/4 nonhematologic toxicities were pneumonia (10.9%) and fatigue (5.9%). Grade 3/4 venous thromboembolism and peripheral neuropathy were rare (1.6% each). The ORR was 32.6%, and the median DOR was 7.4 months. Median PFS and OS were 4.6 months and 11.9 months, respectively. We present the largest trial to date evaluating pomalidomide plus low-dose dexamethasone in patients with RRMM, further confirming that this regimen offers clinically meaningful benefit and is generally well tolerated. www.Clinicaltrials.gov identifier NCT01712789.
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- Mahboubi, Amir, et al.
(author)
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Intensification of lignocellulosic bioethanol production process using continuous double-staged immersed membrane bioreactors
- 2020
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In: Bioresource Technology. - : Elsevier BV. - 0960-8524 .- 1873-2976. ; 296
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Journal article (peer-reviewed)abstract
- Processing complexities associated with different lignocellulosic bioethanol production stages have hindered reaching full commercial capacity. Therefore, in this study efforts were made to remediate some issues associated with hydrolysis and fermentation, by the integration of immersed membrane bioreactors (iMBRs) into lignocellulosic bioethanol production process. In this regards, double-staged continuous saccharification-filtration and co-fermentation-filtration of wheat straw slurry was conducted using iMBRs at filtration fluxes up to 51.0 l.m-2.h-1 (LMH). The results showed a stable long-term (264 h) continuous hydrolysis-filtration and fermentation-filtration with effective separation of lignin-rich solids (up to 70% lignin) from hydrolyzed sugars, and separation of yeast cells from bioethanol stream at an exceptional filtration performance at 21.9 LMH. Moreover, the effect of factors such as filtration flux, medium quality and backwashing on fouling and cake-layer formation was studied. The results confirmed the process intensification potentials of iMBRs in tackling commonly faced technical obstacles in lignocellulosic bioethanol production.
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- Toussaint, Laura, et al.
(author)
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Clinical practice in European centres treating paediatric posterior fossa tumours with pencil beam scanning proton therapy
- 2024
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In: RADIOTHERAPY AND ONCOLOGY. - 0167-8140 .- 1879-0887. ; 198
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Journal article (peer-reviewed)abstract
- Background and purpose: As no guidelines for pencil beam scanning (PBS) proton therapy (PT) of paediatric posterior fossa (PF) tumours exist to date, this study investigated planning techniques across European PT centres, with special considerations for brainstem and spinal cord sparing. Materials and methods: A survey and a treatment planning comparison were initiated across nineteen European PBS-PT centres treating paediatric patients. The survey assessed all aspects of the treatment chain, including but not limited to delineations, dose constraints and treatment planning. Each centre planned two PF tumour cases for focal irradiation, according to their own clinical practice but based on common delineations. The prescription dose was 54 Gy(RBE) for Case 1 and 59.4 Gy (RBE) for Case 2. For both cases, planning strategies and relevant dose metrics were compared. Results: Seventeen (89 %) centres answered the survey, and sixteen (80 %) participated in the treatment planning comparison. In the survey, thirteen (68 %) centres reported using the European Particle Therapy Network definition for brainstem delineation. In the treatment planning study, while most centres used three beam directions, their configurations varied widely across centres. Large variations were also seen in brainstem doses, with a brainstem near maximum dose (D2%) ranging from 52.7 Gy(RBE) to 55.7 Gy(RBE) (Case 1), and from 56.8 Gy(RBE) to 60.9 Gy(RBE) (Case 2). Conclusion: This study assessed the European PBS-PT planning of paediatric PF tumours. Agreement was achieved in e.g. delineation-practice, while wider variations were observed in planning approach and consequently dose to organs at risk. Collaboration between centres is still ongoing, striving towards common guidelines.
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