First-line nivolumab plus chemotherapy vs chemotherapy in patients with advanced gastric,gastroesophageal junction and esophageal adenocarcinoma: CheckMate 649 Chinese subgroup analysis

First-line chemotherapy for advanced/metastatic human epidermal growth factor receptor 2 (HER2)-negative gastric/gastroesophageal junction cancer (GC/GEJC) has poor median overall survival (OS; <1 year). We report efficacy and safety results from Chinese patients in the phase III global CheckMate 649 study of nivolumab plus chemotherapy vs chemotherapy for the first-line treatment of GC/GEJC/esophageal adenocarcinoma (EAC). Chinese patients with previously untreated advanced or metastatic GC/GEJC/EAC were randomized to receive nivolumab (360 mg Q3W or 240 mg Q2W) plus chemotherapy (XELOX [capecitabine and oxaliplatin] Q3W or FOLFOX [oxaliplatin, leucovorin and 5-fluorouracil] Q2W), nivolumab plus ipilimumab (not reported) or chemotherapy alone. OS, blinded independent central review-assessed progression-free survival (PFS), objective response rate (ORR), duration of response (DOR) and safety are reported. Of 1581 patients enrolled and randomized, 208 were Chinese. In these patients, nivolumab plus chemotherapy resulted in clinically meaningful improvement in median OS (14.3 vs 10.2 months; HR 0.61 [95% CI: 0.44-0.85]), median PFS (8.3 vs 5.6 months; HR 0.57 [95% CI: 0.40-0.80]), ORR (66% vs 45%) and median DOR (12.2 vs 5.6 months) vs chemotherapy, respectively. The safety profile was acceptable, with no new safety signals observed. Consistent with results from the global primary analysis of CheckMate 649, nivolumab plus chemotherapy demonstrated a clinically meaningful improvement in OS and PFS and higher response rate vs chemotherapy and an acceptable safety profile in Chinese patients. Nivolumab plus chemotherapy represents a new standard first-line treatment for Chinese patients with non-HER2-positive advanced GC/GEJC/EAC.     

Is Premature Thelarche in the First Two Years of Life Transient?

Objective: Premature thelarche (PT) refers to isolated onset of thelarche in girls younger than 8 years of age. Most cases have an onset under 2 years of age. We aimed to establish whether the onset of thelarche under 2 years of age certifies a transient clinical course, as suggested by several authors.Methods: Sixty-seven girls with an onset of PT under 2 years of age were classified as having early puberty (EP) or classical PT after one year of follow-up. Progression of pubertal findings or absolute growth velocity (GV) standard deviation score (SDS) above 1 SDS constituted the criteria for a diagnosis of EP. Results: Twenty (29.1%) girls were classified as having EP and 47 (70.1%) girls as having classical PT. Basal serum luteinizing hormone (LH; ICMA) values at a cut-off level of 0.3 IU/L were found to be a significant risk factor for having an atypical course [OR=7.8; CI (95%): 2.04– 30.4, p=0.003]. Conclusions: Onset of thelarche under 2 years of age does not assure a transient course in a remarkable proportion of girls with PT. An absolute GV value of >1 SDS or a basal LH level ≥0.3 IU/L are suggested as indicators for close follow-up. Conflict of interest:None declared.     

Determination of the mineral content of bee honeys produced in Middle Anatolia

The mineral content of 43 honey samples from the middle regions of Turkey was investigated. Minerals were determined by inductively coupled plasma-atomic emission spectrophotometer. Calcium, potassium, sodium and phosphorus were the most abundant of the elements in all the studied honeys, with average concentrations ranging between 40.13 and 189.69 mg/kg for calcium, 161.01 and 598.62 mg/kg for potassium, 9.34 and 45.9 mg/kg for sodium, and 460.11 and 3,776.96 mg/kg for phosphorus. Cluster analysis of the honey data revealed that the mineral content of Çorum and Konya honeys was closer as they formed a cluster at a similarity level of 60%.     

The long-term outcomes of persistent childhood allergic asthma: A cross-sectional study from western Anatolia: Childhood persistent asthma in western Anatolia

BackgroundProspective cohort studies have provided useful knowledge about the natural history of asthma. However, most of the studies are conducted in western countries but the course of the disease and long-term outcomes may differ between countries due to environmental and cultural factors.ObjectiveThe aim of this study is to describe the long-term outcomes of childhood asthma, with data from a follow-up study of at least 10 years, in western Anatolia, Turkey.MethodsFifty-two patients diagnosed with persistent allergic asthma participated in the study. The patient's demographics, findings on admission, age at onset of disease, time of diagnosis, history of other allergic conditions, history of parental asthma and allergic disorders, presence of pharmacotherapy and immunotherapy were obtained from patients’ records. The factors influencing remission at the end of 10 years follow-up were evaluated.ResultsA total of 20 patients (38.5%) were on remission at the end of 10 years. The type of allergen, multi-allergen sensitivity, eosinophilia and elevated serum immunoglobulin E on admission, accompanying allergic disorders and atopy in parents, and allergen immunotherapy did not affect the remission rate (p > 0.05).ConclusionChildhood persistent asthma is not a homogeneous clinical entity but high clinical remission rates are obtained in western Anatolia. There is no significant predictor of clinical remission in long term follow-up. Prospective studies should be performed in larger asthmatic populations to obtain further data about the natural course of childhood asthma.