Randomized phase II study of sunitinib versus standard of care for patients with previously treated advanced triple-negative breast cancer

PurposeThis randomized, open-label phase II study compared the efficacy of sunitinib monotherapy with that of single-agent standard-of-care (SOC) chemotherapy in patients with previously treated advanced triple-negative breast cancer (TNBC).MethodsPatients with advanced TNBC, relapsed after anthracycline- and taxane-based chemotherapy, were randomized to receive either sunitinib (37.5 mg/day) or the investigator's choice of SOC therapy. Progression-free survival was the primary endpoint.ResultsMedian progression-free survival was 2.0 months with sunitinib and 2.7 months with SOC chemotherapy (one-sided P = 0.888). Median overall survival was not prolonged with sunitinib (9.4 months) compared with SOC chemotherapy (10.5 months; one-sided P = 0.839). The objective response rate was 3% with sunitinib and 7% with SOC chemotherapy (one-sided P = 0.962).ConclusionsSunitinib monotherapy did not improve efficacy compared with SOC chemotherapy in patients with previously treated advanced TNBC, for which identification of effective treatments and therapeutic targets remains an urgent need.Trial registrationNCT00246571.     

Influence of preparation mode and depth on the fracture strength of zirconia ceramic abutments restored with lithium disilicate crowns

Purpose: Zirconia implant abutments offer enhanced esthetics and promote biologic sealing; however, the effect of laboratory or intraoral preparation on the mechanical stability of zirconia has not been investigated. The purpose of the study was to evaluate the influence of the preparation mode and depth on the fracture strength of zirconia abutments restored with lithium disilicate crowns. Materials and Methods: To replace a maxillary central incisor (11.0 mm in height and 8.0 mm in width), 35 lithium disilicate crowns were cemented onto zirconia abutments on 4.5- ° - 15-mm titanium implants. Lithium disilicate implant crowns were divided into five study groups (n = 7) according to the abutment preparation mode (milling by the manufacturer or milling by the Celay System [Mikrona] [P]) and preparation depth (0.5 mm [A], 0.7 mm [B], or 0.9 mm [C]). All groups were subjected to quasi-static loading (S) at 135 degrees to the implant axis in a universal testing machine. Results: Mean fracture strengths were: group SA, 384 ± 84 N (control); group SB, 294 ± 95 N; group SPB, 332 ± 80 N; group SC, 332 ± 52; group SPC, 381 ± 101 N. All specimens presented a typical fracture mode within the implant/abutment internal connection. Multiple regression analysis revealed that preparation depth up to 0.7 mm statistically influenced the fracture strength (P = .034), whereas the preparation mode did not seem to play an important role (P = .175). Conclusion: Regardless of preparation mode, circumferential preparation of zirconia abutments might negatively affect the fracture strength of adhesively cemented single implant lithium disilicate crowns.     

Molekulare Pathogenese des hepatozellulären Karzinoms

Hepatocellular carcinoma is one of the most prevalent malignancies worldwide and its incidence is increasing. Multimodal strategies directed towards this carcinoma include primary (e.g. immunisation) and secondary (e.g. antiviral therapy) prevention, surgical approaches, novel specific systemic therapies (targeted therapy), and the treatment of comorbidity (cirrhosis). New molecular approaches are currently under development. These tackle several specific targets, with pathology being challenged in many aspects: experimental evaluation, the development of valid tumor-relevant diagnostic tests as well as morphological evaluation in the context of clinical studies, and finally in routine diagnosis.