The ATAC ('Arimidex', Tamoxifen, Alone or in Combination) adjuvant breast cancer trial: first results of the endometrial sub-protocol following 2 years of treatment

BACKGROUND: Tamoxifen treatment results in a doubling of the risk of endometrial cancer after 1-2 years of treatment and a quadrupling after 5 years. Anastrozole, a third-generation aromatase inhibitor, with superior efficacy to tamoxifen, may also offer tolerability benefits in terms of effects on the endometrium. METHODS AND RESULTS: A sub-protocol of the ATAC trial compared the incidence/type of intrauterine changes following treatment with these agents in a subgroup of patients (n = 285) from the main trial. After 2 years anastrozole treatment, endometrial thickness remained 相似文献   

A prototypical process for creating evidentiary standards for biomarkers and diagnostics

A framework for developing evidentiary standards for qualification of biomarkers is a key need identified in the Food and Drug Administration's Critical Path Initiative. This article describes a systematic framework that was developed by Pharmaceutical Research and Manufacturers of America (PhRMA) committees and tested at a workshop in collaboration with the Food and Drug Administration and academia. With some necessary refinements, this could be applied to create an appropriately individualized evidentiary standard for any biomarker purpose.     

A pilot study to explore circulating tumour cells in pancreatic cancer as a novel biomarker

Background:

Obtaining tissue for pancreatic carcinoma diagnosis and biomarker assessment to aid drug development is challenging. Circulating tumour cells (CTCs) may represent a potential biomarker to address these unmet needs. We compared prospectively the utility of two platforms for CTC enumeration and characterisation in pancreatic cancer patients in a pilot exploratory study.

Patients and methods:

Blood samples were obtained prospectively from 54 consenting patients and analysed by CellSearch and isolation by size of epithelial tumour cells (ISET). CellSearch exploits immunomagnetic capture of CTCs-expressing epithelial markers, whereas ISET is a marker independent, blood filtration device. Circulating tumour cell expression of epithelial and mesenchymal markers was assessed to explore any discrepancy in CTC number between the two platforms.

Results:

ISET detected CTCs in more patients than CellSearch (93% vs 40%) and in higher numbers (median CTCs/7.5 ml, 9 (range 0–240) vs 0 (range 0–144)). Heterogeneity observed for epithelial cell adhesion molecule, pan-cytokeratin (CK), E-Cadherin, Vimentin and CK 7 expression in CTCs may account for discrepancy in CTC number between platforms.

Conclusion:

ISET detects more CTCs than CellSearch and offers flexible CTC characterisation with potential to investigate CTC biology and develop biomarkers for pancreatic cancer patient management.     

Opsin exhibits cGMP-activated single-channel activity.

Low concentrations of cGMP evoked reversible single-channel currents in patches excised from liposomes that contained purified bovine opsin. Two elementary conductances, of 32 and 17 pS, were observed in the presence of 10-200 microM cGMP. Both individual channel openings (mean open times, approximately 1.6 ms for the 32-pS conductance and approximately 1.0 ms for the 17-pS conductance) and bursts of openings (mean burst duration, approximately 2-3 ms for the large events) were observed. The cGMP-activated channel activity could be observed in the presence or absence of Ca2+. These results raise the possibility that opsin or rhodopsin, an opsin/rhodopsin isoform, or an opsin/isoform multimer serves as a cGMP-modulated pore in the rod outer segment.     

Heterodimerization of type II phytochromes in Arabidopsis

Coimmunoprecipitation of members of the phytochrome red/farred photoreceptor family from plant extracts has been used to analyze their heteromeric binding interactions. Phytochrome (phy)B or phyD apoproteins with six myc epitopes fused to their N termini are biologically active when expressed in Arabidopsis. Immunoprecipitation of either of these tagged proteins from seedling extracts coprecipitates additional type II phytochromes: six myc (myc6)-phyB coprecipitates phyC-phyE; and myc6-phyD coprecipitates phyB and phyE. No interaction of the epitope-tagged proteins with type I phyA was detected. Gel filtration chromatography shows that all five of the Arabidopsis phytochromes are present in seedlings as dimers, and that the heteromeric type II phytochrome complexes migrate at molecular masses characteristic of heterodimers. Similar levels of heterodimer formation are observed in extracts of dark-grown seedlings, where the phytochromes are cytosolic, and light-grown seedlings, where they are predominantly nuclear. These findings indicate that Arabidopsis, which until now has been thought to contain five homodimeric forms of phytochrome, in fact contains multiple species of both homodimeric and heterodimeric phytochromes. The conservation of the phytochrome family throughout angiosperms suggests that heterodimeric red/far-red receptors may be present in many flowering plants.     

Severe allergy: an audit and service review

BACKGROUND: In 2002, a paediatric respiratory service in South Wales carried out a study to identify children in local schools who had a diagnosis of severe allergy, requiring them to carry an epipen. This investigation was carried out as a result of three schools seeking advice. Three children were identified as suffering from severe allergy; one child from each of the three schools. It was evident that sufficient education and support was not available for these children, their families and school staff regarding allergy management. This led to further investigation to see if there were others experiencing similar problems. METHOD: To identify school-aged children with a diagnosis of severe allergy, a survey took place of the three schools mentioned above plus a further 111 schools. Sixteen additional children were noted to be carrying epipens in 16 separate schools. An audit pro forma was devised and used to collect relevant data to establish previous allergy management and current allergy status. The 16 children and their families were invited to an assessment clinic where they were interviewed by a respiratory nurse specialist. RESULTS: There were deficiencies in allergy management relating to: assessment, diagnosis, medication provision, education, support and ongoing follow up. These deficiencies highlighted the need for the development of a paediatric allergy service and a multi professional collaborative approach to care. CONCLUSION: The findings from the five phases of this study have influenced the development of an allergy clinic. This has led to collaborative working between healthcare professionals, school staff, children, and their families. The findings have promoted practice in terms of conducting thorough nursing and medical assessment, appropriate diagnosis, education and ongoing support for children and their families.