The aim of this randomized multicenter phase III trial was to compare chemotherapy and interferon (IFN) in patients with metastatic carcinoid tumors. Patients with documented progressive, unresectable, metastatic carcinoid tumors were randomized between 5-fluorouracil plus streptozotocin (day 1-5) and recombinant IFN-a-2a (3 MU!3 per week). Primary endpoint was progression-free survival (PFS). From February 1998 to June 2004, 64 patients were included. The two arms were well matched for median age, sex ratio, PS 0-1, previous chemotherapy, surgery, or radiotherapy. The median PFS for chemotherapy was 5.5 months versus 14.1 for IFN (hazard ratioZ0.75 (0.41-1.36)). Overall survival (OS), tolerance, and effects on carcinoid symptoms were not significantly different. Despite a trend in favor of IFN, there was no difference in PFS and OS in advanced metastatic carcinoid tumors and therapeutic effect of both treatments was mild.

A ntimicrobial stewardship has been defined for the veterinary profession as "the actions veterinarians take individually and as a profession to preserve the effectiveness and availability of antimicrobial drugs through conscientious oversight and responsible medical decision-making while safeguarding animal, public, and environmental health." 1 These actions may include making a commitment in one's veterinary practice by assigning a staff member to track stewardship activities, selecting antimicrobials in a judicious and evidence-based manner, or attending continuing education about antimicrobial use (AMU) decisionmaking. The AVMA has outlined 5 core principles of antimicrobial stewardship. Two important stewardship activities include evaluating AMU practices (Core Principle No. 2) and assessing outcomes of AMU (Core Principle No. 4). To accomplish these activities, veterinarians and their partners in animal health are being urged to work together to develop methods of collecting and evaluating AMU data.