Considering that mycobacterial heat-shock protein 65 (hsp65) gene transfer can elicit a profound antitumoral effect, this study aimed to establish the safety, maximum-tolerated dose (MTD) and preliminary efficacy of DNA-hsp65 immunotherapy in patients with advanced head and neck squamous cell carcinoma (HNSCC). For this purpose, 21 patients with unresectable and recurrent HNSCC were studied. Each patient received three ultrasound-guided injections at 21-day intervals of: 150, 600 or 400 mg of DNA-hsp65. Toxicity was graded according to CTCAE directions. Tumor volume was measured before and after treatment using computed tomography scan. The evaluation included tumor mass variation, delayed-type hypersensitivity response and spontaneous peripheral blood mononuclear cell proliferation before and after treatment. The MTD was 400 mg per dose. DNAhsp65 immunotherapy was well tolerated with moderate pain, edema and infections as the most frequent adverse effects. None of the patients showed clinical or laboratory alterations compatible with autoimmune reactions. Partial response was observed in 4 out of 14 patients who completed treatment, 2 of which are still alive more than 3 years after the completion of the trial. Therefore, DNA-hsp65 immunotherapy is a feasible and safe approach at the dose of 400 mg per injection in patients with HNSCC refractory to standard treatment. Further studies in a larger number of patients are needed to confirm the efficacy of this novel strategy.

In the current market environment, a good relationship with clients proves to be an essential item to be worked on maintaining competitive advantages. Especially in business-to-business relationships between retailers and their suppliers where transactions have high economic value.The level of difficulty in managing these relationships highly increases when dealing with multi brand companies, which have high offer from suppliers. Therefore, this article aims to study the satisfaction degree of multi brand retailers in surfwear apparel segment when it comes to the relationship with their suppliers. The survey was applied to a closed mailing of companies in the sector, and the responses were analyzed to verify the accuracy of the hypotheses raised by the authors, from the previously studied literature. Specific items on the actions of relationship marketing have had higher dissatisfaction degree, and presented interesting links between the satisfaction degree of retailers and the years of relationship with the supplier, the number of stores and the volume of purchases carried out.

In the current market environment, a good relationship with clients proves to be an essential item to be worked on maintaining competitive advantages. Especially in business-to-business relationships between retailers and their suppliers where transactions have high economic value.