Background DEPOSEIN (NCT01645839) was a randomized open-label phase III study to explore the role of intrathecal chemotherapy in patients with newly diagnosed leptomeningeal metastasis (LM), a common manifestation of breast cancer. Methods Patients with newly diagnosed LM defined by tumor cells in the cerebrospinal fluid or combination of clinical and neuroimaging signs of LM were randomized to receive systemic therapy alone (control group) or systemic therapy plus intrathecal liposomal cytarabine (experimental group). Progression-free survival related to LM (LM-PFS) was the primary endpoint. Results Thirty-seven and 36 patients were assigned to the control and the experimental groups. Median number of liposomal cytarabine injections in the experimental group was 5 (range 1–20). Focal radiotherapy was performed in 6 (16%) and 3 (8%) patients in the control and experimental groups. In the intent-to-treat population, median LM-PFS was 2.2 months (95% CI: 1.3–3.1) in the control versus 3.8 months (95% CI: 2.3–6.8) in the experimental group (hazard ratio 0.61, 95% CI: 0.38–0.98) (P = 0.04). Seventy-one patients have died. Median overall survival was 4.0 months (95% CI: 2.2–6.3) in the control versus 7.3 months (95% CI: 3.9–9.6) in the experimental group (hazard ratio 0.85, 95% CI: 0.53–1.36) (P = 0.51). Serious adverse events were reported in 22 and 30 patients, respectively. Quality of life until progression did not differ between groups. Conclusion The addition of intrathecal liposomal cytarabine to systemic treatment improves LM-related PFS. Confirmatory trials with optimized patient selection criteria and more active drugs may be required to demonstrate a survival benefit from intrathecal pharmacotherapy.

These results suggest that MASCC is a valid and useful tool to select patients for ambulatory treatments and that oral moxifloxacin monotherapy is safe and effective for the outpatient treatment of cancer patients with low-risk neutropenic fever.

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A series of four coordination polymers based on neodymium have been hydrothermally synthesized with different carboxylic acids as a linker. The structures of the compounds Nd(2)(2,6-ndc)(3)(H(2)O)(3)·H(2)O (1), Nd(2)(2,6-ndc)(2)(ox)(H(2)O)(2) (2), and Nd(2,6-ndc)(form) (3) (2,6-ndc = 2,6-naphthalenedicarboxylate; ox = oxalate; and form = formate) have been determined by single-crystal X-ray diffraction analysis. They exhibit rather dense networks built up from infinite chains of NdO polyhedra connected to each other through the 2,6-ndc ligand. Terminal and bridging aquo species are present in the coordination sphere of Nd for 1, whereas some of them are partially replaced by oxalate groups in 2 and fully substituted by formate groups in 3. The water-free phase 3 as well as the compound Nd(form)(3) (4) were considered for catalytic reaction for polymerization of isoprene in the presence of Al-based cocatalyst, affording cis-polyisoprene with good conversions. Residual Nd material with unchanged structure was found in the polymeric material. The neodymium luminescence of compounds 3 and 4 was also measured.