TZD use was associated with reduced risk of lung cancer. Further studies are warranted to confirm our findings.

Objectives Gallbladder and cholangiocarcinomas represent a heterogeneous group of malignant diseases that commonly present at an advanced stage and that have limited therapeutic options. Based on the role of the Ras-Raf-Mek-Erk pathway and the VEGF axis in biliary carcinomas, we conducted a phase II study of sorafenib in patients with advanced biliary cancers. Methods Eligible patients had no prior therapy for metastatic or unresectable disease. Sorafenib was administered at 400 mg po twice daily continuously. Results The study was terminated after the first stage of accrual due to failure to meet the primary objective. A confirmed response rate of 0% (0% – 11%) was observed. Thirty-nine percent of patients demonstrated stable disease (including 2 with unconfirmed PR). PFS was 3 months (95% CI: 2–4 months) and OS 9 months (95% CI: 4–12 months). The most common grade 3 and 4 toxicities included venous hand-foot skin reaction (13%), bilirubin elevation (13%), thromboembolism (10%), and AST/ALT elevation (10%) and elevated alkaline phosphatase (10%). Conclusion While treatment with sorafenib did not result in objective responses, patients with biliary cancers receiving this drug had some therapeutic benefit. Additional studies with sorafenib in combination with chemotherapy or other targeted agents may be warranted.

Myelodysplastic syndromes (MDS) and acute myeloid leukaemia (AML) have been reported after autologous transplantation (AT) for lymphoma. It is not clear whether myeloablative therapy used in conjunction with autologous transplantation contributes to the development of MDS/AML or whether the conventional chemotherapy preceding the transplant, and administered over a prolonged period, causes these secondary malignancies. To address this issue, we examined 188 patients with multiple myeloma (MM) who had received AT. 71 patients with no more than one cycle of standard chemotherapy were enrolled in our Total Therapy program, designed to avoid exposure to alkylating agents prior to peripheral blood stem cell mobilization (group 1). The median duration of pretransplant therapy in group 1 was 7.6 months and significantly shorter than the 24 months of 117 patients (group 2) with more prolonged conventional therapy (P = 0.0001). All seven patients developing MDS post-transplantation belonged to group 2 (P = 0.02); the median durations from initial therapy and first transplant were 66 months (range 38-86) and 24 months (range 9-39), respectively. Our findings provide evidence that prolonged standard-dose alkylating agent therapy prior to transplantation, rather than autotransplant-supported myeloablative treatment, is associated with development of MDS/AML. Stem cell damaging alkylator treatment should be avoided, not to compromise PBSC collection, but also to reduce the risk of treatment-related MDS/AML.

Aus eigener Kraft: Ein katalytischer Mikromotor, der auf der lokalen Zersetzung von Wasserstoffperoxid zu Sauerstoff und Wasser basiert, kann durch Bestrahlen mit weißem Licht kontrolliert werden. Wellenlänge und Intensität des Lichts beeinflussen den Zustand des Treibstoffs und ermöglichen so eine Fernsteuerung des Mikromotors (siehe Bild).