AT-101 can be safely combined with topotecan at a reduced dose of 1.25 mg/m(2). The response rates observed did not meet the criteria for additional enrollment; however, many patients had a best response of SD and the median time to progression in both cohorts was favorable. Additional trials of AT-101 in SCLC are ongoing.

7127 Background: Abraxane (A) is a cremophor free, albumin-bound nanoparticle of paclitaxel (P) approved for the treatment of metastatic breast cancer. Belani et al. (JCO 21: 2933–2939, 2003) reported that P 100 mg/m2 days 1, 8 and 15 q 28 days with C AUC 6 on day 1 led to a 32% response rate in 132 patients (pts) with NSCLC. The median time to progression (TTP) was 35 weeks (wks) for stage IIIB and 29 wks for stage IV. Methods: This study was designed to determine if substituting A for P at an identical dose would lead to an improved response rate, TTP or decreased toxicity. Results: Fifty-six pts with stage IIIB/IV NSCLC previously untreated with chemotherapy were enrolled. The median age was 66 (range 37 - 83); 37 were male and median ECOG performance status was 1 (range 0–2). Thirteen pts were stage IIIB. Metastases included bone (17), liver (7), brain (2) and lymph nodes (16). Currently a total of 239 cycles of therapy have been administered with a median of 4 (range 1–8) cycles per pt. In 194 (81%) full dose A was administered on days 1, 8 and 15. The table below shows toxicities compared to P: Seven pts (13%) experienced grade (G) 1 neuropathy and 3 pts (5%) experienced G 2 neuropathy. Five pts were inevaluable for response due to removal from study after <2 cycles of treatment (2 died from progressive disease, 2 because of toxicity - thrombocytopenia and neutropenia - and 1 refused). Of 51 evaluable pts 1 (2%) had a complete response and 23 patients (45%) achieved a partial response. Four of 10 evaluable stage IIIB pts obtained a PR. Twenty-one pts were stable for at least 12 weeks of whom twenty remain stable at 12–29 weeks and one progressed at 23 weeks. A total of 13 pts have progressed and 3 pts have died. The Kaplan-Meier estimate of median TTP is 23 wks and maximum follow up is 34 wks. Conclusions: We conclude that combining A and C is tolerable and active in the treatment of newly-diagnosed NSCLC and antitumor activity compares favorably to that of P/C. Further studies are warranted in this population. [Table: see text] [Table: see text]

Simultaneous bilateral spontaneous pneumothoraces (SBSP) are uncommon. This report presents the case of a previously well 19-year-old man with a diagnosis of SBSP and symptoms suggestive of occupational asthma. Despite bilateral bullectomy and pleurodesis using a video-assisted thoracoscopic surgical technique, the pneumothorax reoccurred unilaterally and open surgery was performed. This case illustrates a rare condition of bilateral pneumothoraces presenting as a first presentation of occupational asthma and the issues surrounding its management.

Hypereosinophilic syndrome is a disease characterised by a persistently elevated eosinophil count. The syndrome can be reactive to infections, autoimmune disease, cancers, etc. Multiple organ involvement can occur including cardiomyopathies, pulmonary involvement and neuropathies. We describe a case of a patient who presented with signs and symptoms of asthma with recurrent asthma exacerbations, but in fact proved to be hypereosinophilic syndrome secondary to strongyloides infection.

Selective estrogen receptor modulators drugs, which exert estrogenic as well as antiestrogenic actions in a tissue selective manner, are used for the treatment of osteoporosis, breast cancer and with effects on the uterus and vagina that depend on the interaction with the estrogen receptors in target tissues. Due to decline of estrogen levels after menopause, hot flashes and sweating occurred as the part of the menopausal vasomotor symptoms with the estrogen related urogenital atrophy and loss of bone density. Selective estrogen receptor modulators (SERMs) has three compounds Tamoxifen Citrate, Raloxifene, Bazedofene. Tamoxifen acts as selective estrogen receptor modulator or as a partial agonist of the estrogen receptors. It has mixed estrogenic and anti-estrogenic activity with its profile of effects deficiency by tissue. Raloxifene is used for the treatment of oestoporosis in postmenopausal women and also reduces breast density. Bazedofene has been also developed for the treatment of osteoporosis. The estrogen receptor has two subunits alpha and beta and SERMs interact either of these subunits and form this interaction, there is a certain level of target site specificity and tissue specificity of SERMs action. Tamoxifen represented agonist effects in inhibiting neutralised migration and preventing arthritis progression in ovariectomized mice. Clomiphene citrate and tamoxifen commonly used SERMs for the induction of ovulation. that Bazedoxifen enhances OPCs into functional oligodendrocytes which enhanced OPC differentiation and remyelination. Estrogen receptor alpha play a vital role in the etiology, treatment and prevention of the majority breast cancer. The SERMs raloxifene and bazedoxifen also both reportedly inhibit bone resorptive activity in postmenopausal osteoporosis patients and have been used to prevent bone fragility fractures.