A Phase I Study of Abiraterone Acetate Combined with BEZ235, a Dual PI3K/mTOR Inhibitor, in Metastatic Castration Resistant Prostate Cancer.

Lessons learnedThe combination of standard dose abiraterone acetate and BEZ235, a pan-class I PI3K and mTORC1/2 inhibitor, was poorly tolerated in men with progressive mCRPC.Although the clinical development of BEZ235 has been discontinued in prostate cancer, agents that more selectively target PI3K-AKT-mTOR signaling may have a more favorable therapeutic index and should continue to be explored.BackgroundAndrogen receptor (AR) and phosphatidylinositol-3 kinase (PI3K) signaling are two commonly perturbed pathways in prostate cancer. Preclinical data have shown that the two pathways compensate for each other when one is inhibited, and combined inhibition of AR and PI3K signaling may be a viable strategy to prevent or overcome castration resistance.MethodsThis phase I study evaluated the safety and tolerability of abiraterone acetate and prednisone combined with BEZ235, a dual PI3K and mTORC1/2 inhibitor, in men with progressive metastatic castration resistant prostate cancer (mCRPC) who have not received prior chemotherapy.ResultsSix patients (n = 6) were treated at the starting dose level of abiraterone acetate 1,000 mg with prednisone 5 mg twice daily and BEZ235 200 mg twice daily in a 3 + 3 dose escalation design. The study was terminated early because three of the six patients (50%) experienced dose-limiting toxicities: grade 3 mucositis, grade 3 hypotension, and grade 4 dyspnea and pneumonitis. All six patients had previously progressed on abiraterone/prednisone. The median treatment duration was 27 days (range: 3-130 days). No prostate-specific antigen (PSA) decline or objective response were observed.ConclusionThe combination of standard-dose abiraterone/prednisone with BEZ235 200 mg twice daily was poorly tolerated in patients with mCRPC. The on-target and off-target effects of dual PI3K and mTORC inhibition likely contributed to the unacceptable toxicity profile. The Oncologist 2017;22:503-e43

SimFection: a digital resource for vaccination education

© 2018 Royal Society of Biology. Vaccination coverage in the United Kingdom is below the level recommended by the World Health Organisation, and when vaccination coverage is not sufficient, outbreaks of infectious diseases can occur. In 2015, coverage of the first dose of the Measles-Mumps-Rubella vaccine declined in the United Kingdom for the first time since 2008, indicating a need to raise public awareness and understanding of the importance of vaccination to public health. Identifying 16 – 18-year olds as a target audience, being future parents who would make decisions regarding vaccination of their children, a digital educational resource (‘SimFection’) was developed to deliver key messages about the spread and control of vaccine-preventable infectious diseases (identified via school curricula). The process of development utilised an iterative approach, involving a cyclic process of prototyping, testing, analysis and refinement with a range of audiences including students, schoolchildren, and trainee teachers. The completed resource is now available online for free download

The pK0\Sigma+ final state in proton-proton collisions

This paper reports results from a study of the reaction pp->pK0\Sigma+ at beam momenta of p_{beam} = 2950, 3059, and 3200 MeV/c (excess energies of \epsilon= 126, 161, and 206 MeV). Total cross sections were determined for all energies; a set of differential cross sections (Dalitz plots; invariant mass spectra of all two-body subsystems; angular distributions of all final state particles; distributions in helicity and Jackson frames) are presented for \epsilon= 161 MeV. The total cross sections are proportional to the volume of available three-body phase-space indicating that the transition matrix element does not change significantly in this range of excess energies. It is concluded from the differential data that the reaction proceeds dominantly via the N(1710)P_{11} and/or N(1720)P_{13} resonance(s); N(1650)S_{11} and \Delta(1600)P_{33} could also contribute.Comment: 15 pages, 10 figure