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Combination chemotherapy with gemcitabine and cisplatin in patients with metastatic urothelial cancer of the bladder frequently results in the development of acquired drug resistance. Availability of cell culture models with acquired resistance could help to identify candidate treatments for an efficient second-line therapy. Six cisplatin- and six gemcitabine-resistant cell lines were established. Cell viability assays were performed to evaluate the sensitivity to 16 different chemotherapeutic substances. The activity of the drug transporter ATP-binding cassette transporter, subfamily B, member 1 (ABCB1, a critical mediator of multidrug resistance in cancer) was evaluated using fluorescent ABCB1 substrates. For functional assessment, cells overexpressing ABCB1 were generated by transduction with a lentiviral vector encoding for ABCB1, while zosuquidar was used for selective inhibition. In this study, 8 of 12 gemcitabine- or cisplatin-resistant cell lines were cross-resistant to carboplatin, 5 to pemetrexed, 4 to methotrexate, 3 to oxaliplatin, 5-fluorouracil, and paclitaxel, and 2 to cabazitaxel, larotaxel, docetaxel, topotecan, doxorubicin, and mitomycin c, and 1 of 12 cell lines was cross-resistant to vinflunine and vinblastine. In one cell line with acquired resistance to gemcitabine (TCC-SUPrGEMCI20), cross-resistance seemed to be mediated by ABCB1 expression. Our model identified the vinca alkaloids vinblastine and vinflunine, in Europe an already approved second-line therapeutic for metastatic bladder cancer, as the most effective compounds in urothelial cancer cells with acquired resistance to gemcitabine or cisplatin. These results demonstrate that this in vitro model can reproduce clinically relevant results and may be suitable to identify novel substances for the treatment of metastatic bladder cancer.
Injury of the sciatic nerve results in regulations of pro- and anti-oxidative enzymes at sites of nociceptive signaling including the injured nerve, dorsal root ganglia (DRGs), dorsal horn of the spinal cord, thalamus and somatosensory cortex (Valek et al., 2015) [1]. The present DiB paper shows immunohistochemistry of redoxins including peroxiredoxins (Prdx1–6), glutaredoxins (Glrx1, 2, 3, 5), thioredoxins (Txn1, 2) and thioredoxin reductases (Txnrd1, 2) in the DRGs, spinal cord and sciatic nerve and thalamus in naïve mice and 7 days after Spared sciatic Nerve Injury (SNI) in control mice (Hif1α-flfl) and in mice with a specific deletion of hypoxia inducible factor 1 alpha (SNS-HIF1α−/−) in DRG neurons. The sciatic nerves were immunostained for the respective redoxins and counterstained with hematoxylin. The redoxin immunoreactivity was quantified with ImageJ. For the DRGs and spinal cord the data show the quantitative assessment of the intensity of redoxin immunoreactivity transformed to rainbow pseudocolors. In addition, some redoxin examples of the ipsi and contralateral dorsal and ventral horns of the lumbar spinal cord and some redoxin examples of the thalamus are presented.
In the present work, mismatch negativity (MMN) was used to examine the contribution of spectral vs. temporal perceptual features to vowel length discrimination in children and adults. Three age groups (adults vs. 9-10 years vs. 10-11 years olds) have been taken to examine developmental effects on vowel length perception. Natural (i.e., spectrotemporal) vowel length differences were compared with (artificially modified) stimulus pairs varying only in temporal or spectral characteristics to contrast spectral, temporal and spectrotemporal processing.
The result indicates that, while adults integrate spectral and temporal aspects of the speech signal in an additive way, children of 9-10 years of age sequentially process both features. However, vowel length processing is found to become adultlike at the age of 10-11 years.
Biomedical data obtained during cell experiments, laboratory animal research, or human studies often display a complex distribution. Statistical identification of subgroups in research data poses an analytical challenge. Here were introduce an interactive R-based bioinformatics tool, called “AdaptGauss”. It enables a valid identification of a biologically-meaningful multimodal structure in the data by fitting a Gaussian mixture model (GMM) to the data. The interface allows a supervised selection of the number of subgroups. This enables the expectation maximization (EM) algorithm to adapt more complex GMM than usually observed with a noninteractive approach. Interactively fitting a GMM to heat pain threshold data acquired from human volunteers revealed a distribution pattern with four Gaussian modes located at temperatures of 32.3, 37.2, 41.4, and 45.4 °C. Noninteractive fitting was unable to identify a meaningful data structure. Obtained results are compatible with known activity temperatures of different TRP ion channels suggesting the mechanistic contribution of different heat sensors to the perception of thermal pain. Thus, sophisticated analysis of the modal structure of biomedical data provides a basis for the mechanistic interpretation of the observations. As it may reflect the involvement of different TRP thermosensory ion channels, the analysis provides a starting point for hypothesis-driven laboratory experiments.
Computed ABC analysis for rational selection of most informative variables in multivariate data
(2015)
Objective: Multivariate data sets often differ in several factors or derived statistical parameters, which have to be selected for a valid interpretation. Basing this selection on traditional statistical limits leads occasionally to the perception of losing information from a data set. This paper proposes a novel method for calculating precise limits for the selection of parameter sets.
Methods: The algorithm is based on an ABC analysis and calculates these limits on the basis of the mathematical properties of the distribution of the analyzed items. The limits implement the aim of any ABC analysis, i.e., comparing the increase in yield to the required additional effort. In particular, the limit for set A, the "important few", is optimized in a way that both, the effort and the yield for the other sets (B and C), are minimized and the additional gain is optimized.
Results: As a typical example from biomedical research, the feasibility of the ABC analysis as an objective replacement for classical subjective limits to select highly relevant variance components of pain thresholds is presented. The proposed method improved the biological interpretation of the results and increased the fraction of valid information that was obtained from the experimental data.
Conclusions: The method is applicable to many further biomedical problems including the creation of diagnostic complex biomarkers or short screening tests from comprehensive test batteries. Thus, the ABC analysis can be proposed as a mathematically valid replacement for traditional limits to maximize the information obtained from multivariate research data.
Background: Plant hormones are well known regulators which balance plant responses to abiotic and biotic stresses. We investigated the role of abscisic acid (ABA) in resistance of barley (Hordeum vulgare L.) against the plant pathogenic fungus Magnaporthe oryzae.
Results: Exogenous application of ABA prior to inoculation with M. oryzae led to more disease symptoms on barley leaves. This result contrasted the finding that ABA application enhances resistance of barley against the powdery mildew fungus. Microscopic analysis identified diminished penetration resistance as cause for enhanced susceptibility. Consistently, the barley mutant Az34, impaired in ABA biosynthesis, was less susceptible to infection by M. oryzae and displayed elevated penetration resistance as compared to the isogenic wild type cultivar Steptoe. Chemical complementation of Az34 mutant plants by exogenous application of ABA re-established disease severity to the wild type level. The role of ABA in susceptibility of barley against M. oryzae was corroborated by showing that ABA application led to increased disease severity in all barley cultivars under investigation except for the most susceptible cultivar Pallas. Interestingly, endogenous ABA concentrations did not significantly change after infection of barley with M. oryzae.
Conclusion: Our results revealed that elevated ABA levels led to a higher disease severity on barley leaves to M. oryzae. This supports earlier reports on the role of ABA in enhancing susceptibility of rice to the same pathogen and thereby demonstrates a host plant-independent function of this phytohormone in pathogenicity of monocotyledonous plants against M. oryzae.
In the first part of the thesis, we show that the payment flow of a linear tax on trading gains from a security with a semimartingale price process can be constructed for all càglàd and adapted trading strategies. It is characterized as the unique continuous extension of the tax payments for elementary strategies w.r.t. the convergence "uniformly in probability". In this framework, we prove that under quite mild assumptions dividend payoffs have almost surely a negative effect on investor’s after-tax wealth if the riskless interest rate is always positive. In addition, we give an example for tax-efficient strategies for which the tax payment flow can be computed explicitly.
In the second part of the thesis, we investigate the impact of capital gains taxes on optimal investment decisions in a quite simple model. Namely, we consider a risk neutral investor who owns one risky stock from which she assumes that it has a lower expected return than the riskless bank account and determine the optimal stopping time at which she sells the stock to invest the proceeds in the bank account up to the maturity date. In the case of linear taxes and a positive riskless interest rate, the problem is nontrivial because at the selling time the investor has to realize book profits which triggers tax payments. We derive a boundary that is continuous and increasing in time, and decreasing in the volatility of the stock such that the investor sells the stock at the first time its price is smaller or equal to this boundary.
Cognitive stability and flexibility are core functions in the successful pursuit of behavioral goals. While there is evidence for a common frontoparietal network underlying both functions and for a key role of dopamine in the modulation of flexible versus stable behavior, the exact neurocomputational mechanisms underlying those executive functions and their adaptation to environmental demands are still unclear. In this work we study the neurocomputational mechanisms underlying cue based task switching (flexibility) and distractor inhibition (stability) in a paradigm specifically designed to probe both functions. We develop a physiologically plausible, explicit model of neural networks that maintain the currently active task rule in working memory and implement the decision process. We simplify the four-choice decision network to a nonlinear drift-diffusion process that we canonically derive from a generic winner-take-all network model. By fitting our model to the behavioral data of individual subjects, we can reproduce their full behavior in terms of decisions and reaction time distributions in baseline as well as distractor inhibition and switch conditions. Furthermore, we predict the individual hemodynamic response timecourse of the rule-representing network and localize it to a frontoparietal network including the inferior frontal junction area and the intraparietal sulcus, using functional magnetic resonance imaging. This refines the understanding of task-switch-related frontoparietal brain activity as reflecting attractor-like working memory representations of task rules. Finally, we estimate the subject-specific stability of the rule-representing attractor states in terms of the minimal action associated with a transition between different rule states in the phase-space of the fitted models. This stability measure correlates with switching-specific thalamocorticostriatal activation, i.e., with a system associated with flexible working memory updating and dopaminergic modulation of cognitive flexibility. These results show that stochastic dynamical systems can implement the basic computations underlying cognitive stability and flexibility and explain neurobiological bases of individual differences.
Introduction: ameloblastoma is a slow growing, painless odontogenic swelling which can attain sizes that result in severe deformities of the craniofacial complex. It is the most commonly encountered odontogenic tumor in Nigeria. Surgical intervention is currently the method of treatment; however identification of altered molecular pathways may inform chemotherapeutic potential. The Protein Patched homolog 1 (PTCH-1) is overexpressed in ameloblastoma. Also, mutation in the MDM2 gene can reduce the tumor suppressor function of p53 and promote ameloblastoma growth. No study however has characterized the molecular profile of African cases of ameloblastoma with a view to developing chemotherapeutic alternatives. The objective was to characterize the PTCH-1 genetic profile of Ameloblastoma in Nigerian patients as a first step in investigating its potential for chemotherapeutic intervention.
Methods: twenty-eight FFPE blocks of ameloblastoma cases from Nigerian patients were prepared for antibody processing to PTCH-1 (Polyclonal Anti-PTCH antibody ab39266) and MDM2 (Monoclonal Anti-MDM2 antibody (2A10) ab16895). Cytoplasmic brown staining was considered as positive for PTCH while nuclear staining was positive for MDM2.
Results: moderate and strong expressions for PTCH in ameloblast and stellate reticulum were 78.6% and 60.7% respectively. Only 3 (10.7%) cases expressed MDM2.
Conclusion: the importance of our study is that it supports, in theory, anti-PTCH/SHH chemotherapeutics for Nigerian ameloblastoma cases and also infers the possible additional use of anti-p53 agents.
Römische Grabbauten sind im Grunde kein Thema, dem es an wissenschaftlicher Aufmerksamkeit mangelt. Allerdings lag der Fokus in den vergangenen Jahrzehnten beinahe durchweg auf den Denkmälern in Rom und Italien, die sowohl aus bautypologischer als auch aus sozial- und kulturhistorischer Perspektive intensiv erforscht wurden und werden. Für die Grabbauten in den Provinzen, insbesondere den Nordwestprovinzen fehlte es dagegen lange an übergreifenden Studien. Diese Lücke wird nun durch die in Teilen auf den Ergebnissen eines EUProjektes zum Thema "Transformation" aufbauende Studie von Markus Scholz (S.) geschlossen, der sich den erhaltenen Denkmälern in detaillierter Weise anhand einer typologischen Methodik annimmt. Der Größe des Untersuchungsgebiets, das von Britannien über die Rhein- und Donauprovinzen bis ans Schwarze Meer reicht, und der damit einhergehend immensen Zahl einbezogener Objekte (ca. 3500 Grabbauten) entspricht auch der Umfang des Werkes, das mit zwei Bänden mit jeweils rund 570 Seiten bereits auf den ersten Blick gewichtig anmutet. ...
Derivation and characterization of a new filter for nonlinear high-dimensional data assimilation
(2015)
Data assimilation (DA) combines model forecasts with real-world observations to achieve an optimal estimate of the state of a dynamical system. The quality of predictions in nonlinear and chaotic systems such as atmospheric or oceanic circulation is strongly sensitive to the initial conditions. Therefore, beyond the consistent reconstruction of past states, a primary relevance of advanced DA methods concerns the proper model initialization. The ensemble Kalman filter (EnKF) and its deterministic variants, mostly square root filters such as the ensemble transform Kalman filter (ETKF), represent a popular alternative to variational DA schemes. They are applied in a wide range of research and operations. Their forecast step employs an ensemble integration that fully respects the nonlinear nature of the analyzed system. In the analysis step, they implicitly assume the prior state and observation errors to be Gaussian. Consequently, in nonlinear systems, the mean and covariance of the analysis ensemble are biased and these filters remain suboptimal. In contrast, the fully nonlinear, non-Gaussian particle filter (PF) relies on Bayes' theorem without further assumptions, which guarantees an exact asymptotic behavior. However, it is exposed to weight collapse, particularly in higher-dimensional settings, known as the curse of dimensionality.
This work presents a new method to obtain an analysis ensemble with mean and covariance that exactly match the corresponding Bayesian estimates. This is achieved by a deterministic matrix square root transformation of the forecast ensemble, and subsequently a suitable random rotation that significantly contributes to filter stability while preserving the required second-order statistics. The forecast step remains as in the ETKF. The algorithm, which is fairly easy to implement and computationally efficient, is referred to as the nonlinear ensemble transform filter (NETF). The limitation with respect to fully-nonlinear filtering is that the NETF only considers the mean and covariance of the Bayesian analysis density, neglecting higher-order moments.
The properties and performance of the proposed algorithm are investigated via a set of experiments. The results indicate that such a filter formulation can increase the analysis quality, even for relatively small ensemble sizes, compared to other ensemble filters in nonlinear, non-Gaussian scenarios. They also confirm that localization enhances the applicability of this PF-inspired scheme in larger-dimensional systems. Finally, the novel filter is coupled to a large-scale ocean general circulation model with a realistic observation scenario. The NETF remains stable with a small ensemble size and shows a consistent behavior. Additionally, its analyses exhibit low estimation errors, as revealed by a comparison with a free ensemble integration and the ETKF. The results confirm that, in principle, the filter can be applied successfully and as simple as the ETKF in high-dimensional problems. No further modifications are needed, even though the algorithm is only based on the particle weights. Thus, it is able to overcome the curse of dimensionality, even in deterministic systems. This proves that the NETF constitutes a promising and user-friendly method for nonlinear high-dimensional DA.
Die Sammlung von Aufsätzen des Frankfurter Lehrers, Erziehungswissenschaftlers und Soziologen besteht aus drei Teilen: In dem ersten Teil wird der Frage nachgegangen, aus welcher Perspektive heraus Unterricht hermeneutisch erschlossen werden und in welche Theorietradition sich eine hermeneutische Unterrichtsforschung stellen kann bzw. sollte. In dem zweiten Teil sind sodann Aufsätze versammelt, in denen grundlegende Fragen des Unterrichts neu aufgegriffen werden: Welche Probleme stellen sich zu Beginn einer jeden Unterrichtsstunde und welche Möglichkeiten gibt es, diese zu lösen? Worauf beruht die Autorität einer Lehrperson und wie wird diese im Unterricht durch die beteiligten Akteure kommunikativ erzeugt oder auch vermindert? Wie sind Unterrichtsstörungen zu deuten und wie ist mit ihnen umzugehen, wenn davon ausgegangen wird, dass diese Momente eines Interaktionsprozesses sind, die jeweils situativ emergieren? Was bedeutet es für Schüler, sich am Unterricht zu beteiligen? Und welche Situationen können sich ergeben, wenn die Schülerschaft einer Klasse in kultureller Hinsicht äußerst heterogen ist? Die Art und Weise, wie diese Fragen behandelt werden, ist nicht nur durch das besondere methodische Vergehen gekennzeichnet, sondern auch durch einen kasuistischen Zugang: Auf der Basis theoretischer Vorüberlegungen wird stets ein empirisches Beispiel herangezogen, um an diesem diese theoretischen Überlegungen nicht nur zu überprüfen, sondern schließlich auch weiterzuentwickeln. Dabei ist die Stoßrichtung stets dieselbe: Die Vielzahl möglicher Deutungen von Unterricht wird nicht bestritten, doch die Fruchtbarkeit einer dezidiert pädagogischen Deutung dieses Geschehens wird immer wieder hervorgehoben. Abgeschlossen wird der Band mit Aufsätzen zu Fragen der Professionalisierung von Lehrerinnen und Lehrern. So wird das Verhältnis zwischen der Didaktik, vor allem didaktischer Theorien und der Theorie der Professionalisierung ausgelotet. Und es wird der Frage nachgegangen, welche Konsequenzen sich aus der pädagogischen Kasuistik für die Professionalisierung von Lehrpersonen sowie für die Theorie der Professionalisierung ziehen lassen. Auch diese Fragen werden jeweils mit Bezug auf empirische Beispiele erörtert. (DIPF/Verlag)
Mehr als 18 Milliarden Euro hat die Commerzbank im Zuge der Finanzkrise in Form von staatlichen Garantien, Kapitalspritzen oder Einlagen erhalten. Auch die Hypo Real Estate, die WestLB, die SachsenLB und die IKB profitierten von Stützungsmaßnahmen. Die EU genehmigte diese und andere staatlichen Hilfsmaßnahmen. Grundsätzlich sind staatliche Stützungsmaßnahmen jedoch als wirtschaftlicher Vorteil zu werten und damit zunächst eine verbotene Beihilfe. In seinem Working Paper betrachtet Tuschl die rechtlichen Grundlagen des EU-Beihilferechts und zeigt die teilweise differierende Praxis der EU-Kommission auf.
Previous study showed that kaffir lime leaf contains alkaloid, flavonoid, terpenoid, tannin and saponin. The objective of this study was to examine the cytotoxic effect of kaffir lime leaf extract on cervical cancer and neuroblastoma cell lines. The method used for this research to determine cell viability was an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay. Results showed that an ethyl acetate extract had an IC50 for HeLa cells, UKF-NB3, IMR-5 and SK-N-AS parental cells of 40.7 μg · mL–1, 28.4 μg · mL–1, 14.1 μg · mL–1, and 25.2 μg · mL–1 respectively. Furthermore, the IC50 of chloroform extracts for HeLa cells, UKF-NB3, IMR-5 and SK-N-AS parental were 17.6 μg · mL–1, 18.9 μg · mL–1, 6.4 μg · mL–1, and 9.4 μg · mL–1 respectively. These data showed that kaffir lime extract reduces the viability of cervical and neuroblastoma cell lines and may have potential as anti-cancer compounds.
Background: Measurement of prostate-specific antigen (PSA) advanced the diagnostic and prognostic potential for prostate cancer (PCa). However, due to PSA’s lack of specificity, novel biomarkers are needed to improve risk assessment and ensure optimal personalized therapy. A set of protein molecules as potential biomarkers was therefore evaluated in serum of PCa patients.
Methods: Serum samples from patients undergoing radical prostatectomy (RPE) for biopsy-proven PCa without neoadjuvant treatment were compared to serum samples from healthy subjects. Preliminary screening of 119 proteins in 10 PCa patients and 10 controls was carried out by the Proteome Profiler Antibody Array. Those markers showing distinct differences between patients and controls were then further evaluated by ELISA in the serum of 165 PCa patients and 19 controls. Uni- and multivariate as well as correlation analysis were performed to test the capability of these molecules to detect disease and predict pathological outcome.
Results: Screening showed that soluble (s)E-cadherin, E-selectin, MMP2, MMP9, TIMP1, TIMP2, Galectin and Clusterin warranted further evaluation. sE-Cadherin, TIMP1, Galectin and Clusterin were significantly over- and MMP9 under-expressed in PCa compared to controls. The concentration of sE-cadherin, MMP2 and Clusterin correlated negatively and that of MMP9 and TIMP1 positively with the Gleason Sum at prostatectomy. Only sE-cadherin significantly correlated with the highest Gleason pattern. Compared to serum PSA, sE-cadherin provided an independent and better matching predictive ability for discriminating PCas with an upgrade at RPE and aggressive tumors with a Gleason Sum ≥7.
Conclusions: sE-cadherin performed most favorably from a large panel of serum proteins in terms of diagnostic and predictive potential in curatively treatable PCa. sE-cadherin merits further investigation as a biomarker for PCa.
This paper looks into the specific influence that the European banking union will have on (future) bank client relationships. It shows that the intended regulatory influence on market conditions in principle serves as a powerful governance tool to achieve financial stability objectives.
From this vantage, it analyzes macro-prudential instruments with a particular view to mortgage lending markets – the latter have been critical in the emergence of many modern financial crises. In gauging the impact of the new European supervisory framework, it finds that the ECB will lack influence on key macro-prudential tools to push through more rigid supervisory policies vis-à-vis forbearing national authorities.
Furthermore, this paper points out that the current design of the European bail-in tool supplies resolution authorities with undue discretion. This feature which also afflicts the SRM imperils the key policy objective to re-instill market discipline on banks’ debt financing operations. The latter is also called into question because the nested regulatory technique that aims at preventing bail-outs unintendedly opens additional maneuvering space for political decision makers.
This paper looks into the specific influence that the European banking union will have on (future) bank client relationships. It shows that the intended regulatory influence on market conditions in principle serves as a powerful governance tool to achieve financial stability objectives.
From this vantage, it analyzes macro-prudential instruments with a particular view to mortgage lending markets – the latter have been critical in the emergence of many modern financial crises. In gauging the impact of the new European supervisory framework, it finds that the ECB will lack influence on key macro-prudential tools to push through more rigid supervisory policies vis-à-vis forbearing national authorities.
Furthermore, this paper points out that the current design of the European bail-in tool supplies resolution authorities with undue discretion. This feature which also afflicts the SRM imperils the key policy objective to re-instill market discipline on banks’ debt financing operations. The latter is also called into question because the nested regulatory technique that aims at preventing bail-outs unintendedly opens additional maneuvering space for political decision makers.
Negative Zinsen auf Einlagen – juristische Hindernisse und ihre wettbewerbspolitischen Auswirkungen
(2015)
Im anhaltenden Niedrigzinsumfeld tun Banken sich schwer damit, die ihnen zur Verfügung gestellte Liquidität einer renditeträchtigen Nachfrage zuzuführen. Darüberhinaus müssen sie auf Liquiditätsüberschüsse, die im Rahmen der Einlagenfazilität des Eurosystems über Nacht bei den nationalen Zentralbanken der Eurozone deponiert werden, Strafzinsen entrichtet. Vor diesem Hintergrund könnten Banken durch negative Einlagenzinsen das Anliegen verfolgen, die Nachfrage nach Aufbewahrung von (Sicht)Einlagen zu verringern. Einer solchen Strategie stehen aber aus juristischer Sicht Hindernisse entgegen, soweit der beschriebene Paradigmenwechsel auch im Rahmen existierender Kundenbeziehungen einseitig vorgenommen werden soll. Die rechtlichen Hürden sind weder Ausdruck einer realitätsfernen Haarspalterei, noch eines verbraucherschützenden Furors. Vielmehr ermöglichen sie privaten und gewerblichen Bankkunden, im Zeitpunkt der angestrebten Zinsanpassung bewusst über die Verwendung ihrer liquiden Mittel zu entscheiden.
Background: From 2008–2013, the European indication for panitumumab required that patients' tumor KRAS exon 2 mutation status was known prior to starting treatment. To evaluate physician awareness of panitumumab prescribing information and how physicians prescribe panitumumab in patients with metastatic colorectal cancer (mCRC), two European multi-country, cross-sectional, observational studies were initiated in 2012: a physician survey and a medical records review. The first two out of three planned rounds for each study are reported.
Methods: The primary objective in the physician survey was to estimate the prevalence of KRAS testing, and in the medical records review, it was to evaluate the effect of test results on patterns of panitumumab use. The medical records review study also included a pathologists' survey.
Results: In the physician survey, nearly all oncologists (299/301) were aware of the correct panitumumab indication and the need to test patients' tumor KRAS status before treatment with panitumumab. Nearly all oncologists (283/301) had in the past 6 months of clinical practice administered panitumumab correctly to mCRC patients with wild-type KRAS status. In the medical records review, 97.5% of participating oncologists (77/79) conducted a KRAS test for all of their patients prior to prescribing panitumumab. Four patients (1.3%) did not have tumor KRAS mutation status tested prior to starting panitumumab treatment. Approximately one-quarter of patients (85/306) were treated with panitumumab and concurrent oxaliplatin-containing chemotherapy; of these, 83/85 had confirmed wild-type KRAS status prior to starting panitumumab treatment. All 56 referred laboratories that participated used a Conformité Européenne-marked or otherwise validated KRAS detection method, and nearly all (55/56) participated in a quality assurance scheme.
Conclusions: There was a high level of knowledge amongst oncologists around panitumumab prescribing information and the need to test and confirm patients' tumors as being wild-type KRAS prior to treatment with panitumumab, with or without concurrent oxaliplatin-containing therapy.