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Background: Cyclin-dependent kinase 4/6 inhibitor addition to hormonal therapy has shown to improve the survival of hormone receptor (HR)-positive, HER2-negative advanced breast cancer (ABC). Methods: We retrospectively analyzed untreated patients with HR-positive, HER2-negative ABC, who received letrozole and palbociclib at the Cancer Institute, Chennai, from October 2017 to January 2019. Results: A total of 24 patients were included in this study. The median progression-free survival (PFS) was 18 months, and the median overall survival (OS) had not reached. The 1-year PFS and OS were 73.7% and 89.2%, respectively. The common toxicities were neutropenia and fatigue but none of the patients had febrile neutropenia. Conclusion: Letrozole-Palbociclib is effective with manageable toxicity as the first-line treatment for HR-positive, HER2-negative ABC.

Background: Peripheral T-cell lymphomas (PTCL) are a heterogeneous group of diseases with aggressive behavior and inferior outcomes as compared to B-cell lymphomas. We report the outcomes from a single center over a period of 18 years. Methods: The baseline clinical features, pathological subtypes, and prognostic factors of all patients with PTCL treated at our center between January 2000 and December 2017 were retrospectively analyzed. Event-free survival (EFS) and overall survival (OS) were calculated using the Kaplan–Meier method and prognostic factors were compared using the log-rank test. Results: During the study period, 144 patients (2–74 years) were diagnosed with PTCL. Male patients were 101 (70%) and females were 43 (30%). Mean age at diagnosis was 43.5 years (20–74 years) for adults (≥ ≥18 years). Of the 144 patients, 42 (29%) had limited stage (Stage I/II) and 102 (71%) had advanced-stage disease (III/IV). The most common histological diagnosis was PTCL-not otherwise specified observed in 61 patients (42.4%) followed by anaplastic large-cell lymphoma (ALCL) in 65 patients (45.2%). The median duration of follow-up was 70.5 months (range, 1–218 months). Five-year OS and EFS for the entire population were 55% and 33%, respectively. Patients with limited stage had better survival when compared to those with advanced disease. Five-year EFS was 52% versus 25% (P = 0.006) and 5-year OS was 70% versus 47% (P = 0.02) in limited and advanced stage, respectively. Patients with PTCL, anaplastic lymphoma kinase (ALK)-positive ALCL and ALK-negative ALCL had 5-year EFS and OS of 20% and 38%, 46% and 76%, 43% and 76%, respectively (P value for EFS = 0.009 and OS < 0.001). Conclusion: Majority of patients with PTCL at our center presented with advanced-stage disease. Outcomes of patients with ALCL are better than those diagnosed with other subtypes of PTCL.

This paper compares the efficiency of a solid-state transformer based on matrix converter and a low-frequency conventional transformer. Solid-state transformers can perform the functions of a low-frequency power transformer and also provide additional functionalities for the grid. However, efficiency is an issue when it comes to the replacement of a conventional transformer by a solid-state transformer. Low-frequency conventional power transformers have very high efficiencies. With the development of SiC devices and the nanocrystalline material for the high-frequency transformer, which promise high power densities, it has become possible to construct solid-state transformers with high efficiency. This paper compares the efficiency of a solid-state transformer bsed on matrix converter and a conventional low-frequency power transformer both rated 500 kVA for the grid voltage ratios 33 kV/11 kV and 11 kV/430 V.

Oral Metronomic chemotherapy (OMC) is used in patients with lymphoma who may not tolerate intravenous chemotherapy or have refractory disease. It is cheaper, less toxic and easy to administer. Adult patients with lymphoma who received OMC (combination of cyclophosphamide, etoposide and prednisolone) were included in this retrospective analysis. Response assessment was clinical with limited use of radiology. Progression free and overall survival (PFS and OS) were calculated from the time of start of OMC until documentation of disease progression or death. Between 2007 and 2017, 149 patients were given OMC [median age: 62 years (19-87); 94 patients (63.1%) male]. Majority [112 patients (75.2%)] had stage III/IV disease. The most common subtype of lymphoma was diffuse large B cell lymphoma (40.9%). OMC was used at diagnosis in 41 patients (27.5%) and after relapse in 108 patients (72.5%). Overall response rates were 43.9 and 41.7% with clinical CR in 14 (34.1%) and 21 (19.4%) in patients given first line and later lines of OMC respectively. After a median follow up of 12 months (range 1-123 months), median PFS and OS were 10.5 (95% CI 8.6-12.5) and 18.8 (95% CI 12.1-25.5) months respectively. PFS and OS at 12 months were 47.6 and 64.2% respectively. Though OMC is used in many centers in India, there is scanty published information on its efficacy in lymphoma. In this analysis, we demonstrate its activity in a subset of patients with predominantly high-grade and advanced stage NHL. OMC is a useful option in frail patients and a small proportion can achieve deep and long lasting responses.

This paper proposes a method to estimate the core loss of a high frequency transformer with non sinusoidal excitation. The voltage waveform obtained across a high frequency transformer, in a solid state transformer made using direct AC/AC converters is an example of a non-sinusoidal waveform. The correct estimation of core loss for such a non-sinusoidal excitation is difficult. The difficulty in estimation of core loss stems from the non applicability of the Steinmetz Equation to non-sinusoidal excitations. Manufacturers do not typically provide the core loss data for non-sinusoidal excitation. A number of improvements on the Steinmetz Equation have led to increased accuracy but in turn have increased the complexity of calculation. This paper proposes a simple method to estimate the core loss. The method combines experimental and modeling approach. The estimation of core loss is performed for a high frequency transformer made from nanocrystalline material, for non-sinusoidal excitations. The method presented in this paper reduces the dependence of the estimation on Steinmetz parameters, the material of the core involved and the type of excitation. The method involves measuring the core loss for square excitation and using the obtained data to model the transformer in MATLAB/Simulink. This model can then be used to estimate the core loss for non-sinusoidal excitation of the given transformer. The proposed method is implemented by estimating the core loss of a 10.5kVA high frequency transformer with non-sinusoidal excitation. The non-sinusoidal excitations are obtained from a direct AC-AC matrix converter.

The standard duration of adjuvant trastuzumab is 1 year. But the decision to use for 1 year was chosen arbitrarily in clinical trials. Many patients from developing countries like India cannot afford 1 year of adjuvant trastuzumab. We retrospectively analysed 70 patients with HER2-positive breast cancer, who received short-course trastuzumab, and compared them with a matched historical cohort (n = 65) of HER2-positive breast cancer patients who did not receive trastuzumab. The 1-year DFS and OS of patients who received short-course trastuzumab were 91% and 96%, respectively. This cohort was matched for age, stage and menopausal status with a historical cohort (N = 65) of HER2-positive breast cancer who did not receive trastuzumab. The 1-year DFS (94 vs 71%, p = 0.045) and 1-year OS (94 vs 80%, p = 0.006) were superior for those who received short-course trastuzumab. Adjuvant short-course trastuzumab (weekly for 9 weeks) improved survival in HER2-positive breast cancer as compared to the historical cohort without trastuzumab.

There is no standard chemotherapy for patients with MBC who progress after exposure to anthracycline and taxane. We conducted this study to assess the outcome of patients who were treated with eribulin. This was a retrospective study of patients with MBC who were treated with eribulin from December 2016 to March 2018 in Cancer Institute, Chennai. Twelve patients with MBC previously exposed to both anthracycline and taxane, who received eribulin, were included in this analysis. The overall response rate was 33%. With a median follow-up of 26 months, the median PFS and median OS were 3.5 months and 13.5 months, respectively. Grade 3 neuropathy occurred in 16% of patients. Eribulin is an option in heavily pre-treated MBC considering the promising long-term outcome. Patients with pre-existing neuropathy should not be considered for eribulin.

BACKGROUND Fosaprepitant is a neurokinin-1 receptor antagonist, approved for the prevention of chemotherapy-induced nausea and vomiting. The data on the use of fosaprepitant in children are limited and therefore we conducted a phase III randomized controlled trial. PROCEDURE Children aged 1-12 years scheduled to receive moderately or highly emetogenic chemotherapy were randomly assigned to arm-A (fosaprepitant) or arm-B (placebo). Children recruited to arm-A received intravenous ondansetron plus dexamethasone followed by fosaprepitant infusion. Children recruited to arm-B received the same drugs as those given to children in arm-A, except that fosaprepitant was substituted with a placebo. Ondansetron and dexamethasone were continued for 48 hours after completion of chemotherapy. The primary end point of the study was to determine the proportion of patients who achieved a complete response (CR), defined as no vomiting, no retching, and no use of rescue medication, during the 24-120 hours (delayed phase) after administration of the last dose of chemotherapy. Secondary end points were the proportion of patients who achieved a CR during the acute phase (0-24 hours) and overall after administration of the last dose of chemotherapy. RESULTS One-hundred-sixty-three patients were analyzed (81 in the fosaprepitant arm and 82 in the placebo arm). CR rates were significantly higher in the fosaprepitant arm compared to those in the placebo arm during the acute phase (86% vs 60%, P

Highly significant temporal variations of salinity, Na + and Cl − content were observed in the habitat. Although quantity of major amino acids was significantly different in leaves, stems and roots of Trianthema monogyna L. and T. triquetra Rott. ex Willd., their concentrations did not reflect any temporal effects. Accumulation of sugars in vegetative organs and their fluctuations were not significant for thin leaved species T. monogyna , but their content in T. triquetra was affected by temporal changes. Amounts of Na + , Cl − , Ca 2+ and K + in plant organs were positively related with changes in salinity and mineral ion composition of the habitat. Two species remarkably differed in accumulating amino acids, sugars and mineral ions.

This paper describes a reference-less 4Gbps Clock and Data Recovery (CDR) circuit. A novel compensation technique is used to initialize the Voltage Controlled Oscillator's (VCO) frequency close to the data rate. A new method for the theoretical estimation of filtered phase noise power responsible for bit error is presented and is verified experimentally. CDR is implemented in 65nm CMOS technology on 1.8V supply and consumes 50mA current.

Background: There are very few options for the treatment of patients of SCCHN who relapse after surgery and/or radiotherapy and/or chemotherapy other than best supportive care (BSC). Over expression of the EGFR has been demonstrated in more than 80% of patients with SCCHN. In the present study, we compared the response rates, overall survival, toxicity profile and quality of life in patients of recurrent SCCHN receiving oral methotrexate versus a combination of EGFR inhibitor (Gefitinib) + COX II inhibitor (Etoricoxib). Patients and Methods: Twenty five patients of Advanced and Recurrent HNSCC were included in each group. Patients were randomly assigned to receive Gefitinib (250 mg twice a day before meals) plus Etoricoxib (120 mg/day) [Group A] or Oral Methotrexate (15 mg/week) [Group B]. All patients received BSC. Patients were follow-up 4 weekly with routine blood investigations and quality of life questionnaires - QLQ C-30 and QLQ H & N-35. CT scan of Head and Neck was done every 8 weeks. EGFR mutation studies were not performed. Results : Partial Response (PR) was seen in 6.25% of patients in group-A; and 0% from group-B. Stable Disease (SD) observed in 25% of patients from group-A and 10% patients from group-B. At the end of study, mean overall survival (OS) in group-A was 107.15 days; whereas mean overall survival in group-B was 73.95 days. The difference in survival was statistically significant (P Conclusions: In this small pilot study, in patients with advanced and recurrent SCCHN, dual targeted treatment (EGFR and COX II) with combination of Gefitinib plus Etoricoxib improved response rates, quality of life and overall survival as compared to oral methotrexate. The combination was well tolerated with minor side-effects and should be considered in this poor prognostic subset of patients. Larger, multi-centric studies are needed to confirm these results. Citation Format: Hemant Malhotra, Archit Joshi, Sandeep Jasuja, Ajay Yadav. Gefitinib [epidermal growth factor receptor (EGFR) inhibitor] plus etoricoxib (COX-2 inhibitor) versus oral methotrexate in advanced, recurrent head and neck squamous cell carcinoma (HNSCC): results of a randomized pilot study. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 2582. doi:10.1158/1538-7445.AM2015-2582