Search

Background: Immunotherapy directed at 5T4 tumor antigen may delay the need for further chemotherapy. An attenuated modified vaccinia Ankara virus containing the gene encoding for 5T4 (MVA-5T4) was studied in asymptomatic relapsed ovarian cancer., Objective: To assess the effectiveness and safety of MVA-5T4 as treatment for asymptomatic relapsed ovarian cancer., Methods: TRIOC was a phase II randomized (1:1), placebo-controlled, double-blind multicenter study. The primary aim was to assess the effectiveness and safety of MVA-5T4 as a treatment for asymptomatic patients with relapsed ovarian cancer. Eligible patients had International Federation of Gynecology and Obstetrics (FIGO) stage IC1-III or IVA epithelial ovarian, fallopian tube, or primary peritoneal carcinoma, Eastern Cooperative Oncology Group (ECOG) 0-1, with relapse defined by a rise in CA-125 to twice the upper limit of normal or low-volume disease on CT scan. The primary endpoint was disease progression (including deaths from ovarian cancer) at 25 weeks. Following a brief suspension, the trial restarted as a single-arm study. The revised single-arm design required 45 evaluable patients treated with MVA-5T4 to detect a 25-week progression rate of 50%, assuming an expected 70% rate without MVA-5T4; 85% power with one-sided 5% significance., Results: A total of 94 eligible patients were recruited, median age was 65 years (range 42-82), median follow-up 34 months (range 2-46). Overall, 59 patients received MVA-5T4 and 35 patients received placebo. The median number of MVA-5T4 injections received was 7 (range 0-9), compared with a median of 6 (range 1-12) for patients receiving placebo. Median progression-free survival was the same in both arms (3.0 months). The 25-week progression rate was similar in both arms: 80.0% for patients treated with MVA-5T4 and 85.7% for those receiving placebo (risk difference -5.7%, 95% CI -21.4% to 10.0%). Median time to clinical intervention was improved with MVA-5T4: 7.6 months (range 6.7-9.5) vs 5.6 (range 4.9-7.6), CONCLUSION: MVA-5T4 vaccination in patients with asymptomatic relapse was well-tolerated but did not improve the progression rate at 25 weeks. The majority of patients who received MVA-5T4 had clinical intervention later than those assigned to placebo., Trial Registration Number: NCT01556841., Competing Interests: Competing interests: None declared., (© IGCS and ESGO 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

The objective of this study was to determine if posture during gait can be affected by position of the load. It was hypothesized that the front pack would result in postural changes in the gait cycle, compared to a similarly loaded backpack. Thirteen healthy adults, free of any injury, volunteered to participate in this study. Two dimensional video data were collected at 50 Hz using a MacReflex video system. A backpack and a front pack were compared using loads of 10 and 15% of body weight. Markers were placed on the ear, acromion, greater trochanter and lateral joint line of the knee, lateral malleolus and fifth metatarsophalangeal joint. Data were collected while the participants walked at 0.75 stride/s. The data were used to calculate joint angles and displacements during each gait cycle. There was a significant difference noted in angles of the hip flexion, with the backpack condition demonstrating a greater flexion in each stride than either the control or front pack. Both backpack and front pack conditions demonstrated a significant change in neck motion compared to the control condition. The results of the position analysis over time also revealed an increase in the forward head position when participants were wearing the backpack compared to either the control or the front pack condition. It was concluded that the use of a front pack results in a more upright posture in gait, when compared to a backpack carrying the same load.