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Purpose: BIBF 1120 is an oral, potent angiokinase inhibitor targeting receptors of the vascular endothelial growth factors, platelet-derived growth factors, and fibroblast growth factors. This phase I, accelerated titration study assessed the maximum tolerated dose, safety, pharmacokinetics, and pharmacodynamic effects of BIBF 1120.Patients and Methods: Sixty-one patients with advanced cancers received BIBF 1120 in successive cohorts. Twenty-five received 50 to 450 mg once daily and 36 received 150 to 300 mg twice daily in 4-week treatment courses interspersed by 1 week of washout. Dynamic contrast-enhanced magnetic resonance imaging assessed antiangiogenic effect in 42 patients.Results: Most frequent BIBF 1120-related adverse events were mostly mild to moderate (Common Toxicity Criteria grade 1-2) nausea (68.9%), vomiting (45.9%), and diarrhea (44.3%). The majority of dose-limiting adverse events of Common Toxicity Criteria grade 3 or 4 were reversible liver enzyme elevations. The maximum tolerated dose was 250 mg of BIBF 1120 for once and twice daily dosing. BIBF 1120 was absorbed moderately fast (t max = 1-3 hours at steady state), with no deviation from dose linearity and no decrease of exposure over time. The gMean terminal half-life was from 13 to 19 hours. One complete and two partial responses occurred in patients with renal cell cancer (n = 2) and colorectal cancer (n = 1). Dynamic contrast-enhanced magnetic resonance imaging showed a significant reduction in tumor blood flow in 55% of evaluable patients.

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BI 2536 monotherapy has modest efficacy and favorable safety in relapsed non-small cell lung cancer. The findings support the further development of polo-like kinase-1 inhibitors within this indication.

Among the surrogate endpoints for overall survival (OS) in oncology trials, progression-free survival (PFS) is more and more taking the leading role. Although there have been some empirical investigations on the dependence structure between OS and PFS (in particular between the median OS and the median PFS), statistical models are almost non-existing. This paper aims at filling this gap by introducing an easy-to-handle model based on exponential time-to-event distributions that describe the dependence structure between OS and PFS. Based on this model, explicit formulae for individual correlations are derived together with a lower bound for the correlation of OS and PFS, which is given by the fraction of the two medians for OS and PFS. Two methods on how to estimate the parameter of the model from real data are discussed. One method is based on a maximum-likelihood estimator whereas the other method uses a plug-in approach. Three examples from non-small cell lung cancer are considered. In the first example, the parameters of the model are determined and the estimated survival curce is compared with the observed one. The second example explains how to obtain sample size estimates for OS based on assumptions on median PFS and OS. Finally, the third example provides a way of modelling and quantifying confounding effects that might explain a levelling of differences in OS although a difference in PFS is observed.

Functional magnetic resonance imaging (fMRI) and magnetoencephalography (MEG) were used to study the relationships between lateralized auditory perception in humans and the contralaterality of processing in auditory cortex. Subjects listened to rapidly presented streams of short FM-sweep tone bursts to detect infrequent, slightly deviant tone bursts. The stimulus streams consisted of either monaural stimuli to one ear or the other or binaural stimuli with brief interaural onset delays. The onset delay gives the binaural sounds a lateralized auditory perception and is thought to be a key component of how our brains localize sounds in space. For the monaural stimuli, fMRI revealed a clear contralaterality in auditory cortex, with a contralaterality index (contralateral activity divided by the sum of contralateral and ipsilateral activity) of 67%. In contrast, the fMRI activations from the laterally perceived binaural stimuli indicated little or no contralaterality (index of 51%). The MEG recordings from the same subjects performing the same task converged qualitatively with the fMRI data, confirming a clear monaural contralaterality, with no contralaterality for the laterally perceived binaurals. However, the MEG monaural contralaterality (55%) was less than the fMRI and decreased across the several hundred millisecond poststimulus time period, going from 57% in the M50 latency range (20-70 ms) to 53% in the M200 range (170-250 ms). These data sets provide both quantification of the degree of contralaterality in the auditory pathways and insight into the locus and mechanism of the lateralized perception of spatially lateralized sounds.

An important aspect of auditory scene analysis is sequential grouping of sounds that are similar to one another in preference to sounds that follow one another. This grouping problem is captured by stream segregation tasks with alternating distinct sounds. We examined human auditory cortex activity with low noise fMRI in a stream segregation experiment relying on timbre differences of alternating harmonic tones (organ-like and trumpet-like). We found that stream segregation performance in comparison to monitoring a non-separable control stream increased activation exclusively in left auditory cortex and particularly in posterior areas. Our results suggest that left auditory cortex is selectively involved in this complex sequential task although the available cue for sequential grouping was timbre, usually attributed to right hemisphere analysis.

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