ABSTRACT
BACKGROUND: Based on the tumor-driven concomitant activation of angiogenesis and coagulation we conducted a phase I combination study of sunitinib with the low molecular weight heparin dalteparin in patients with metastatic clear cell renal cell carcinoma (ccRCC). MATERIALS AND METHODS: Patients received standard treatment with sunitinib (50 mg daily, 4 weeks on, 2 weeks off). During the second week of no sunitinib in the first cycle (week 6) patients received dalteparin monotherapy (in escalating doses). Combination therapy of the 2 agents was administered from the second cycle onward. Seventeen patients were enrolled at 3 dose levels of dalteparin. RESULTS: Diarrhea and fatigue were the most frequent reported drug-related toxicities (41%). One dose-limiting toxicity (grade 3 anemia) was observed at the highest dose level of dalteparin. There were 4 partial responses (24%) and the median progression-free survival in this study was 14 months (95% confidence interval, 8.0-23.4). Anti-factor Xa levels were increased during combination therapy compared with dalteparin monotherapy. CONCLUSIONS: Combination therapy of sunitinib with therapeutic doses of dalteparin is safe and well tolerated. The increased anti-factor Xa levels during combination treatment suggest that sunitinib might increase the anticoagulation activity of dalteparin. The positive safety profile warrants prospective evaluation of the clinical benefit of this combination strategy in patients with ccRCC.
ABSTRACT
Male F1 hybrids between inbred strains and Mus macedonicus have very small testes and are sterile. Cytological analysis of testes shows very few meioses. To determine the genetic basis for this sterility, (C57BL/6J x Mus macedonics) F1 females were mated to males from C57BL/10J. In about half the male progeny no meiosis I was observed. About half of the animals that progressed through meiosis I showed other indications of low fertility and the balance appeared fertile. QTL analysis of the progeny suggested that loci on proximal Chrs 17 and X were involved in the sterility and a locus on Chr X in variation of body weight. There is also evidence that X//Y dissociation of the pseudo-autosomal region occurs. The QTLs on Chrs X and 17 together account for about 37% of the variance for testis weight. Congenic lines B.MAC-X(1-38), and B.MAC-17(1-23) have been constructed using a modified speed congenic approach. Testis tubules from B.MAC-X(1-38) are narrow and vacuolated. They contain only Sertoli cells and mitotically dividing spermatogonia. Very occasionally a meiotic metaphase can be observed, but no sperm are produced. Homozygous males from B.MAC-17(1-23) are sterile, producing sperm heads but no complete sperm.
