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The free combination of tiotropium + olodaterol was well tolerated at all doses in this trial, with no specific safety concerns or cardiovascular safety concerns raised.
When the data for higher doses in this trial is pooled with the other two trials (which are open label trials), a benefit is seen for relapse prevention by addition of TQ compared to CQ monotherapy.
Phase I data were insufficient to characterize this effect due to a small sample size (N = 12 patients on the combination of anti-PCSK9 and statins) and the short duration of statin treatment and limited statin doses in this trial.
Despite the lower doses in this trial (0.5 3 μg/kg), six patients stopped or had treatment withheld due to elevated transaminase levels and four patients had raised lipase or amylase elevations which resolved after stopping PEG-IFNλ1.
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Of these 37 patients, 29 patients were found eligible and were dosed in this trial.
The maximum-tolerated dose in this trial was GEM 1000 mg m−2 and EPI 45 mg m−2.
The dose in this trial is higher than previously used doses in human pregnancy but still falls well below the maternal and fetal NOAEL (HED 16 and 32 mg/kg respectively) and maternal LOAEL (HED 32 mg/kg).
Doses administered in this trial were equal to the doses that are used for the treatment of malaria.
As special caution is needed with capecitabine in combination for elderly patients, the doses administered in this trial were reduced to 750 mg m−2 twice daily, on days 1 14 if age was ⩾65 years.
The lack of any survival benefit with levosimendan, compared with dobutamine, has been ascribed to the associated vasodilatory action of levosimendan, when administered at the doses used in this trial [ 49].
As these angiogenic pathways were presumably not enough suppressed by sunitinib – at least at the doses used in this trial (Feldman et al, 2009), we searched for a more potent and specific VEGFR-inhibitor, which may show a more pronounced antiangiogenic effect in GCT.
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Justyna Jupowicz-Kozak
CEO of Professional Science Editing for Scientists @ prosciediting.com