We speculate that triple therapy including selleck inhibitor telaprevir at the reduced dose of 1500 mg/day could maintain high levels of adherence to PEG IFN and RBV, and consequently
achieve high SVR rates. In this study, we investigated the independent predictors for SVR in the multivariate analysis (Table 3). As reported in previous studies, IL28B genotype remained the strongest predictor of SVR.[30, 31] The next strongest predictive factor was sex: women had significantly lower SVR rates than did men (Fig. 3). However, when we investigated the SVR rates of the telaprevir 2250 mg/day group and 1500 mg/day group, we found that there were significant differences in SVR rates between men and women in the telaprevir 2250 mg/day group but no differences in the telaprevir 1500 mg/day group. In the previous study, we reported that female sex was one of the factors influencing decreases in hemoglobin levels during triple therapy administrated 2250 mg/day of initial telaprevir dose. In the present study, the discontinuation rates of telaprevir due to anemia were significantly higher in women in the telaprevir 2250 mg/day group as compared
with men (36.7% vs 3.3%, P = 0.002, data not shown), but there were no differences in the discontinuation rates of telaprevir due to anemia Fulvestrant solubility dmso between men and women in the telaprevir 1500 mg/day group (0% vs 10%, P = 0.237, data not shown). Therefore, we speculate that there were significant differences in SVR rates between men selleck and women because of high telaprevir discontinuation rates owing to anemia in women. In conclusion, after the completion of 24 weeks of therapy, triple therapy including telaprevir at a reduced dose of 1500 mg/day
was as effective as triple therapy including telaprevir 2250 mg/day at suppressing HCV RNA to undetectable levels and achieving SVR. Of note, we found that telaprevir 1500 mg/day was associated with lower levels of anemia and discontinuation of telaprevir owing to anemia, and higher PEG IFN and RBV adherence during triple therapy. These results suggest that the telaprevir 1500 mg/day regimen is an effective and safe alternative for the treatment of elderly and female Japanese patients. This study is a retrospective study. Prospective randomized controlled studies with longer follow-up periods are required to fully assess the efficacy and safety of an initial telaprevir dose of 1500 mg/day. THIS STUDY WAS supported in part by a Grant-in-Aid from the Ministry of Health, Labor and Welfare, Japan. “
“Tumor heterogeneity is a major obstacle for developing effective anticancer treatments. Recent studies have pointed to large stochastic genetic heterogeneity within cancer lesions, where no pattern seems to exist that would enable a more structured targeted therapy approach.