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1 2 Jemal A, Murray T, Ward E et al. Cancer statistics, 2005. CA Cancer J Clin 2005; 55: 1030. Advanced Colorectal Cancer Meta-Analysis Project. Modulation of fluorouracil by leucovorin in patients with advanced colorectal cancer: evidence in terms of response rate. J Clin Oncol 1992; 10: 896903. Meta-analysis Group In Cancer. Efficacy of intravenous continuous infusion of fluorouracil compared with bolus administration in advanced colorectal cancer. J Clin Oncol 1998; 16: 301308. Scheithauer W, McKendrick J, Begbie S et al. Oral capecitabine as an alternative to i.v. 5-fluorouracil-based adjuvant therapy for colon cancer: safety results of a randomized, phase III trial. Ann Oncol 2003; 14: 1735 Van Cutsem E, Twelves C, Cassidy J et al. Oral capecitabine compared with intravenous fluorouracil plus leucovorin in patients with metastatic colorectal cancer: results of a large phase III study. J Clin Oncol 2001; 19: 40974106. Van Cutsem E, Hoff PM, Harper P et al. Oral capecitabine vs intravenous 5-fluorouracil and leucovorin: integrated efficacy data and novel analyses from two large, randomised, phase III trials. Br J Cancer 2004; 90: 11901197. Goldberg RM, Sargent DJ, Morton RF et al. A randomized controlled trial of fluorouracil plus leucovorin, irinotecan, and oxaliplatin combinations in patients with previously untreated metastatic colorectal cancer. J Clin Oncol 2004; 22: 2330. Tournigand C, Andre T, Achille E et al. FOLFIRI followed by FOLFOX6 or the reverse sequence in advanced colorectal cancer: a randomized GERCOR study. J Clin Oncol 2004; 22: 229237. Douillard JY, Cunningham D, Roth AD et al. Irinotecan combined with fluorouracil compared with fluorouracil alone as first-line treatment for metastatic colorectal cancer: a multicentre randomised trial. Lancet 2000; 355: 10411047. Ferrari VD, Valcamonico F, Amoroso V et al. FAFOXIRI: a phase II trial of an alternating regimen of irinotecan 5-fluorouracil folinic acid and oxaliplatin 5-fluorouracil folinic acid in metastatic colorectal cancer. J Clin Oncol 2005; 23: 285s. Updated based on presentation. ; 17 Cassidy J, Tabernero J, Twelves C et al. XELOX capecitabine plus oxaliplatin ; : active first-line therapy for patients with metastatic colorectal cancer. J Clin Oncol 2004; 22: 20842091. Sastre J, Massuti B, Tabernero JM et al. Preliminary results of a randomized phase III trial of the TTD Group comparing capecitabine and oxaliplatin CapeOx ; vs. oxaliplatin and 5-fluorouracil in continuous infusion 5-FU CI ; as first line treatment in advanced or metastatic colorectal cancer CRC ; . J Clin Oncol 2005; 23: 252s. Updated based on presentation. ; 19 Jordan K, Kellner O, Kegel T et al. Phase II trial of capecitabine irinotecan and capecitabine oxaliplatin in advanced gastrointestinal cancers. Clin Colorectal Cancer 2004; 4: 4650. Park SH, Bang SM, Cho EK et al. First-line chemotherapy with irinotecan plus capecitabine for advanced colorectal cancer. Oncology 2004; 66: 353357. Grothey A, Sargent D, Goldberg RM et al. Survival of patients with advanced colorectal cancer improves with the availability of fluorouracil-leucovorin, irinotecan, and oxaliplatin in the course of treatment. J Clin Oncol 2004; 22: 12091214. Seymour MT. Fluorouracil, oxaliplatin and CPT-11 irinotecan ; , use and sequencing MRC FOCUS ; : a 2135-patient randomized trial in advanced colorectal cancer ACRC ; . J Clin Oncol 2005; 23: 250s. Updated based on presentation. ; 23 Kohne CH, Van Cutsem E, Wils JA et al. Irinotecan improves the activity of the AIO regimen in metastatic colorectal cancer: results of EORTC GI Group study 40986. Proc Soc Clin Oncol 2003; 22: 254. Hurwitz H, Fehrenbacher L, Novotny W et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 23352342. Kohne C, de Greve J, Bokemeyer C et al. Capecitabine plus irinotecan versus 5-FU FA irinotecan + - celecoxib in first line treatment of metastatic colorectal cancer. Safety results of the prospective multicenter EORTC phase III study 40015. J Clin Oncol 2005; 23: 252s. Updated based on presentation. ; 26 Schalhorn A, Ludwig F, Quietzsch D et al. Phase III trial of irinotecan plus oxaliplatin IROX ; versus irinotecan plus 5-FU folinic acid FOLFIRI ; as first-line treatment of metastatic colorectal cancer CRC ; : the FIRE-trial. J Clin Oncol 2005; 23: 250s. Updated based on presentation. ; 27 Fernando N, Yu D, Morse M et al. A phase II study of oxaliplatin, capecitabine and bevacizumab in the treatment of metastatic colorectal cancer. J Clin Oncol 2005; 23: 260s. Updated based on presentation. ; 28 Hochster HS, Welles L, Hart L et al. Safety and efficacy of bevacizumab Bev ; when added to oxaliplatin fluoropyrimidine O F ; regimens as first-line treatment of metastatic colorectal cancer mCRC ; : TREE 1 & 2 Studies. J Clin Oncol 2005; 23: 249s. Updated based on presentation. ; 29 Mitchell E, Marshall J, Chang J et al. Randomized phase III study of 3 irinotecan regimens in 1st-line metastatic colorectal cancer CRC ; : safety tolerability of irinotecan + oral capecitabine with or without celecoxib BICC ; . J Clin Oncol 2005; 23: 283s. Updated based on presentation. ; 30 Diaz Rubio ED, Tabernero J, van Cutsem E et al. Cetuximab in combination with oxaliplatin 5-fluorouracil 5-FU ; folinic acid FA ; FOLFOX-4 ; in the first-line treatment of patients with epidermal growth factor receptor EGFR ; -expressing metastatic colorectal cancer: an international phase II study. J Clin Oncol 2005; 23: 254s. Updated based on presentation.
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Raising the potential for eventual routine culture of schistosome sporocysts without the need to maintain snail colonies. Although the first priority will be to develop the toolkit to support studies of B. glabrata as a model, thus enabling us to gain deeper insights into snail schistosome interactions, we should most emphatically not lose sight of the fact that most human cases of schistosomiasis still occur in Africa, and probably always will. Thus it will be relevant to learn more about species such as Biomphalaria pfeifferi, Bulinus truncatus, and Bulinus globosus which play important roles in transmission in tropical Africa. Transferral of much of the technology to these species should then be possible and should be encouraged because it should not be assumed that the fundamental nature of all schistosomesnail relationships is the same. This might be particularly true for the Asian schistosomes transmitted by pomatiopsid snails which have generally been little studied.
Longitudinal backbone structure. Because the distances between the dotlike nuclei in the rows and needles and the maximal length of the needles of the embryonic bone are independent of the macromolecular collagen substructure, and the morphological appearance is similar to that in salivary stones, we can conclude that the first dotlike nuclei are formed on a noncollagenous matrix. Assuming that the nuclei grow symmetrically along the chain macromolecule and that the centers of first nucleation on the matrix do not move, the distances between the centers of nucleation would show the corresponding distances between the active centers of the macromolecules, which induce the apatitic nucleation. In about 150 measurements of the distances between the neighboring nuclei in the rows and needles for bone, carried out with an eyepiece with vernier, we found the distances to be in the range of 25-50 A, with an area of most frequent appearance near 30 A. From this, we conclude that in this range of 25-50 A there are only one or a very few real existing distances. The smallest nuclei that we could clearly measure had a diameter of 15 + The nuclei of early formation had a crystal lattice not fully developed, with only 2 to 8 electron-diffraction lines, instead of the 13 in mature bone and dentin. 13. SOME NEW DATA CONCERNING THE.
91. Comella P, Natale D, Farris A, et al. Capecitabine plus oxaliplatin for the first-line treatment of elderly patients with metastatic colorectal carcinoma. Cancer. 2005; 104 2 ; : 282-289. 92. Feliu J, Escudero P, Llosa F, et al. Capecitabine As First-Line Treatment for Patients Older Than 70 Years With Metastatic Colorectal Cancer: An Oncopaz Cooperative Group Study. J Clin Oncol. 2005; 23 13 ; : 3104-3111. 93. Pierelli L, Perillo A, Greggi S, et al. Erythropoietin addition to granulocyte colony-stimulating factor abrogates life-threatening neutropenia and increases peripheral blood progenitor-cell mobilization after epirubicin, paclitaxel, and cisplatin in combination chemotherapy. J Clin Oncol 1999; 17: 1288-1296. Silber JH, Fridman M, Di Paola RS, et al. First-cycle blood counts and subsequent neutropenia, dose reduction, or delay in early-stage breast cancer therapy. J Clin Oncol 1998; 16: 2392-2400. Metivier F, Marchais SJ, Guerin AP, et al. Pathophysiology of anaemia: focus on the heart and blood vessels. Nephrol Dial Transplant 2000; 15: 14-18. Silverberg DS, Wexler D, Blum M, et al. The use of subcutaneous erythropoietin and intravenous iron for the treatment of the anemia of severe, resistant congestive heart failure improves cardiac and renal function and functional cardiac class, and markedly reduces hospitalizations. J Coll Cardiol 2000; 35: 1737-1744. Wu WC, Rathore SS, Wang Y, et al. Blood transfusion in elderly patients with acute myocardial infarction. N Engl J Med 2001; 345: 1230-1236. Pickett JL, Theberge DC, Brown WS, et al. Normalizing hematocrit in dialysis patients improves brain function. J Kidney Dis 1999; 33: 1122-1130. Crawford J, Cella D, Cleeland CS, et al. Relationship between changes in hemoglobin level and quality of life during chemotherapy in.
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REFERENCES 1. National Institute for Clinical Excellence. Improving outcomes in colorectal cancers: manual update; May 2004. Available at: : nice . Accessed18 08 04 2. National Institute of Clinical Excellence. Guidance on the use of capecitabine and tegafur with uracil for metastatic colorectal cancer. Technology Appraisal Guidance No. 61; May 2003. Available at: : nice . Accessed 05 04 National Institute of Clinical Excellence. Guidance on the use of irinotecan, oxaliplatin, raltitrexed for the treatment of advanced colorectal cancer. Technology Appraisal Guidance No. 33; March 2002. Available at: : nice . Accessed 05 04 Labeling text, AvastinTM Bevacizumab ; . Available at: : fda.gov. Accessed 11 04 Roche -- Corporate Media News, 5th December 2003. Available at: : roche . Accessed 14 04 Kabbinavar F, Hurwitz HI, Fehrenbacher L et al. Phase II, randomised trial comparing bevacizumab plus fluorouracil FU ; Leucovorin LV ; with FU LV alone in patients with metastatic colorectal cancer. J Clin Oncol 2003; 21: 6065 Roche -- Corporate Media News, 26th November 2003. Available at: : roche . Accessed 14 04 Drug Development Technology. Industry Projects: Avastin bevacizumab ; angiogenesis inhibitor and cancer therapy. Available at: : drugdevelopment-technology projects avastin. Accessed 14 05 04 Giantonio BJ, Levy D, O'Dwyer PJ et al. Bevacizumab antiVEGF ; plus IFL irinotecan, fluorouracil, leucovorin ; as front-line therapy for advanced colorectal cancer advCRC ; : updated results from the Eastern Cooperative Oncology Group ECOG ; Study E2200. American Society of Clinical Oncology 2004 Gastrointestinal Cancers Symposium. Abstract 289. Available at: : asco . Accessed 18 08 04 Monographs for unlicensed medicines indications must not be circulated to prescribers. Not to be used for commercial purposes. 10.Hurwitz H, Fehrenbacher L, Novotney W et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335-2342 Therasse P, Arbuck SG, Eisenhauer EA et al. New guidelines to evaluate the response to treatment in solid tumours. J Natl Cancer Inst 2000; 92: 205-216 Cancer Institute. Cancer therapy evaluation program: NCI Protocol: TRC-0301. Available at: : ctep ncer.gov. Accessed 14 05 04 AB, Catalano PJ, Meropol NJ et al. Bevacizumab antiVEGF ; plus FOLFOX4 in previously treated advanced colorectal cancer advCRC ; : an interim toxicity analysis of the Eastern Cooperative Oncology Group ECOG ; study E3200. Proc Soc Clin Oncol 2003; 22: 243 abstract 975 ; . Available at: : asco . Accessed 19 08 04 Cancer Institute's PDQ database of clinical trials. Available at : cancer.gov. Accessed 14 05 04 Bevacizumab Pharmacy and Therapeutics Review Updated 2004 Evaluation ; . Facts and Comparisons; May 2004: 153-160 16.FDA Genentech, Inc. Dear Doctor letter: bevacizumab AVASTINTM July 2004. Available at: : fda.gov medwatch SAFETY 2004 safety04 #avastin. Accessed 19 08 04 Research Council Clinical Trials Unit. CR08: A trial to assess the role of irinotecan and oxaliplatin in advanced colorectal cancer. Available at: : ctu.mrc.ac studies CR08 . Accessed 19 08 04 and carbachol.
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1 . Twelves C, Wong A, Nowacki MP et al. Capecitabine as adjuvant treatment for stage III colon cancer.N Engl J Med 2005; 352: 2696-2704. Nagore E, Insa A, Sanmartin O. Antineoplastic therapyinduced palmar-plantar erythrodysesthesia `hand-foot' ; syndrome. Incidence, recognition and management. A J m Clin Dermatol 2000; 1 4 ; : 225-34. Peter Gilbar. Palmar-plantar erythrodysesthesia Oncol Pharm Practice 2003; 9: 137-150.
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| Capecitabine alcohol[A]s Burroughs remarks about language: "It is a component of the body like any other. Words are micro-organisms, living dust that the electronic revolution only assembles and orders, right up to the differentiated levels of meaning." [Virilio, 1991a, p.67] Acker, Kathy, Pussy, King of the Pirates, Grove Press, New York, 1996. Ackermann, Robert John, Nietzsche: A Frenzied Look, University of Massachusetts Press, Amherst, 1990. Adams, Jad, AIDS: The HIV Myth. St. Martin's, New York, 1989. Adorno, Theodor W., Negative Dialectics, Translated by E.B. Ashton, Continuum, New York, 1973. Althusser, Louis, Essays in Self-Criticism, Translated by Grahame Lock, NLB, London, 1976. Althusser, Louis, For Marx, Translated by Ben Brewster, Pantheon, New York, 1969. Althusser, Louis and Etienne Balibar, Reading Capital, Translated by Ben Brewster, Verso, London, 1970. Althusser, Louis, Lenin and Philosophy, and Other Essays, Translated by Ben Brewster, Monthly Review Press, New York, 1971. Althusser, Louis, Montesquieu, Rousseau, Marx: Politics and History, Translated by Ben Brewster, Verso, London, 1972. Althusser, Louis, Essays on Ideology, Verso, London, 1984. Althusser, Louis, Philosophy and the Spontaneous Philosophy of the Scientists, and Other Essays, Edited with and introduction by Gregory Elliot, Translated by Ben Brewster, Verso, London, 1990. Althusser, Louis, "On Marx and Freud, " Rethinking Marxism 4 1 ; , Spring 1991. Anderson, Benedict, Imagined Communities: Reflections on the Origin and Spread of Nationalism, Verso, London, 1983. Assiter, Alison, "Althusser and Structuralism, " British Journal of Sociology v35, June 1985. Assiter, Alison, Althusser and Feminism, Pluto Press, London, 1990. Auerbach, Erich and Willard R. Trask, Mimesis : The Representation of Reality in Western Literature, Princeton Univ Press, Princeton, NJ, 1953. Aurelius Antonus, Marcus, Meditations De Rebus Suis ; , Translated by Maxwell Staniforth, with an Introduction by Hannibal Lecter, Penguin Books, New York, 1964 and carboplatin.
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Tions. At the very least, departing staff should be encouraged to `tell their story'19 of their time in the organisation in whatever way feels comfortable to them. This story can then be screened for specific lessons that may be of more general interest. The development of information communication technology has rapidly expanded the possibilities for gathering, analysing, storing and sharing information. The use of email, on-line discussion groups, databases, web-sites, downloadable documents, organisational intra-nets and the creation of virtual learning communities and on-line learning provide an exciting, if sometimes bewildering, range of opportunities for organisational and individual learning. It has also spawned the field of Knowledge Management which is particularly relevant to establishing and maintaining organisational memory. An excellent example of how ICT has been used in a deliberate and well-planned way to improve organisational learning is the World Wide Fund for Nature WWF ; `K-Zone' see Box 4.
Three of three patients treated at 1, 500 36 mg m 2 ; capecitabine docetaxel developed grade 3 hand-foot syndrome or diarrhea during either their first or second course, whereas only two of 13 patients at 1, 250 36 mg m 2 ; doses developed significant toxicity and carmustine
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Capecitabine therapy. Capecitabine was held in 7 patients 3 due to diarrhea, 3 due to grade 3 hand-foot syndrome, and 1 instance for G4 bleeding ; . Other delays or alteration in therapy were unrelated to toxicity. Six patients were hospitalized for side effects related to capecitabine; one hospitalization was for G4 bleeding noted above, the rest were for gastrointestinal side effects. Toxicity was controlled with symptomatic treatment on outpatient basis. One possible treatment-related death occurred and was attributable to uncontrolled GI bleeding. This bleeding occurred within the radiation port as a late complication, while the patient was receiving post-radiation capecitabine monotherapy approximately 3 months following completion of capecitabineradiotherapy ; . RESPONSE AND SURVIVAL Chemo-radiotherapy After initial treatment with capecitabine and radiation 6-week chemo-radiotherapy ; , 2 of 20 patients with unresected, locally advanced tumor were converted to radiographically resectable disease 2 complete response ; . Two other patients with locally advanced unresectable disease exhibited a partial response of 29% and 42%, respectively. Eight patients exhibited stable disease, and 10 patients exhibited progressive disease, of whom 1 showed an increase in tumor size by 100%, the other 9 exhibited metastatic disease in the liver. All the patients with resected tumor either negative or positive margins ; had no radiological evidence of recurrent disease at the end of 6-week chemo-radiotherapy. Mono-chemotherapy Eleven patients received further treatment with capecitabine cycles alone. With continued capecitabine therapy, 3 patients with locally advanced unre and carteolol.
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Positive metastatic breast cancer: preliminary data from a phase II study; Proc Soc Clin Oncol 21: 19a Abstract 73 2002. 8. Burris, et al.: A phase II trial of docetaxel and Herceptin in metastatic breast cancer patients overexpressing HER-2; Proc Soc Clin Oncol 19: 131a Abstract 512 2000. 9. Nicholson, et al.: A phase II trial of weekly docetaxel and herceptin as first- or second-line treatment in HER2 overexpressing metastatic breast cancer; Proc Soc Clin Oncol 20: 50b Abstract 1949 2001. 10. Esteva, et al.: Phase II study of weekly docetaxel and trastuzumab for patients with HER-2 overexpressing metastatic breast cancer; J Clin Oncol 20: 1800-1808; 2002. Burstein, et al.: Clinical activity of trastuzumab and vinorelbine in women with HER2-overexpressing metastatic breast cancer; J Clin Oncol 19: 2722-2730; 2001. Jahanzeb, et al.: Weekly Herceptin with navelbine in chemonaive patients with HER2 positive metastatic breast cancer: a phase II multicenter trial; Breast Cancer Research Treatment 69: 284 Abstract 429 2001. 13. Nabholtz, et al.: results of two open label multicentre phase II pilot studies with herceptin in com18. Leyland-Jones, et al.: Pharmacokinetics, safety and efficacy of trastuzumab administered every 3 weeks in combination with Paclitaxel. In press. 24. Bines, et al.: Multi-center Brazilian study of weekly docetaxel and trastuzumab as primary therapy in stage III, HER-2 overexpressing breast cancer. Proc Soc Clin Oncol 21 Abstract 268 2003. 17. Bangemann, et al.: Capecitabine combined with trastuzumab in the therapy of intensively pretreated HER2-overexpressing metastatic breast cancer MBC Annals of Oncology 11: 143 Abstract 635P 2000. 23. Burstein, et al.: Pre-operative therapy with trastuzumab and paclitaxel followed by sequential adjuvant doxorubicin -cyclophosphamide for HER2 overexpressing stage II or III breast cancer: a pilot study. J Clin Oncol 21: 4653; 2003-07-22. Bangemann, et al.: Treatment of HER2 overexpressing metastatic breast cancer MBC ; with trastuzumab Herceptin ; and chemotherapy; Breast Cancer Research Treatment 64: 123 Abstract 530 2000. 22. Van Pelt, et al.: Phase II study of neoadjuvant trastuzumab plus docetaxel for locally advanced and metastatic breast cancer that overexpresses HER2 neu a preliminary report; Breast Cancer Res Treat 76 Abstract 441 2002. 15. Heinemann, et al.: Gemcitabine and cisplatin + trastuzumab Herceptin ; in intensively pretreated metastatic breast cancer MBC Proc Soc Clin Oncol 21: 61b Abstract 2056 2002. 14. O`Shaughnessy. et al.: Gemcitabine and trastuzumab for HER-2 positive metastatic breast cancer: preliminary results of a phase II study; Breast Cancer Research Treatment 69: 302 Abstract 523 2001. 21. Steger, et al.: Pilot-trial of trastuzumab and weekly epidoxorubicin docetaxel in the neoadjuvant treatment of primary breast cancer-preliminary results. Proc Soc Clin Oncol 20: 39b Abstract 1966 2002. bination with docetaxel and platinum salts cis or carboplatin ; TCH ; as therapy for advanced breast cancer ABC ; in women with tumors overexpressing the HER2-neu proto-oncogene; The European Journal of Cancer 37: 190 Abstract 695 2001. 20. Hurley J, et al.: Neoadjuvant herceptin -taxotere cisplatin in the treatment of locally advanced and in-flammatory breast cancer; Proc Soc Clin Oncol 20: 50a Abstract 196 2002. 19. Pietras, et al.: Remission of human breast cancer xenocrafts on therapy with humanized monoclonal antibody to HER-2 receptor and DNA-reactive drugs; Oncogene 17: 2235-2249; 1998 and capecitabine.
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Also not treated with tamoxifen, if their cancers do not express the gene for the oestrogen receptor.220 Therefore, genotyping may help for treatment strategies and in some drug treatment choice, genotyping may be an absolute necessity. The adenoviral agent, ONYX-015 Onyx Pharmaceutical ; , for instance, aims to combat tumours caused by mutations in the tumour suppressor gene p53. As part of the clinical trials, Onyx is providing genotyping of patients for p53 mutations. This drug will require the development of an accompanying diagnostic tool to stratify the populations. A number of gene therapy approaches have been taken in clinical trials for cancer therapy, including the delivery of tumour-suppressing genes, notably p53, cytokines and the herpes simplex virusthymidine kinase gene plus gancyclovir treatment.221223 A phase I clinical trial of wild-type p53 p53wt ; gene therapy of patients with hepatocellular carcinoma HCC ; in the UK has already produced objective tumour responses in 50% of the patients treated.224 The principle behind using p53 for gene therapy is well established. A number of groups have demonstrated that p53wt inhibits the growth of HCC cells in vitro; while others have shown that if p53 is injected into nude mice pretreated with human cancer cells, their tumours get smaller. This study is the first to attempt gene therapy with p53 of HCC patients. However, with all the above, a major limitation is the inefficiency of delivery into the tumour cells and the relatively inefficient killing of neighbouring untransduced cells by bystander effects. A recent preclinical study suggests that interferon-b gene therapy inhibits tumour formation and causes regression of established tumours in immune-deficient mice, and it was argued that local interferon-b gene therapy with replication-defective adenoviral vectors might be an effective treatment for some solid tumours.225 The type 1 interferons IFNs ; , the IFN-a family and IFN-b execute diverse biological functions including growth inhibition and immune cell stimulation, and have been shown to be inhibitors of angiogenesis sprouting of new vessels from pre-existing blood vessels ; , and therefore could inhibit tumour growth by blocking tumour vascularization.226, 227 This study demonstrated that ex vivo IFN-b gene transduction by a replicationdefective adenovirus in as few as 1% of implanted cells blocked tumour formation. Direct in vivo IFN-b gene delivery into established tumours generated high local concentrations of IFN-b and inhibited tumour growth, and the results show a remarkable ability of IFN-b gene therapy to block the formation of tumours de novo and to cause regression of established tumours. The ex vivo transduction results confirmed the potential bystander effects of a potent secreted cytokine, with as few as 0.31% transduced and caverject.
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