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Background/aim In our previous study, first-line eribulin (ERI) showed 25 weeks of progression-free survival (PFS). This study investigated the efficacy and safety of ERI re-administration in metastatic breast cancer (MBC) patients. Patients and methods HER2-negative MBC patients who had never received chemotherapy for MBC received first-line ERI for 18 weeks if they did not have disease progression, and then one cycle of S-1 before ERI re-administration. Results Twelve patients received ERI re-administration. The PFS of re-administered ERI was 13 weeks. Total duration of ERI use was 30 weeks. The incidence and severity of adverse events were consistent with previous reports. Conclusion In the first-line setting, the total PFS of eribulin was extended by S-1 administration before disease progression, compared with that of our previous report.

The pharmacokinetic characteristics of some antimicrobials lead to very high urinary concentrations. This, together with the superficial nature of bladder infection and effective voiding, supports the use of short-course antimicrobial therapy for treatment of acute uncomplicated cystitis. Even a single dose is effective for >90% of episodes for some antimicrobials. Short-course therapy for 3 days is, however, the current accepted standard of therapy for acute uncomplicated urinary tract infection (UTI). Complicated UTI is a more diverse clinical entity. For individuals with some underlying abnormalities, including incomplete drainage of urine or renal failure, short-course therapy is never appropriate. However, some individuals with complicated UTI have adequate urinary emptying, infection limited to the bladder and normal renal function. For these persons, the same principles that promote effective short-course therapy for treatment of acute uncomplicated UTI should also apply. However, clinical studies reported to date do not support the use of short-course therapy for treatment of complicated cystitis. Further studies enrolling well-characterised patient populations with consistent clinical presentations are required to define the role, if any, of short-course therapy in complicated UTI.

One of the surprises of the flood of placebocontrolled, endoscopic, double-blind studies of duodenal ulcer healing in the last 10 yr has been the realization that placebo therapy results in healing in up to 50% of patients treated for 4-6 wk and may approach the rate of healing noted with active therapy* after this time (;1,2). For example, in a large American multicenter double-blind study of cimetidine versus placebo for duodenal ulcer (3), a significant difference in healing rates was evident only at 2 wk but not at 4 or 6 wk. Even more striking is the similarity in symptom relief between placebo and active agents: no statistically significant differences are demonstrable in most studies (4-6). These observations have led some to conclude that ulcer therapy with currently available drugs such as antacids, antisecretory agents, or sucralfate may not be truly efficacious (7) and others to conclude that placebo treatment for peptic ulcer might be the ideal therapy: safe, cheap, and effective (8). These conclusions, however, may be wrong. Because of the relatively small size of each individual study, the good overall results with placebo might mask rare but important complications or problems that might be avoided by using active agents. To evaluate this, we examined the results of 48 double

1. 1. G-27202, a metabolic derivative of phenyl-butazone, has potent anti-inflammatory properties. 2. 2. This agent has not demonstrated any toxic effects during short term therapy on the dosage schedule outlined. 3. 3. The use of anti-inflammatory agents may play a definite ancillary role in reducing inflammation due to surgical intervention. 4. 4. Further studies on the basic activity of this agent in the role of a host modifier in clinical trials are in progress.