Impact of immune-related adverse events on survival outcomes in extensive-stage small cell lung cancer patients treated with immune checkpoint inhibitors.

BACKGROUND: Immune checkpoint inhibitors have recently become the standard of care in the first-line treatment of extensive-stage small cell lung cancer. Although immune-related adverse events have been reported to influence prognosis in non-small cell lung cancer patients, few studies have investigated the prognostic value of immune-related adverse events in small cell lung cancer patients. In this study, we evaluated the prognosis of patients who developed immune-related adverse events after first-line treatment with immune checkpoint inhibitor-based chemotherapy for extensive-stage small cell lung cancer. METHODS: We enrolled 90 patients with extensive-stage small cell lung cancer who received immune checkpoint inhibitor-based chemotherapy as first-line treatment from September 2019 to December 2022 in six hospitals in Japan. The patients were categorized into groups with and without immune-related adverse events. RESULTS: There were 23 patients with and 67 without immune-related adverse events. Seventeen patients had grade 1-2 immune-related adverse events, and nine (including overlapping cases) had grade ≥3. The most frequent immune-related adverse event was a skin rash. The median survival time was 22 months in patients with immune-related adverse events and 9.3 months in patients without immune-related adverse events. The hazard ratio was 0.40 (95% confidence interval: 0.19-0.83, p = 0.013). CONCLUSIONS: The results of this study show that immune-related adverse events are associated with improved survival outcomes in patients with extensive-stage small cell lung cancer.

Real-World Data on Subsequent Therapy for First-Line Osimertinib-Induced Pneumonitis: Safety of EGFR-TKI Rechallenge (Osi-risk Study TORG-TG2101).

BACKGROUND: Although osimertinib is a promising therapeutic agent for advanced epidermal growth factor receptor (EGFR) mutation-positive lung cancer, the incidence of pneumonitis is particularly high among Japanese patients receiving the drug. Furthermore, the safety and efficacy of subsequent anticancer treatments, including EGFR-tyrosine kinase inhibitor (TKI) rechallenge, which are to be administered after pneumonitis recovery, remain unclear. OBJECTIVE: This study investigated the safety of EGFR-TKI rechallenge in patients who experienced first-line osimertinib-induced pneumonitis, with a primary focus on recurrent pneumonitis. PATIENTS AND METHODS: We retrospectively reviewed the data of patients with EGFR mutation-positive lung cancer who developed initial pneumonitis following first-line osimertinib treatment across 34 institutions in Japan between August 2018 and September 2020. RESULTS: Among the 124 patients included, 68 (54.8%) patients underwent EGFR-TKI rechallenge. The recurrence rate of pneumonitis following EGFR-TKI rechallenge was 27% (95% confidence interval [CI] 17-39) at 12 months. The cumulative incidence of recurrent pneumonitis was significantly higher in the osimertinib group than in the first- and second-generation EGFR-TKI (conventional EGFR-TKI) groups (hazard ratio [HR] 3.1; 95% CI 1.3-7.5; p = 0.013). Multivariate analysis revealed a significant association between EGFR-TKI type (osimertinib or conventional EGFR-TKI) and pneumonitis recurrence, regardless of severity or status of initial pneumonitis (HR 3.29; 95% CI 1.12-9.68; p = 0.03). CONCLUSIONS: Osimertinib rechallenge after initial pneumonitis was associated with significantly higher recurrence rates than conventional EGFR-TKI rechallenge.

Next-generation sequencing clarified why first-line treatment with osimertinib was ineffective in an autopsied case of EGFR-mutated lung squamous cell carcinoma.

Epidermal growth factor receptor (EGFR)-mutated squamous cell carcinoma (SCC) is less common than adenocarcinoma. The third-generation EGFR-tyrosine kinase inhibitor, osimertinib, is effective in EGFR-mutated lung adenocarcinoma, but its efficacy in EGFR-mutated lung SCC is unclear. The patient was an 83-year-old male. He was diagnosed with SCC of the lung, and molecular analysis revealed that the tumor was positive for EGFR exon19 deletion. He was treated with osimertinib 80 mg/day. No adverse events were observed, but after 18 days of therapy, he complained of dyspnea, and a computed tomography scan showed enlarged lung cancer. The case was categorized as a progressive disease. The patient died 3 weeks later. The autopsy findings confirmed the diagnosis of lung SCC, with morphology and immunohistochemical staining identical to the tumor obtained by bronchoscopy. Next-generation sequencing showed the presence of TP53 R158L, CDK6, and KRAS amplifications. The current case report shows that next-generation sequencing can explain why osimertinib is ineffective in EGFR-mutated SCC.

Efficacy and Safety of Amrubicin in Small Cell Carcinoma Previously Treated with Immune Checkpoint Inhibitors and Chemotherapy.

Adding an immune checkpoint inhibitor to chemotherapy to treat extensive-stage small cell lung cancer is effective. However, there are no reports of an effective second-line treatment in patients previously treated with chemotherapy and immune checkpoint inhibitors as a first-line treatment. Here, we assessed the efficacy and safety of amrubicin as a second-line treatment for extensive-stage small cell lung cancer after chemotherapy and immune checkpoint inhibitor combination therapy. The study enrolled 150 patients with extensive-stage small cell lung cancer. The efficacy and the incidence of adverse events were compared between patients previously treated with immune checkpoint inhibitors and patients without previous immune checkpoint inhibitor treatment. One hundred and twenty-three patients were eligible. There was no difference in objective response rate, time-to-treatment failure, progression-free survival, and overall survival between both groups. The incidence of adverse events was similar in both treatment groups. Pretreatment with immune checkpoint inhibitors was not associated with an increase in amrubicin-related adverse events. This study shows that the efficacy of amrubicin in extensive-stage small cell lung cancer remains unchanged irrespective of previous treatment with immune checkpoint inhibitors. Amrubicin-related adverse events did not increase in patients previously treated with immune checkpoint inhibitors.

Clinical Relevance of Myopenia and Myosteatosis in Colorectal Cancer.

Sarcopenia was initially described as a decrease in muscle mass associated with aging and subsequently also as a consequence of underlying disease, including advanced malignancy. Accumulating evidence shows that sarcopenia has clinically significant effects in patients with malignancy, including an increased risk of adverse events associated with medical treatment, postoperative complications, and a poor survival outcome. Colorectal cancer (CRC) is one of the most common cancers worldwide, and several lines of evidence suggest that preoperative sarcopenia negatively impacts various outcomes in patients with CRC. In this review, we summarize the current evidence in this field and the clinical relevance of sarcopenia in patients with CRC from three standpoints, namely, the adverse effects of medical treatment, postoperative infectious complications, and oncological outcomes.

Repetitive afterglow in zirconia by pulsed near-infrared irradiation toward biological temperature sensing.

Photoluminescence provides information about the surrounding environment. In this study, aiming to develop a non-invasive deep body-temperature sensing method, we investigated photoluminescence properties of afterglow zirconia (ZrO2) by pulsed near-infrared (NIR) light irradiation based on the biological temperature. Pulsed light irradiation produced optically stimulated luminescence, followed by afterglow, with the property of repeating 100 times or more. Furthermore, the basic principle of temperature measurement was demonstrated through afterglow decay curve measurements. The use of harmless ZrO2 as a sensing probe and NIR light, which is relatively permeable to living tissues, is expected to realize temperature measurements in the brain and may also facilitate optogenetic treatment.

The Absence of Osmoregulated Periplasmic Glucan Confers Antimicrobial Resistance and Increases Virulence in Escherichia coli.

Clarifying the molecular mechanisms by which bacteria acquire virulence traits is important for understanding the bacterial virulence system. In the present study, we utilized a bacterial evolution method in a silkworm infection model and revealed that deletion of the opgGH operon, encoding synthases for osmoregulated periplasmic glucan (OPG), increased the virulence of a nonpathogenic laboratory strain of Escherichia coli against silkworms. The opgGH knockout mutant exhibited resistance to host antimicrobial peptides and antibiotics. Compared with the parent strain, the opgGH knockout mutant produced greater amounts of colanic acid, which is involved in E. coli resistance to antibiotics. RNA sequence analysis revealed that the opgGH knockout altered the expression of various genes, including the evgS/evgA two-component system that functions in antibiotic resistance. In both a colanic acid-negative background and an evgS-null background, the opgGH knockout increased E. coli resistance to antibiotics and increased the silkworm-killing activity of E. coli. In the null background of the envZ/ompR two-component system, which genetically interacts with opgGH, the opgGH knockout increased antibiotic resistance and virulence in silkworms. These findings suggest that the absence of OPG confers antimicrobial resistance and virulence in E. coli in a colanic acid-, evgS/evgA-, and envZ/ompR-independent manner. IMPORTANCE The gene mutation types that increase the bacterial virulence of Escherichia coli remain unclear, in part due to the limited number of methods available for isolating bacterial mutants with increased virulence. We utilized a bacterial evolution method in the silkworm infection model, in which silkworms were infected with mutagenized bacteria and highly virulent bacterial mutants were isolated from dead silkworms. We revealed that knockout of OPG synthases increased E. coli virulence against silkworms. The OPG knockout mutants were resistant to host antimicrobial peptides as well as antibiotics. Our findings not only suggest a novel mechanism for virulence acquisition in E. coli but also support the usefulness of the bacterial experimental evolution method in the silkworm infection model.

De Novo T790M Mutation in an L858R Epidermal Growth Factor Receptor Mutant-Associated Lung Adenocarcinoma.

Background: Lung cancer is the leading cause of mortality for cancer worldwide. A point mutation in exon 21 of the epidermal growth factor receptor resulting in the substitution of arginine for leucine at position 858 (L858R) is a frequent cause of lung adenocarcinoma. Tyrosine kinase inhibitors are effective for treating patients with lung cancer associated with mutant epidermal growth factor receptors but most tumors become resistant shortly after treatment. The substitution of methionine for threonine at position 790 (T790M) on exon 20 is the most frequently acquired mutation leading to resistance to tyrosine kinase inhibitors. Whether the T790M mutation occurred after tyrosine kinase inhibitor therapy or it already existed before therapy is unclear. Methods: Here, we developed mice with tetracycline-inducible lung-specific expression of the full-length genomic DNA of the human epidermal growth factor receptor containing an L858R mutation or both L858R and T790M mutations and evaluated de novo T790M mutation in untreated transgenic mice carrying a single L858R EGFR mutation. Results: The L858R mutation-associated lung adenocarcinoma acquired de novo T790 mutation without previous therapy. Conclusions: The results of this study suggest that lung tumors may spontaneously acquire T790M mutations without any drug-related selective pressure.

Dynamic control of heat flow using a spin-chain ladder cuprate film and an ionic liquid.

Dynamic control of heat flow for applications in thermal management has attracted much interest in fields such as electronics and thermal engineering. Spin-chain ladder cuprates are promising materials to realize dynamic control of heat flow, since their magnon thermal conductivity is sensitive to the hole density in the spin ladders, which can be dynamically controlled by an external field. Here, we demonstrate the electric control of heat flow using a polycrystalline cuprate film and an ionic liquid. The results showed that a voltage application to the interface causes imperfectly recoverable decreases in both the thermal conductance of the film and the peak due to magnons in the Raman spectra. This result may be attributed to an increase in the hole density in the spin ladders. This report highlights that magnon thermal conduction has potential for the development of advanced thermal management applications.

Temperature dependence of afterglow in zirconia and its optically-stimulated luminescence by bone-through irradiation for biological temperature probe.

Development of minimally invasive and site-selective biological temperature sensing is quite important in medical field. This study presents a novel temperature sensing technique based on afterglow and optically-stimulated luminescence (OSL). The dependence of afterglow photoluminescent intensity on the environmental temperature of zirconia (ZrO2) phosphor is examined to validate its use as a sensing probe. In addition, assuming the measurement in deep-part of human body, we have applied the information gathered from our validation to observe OSL from the ZrO2 by irradiation with near-infrared laser through a bone sample. This study demonstrates an alternative medical application of phosphor, and introduces an elemental-technology for the temperature sensing.

Transparent glass-ceramics for thermal management application: achievement of optical transparency and high thermal conductivity.

Oxide glass is an industrial material with advantages such as optical transparency and shaping ability of the melt, but at the same time, it is a bad conductor of heat due to its disordered structures. Therefore, heat dissipation in glass components often becomes a problem and its applications to the thermal management has been limited to use as a heat insulator. To break this mold and to apply it to fields, e.g., transparent sealing materials, for which low thermal conductive glasses and organic polymers have been conventionally used, we fabricated an MgO-dispersed glass-ceramics in our previous work. It comprises MgO crystal and glass matrix and their reflective indices are matched, leading to optical transparency and improvement in thermal conductivity. Here we investigate the atomic-scale structures in the MgO-dispersed glass-ceramics by nuclear magnetic resonance, etc. and attempt to further improve the thermal conductivity and the transparency. As a result, we show an MgO-dispersed glass-ceramic with a thermal conductivity of 3.3 W (m-1 K-1), corresponding to 300% of that of the glass matrix, high optical transparency, and glass transition. This report highlights that our strategies pave the way for development of novel transparent, functional glass-ceramics.

Synthesis of Distorted 1,8,13-Trisilyl-9-hydroxytriptycenes by Triple Cycloaddition of Ynolates to 3-Silylbenzynes.

1,8,13-Trialkyl(aryl)silyl-9-hydroxytriptycenes (trisilyltriptycenes) were synthesized by the triple addition of ynolates and 3-silylbenzynes with high regioselectivity. Benzene rings in the resulting triptycenes were highly distorted where the dihedral angles between the substituents were as high as 35°. The distortion energy induced step-by-step halogenation reactions to yield halogenated triptycenes, including chiral triptycenes. The 1,8,13-trihalogenated triptycenes were then converted to 1,8,13-functionalized triptycenes.

Efficacy of prophylactic cranial irradiation in patients with limited-disease small-cell lung cancer who were confirmed to have no brain metastasis via magnetic resonance imaging after initial chemoradiotherapy.

BACKGROUND: Prophylactic cranial irradiation (PCI) is recommended for patients with limited-disease small-cell lung cancer (LD-SCLC) who achieved good response to definitive chemoradiotherapy. However, most clinical studies lacked brain imaging scans before PCI. Our study aimed to investigate whether PCI has a survival benefit in patients who have no brain metastases (BM) confirmed via magnetic resonance imaging (MRI) before PCI. RESULTS: Eighty patients were included in this study. Sixty patients received PCI (PCI group) and 20 patients did not (non-PCI group). OS was not significantly different between the two groups. The median OS time was 4.3 years (95% CI: 2.6 years-8.6 years) in the PCI group and was not reached (NR) (95% CI: 1.9 years-NR) in the non-PCI group (p = 0.542). Moreover, no differences were observed in the 3-year rates of PFS (46.2% and 44.4%, p = 0.720) and cumulative incidence of BM (24.0% vs. 27%, p = 0.404). CONCLUSIONS: Our result suggests that PCI may not have a survival benefit in patients with LD-SCLC confirmed to have no BM after initial therapy, even if patients achieve a good response to definitive chemoradiotherapy. PATIENTS AND METHODS: We retrospectively evaluated patients with LD-SCLC who were confirmed to have no BM via MRI after initial chemoradiotherapy at the Shizuoka Cancer Center between September 2002 and August 2015. The overall survival (OS), progression-free survival (PFS), and cumulative incidence of BM were estimated using the Kaplan-Meier method between patients who received PCI and those who did not. Propensity score matching was used to balance baseline characteristics.

VO2-dispersed glass: A new class of phase change material.

Energy storage technology is crucial for a sustainable society, and its realisation strongly depends on the development of materials. Oxide glass exhibits high durability. Moreover, the amorphous structure of the glass without periodic ordering demonstrates excellent formability and controllability, thus enabling a large-scale production. These factors provide impetus for the development of new materials for thermal management applications. As vanadium dioxide (VO2) with a strongly correlated electron system exhibits a structural phase transition, leading to a large heat of transition. Therefore, VO2 demonstrates immense potential as a phase change material (PCM). This study reports the fabrication of VO2-dispersed glass and examines its potential as a new latent heat storage material, which can be applied for massive PCM heat storage applications.

The incidence and risk factors of febrile neutropenia in chemotherapy-naïve lung cancer patients receiving etoposide plus platinum.

PURPOSE: This study was to determine the incidence and risk factors of febrile neutropenia in chemotherapy-naïve Japanese patients treated systemically with etoposide plus platinum for lung cancer. METHODS: The study was a retrospective analysis of 244 patients who were monitored for febrile neutropenia through multiple cycles of the combination of etoposide with platinum, and the associations between incidence of febrile neutropenia and patient characteristics were evaluated. RESULTS: Eighty-eight patients were treated with etoposide plus cisplatin and 156 were treated with etoposide plus carboplatin. Of the 244 patients treated, 198 (81.1%) completed 4 cycles for chemotherapy. Febrile neutropenia was observed in 48 of 244 patients (19.7%), including 18 of 88 (20.5%) patients who received etoposide plus cisplatin and 30 of 156 (19.2%) patients who received etoposide plus carboplatin. Grade 3 or 4 of neutropenia was experienced by a total of 208 patients (85.2%); 79 of 88 (89.8%) receiving etoposide plus cisplatin and 129 of 156 (82.7%) receiving etoposide plus carboplatin. Male gender and previous radiotherapy were identified by multivariate analysis as independent risk factors for febrile neutropenia. CONCLUSIONS: These results contrast with findings in Western patients and suggest that ethnic differences exist in the incidence of febrile neutropenia in patients receiving etoposide plus platinum chemotherapy. In addition, our results suggest that primary prophylaxis with granulocyte colony-stimulating factor should be considered for patients with these risk factors for febrile neutropenia prior to treatment with etoposide plus platinum.

Pockels effect of silicate glass-ceramics: Observation of optical modulation in Mach-Zehnder system.

Silicate glass has been used for long time because of its advantages from material's viewpoint. In this paper, we report the observation of Pockels effect by Mach-Zehnder interferometer in polycrystalline ceramics made from a ternary silicate glass via crystallization due to heat-treatment, i.e., glass-ceramics. Since the silicate system is employed as the precursor, merits of glass material are fully utilized to fabricate the optical device component, in addition to that of functional crystalline material, leading us to provide an electro-optic device, which is introducible into glass-fiber network.

Microstructure of transparent strontium fresnoite glass-ceramics.

Glass-ceramics grown from a glass of the composition Sr2TiSi2.45O8.9 (STS 45) are analyzed by scanning electron microscopy (SEM) and electron backscatter diffraction (EBSD). Oriented nucleation with the c-axes preferably perpendicular to the surface is detected. A very strong 001-texture is observed after only 10 µm of growth into the bulk, making this the first system in which an orientation preferred during nucleation prevails during growth into the bulk in glass-ceramics. Piezoelectric measurements are performed and d33-values presented and discussed. The obtained results are critically viewed with respect to the two growth models describing Sr2TiSi2O8 growth in glasses.

Low-temperature excess heat capacity in fresnoite glass and crystal.

The effect of thermal annealing on low-temperature excess heat capacity was investigated in fresnoite (Ba2TiSi2O8) glass. The amplitudes of the excess heat capacity decreased, and their positions shifted to a higher temperature by relaxation or crystallization. In particular, we revealed that the change in the excess heat capacity during transition from the glassy state to the crystalline state is relatively small compared with that of other oxides. Therefore, it is suggested that distribution of the excess vibrational density of states of the glass is similar to that of the corresponding crystal.

Parasitic amorphous on single-domain crystal: structural observations of silicate glass-ceramics.

Glass-ceramics (GCs) are materials obtained from the crystallisation of functional phases in glass, and have a structure that the crystallised phase embedded in the glass matrix. Glass-forming oxides are commonly added to the functional phases to improve the stability of precursor glass; however, the issue of glass-ceramics permitting the presence of residual phases resulting from addition is required to be clarified. To elucidate this issue, we prepared 'perfectly surface-crystallised' GC consisting of fresnoite-type Sr(2)TiSi(2)O(8) from a non-stoichiometric glass and performed texture/morphology observations. Numerous SiO(2)-rich binodal-like nanospheres (~10 nm) were parasitic on the fresnoite single-crystal domains. The parasitic texture is considered to form via the following process: (i) binodal-type phase separation into stoichiometric fresnoite (crystalline matrix) and SiO(2)-rich phases (amorphous nanoparticles) and (ii) single-domain formation by surface crystallisation in the matrix. Furthermore, in terms of texture, the resulting GC differs from the GCs reported to date, i.e., inverse GC.

Correlation between emission property and concentration of Sn2+ center in the SnO-ZnO-P2O5 glass.

The authors report on the correlation between the photoluminescence (PL) property and the SnO amount in SnO-ZnO-P2O5 (SZP) glass. In the PL excitation (PLE) spectra of the SZP glass containing Sn2+ emission center, two S1 states, one of which is strongly affected by SnO amount, are assumed to exist. The PLE band closely correlates with the optical band edge originating from Sn2+ species, and they both largely red-shifts with increasing amount of SnO. The emission decay time of the SZP glass decreased with increasing amount of SnO and the internal quantum efficiencies of the SZP glasses containing 1~5 mol% of SnO are comparable to that of MgWO4. It is expected that the composition-dependent S1 state (the lower energy excitation band) governs the quantum efficiency of the SZP glasses.