ABSTRACT
Objective: To evaluate the impact of sequential (first- to third-generation) epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) treatment on top-corrected QT interval (top-QTc) in non-small cell lung cancer (NSCLC) patients. Methods: We retrospectively reviewed the medical records of NSCLC patients undergoing sequential EGFR-TKI treatment at Shanghai Chest Hospital between October 2016 and August 2021. The heart rate (HR), top-QT interval, and top-QTc of their ECGs were extracted from the institutional database and analyzed. Logistic regression was performed to identify predictors for top-QTc prolongation. Results: Overall, 228 patients were enrolled. Compared with baseline (median, 368 ms, same below), both first-generation (376 ms vs. 368 ms, p < 0.001) and sequential third-generation EGFR-TKIs (376 ms vs. 368 ms, p = 0.002) prolonged top-QT interval to a similar extent (p = 0.635). Top-QTc (438 ms vs. 423 ms, p < 0.001) and HR (81 bpm vs.79 bpm, p = 0.008) increased after first-generation EGFR-TKI treatment. Further top-QTc prolongation (453 ms vs. 438 ms, p < 0.001) and HR increase (88 bpm vs. 81 bpm, p < 0.001) occurred after treatment advanced. Notably, as HR elevated during treatment, top-QT interval paradoxically increased rather than decreased, and the top-QTc increased rather than slightly fluctuated. Moreover, such phenomena were more significant after treatment advanced. After adjusting for confounding factors, pericardial effusion and lower serum potassium levels were independent predictors of additional QTc prolongation during sequential third-generation EGFR-TKI treatment. Conclusion: First-generation EGFR-TKI could prolong top-QTc, and sequential third-generation EGFR-TKI induced further prolongation. Top-QT interval paradoxically increased and top-QTc significantly increased as HR elevated, which was more significant after sequential EGFR-TKI treatment. Pericardial effusion and lower serum potassium levels were independent predictors of additional QTc prolongation after sequential EGFR-TKI treatment.
ABSTRACT
Van der Waals heterojunction (vdWs) of 2D materials with integrated or extended superior characteristics, opening up new opportunities in functional electronic and optoelectric device applications. Exploring methods to achieve multifunctional vdWs heterojunction devices is one of the most promising prospects in this area. Herein, a diverse function of forward rectifying diode, Zener tunneling diode, and backward rectifying diodes are realized in GeAs/ReS2 heterojunction by modulating the doping level of GeAs. The tunneling diode presents an interesting trend forward negative differential resistance (NDR) behavior which may facilitate the application of multi-value logic. More importantly, the GeAs/ReS2 forward rectifying diode exhibits highly sensitive photodetection in the wide-spectrum range up to 1550 nm corresponding to a short-wave infrared (SWIR) region. In addition, as two strong anisotropic 2D materials of GeAs and ReS2 , the heterojunction exhibits strong polarization-sensitive photodetection behavior with a dichroic photocurrent ratio of 1.7. This work provides an effective strategy to achieve multifunctional 2D vdW heterojunction devices and develops more possibilities to broaden their functionalities and applications.
ABSTRACT
Germanium arsenic (GeAs) as a promising two-dimensional (2D) semiconducting material has attracted extensive attention. The high carrier mobility and tunable bandgap of GeAs offer broad prospects in electronic and optoelectronic device-related applications. The unique intrinsic anisotropy arising from the low-symmetry structure can be applied in the design of new devices. However, the rapid degradation of mechanically exfoliated GeAs in the environment poses a challenge to its practical development in scalable devices. Here, an approach to stabilize the sensitive material without isolation from the ambient environment is reported. The graphene capping layer effectively suppresses environmental degradation, enabling the encapsulated GeAs photodetectors to maintain the key electronic properties for more than 3 months under ambient conditions. In addition, the regulation of the work function of graphene significantly improves the device performance. An improved responsivity of 965.07 A/W is 20 times higher than that of pure GeAs. This work provides opportunities for the practical application of GeAs and other environmentally sensitive 2D materials.
