Toward the next generation EGFR inhibitors: an overview of osimertinib resistance mediated by EGFR mutations in non-small cell lung cancer.

Epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) is currently the standard first-line therapy for EGFR-mutated advanced non-small cell lung cancer (NSCLC). The life quality and survival of this subgroup of patients were constantly improving owing to the continuous iteration and optimization of EGFR-TKI. Osimertinib, an oral, third-generation, irreversible EGFR-TKI, was initially approved for the treatment of NSCLC patients carrying EGFR T790M mutations, and has currently become the dominant first-line targeted therapy for most EGFR mutant lung cancer. Unfortunately, resistance to osimertinib inevitably develops during the treatment and therefore limits its long-term effectiveness. For both fundamental and clinical researchers, it stands for a major challenge to reveal the mechanism, and a dire need to develop novel therapeutics to overcome the resistance. In this article, we focus on the acquired resistance to osimertinib caused by EGFR mutations which account for approximately 1/3 of all reported resistance mechanisms. We also review the proposed therapeutic strategies for each type of mutation conferring resistance to osimertinib and give an outlook to the development of the next generation EGFR inhibitors. Video Abstract.

Case Report: Pulmonary sarcomatoid carcinoma complicating TP53 mutation treated successfully with Tislelizumab combined with Anlotinib-a case report.

Pulmonary sarcomatoid carcinoma (PSC) is a rare subtype of lung malignant tumor. Conventional chemotherapy has a suboptimal effectiveness. PSC has the characteristics of rapid disease progression and poor prognosis. We herein report a 56-year-old male patient with substantial smoking history was pathologically diagnosed as PSC, cT4N0M0 IIIA stage. Peripheral blood NGS showed TP53 mutation. The patient had poor tolerance to the first-line chemotherapy regimen "albumin paclitaxel + cisplatin," but the severe anemia was significantly improved after 5 days of anti-angiogenic therapy with Anlotinib. At this time, the patient received anti-PD-1 immunotherapy with Tislelizumab. Half a month later, degree III liver injury occurred repeatedly. After excluding drug-induced liver injury, we found that HCV-RNA 3.10 × 105 IU/ml and suspended all anti-tumor therapy. After the start of anti-HCV treatment with Epclusa, the treatment of Tislelizumab combined with Anlotinib was restarted, and there was no liver injury after that. The patient received monthly maintenance therapy with Tislelizumab combined with Anlotinib to the present. The pulmonary lesions continued to decrease, and only one lung cavity is left. The patient has achieved clinical complete remission (CCR) with PSF over 20 months. Our findings suggest that Tislelizumab combined with Anlotinib may be a preferred strategy in PSC complicating TP53 mutation. Core tip: Immune-check point inhibitors (ICIs) have been reported for the treatment of PSC in a small number of case reports and retrospective analysis, but there are few reports of ICIs combined with anti-angiogenic drugs. This patient was diagnosed as locally advanced PSC complicated with TP53 mutation and hepatitis C. After 14 cycles of Tislelizumab combined with Anlotinib treatment (during the course of treatment, several courses were not treated on time for economic reasons, rather than adverse reactions), the patient has achieved CCR. III degree liver injury occurred during the treatment, and the liver function returned to normal range after anti-hepatitis C treatment, which did not affect the continued treatment of this regimen.

Exosomal circ_0007385 enhances non-small cell lung cancer cell proliferation and stemness via regulating miR-1253/FAM83A axis.

Exosomes are critical mediators of intercellular communication in the tumor microenvironment. Exosomal circular RNAs (circRNAs) can act as biomarkers and play crucial roles in many cancers, including non-small cell lung cancer (NSCLC). The aim of this study was to explore the functions and regulatory mechanism of exosomal circ_0007385 in NSCLC. The expression levels of circ_0007385, microRNA-1253 (miR-1253), family with sequence similarity 83, member A (FAM83A) mRNA were determined by quantitative real-time PCR (qRT-PCR). Cell Counting Kit-8 (CCK-8), 5-Ethynyl-2'-deoxyuridine (Edu), and colony formation assays were utilized to determine cell proliferation ability. Sphere formation efficiency was determined by sphere formation assay. All protein levels were detected by western blot assay. Exosomes were detected using transmission electron microscopy analysis. Size distribution of exosomes was analyzed by nanoparticle tracking analysis. The interaction between miR-1253 and circ_0007385 or FAM83A was confirmed by dual-luciferase reporter, RNA immunoprecipitation (RIP) and RNA pull-down assays. Mice xenograft model was established to verify the function of circ_0007385 in vivo. Circ_0007385 was upregulated in NSCLC tissues and cells. Knockdown of circ_0007385 inhibited NSCLC cell proliferation and stemness, while exosomal circ_0007385 facilitated NSCLC cell proliferation and stemness. In addition, miR-1253 was a direct target of circ_0007385, and miR-1253 reversed the inhibitory effects of circ_0007385 on cell proliferation and stemness in NSCLC cells. Moreover, FAM83A was a direct target of miR-1253, and miR-1253 suppressed NSCLC cell proliferation and stemness by targeting FAM83A. Furthermore, circ_0007385 knockdown inhibited tumor growth in vivo. Exosomal circ_0007385 promoted NSCLC cell proliferation and stemness by regulating miR-1253/FAM83A axis.

MicroRNA-4491 enhances cell proliferation and inhibits cell apoptosis in non-small cell lung cancer via targeting TRIM7.

MicroRNAs (miRNAs) are involved in the development of non-small cell lung cancer (NSCLC). However, the biological roles of several aberrantly expressed miRNAs have not been explored yet. In the present study, miR-4491 was identified as a novel upregulated miRNA in NSCLC tissues and cell lines. Downregulation of miR-4491 by a miR-4491 inhibitor inhibited the proliferation and triggered the apoptosis of NSCLC cells. Tripartite motif containing 7 (TRIM7), a tumor suppressor gene expressed in NSCLC, was demonstrated in the present study to be directly targeted by miR-4491. This finding was verified by bioinformatics analysis, reverse transcription-quantitative PCR, western blotting and dual luciferase reporter assays. Furthermore, downregulation of miR-4491 inactivated nuclear factor-κB signaling via induction of TRIM7. In addition, TRIM7 silencing attenuated the effect of miR-4491 inhibitor in NSCLC cells. The decreased TRIM7 level in NSCLC tissues was negatively correlated with miR-4491 expression in NSCLC tissues. In conclusion, the findings from this study demonstrated that miR-4491 expression was upregulated in NSCLC tissues and cells and that miR-4491 may promote NSCLC progression via targeting TRIM7.

Modeling Analysis of Silk Fibroin/Poly(ε-caprolactone) Nanofibrous Membrane under Uniaxial Tension.

Evaluating the mechanical ability of nanofibrous membranes during processing and end uses in tissue engineering is important. We propose a geometric model to predict the uniaxial behavior of randomly oriented nanofibrous membrane based on the structural characteristics and tensile properties of single nanofibers. Five types of silk fibroin (SF)/poly(ε-caprolactone) (PCL) nanofibers were prepared with different mixture ratios via an electrospinning process. Stress-strain responses of single nanofibers and nanofibrous membranes were tested. We confirmed that PCL improves the flexibility and ductility of SF/PCL composite membranes. The applicability of the analytical model was verified by comparison between modeling prediction and experimental data. Experimental stress was a little lower than the modeling results because the membranes were not ideally uniform, the nanofibers were not ideally straight, and some nanofibers in the membranes were not effectively loaded.

Enhancing CO2 Electroreduction with the Metal-Oxide Interface.

The electrochemical CO2 reduction reaction (CO2RR) typically uses transition metals as the catalysts. To improve the efficiency, tremendous efforts have been dedicated to tuning the morphology, size, and structure of metal catalysts and employing electrolytes that enhance the adsorption of CO2. We report here a strategy to enhance CO2RR by constructing the metal-oxide interface. We demonstrate that Au-CeOx shows much higher activity and Faradaic efficiency than Au or CeOx alone for CO2RR. In situ scanning tunneling microscopy and synchrotron-radiation photoemission spectroscopy show that the Au-CeOx interface is dominant in enhancing CO2 adsorption and activation, which can be further promoted by the presence of hydroxyl groups. Density functional theory calculations indicate that the Au-CeOx interface is the active site for CO2 activation and the reduction to CO, where the synergy between Au and CeOx promotes the stability of key carboxyl intermediate (*COOH) and thus facilitates CO2RR. Similar interface-enhanced CO2RR is further observed on Ag-CeOx, demonstrating the generality of the strategy for enhancing CO2RR.

Characterization of cadmium-resistant endophytic fungi from Salix variegata Franch. in Three Gorges Reservoir Region, China.

The community and Cd-resistance of endophytic fungi from roots of Salix variegata Franch. collected from the water-level-fluctuation zone of Three Gorges Reservoir Region, China, were investigated. A total of 53 strains were isolated and identified to 13 morphotaxa, in which Chromosporium, Fusarium and Gonatobotrys were dominant genera. Among them, 27 isolates were selected to measure their resistance to 0.02 mg ml(-1) Cd(2+) and 11 were growth stimulated (Tolerance index>100%). Of these active isolates, four dark septate endophyte (DSE) isolates (Paraphaeosphaeria sp. SR46, Pyrenochaeta sp. SR35, Rhizopycnis vagum SR37 and R. vagum SR44) were further tested for minimum inhibitory concentrations (MICs) against Cd and SR46 was found to be the most tolerant isolate with MIC of 0.39 mg ml(-1). Additionally, the maximum uptake values of these DSEs ranged from 3.01 to 7.89 mg g(-1), but there was no significant correlation between metal uptake with fungal biomass and metal tolerance. Subsequently, a pot experiment was conducted for investigating the impact of SR46 on corn seedlings in Cd-enriched soil. The results obtained suggested that SR46 reduced the Cd bioaccumulation of plant under low (100 mg kg(-1)) Cd stress and enhanced the Cd translocation from root zone to aerial parts under high (200 mg kg(-1)) Cd stress. Besides, it promoted plant growth without Cd stress. These findings indicated S. variegata harbors an endophytic fungal flora showing a high genetic diversity as well as a high level of metal resistance to Cd that has potential values in cadmium cycling and restoration of plant, soil and water system.