ADJUVANT-CTONG1104 (ClinicalTrials.gov identifier: NCT01405079), a randomized phase III trial, showed that adjuvant gefitinib treatment significantly improved disease-free survival (DFS) versus ...vinorelbine plus cisplatin (VP) in patients with epidermal growth factor receptor (
) mutation-positive resected stage II-IIIA (N1-N2) non-small-cell lung cancer (NSCLC). Here, we report the final overall survival (OS) results.
From September 2011 to April 2014, 222 patients from 27 sites were randomly assigned 1:1 to adjuvant gefitinib (n = 111) or VP (n = 111). Patients with resected stage II-IIIA (N1-N2) NSCLC and
-activating mutation were enrolled, receiving gefitinib for 24 months or VP every 3 weeks for four cycles. The primary end point was DFS (intention-to-treat ITT population). Secondary end points included OS, 3-, 5-year (y) DFS rates, and 5-year OS rate. Post hoc analysis was conducted for subsequent therapy data.
Median follow-up was 80.0 months. Median OS (ITT) was 75.5 and 62.8 months with gefitinib and VP, respectively (hazard ratio HR, 0.92; 95% CI, 0.62 to 1.36;
= .674); respective 5-year OS rates were 53.2% and 51.2% (
= .784). Subsequent therapy was administered upon progression in 68.4% and 73.6% of patients receiving gefitinib and VP, respectively. Subsequent targeted therapy contributed most to OS (HR, 0.23; 95% CI, 0.14 to 0.38) compared with no subsequent therapy. Updated 3y DFS rates were 39.6% and 32. 5% with gefitinib and VP (
= .316) and 5y DFS rates were 22. 6% and 23.2% (
= .928), respectively.
Adjuvant therapy with gefitinib in patients with early-stage NSCLC and
mutation demonstrated improved DFS over standard of care chemotherapy. Although this DFS advantage did not translate to a significant OS difference, OS with adjuvant gefitinib was one of the longest observed in this patient group compared with historic data.
Improving the stability of sensitive catalytic systems is an emerging research topic in the catalysis field. However, the current design of heterogeneous catalysts mainly improves their catalytic ...performance. This paper presents a single‐atom catalyst (SAC) strategy to improve the cobalt‐catalysed fluorination of acyl chlorides. A stable Co−F intermediate can be formed through the oxidative fluorination of Co1−N4@NC SAC, which can replace the unstable high‐valent cobalt catalytic system and avoid the use of phosphine ligands. In the SAC system, KF can be employed as a fluorinating reagent to replace the AgF, which can be applied to various substrates and scale‐up conversion with high turnover numbers (TON=1.58×106). This work also shows that inorganic SACs have tremendous potential for organofluorine chemistry, and it provides a good reference for follow‐up studies on the structure‐activity relationship between catalyst design and chemical reaction mechanisms.
A Co single‐atom catalyst was synthesized via thermal decomposition of a zeolitic imidazolate framework (ZIF). The Co1−N4@NC catalyst generated a stable Co−F intermediate in situ through an oxidative fluorination pathway to replace the substitution fluorination of the unstable high‐valent Co system. In the presence of Co−F intermediates, KF can be used to replace AgF. Co1−N4@NC exhibited ultrahigh catalytic activity for the fluorination of acyl chlorides.
Knowledge graphs (KG) often encounter knowledge incompleteness. The path reasoning that predicts the unknown path relation between pairwise entities based on existing facts is one of the most ...promising approaches to the knowledge graph completion. However, most conventional path reasoning methods exclusively consider the entity description included in fact triples, ignoring both the type information of entities and the interaction between different semantic representations. In this study, we propose a novel method, Type-aware Attentive Path Reasoning (TAPR), to complete the knowledge graph by simultaneously considering KG structural information, textual information, and type information. More specifically, we first leverage types to enrich the representational learning of entities and relationships. Next, we describe a type-level attention to select the most relevant type of given entity in a specific triple without any predefined rules or patterns to reduce the impact of noisy types. After learning the distributed representation of all paths, path-level attention assigns different weights to paths, from which relations among entity pairs are calculated. We conduct a series of experiments on a real-world dataset to demonstrate the effectiveness of TAPR. Experimental results show that our method significantly outperforms all baselines on link prediction and entity prediction tasks.
Cisplatin-based adjuvant chemotherapy is the standard of care for patients with resected stage II–IIIA non-small-cell lung cancer (NSCLC). RADIANT and SELECT trial data suggest patients with ...EGFR-mutant stage IB–IIIA resected NSCLC could benefit from adjuvant EGFR tyrosine kinase inhibitor treatment. We aimed to compare the efficacy of adjuvant gefitinib versus vinorelbine plus cisplatin in patients with completely resected EGFR-mutant stage II–IIIA (N1–N2) NSCLC.
We did a randomised, open-label, phase 3 trial at 27 centres in China. We enrolled patients aged 18–75 years with completely resected (R0), stage II–IIIA (N1–N2), EGFR-mutant (exon 19 deletion or exon 21 Leu858Arg) NSCLC. Patients were stratified by N stage and EGFR mutation status and randomised (1:1) by Pocock and Simon minimisation with a random element to either gefitinib (250 mg once daily) for 24 months or intravenous vinorelbine (25 mg/m2 on days 1 and 8) plus intravenous cisplatin (75 mg/m2 on day 1) every 3 weeks for four cycles. The primary endpoint was disease-free survival in the intention-to-treat population, which comprised all randomised patients; the safety population included all randomised patients who received at least one dose of study medication. Enrolment to the study is closed but survival follow-up is ongoing. The study is registered with ClinicalTrials.gov, number NCT01405079.
Between Sept 19, 2011, and April 24, 2014, 483 patients were screened and 222 patients were randomised, 111 to gefitinib and 111 to vinorelbine plus cisplatin. Median follow-up was 36·5 months (IQR 23·8–44·8). Median disease-free survival was significantly longer with gefitinib (28·7 months 95% CI 24·9–32·5) than with vinorelbine plus cisplatin (18·0 months 13·6–22·3; hazard ratio HR 0·60, 95% CI 0·42–0·87; p=0·0054). In the safety population, the most commonly reported grade 3 or worse adverse events in the gefitinib group (n=106) were raised alanine aminotransferase and asparate aminotransferase (two 2% patients with each event vs none with vinorelbine plus cisplatin). In the vinorelbine plus cisplatin group (n=87), the most frequently reported grade 3 or worse adverse events were neutropenia (30 34% patients vs none with gefitinib), leucopenia (14 16% vs none), and vomiting (eight 9% vs none). Serious adverse events were reported for seven (7%) patients who received gefitinib and 20 (23%) patients who received vinorelbine plus cisplatin. No interstitial lung disease was noted with gefitinib. No deaths were treatment related.
Adjuvant gefitinib led to significantly longer disease-free survival compared with that for vinorelbine plus cisplatin in patients with completely resected stage II–IIIA (N1–N2) EGFR-mutant NSCLC. Based on the superior disease-free survival, reduced toxicity, and improved quality of life, adjuvant gefitinib could be a potential treatment option compared with adjuvant chemotherapy in these patients. However, the duration of benefit with gefitinib after 24 months might be limited and overall survival data are not yet mature.
Guangdong Provincial Key Laboratory of Lung Cancer Translational Medicine; National Health and Family Planning Commission of People's Republic of China; Guangzhou Science and Technology Bureau; AstraZeneca China.
Abstract
Strategies for treating osteoarthritis (OA) have become a research focus because an effective treatment for OA is unavailable. The objective of this study was to explore the effects and ...underlying mechanisms of glutamine (Gln) in OA. First, the chondrocytes were identified and a standard IL-1β-induced OA model was established. After treatment with Gln or saline, the viability and apoptosis of chondrocytes were evaluated using a CCK-8 assay and flow cytometry analysis, which revealed that Gln can improve the IL-1β-induced OA cells. Meanwhile, Gln can enhance the expression of aggrecan and collagen II, which are protective proteins for articular cartilage. Instead, Gln inhibited the expression of matrix metalloproteinase-1 (MMP-1) and matrix metalloproteinase-13 (MMP-13), which can degrade cartilage. To better understand the underlying mechanisms of Gln in IL-1β-induced chondrocytes, the classical OA pathways of JNK and NF-κB were examined at the protein and mRNA levels using western blot and qRT–PCR analyses. We found that JNK and NF-κB were downregulated gradually depending on the Gln dose and protective and destructive factors changed based on changes of JNK and NF-κB. The effects of high-dose Gln were more effective than low-dose. Moreover, Gln was applied to the animal OA model to check the effects in vivo. The results showed that Gln attenuated cartilage degeneration and decreased OARSI scores, which demonstrated that Gln can improve OA. The experiments showed that Gln can benefit mice with OA by inhibiting the JNK and NF-κB signaling pathways.
The ADJUVANT study reported the comparative superiority of adjuvant gefitinib over chemotherapy in disease-free survival of resected EGFR-mutant stage II-IIIA non-small cell lung cancer (NSCLC). ...However, not all patients experienced favorable clinical outcomes with tyrosine kinase inhibitors (TKI), raising the necessity for further biomarker assessment. In this work, by comprehensive genomic profiling of 171 tumor tissues from the ADJUVANT trial, five predictive biomarkers are identified (TP53 exon4/5 mutations, RB1 alterations, and copy number gains of NKX2-1, CDK4, and MYC). Then we integrate them into the Multiple-gene INdex to Evaluate the Relative benefit of Various Adjuvant therapies (MINERVA) score, which categorizes patients into three subgroups with relative disease-free survival and overall survival benefits from either adjuvant gefitinib or chemotherapy (Highly TKI-Preferable, TKI-Preferable, and Chemotherapy-Preferable groups). This study demonstrates that predictive genomic signatures could potentially stratify resected EGFR-mutant NSCLC patients and provide precise guidance towards future personalized adjuvant therapy.
Abstract
The nearly 33 yr long-term radio light curve obtained with the Metsähovi Radio Observatory 14 m telescope at 37 GHz and the recent 12.7 yr
γ
-ray light curve of the blazar S5 0716+714 at ...0.1–300 GeV from the Fermi Large Area Telescope (Fermi-LAT) were analyzed by using the Lomb–Scargle periodogram and the weighted wavelet Z-transform techniques. In the radio light curve, we discovered a possible quasi-periodic oscillation (QPO) signal of about 352 ± 23 days at a confidence level of ∼3
σ
. We recalculated the periodicity and its significance in a chosen time range that has higher variability and denser sampling, and then found that the significance had increased to a confidence level of 99.996% (∼4.1
σ
). This QPO component was further confirmed by fitting a linear autoregressive integrated moving average model to the selected radio light curve. A possible QPO of 960 ± 80 days at a 99.35% level (∼2.7
σ
) was found in the
γ
-ray light curve, which generally agrees with the earlier QPO claims of S5 0716+714. This paper discusses possible mechanisms for this potential year-like QPO. One possibility is a pure geometrical scenario with blobs moving helically inside the jet. Another is a supermassive binary black hole involving a gravitational wave-driven regime. In the latter scenario, we derived a milliparsec separation in the binary system that undergoes coalescence within a century due to the emission of low-frequency gravitational waves.
The oxygen evolution reaction (OER), characterized by a four‐electron transfer kinetic process, represents a significant bottleneck in improving the efficiency of hydrogen production from water ...electrolysis. Consequently, extensive research efforts have been directed towards identifying single‐atom electrocatalysts with exceptional OER performance. Despite the comprehensive understanding of the OER mechanism, its application to other valuable synthetic reactions has been limited. Herein, we leverage the MOOH intermediate, a key species in the Mn−N−C single‐atom catalyst (Mn‐SA@NC), which can be cyclically delivered in the OER. We exploit this intermediate’ s capability to facilitate electrophilic transfer with silane, enabling efficient silane oxidation under electrochemical conditions. The SAC electrocatalytic system exhibits remarkable performance with catalyst loadings as low as 600 ppm and an exceptional turnover number of 9132. Furthermore, the catalytic method demonstrates stability under a 10 mmol flow chemistry setup. By serving as an OER electrocatalyst, the Mn‐SA@NC drives the entire reaction, establishing a practical Mn SAC‐catalyzed organic electrosynthesis system. This synthesis approach not only presents a promising avenue for the utilization of electrocatalytic OER but also highlights the potential of SACs as an attractive platform for organic electrosynthesis investigations.
We synthesized a Mn single‐atom catalyst (SAC) stabilized on N‐doped carbon via thermal decomposition of a ZIF (Mn‐SA@NC). By serving as an OER electrocatalyst, the Mn‐SA@NC drives the electrochemical oxidation of silane to silanol. This synthesis approach not only presents a promising avenue for the utilization of electrocatalytic OER but also highlights the potential of SACs as an attractive platform for organic electrosynthesis investigations.
The collagenases of Vibrio species, many of which are pathogens, have been regarded as an important virulence factor. However, there is little information on the structure and collagenolytic ...mechanism of Vibrio collagenase. Here, we report the crystal structure of the collagenase module (CM) of Vibrio collagenase VhaC and the conformation of VhaC in solution. Structural and biochemical analyses and molecular dynamics studies reveal that triple-helical collagen is initially recognized by the activator domain, followed by subsequent cleavage by the peptidase domain along with the closing movement of CM. This is different from the peptidolytic mode or the proposed collagenolysis of Clostridium collagenase. We propose a model for the integrated collagenolytic mechanism of VhaC, integrating the functions of VhaC accessory domains and its collagen degradation pattern. This study provides insight into the mechanism of bacterial collagenolysis and helps in structure-based drug design targeting of the Vibrio collagenase.
This paper presents a theoretical and numerical study on the stress intensity factors for double-edged cracked steel plates strengthened with fiber reinforced polymer (FRP) plates. Based on the ...stress intensity factor solution for infinite center-cracked steel plates strengthened with FRP plates, expressions of the stress intensity factors were proposed for double-edged cracked steel plates strengthened with FRP plates by introducing two correction factors:
and
. A finite element (FE) simulation was carried out to calculate the stress intensity factors of the steel plate specimens. Numerous combinations of the specimen width, crack length, FRP thickness and Young's modulus, adhesive thickness, and shear modulus were considered to conduct the parametric investigation. The FE results were used to investigate the main influencing factors of the stress intensity factors and the correction factor,
. The expression of the correction factor,
, was formulated and calibrated based on the FE results. The proposed expressions of the stress intensity factors were a function of the applied stress, the crack length, the ratio between the crack length and the width of the steel plate, the stiffness ratio between the FRP plate and steel plate, the adhesive thickness, and the shear modulus. Finally, the theoretical results and numerical results were compared to validate the proposed expressions.