Ligand-stabilized copper selenide (Cu(2-x)Se) nanocrystals, approximately 16 nm in diameter, were synthesized by a colloidal hot injection method and coated with amphiphilic polymer. The nanocrystals ...readily disperse in water and exhibit strong near-infrared (NIR) optical absorption with a high molar extinction coefficient of 7.7 × 10(7) cm(-1) M(-1) at 980 nm. When excited with 800 nm light, the Cu(2-x)Se nanocrystals produce significant photothermal heating with a photothermal transduction efficiency of 22%, comparable to nanorods and nanoshells of gold (Au). In vitro photothermal heating of Cu(2-x)Se nanocrystals in the presence of human colorectal cancer cell (HCT-116) led to cell destruction after 5 min of laser irradiation at 33 W/cm(2), demonstrating the viabilitiy of Cu(2-x)Se nanocrystals for photothermal therapy applications.
The randomised phase 2 CABOSUN trial comparing cabozantinib with sunitinib as initial therapy for advanced renal cell carcinoma (RCC) of intermediate or poor risk met the primary end-point of ...improving progression-free survival (PFS) as assessed by investigator. We report PFS by independent radiology review committee (IRC) assessment, ORR per IRC and updated overall survival (OS).
Previously untreated patients with advanced RCC of intermediate or poor risk by IMDC criteria were randomised 1:1 to cabozantinib 60 mg daily or sunitinib 50 mg daily (4 weeks on/2 weeks off). Stratification was by risk group and presence of bone metastases.
A total of 157 patients were randomised 1:1 to cabozantinib (n = 79) or sunitinib (n = 78). Median PFS per IRC was 8.6 months (95% confidence interval CI 6.8–14.0) versus 5.3 months (95% CI 3.0–8.2) for cabozantinib versus sunitinib (hazard ratio HR 0.48 95% CI 0.31–0.74; two-sided p = 0.0008), and ORR per IRC was 20% (95% CI 12.0–30.8) versus 9% (95% CI 3.7–17.6), respectively. Subgroup analyses of PFS by stratification factors and MET tumour expression were consistent with results for the overall population. With a median follow-up of 34.5 months, median OS was 26.6 months (95% CI 14.6–not estimable) with cabozantinib and 21.2 months (95% CI 16.3–27.4) with sunitinib (HR 0.80 95% CI 0.53–1.21. The incidence of grade 3 or 4 adverse events was 68% for cabozantinib and 65% for sunitinib.
In this phase 2 trial, cabozantinib treatment significantly prolonged PFS per IRC compared with sunitinib as initial systemic therapy for advanced RCC of poor or intermediate risk.
NCT01835158.
•Cabozantinib was evaluated vs sunitinib as initial therapy for advanced renal cell carcinoma(aRCC) of intermediate/poor risk.•Improved progression-free survival (PFS) per investigator with cabozantinib was previously reported.•PFS per independent assessment was significantly prolonged with cabozantinib.•PFS for subgroups were consistent with results for the overall population.•Cabozantinib may be an initial treatment option for patients with aRCC of intermediate or poor risk.
The insulator‐to‐metal transition (IMT) in vanadium dioxide (VO2) can enable a variety of optics applications, including switching and modulation, optical limiting, and tuning of optical resonators. ...Despite the widespread interest in VO2 for optics, the wavelength‐dependent optical properties across its IMT are scattered throughout the literature, are sometimes contradictory, and are not available at all in some wavelength regions. Here, the complex refractive index of VO2 thin films across the IMT is characterized for free‐space wavelengths from 300 nm to 30 µm, using broadband spectroscopic ellipsometry, reflection spectroscopy, and the application of effective‐medium theory. VO2 films of different thicknesses are studied, on two different substrates (silicon and sapphire), and grown using different synthesis methods (sputtering and sol–gel). While there are differences in the optical properties of VO2 synthesized under different conditions, these differences are surprisingly small in the ≈2–11 µm range where the insulating phase of VO2 also has relatively low optical loss. It is anticipated that the refractive‐index datasets from this article will be broadly useful for modeling and design of VO2‐based optical and optoelectronic components, especially in the mid‐wave and long‐wave infrared.
The optical properties of vanadium dioxide (VO2) for wavelengths from 0.3 to 30 µm are described, as VO2 traverses its insulator‐to‐metal phase transition. A combination of characterization techniques and effective‐medium theory is used to explore films of different thicknesses, on different substrates, and grown using different methods, making the work broadly useful for modeling VO2‐based optical and optoelectronic components.
Summary Background Cabozantinib is an oral inhibitor of tyrosine kinases including MET, VEGFR, and AXL. The randomised phase 3 METEOR trial compared the efficacy and safety of cabozantinib versus the ...mTOR inhibitor everolimus in patients with advanced renal cell carcinoma who progressed after previous VEGFR tyrosine-kinase inhibitor treatment. Here, we report the final overall survival results from this study based on an unplanned second interim analysis. Methods In this open-label, randomised phase 3 trial, we randomly assigned (1:1) patients aged 18 years and older with advanced or metastatic clear-cell renal cell carcinoma, measurable disease, and previous treatment with one or more VEGFR tyrosine-kinase inhibitors to receive 60 mg cabozantinib once a day or 10 mg everolimus once a day. Randomisation was done with an interactive voice and web response system. Stratification factors were Memorial Sloan Kettering Cancer Center risk group and the number of previous treatments with VEGFR tyrosine-kinase inhibitors. The primary endpoint was progression-free survival as assessed by an independent radiology review committee in the first 375 randomly assigned patients and has been previously reported. Secondary endpoints were overall survival and objective response in all randomly assigned patients assessed by intention-to-treat. Safety was assessed per protocol in all patients who received at least one dose of study drug. The study is closed for enrolment but treatment and follow-up of patients is ongoing for long-term safety evaluation. This trial is registered with ClinicalTrials.gov , number NCT01865747. Findings Between Aug 8, 2013, and Nov 24, 2014, 658 patients were randomly assigned to receive cabozantinib (n=330) or everolimus (n=328). The median duration of follow-up for overall survival and safety was 18·7 months (IQR 16·1–21·1) in the cabozantinib group and 18·8 months (16·0–21·2) in the everolimus group. Median overall survival was 21·4 months (95% CI 18·7–not estimable) with cabozantinib and 16·5 months (14·7–18·8) with everolimus (hazard ratio HR 0·66 95% CI 0·53–0·83; p=0·00026). Cabozantinib treatment also resulted in improved progression-free survival (HR 0·51 95% CI 0·41–0·62; p<0·0001) and objective response (17% 13–22 with cabozantinib vs 3% 2–6 with everolimus; p<0·0001) per independent radiology review among all randomised patients. The most common grade 3 or 4 adverse events were hypertension (49 15% in the cabozantinib group vs 12 4% in the everolimus group), diarrhoea (43 13% vs 7 2%), fatigue (36 11% vs 24 7%), palmar-plantar erythrodysaesthesia syndrome (27 8% vs 3 1%), anaemia (19 6% vs 53 17%), hyperglycaemia (3 1% vs 16 5%), and hypomagnesaemia (16 5% vs none). Serious adverse events grade 3 or worse occurred in 130 (39%) patients in the cabozantinib group and in 129 (40%) in the everolimus group. One treatment-related death occurred in the cabozantinib group (death; not otherwise specified) and two occurred in the everolimus group (one aspergillus infection and one pneumonia aspiration). Interpretation Treatment with cabozantinib increased overall survival, delayed disease progression, and improved the objective response compared with everolimus. Based on these results, cabozantinib should be considered as a new standard-of-care treatment option for previously treated patients with advanced renal cell carcinoma. Patients should be monitored for adverse events that might require dose modifications. Funding Exelixis Inc.
Cabozantinib, a tyrosine kinase inhibitor (TKI) of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2, and rearranged during transfection (RET), demonstrated ...clinical activity in patients with medullary thyroid cancer (MTC) in phase I.
We conducted a double-blind, phase III trial comparing cabozantinib with placebo in 330 patients with documented radiographic progression of metastatic MTC. Patients were randomly assigned (2:1) to cabozantinib (140 mg per day) or placebo. The primary end point was progression-free survival (PFS). Additional outcome measures included tumor response rate, overall survival, and safety.
The estimated median PFS was 11.2 months for cabozantinib versus 4.0 months for placebo (hazard ratio, 0.28; 95% CI, 0.19 to 0.40; P < .001). Prolonged PFS with cabozantinib was observed across all subgroups including by age, prior TKI treatment, and RET mutation status (hereditary or sporadic). Response rate was 28% for cabozantinib and 0% for placebo; responses were seen regardless of RET mutation status. Kaplan-Meier estimates of patients alive and progression-free at 1 year are 47.3% for cabozantinib and 7.2% for placebo. Common cabozantinib-associated adverse events included diarrhea, palmar-plantar erythrodysesthesia, decreased weight and appetite, nausea, and fatigue and resulted in dose reductions in 79% and holds in 65% of patients. Adverse events led to treatment discontinuation in 16% of cabozantinib-treated patients and in 8% of placebo-treated patients.
Cabozantinib (140 mg per day) achieved a statistically significant improvement of PFS in patients with progressive metastatic MTC and represents an important new treatment option for patients with this rare disease. This dose of cabozantinib was associated with significant but manageable toxicity.
Cabozantinib is an inhibitor of kinases, including MET and vascular endothelial growth factor receptors, and has shown activity in men with previously treated metastatic castration-resistant prostate ...cancer (mCRPC). This blinded phase III trial compared cabozantinib with prednisone in patients with mCRPC.
Men with progressive mCRPC after docetaxel and abiraterone and/or enzalutamide were randomly assigned at a two-to-one ratio to cabozantinib 60 mg once per day or prednisone 5 mg twice per day. The primary end point was overall survival (OS). Bone scan response (BSR) at week 12 as assessed by independent review committee was the secondary end point; radiographic progression-free survival (rPFS) and effects on circulating tumor cells (CTCs), bone biomarkers, serum prostate-specific antigen (PSA), and symptomatic skeletal events (SSEs) were exploratory assessments.
A total of 1,028 patients were randomly assigned to cabozantinib (n = 682) or prednisone (n = 346). Median OS was 11.0 months with cabozantinib and 9.8 months with prednisone (hazard ratio, 0.90; 95% CI, 0.76 to 1.06; stratified log-rank P = .213). BSR at week 12 favored cabozantinib (42% v 3%; stratified Cochran-Mantel-Haenszel P < .001). rPFS was improved in the cabozantinib group (median, 5.6 v 2.8 months; hazard ratio, 0.48; 95% CI, 0.40 to 0.57; stratified log-rank P < .001). Cabozantinib was associated with improvements in CTC conversion, bone biomarkers, and post-random assignment incidence of SSEs but not PSA outcomes. Grade 3 to 4 adverse events and discontinuations because of adverse events were higher with cabozantinib than with prednisone (71% v 56% and 33% v 12%, respectively).
Cabozantinib did not significantly improve OS compared with prednisone in heavily treated patients with mCRPC and progressive disease after docetaxel and abiraterone and/or enzalutamide. Cabozantinib had some activity in improving BSR, rPFS, SSEs, CTC conversions, and bone biomarkers but not PSA outcomes.
A method to produce biocompatible polymer‐coated silicon nanocrystals for medical imaging is shown. Silica‐embedded Si nanocrystals are formed by HSQ thermolysis. The nanocrystals are then liberated ...from the oxide and terminated with Si–H bonds by HF etching, followed by alkyl monolayer passivation by thermal hydrosilylation. The Si nanocrystals have an average diameter of 2.1 nm ± 0.6 nm and photoluminesce with a peak emission wavelength of 650 nm, which lies within the transmission window of 650–900 nm that is useful for biological imaging. The hydrophobic Si nanocrystals are then coated with an amphiphilic polymer for dispersion in aqueous media with the pH ranging between 7 and 10 and an ionic strength between 30 mM and 2 M, while maintaining a bright and stable photoluminescence and a hydrodynamic radius of only 20 nm. Fluorescence imaging of polymer‐coated Si nanocrystals in biological tissue is demonstrated, showing the potential for in vivo imaging.
Luminescent silicon (Si) nanocrystals are formed from the thermolysis of hydrogen silsesquioxane and passivated with a dodecane monolayer via thermal hydrosilylation. The nanocrystals are rendered hydrophilic for biological imaging by coating with an amphiphilic polymer. The polymer‐coated nanocrystals are imaged in biological tissue, highlighting the potential of Si nanocrystals for in vivo diagnostic imaging.
H-terminated Si nanocrystals undergo room temperature hydrosilylation with bifunctional alkenes with distal polar moieties-ethyl ester, methyl ester, or carboxylic acids-without the aid of light or ...added catalyst. The passivated Si nanocrystals exhibit bright photoluminescence (PL) and disperse in polar solvents, including water. We propose a reaction mechanism in which ester or carboxylic acid groups facilitate direct nucleophilic attack of the highly curved Si surface of the nanocrystals by the alkene.
Small-angle X-ray scattering (SAXS) data reveal that superlattices of organic ligand-stabilized gold (Au) nanocrystals can undergo a series of ordered structure transitions at elevated temperature. ...An example is presented of a body-centered cubic superlattice that evolves into a hexagonal close-packed structure, followed by the formation of binary simple cubic AB13 and hexagonal AB5 superlattices. Ultimately the superlattice decomposes at high temperature to bicontinuous domains of coalesced Au and intervening hydrocarbon. Transmission electron microscopy revealed that the ordered structure transformations result from partial ligand desorption and controlled Au nanocrystal growth during heating, which forces changes in superlattice symmetry. These observations suggest some similarity between organic ligand-coated nanocrystals and microphase-segregated diblock copolymers, where thermally induced nanophase-segregation of Au and organic ligand influences the ordered arrangements in the superlattice.
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