Dual-layer optical encryption fluorescent polymer waveguide chip based on optical pulse-code modulation technique

Information encryption technique has broad applications in individual privacy, military confidentiality, and national security, but traditional electronic encryption approaches are increasingly unable to satisfy the demands of strong safety and large bandwidth of high-speed data transmission over network. Optical encryption technology could be more flexible and effective in parallel programming and multiple degree-of-freedom data transmitting application. Here, we show a dual-layer optical encryption fluorescent polymer waveguide chip based on optical pulse-code modulation technique. Fluorescent oligomers were doped into epoxy cross-linking SU-8 polymer as a gain medium. Through modifying both the external pumping wavelength and operating frequency of the pulse-code modulation, the sender could ensure the transmission of vital information is secure. If the plaintext transmission is eavesdropped, the external pumping light will be switched, and the receiver will get warning commands of ciphertext information in the standby network. This technique is suitable for high-integration and high-scalability optical information encryption communications.

Ceramide sensing by human SPT-ORMDL complex for establishing sphingolipid homeostasis

The ORM/ORMDL family proteins function as regulatory subunits of the serine palmitoyltransferase (SPT) complex, which is the initiating and rate-limiting enzyme in sphingolipid biosynthesis. This complex is tightly regulated by cellular sphingolipid levels, but the sphingolipid sensing mechanism is unknown. Here we show that purified human SPT-ORMDL complexes are inhibited by the central sphingolipid metabolite ceramide. We have solved the cryo-EM structure of the SPT-ORMDL3 complex in a ceramide-bound state. Structure-guided mutational analyses reveal the essential function of this ceramide binding site for the suppression of SPT activity. Structural studies indicate that ceramide can induce and lock the N-terminus of ORMDL3 into an inhibitory conformation. Furthermore, we demonstrate that childhood amyotrophic lateral sclerosis (ALS) variants in the SPTLC1 subunit cause impaired ceramide sensing in the SPT-ORMDL3 mutants. Our work elucidates the molecular basis of ceramide sensing by the SPT-ORMDL complex for establishing sphingolipid homeostasis and indicates an important role of impaired ceramide sensing in disease development.

Triple-layered optical interconnecting integrated waveguide chip based on epoxy cross-linking fluorinated polymer photonic platform

In this study, a triple-layered optical interconnecting integrated waveguide chip was designed and fabricated using an epoxy cross-linking polymer photonic platform. Fluorinated photopolymers FSU-8 and AF-Z-PC EP were self-synthesized as waveguide cores and cladding materials, respectively. The triple-layered optical interconnecting waveguide device comprised 4 × 4 arrayed waveguide grating (AWG) -based wavelength-selective switching (WSS) arrays, 4 × 4 multi-mode interference (MMI) -cascaded channel-selective switching (CSS) arrays, and 3 × 3 direct-coupling (DC) interlayered switching arrays. The overall optical polymer waveguide module was fabricated by direct UV writing. For the multilayered WSS arrays, the wavelength-shifting sensitivity was ∼0.48 nm/°C. For the multilayered CSS arrays, the average switching time was ∼280 µs, and the maximum power consumption was <30 mW. For interlayered switching arrays, the extinction ratio approximated 15.2 dB. The transmission loss for the triple-layered optical waveguide chip was measured as 10.0-12.1 dB. The flexible multilayered photonic integrated circuits (PIC) can be used in high-density integrated optical interconnecting systems with a large-volume optical information transmission capacity.

Combined chemo-endocrine therapy as a potential new option for HR+/HER2- advanced breast cancer: a prospective study of fulvestrant plus oral vinorelbine

OBJECTIVE

Endocrine therapy with fulvestrant has shown synergistic antitumor effects with some chemotherapy drugs in vitro. This study evaluated the efficacy and safety of fulvestrant with vinorelbine in patients with hormone receptor positive (HR+)/human epidermal growth factor receptor-2-negative (HER2-) recurrent or metastatic breast cancer.

METHODS

Patients were intramuscularly administered fulvestrant 500 mg (day 1 per cycle for 28 days) and oral vinorelbine (60 mg/m² on days 1, 8, and 15 of each cycle). The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival, objective response rate, disease control rate, duration of response, and safety.

RESULTS

A total of 38 patients with HR+/HER2- advanced breast cancer included in the study were followed up for a median time of 25.1 months. The overall median PFS was 9.86 months [95% confidence interval (CI) 7.2-23.13], and the median PFS of the first-line and the second-line treatment population was 20.73 months (95% CI 9.82 to NR) and 4.27 months (95% CI 3.68 to NR), respectively. Most adverse events reported were of grade 1/2, and none were of grade 4/5.

CONCLUSIONS

This is the first exploratory study of a fulvestrant and oral vinorelbine regimen in the treatment of HR+/HER2- recurrent and metastatic breast cancer. The combination chemo-endocrine therapy was efficacious, safe, and promising for patients with HR+/HER2- advanced breast cancer.

Mechanism of sphingolipid homeostasis revealed by structural analysis of Arabidopsis SPT-ORM1 complex

The serine palmitoyltransferase (SPT) complex catalyzes the first and rate-limiting step in sphingolipid biosynthesis in all eukaryotes. ORM/ORMDL proteins are negative regulators of SPT that respond to cellular sphingolipid levels. However, the molecular basis underlying ORM/ORMDL-dependent homeostatic regulation of SPT is not well understood. We determined the cryo-electron microscopy structure of Arabidopsis SPT-ORM1 complex, composed of LCB1, LCB2a, SPTssa, and ORM1, in an inhibited state. A ceramide molecule is sandwiched between ORM1 and LCB2a in the cytosolic membrane leaflet. Ceramide binding is critical for the ORM1-dependent SPT repression, and dihydroceramides and phytoceramides differentially affect this repression. A hybrid β sheet, formed by the amino termini of ORM1 and LCB2a and induced by ceramide binding, stabilizes the amino terminus of ORM1 in an inhibitory conformation. Our findings provide mechanistic insights into sphingolipid homeostatic regulation via the binding of ceramide to the SPT-ORM/ORMDL complex that may have implications for plant-specific processes such as the hypersensitive response for microbial pathogen resistance.

Association between homologous recombination deficiency and outcomes with platinum and platinum-free chemotherapy in patients with triple-negative breast cancer

OBJECTIVE

The choice of chemotherapeutic regimen for triple-negative breast cancer (TNBC) remains controversial. Homologous recombination deficiency (HRD) has attracted increasing attention in informing chemotherapy treatment. This study was aimed at investigating the feasibility of HRD as a clinically actionable biomarker for platinum-containing and platinum-free therapy.

METHODS

Chinese patients with TNBC who received chemotherapy between May 1, 2008 and March 31, 2020 were retrospectively analyzed with a customized 3D-HRD panel. HRD positivity was defined by an HRD score ≥ 30 or deleterious BRCA1/2 mutation. A total of 386 chemotherapy-treated patients with TNBC were screened from a surgical cohort (NCT01150513) and a metastatic cohort, and 189 patients with available clinical and tumor sequencing data were included.

RESULTS

In the entire cohort, 49.2% (93/189) of patients were identified as HRD positive (40 with deleterious BRCA1/2 mutations and 53 with BRCA1/2 intact with an HRD score of ≥ 30). In the first-line metastatic setting, platinum therapy was associated with longer median progression-free survival (mPFS) than platinum-free therapy [9.1 vs. 3.0 months; hazard ratio (HR), 0.43; 95% confidence interval 0.22-0.84; P = 0.01]. Among HRD-positive patients, the mPFS was significantly longer in those treated with platinum rather than platinum-free therapy (13.6 vs. 2.0 months; HR, 0.11; P = 0.001). Among patients administered a platinum-free regimen, HRD-negative patients showed a PFS significantly superior to that of HRD-positive patients (P = 0.02; treatment-biomarker P-interaction = 0.001). Similar results were observed in the BRCA1/2-intact subset. In the adjuvant setting, HRD-positive patients tended to benefit more from platinum chemotherapy than from platinum-free chemotherapy (P = 0.05, P-interaction = 0.02).

CONCLUSIONS

HRD characterization may guide decision-making regarding the use of platinum treatment in patients with TNBC in both adjuvant and metastatic settings.

Assessing early changes in plasma HER2 levels is useful for predicting therapeutic response in advanced breast cancer: A multicenter, prospective, noninterventional clinical study

BACKGROUND

Early prediction of treatment response is crucial for the optimal treatment of advanced breast cancer. We aimed to explore whether monitoring early changes in plasma human epidermal growth factor receptor 2 (HER2) levels using digital PCR (dPCR) could predict the treatment response in advanced breast cancer.

METHODS

This was a multicenter, prospective, noninterventional clinical study of patients with advanced breast cancer. All enrolled patients underwent blood testing to measure the HER2 levels by digital PCR before treatment initiation and once every 3 weeks during the study. The primary endpoints were^a the diagnostic value of dPCR for detecting HER2 status in the blood and^b the relevance of potential changes in the plasma HER2 level at 3 weeks from baseline for predicting treatment response.

RESULTS

Overall, 85 patients were enrolled between October 9, 2018, and January 23, 2020. dPCR had a specificity of 91.67% (95% CI: 80.61% to 97.43%) for detecting HER2 amplification, and the area under the receiver operating characteristic (ROC) curve was 0.84 (p < 0.01). A clinically relevant specificity threshold of approximately 90%, which was equivalent to a ≥15% decrease in the plasma HER2 ratio at 3 weeks from baseline, showed a positive predictive value of 97.37% (95% CI: 77.11% to 98.65%) in terms of predicting clinical benefit. Patients whose plasma HER2 ratio was reduced by ≥15% had a longer median progression-free survival (PFS) than those whose ratio was reduced by <15% (9.20 months vs. 4.50 months, p < 0.01).

CONCLUSIONS

Early changes in the plasma HER2 ratio may predict the treatment response in patients with advanced breast cancer and could facilitate optimal treatment selection.

Abstract P3-02-07: Combined Chemo-endocrine Therapy Maybe a New Option for HR+/HER2− Advanced Breast Cancer: A Prospective, Single-center Clinical Study of Fulvestrant plus Oral Vinorelbine

Background Fulvestrant have demonstrated synergistic antitumor effect with chemotherapy regimen. This study evaluates the efficacy and safety of Fulvestrant with Vinorelbine in patients with hormone receptor positive (HR+)/human epidermal growth factor receptor-2-negative (HER2−) recurrent or metastatic breast cancer. Methods In this prospective, single-arm and investigator-initiated clinical study, patients with recurrent or metastatic HR+/HER2− breast cancer after the first line adjuvant endocrine therapy for &gt; 1 year were eligible, in which the subjects of the first line was defined as the patients with recurrence and metastasis after adjuvant endocrine therapy for over 1 year and did not receive treatment for the recurrence and metastasis and the second-line defined as the patients who had disease progression after receiving first-line endocrine therapy or first-line chemotherapy). Patients were administered i.m. Fulvestrant 500mg (day 1 per cycle for 28 days) and oral Vinorelbine (60 mg/m2 on day 1, 8 and 15 of each cycle). The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DoR), and safety. The Kaplan–Meier method and log-rank test were used to evaluate PFS and OS. Results Total 38 HR+/HER2- advanced breast cancer patients with median follow-up time (25.1 months) were enrolled in, and median PFS [9.86 months (95% CI: 7.2, 23.13)] were discovered. The median PFS of the first-line and the second-line treatment population were 20.73 months (95% CI: 9.82, NR) and 4.27 months (95% CI: 3.68, NR), respectively. The median OS of the intent-to-treat (ITT) and the first-line treatment population were not reached, and the OS of the second-line treatment was 28.2 months (95% CI: 11.5, NR). The ORR of the ITT population was 39.47% (95% CI: 23.93, 55.01). The ORR of the patients receiving first-line and second-line treatments were 44.44% (95% CI: 25.70, 63.19) and 27.27% (95% CI: 0.95, 53.59), respectively. The DCR of ITT population was 92.11% (95% CI: 83.54, 100.00)], and the median DoR was approximately 15.33 months (95% CI: 7.23, 22.54)]. In the safety analysis, most of the adverse events were grade of 1/2, and none of grade 4/5 adverse events were reported. Conclusion This is the first exploratory study of Fulvestrant with oral Vinorelbine regimen in the treatment of HR+/HER2− recurrent and metastatic breast cancer conducted worldwide. The combinative chemo-endocrine therapy was efficacious, safe and promising for patients with HR+/HER2− advanced breast cancer.

Citation Format: Xue Wang, Jian Yue, Jiayu Wang, Pin Zhang, Fei Ma, Binghe Xu, Peng Yuan. Combined Chemo-endocrine Therapy Maybe a New Option for HR+/HER2− Advanced Breast Cancer: A Prospective, Single-center Clinical Study of Fulvestrant plus Oral Vinorelbine [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-02-07.

Clinicopathologic characteristics and prognostic significance of HER2-low expression in patients with early breast cancer: A systematic review and meta-analysis

Background

HER2-low expression breast cancer (BC) accounts for approximately 45%-55% of all BC cases. The purpose of this study was to investigate the prognostic difference between patients with HER2-low expression and HER2-zero BC.

Methods

An electronic search of Pubmed, Embase, Cochrane Library, and Web of Science databases was performed to screen studies that included prognostic comparisons between HER2-zero and HER2-low expression groups. A total of 14 studies involving 52106 patients were included.

Results

Our results indicated that HER2-low expression was associated with a significant benefit in OS among all patients with early BC (HR, 0.83; 95% CI, 0.78-0.88), patients with hormone-receptor positive BC (HR, 0.83; 95% CI, 0.77-0.89), and patients with TNBC (HR, 0.78; 95% CI, 0.70-0.87). HER2-low expression was associated with a significant benefit in DFS among all patients (HR, 0.81; 95% CI, 0.71-0.93), patients with hormone receptor-positive BC (HR, 0.81; 95% CI, 0.72-0.90), but no significant difference in DFS was found in patients with TNBC (HR, 0.87; 95% CI, 0.65-1.17). HER2-low expression was associated with a significant benefit in RFS among all patients (HR, 0.90; 95% CI, 0.85-0.95), patients with hormone receptor-positive BC (HR, 0.90; 95% CI, 0.84-0.96), but no significant difference in RFS was found in patients with TNBC (HR, 0.80; 95% CI, 0.55-1.16).

Conclusions

Among patients with early-stage BC, patients with HER2-low expression BC had better OS in the overall population, hormone receptor-positive and TNBC subgroups. Besides, favorable DFS and RFS were observed in both the overall population and hormone receptor-positive subgroup.

Systematic review registration

https://www.crd.york.ac.uk/PROSPERO/, identifier (CRD 42022349458).

Effect of Epirubicin Plus Paclitaxel vs Epirubicin and Cyclophosphamide Followed by Paclitaxel on Disease-Free Survival Among Patients With Operable ERBB2-Negative and Lymph Node-Positive Breast Cancer: A Randomized Clinical Trial

IMPORTANCE

Adjuvant therapy is an important and effective treatment for breast cancer. However, there is a lack of head-to-head clinical trials comparing the regimens epirubicin plus paclitaxel (EP) vs epirubicin and cyclophosphamide followed by paclitaxel (EC-P) in breast cancer.

OBJECTIVE

To evaluate the noninferiority of a cyclophosphamide-free (EP) regimen compared with the standard EC-P regimen for patients with operable hormone receptor-positive, ERBB2 (formerly HER2)-negative, lymph node-positive breast cancer.

DESIGN, SETTING, AND PARTICIPANTS

This prospective, open-label, phase 3, noninferiority randomized clinical trial was conducted from June 1, 2010, to June 30, 2016, in the Cancer Hospital, Chinese Academy of Medical Sciences, Beijing. Patients with hormone receptor-positive, ERBB2-negative, lymph node-positive operable breast cancer were included and randomized into 2 treatment groups. Data were analyzed from June 30, 2016, to November 1, 2022.

INTERVENTIONS

Patients received adjuvant epirubicin (75 mg/m2) and paclitaxel (175 mg/m2) every 3 weeks for 6 cycles (EP regimen) or epirubicin (90 mg/m2) and cyclophosphamide (600 mg/m2) every 3 weeks for 4 cycles followed by paclitaxel (175 mg/m2) every 3 weeks for 4 cycles (EC-P regimen) as the intention-to-treat (ITT) population.

MAIN OUTCOMES AND MEASURES

The primary outcome was disease-free survival (DFS), and the secondary outcomes included overall survival (OS), distant DFS, and safety.

RESULTS

A total of 900 patients were registered, and 813 eligible patients (median age, 48 [IQR, 41-56] years) were randomly assigned to the EP group (n = 407) or the EC-P group (n = 406) after the surgical procedure. Through a median follow-up of 93.6 (IQR, 60.9-114.1) months, the hazard ratio (HR) of DFS for EP vs EC-P was 0.82 (95% CI, 0.62-1.10; 5-year DFS, 86.0% vs 80.6%; noninferior P = .001). The 5-year OS for the ITT population treated with the EP or the EC-P regimen was 94.7% vs 95.0%, respectively (HR, 0.95 [95% CI, 0.61-1.49]). Patients in the EP group had more frequent toxic effect events than those in the EC-P group.

CONCLUSIONS AND RELEVANCE

In this prospective, open-label, phase 3, randomized clinical trial, the EP regimen was noninferior to the EC-P regimen. These findings supported that the EP regimen could be an effective adjuvant chemotherapy regimen for women with ERBB2-negative breast cancer.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT01134523.

Prognostic factors and adjuvant systemic therapy for patients with HER2-positive T1N0 breast cancer: evidence from a real-world study with long-term follow-up

PURPOSE

The optimal adjuvant systemic treatment and potential prognostic factors for patients with T1N0 HER2-positive breast cancer are still unclear. We conducted a real-world study in this relatively low-risk population to identify the clinical-pathological factors of potential prognostic value and to compare the efficacy of different adjuvant strategies.

METHODS

We included patients with HER2-positive T1N0 breast cancer of infiltrating ductal carcinoma (IDC) histology treated at the Cancer Hospital, Chinese Academy of Medical Sciences from April 2010 to April 2017. We performed Cox multivariate analysis to identify the potential prognostic factors for invasive disease-free survival (IDFS). We also compared survival outcomes of (1) patients treated with adjuvant chemotherapy alone, or chemotherapy plus trastuzumab, or observation; (2) patients receiving adjuvant anthracycline-based and non-anthracycline regimens, both combined with trastuzumab. Inverse probability of treatment weighting (IPTW) propensity score was used to reduce selection bias.

RESULTS

Overall, 692 consecutive patients were included, with a median follow-up of 78.0 months for IDFS. Age ≤ 40, T1c, ER + PR + , and adjuvant trastuzumab were identified as independent prognostic factors. For adjuvant treatment, compared with observation and chemotherapy alone, chemotherapy plus trastuzumab could significantly benefit patients (HR = 2.70, P = 0.034; HR = 3.95, P < 0.001). Meanwhile, compared with observation, chemotherapy alone did not significantly benefit patients (HR = 1.37, P = 0.424). For the comparison of anthracycline-based versus non-anthracycline regimens when combined with trastuzumab, patients in both groups had similar IDFS (HR = 1.74, P = 0.242).

CONCLUSIONS

HER2-positive T1N0 IDC patients could benefit from adjuvant chemotherapy plus trastuzumab. Age ≤ 40, T1c, ER + PR + , and adjuvant trastuzumab are independent prognostic factors for this population.

Transitional Dynamics of Sarcopenia and Associations of Nutritional Indices with State Transitions in Chinese aged ≥ 50

OBJECTIVES

Sarcopenia's temporal profile can be regarded as a dynamic process with distinct states, in which malnutrition plays an important role. This study aimed to address two research gaps: sarcopenia's transitional dynamics and associations of nutritional indices with state transitions in community-dwelling Chinese adults aged 50 and older.

DESIGN

A prospective population-based cohort study.

SETTING

Community-based setting in western China.

PARTICIPANTS

The analytic sample included data from 1910 participants aged ≥ 50 in the West China Health and Aging Trend study between 2018-2022.

MEASUREMENTS

We defined three states: the initial normal state (normal muscle strength, physical performance and muscle mass), the worst sarcopenia state (low muscle mass plus low muscle strength and/or low physical performance) and the intermediate subclinical state (the other scenarios). The relevant measurement methods and cut-off points were based on the 2019 AWGS consensus. Using a continuous-time multistate Markov model, we calculated probabilities of transitions between different states over 1, 2 and 4 years; we also examined associations between nutritional indices and transitions, including body mass index (BMI), calf circumference (CC), mid-arm circumference (MAC), triceps skinfold thickness (TST), albumin (ALB), geriatric nutrition risk index (GNRI), vitamin D (VitD) and prealbumin (PA).

RESULTS

For individuals in the normal state, their probabilities of remaining stable versus progressing to a subclinical state were 53.4% versus 42.1% at 2 years, and 40.6% versus 49.0% at 4 years. In the subclinical population, their 2- and 4-year chances were 60.2% and 51.2% for maintaining this state, 11.8% and 16.2% for developing sarcopenia, 28.0% and 32.6% for reverting to normal. For sarcopenic individuals, the likelihood of staying stable versus retrogressing to the subclinical state were 67.0% versus 26.3% at 2 years, and 48.3% versus 36.3% at 4 years. Increased BMI, CC, MAC, TST, ALB, GNRI and PA correlated with reversion from the subclinical state, among which increased TST, ALB and PA were also paralleled with reversion from sarcopenia, while decreased BMI, CC, MAC, TST and GNRI were associated with progression to sarcopenia. VitD was not significantly associated with any transitions.

CONCLUSION

This study reveals how sarcopenia changes over time in a Chinese population. It also highlights the usefulness of simple and cost-effective nutritional status indices for indicating state transitions, which can help identify individuals at risk of sarcopenia and guide targeted interventions within the optimal time window.

Design of Monolithic 2D Optical Phased Arrays Heterogeneously Integrated with On-Chip Laser Arrays Based on SOI Photonic Platform

In this work, heterogeneous integration of both two-dimensional (2D) optical phased arrays (OPAs) and on-chip laser arrays based on a silicon photonic platform is proposed. The tunable multi-quantum-well (MQW) laser arrays, active switching/shifting arrays, and grating antenna arrays are used in the OPA module to realize 2D spatial beam scanning. The 2D OPA chip is composed of four main parts: (1) tunable MQW laser array emitting light signals in the range of 1480-1600 nm wavelengths; (2) electro-optic (EO) switch array for selecting the desired signal light from the on-chip laser array; (3) EO phase-shifter array for holding a fixed phase difference for the uniform amplitude of specific optical signal; and (4) Bragg waveguide grating antenna array for controlling beamforming. By optimizing the overall performances of the 2D OPA chip, a large steering range of 88.4° × 18° is realized by tuning both the phase and the wavelength for each antenna. In contrast to the traditional thermo-optic LIDAR chip with an external light source, the overall footprint of the 2D OPA chip can be limited to 8 mm × 3 mm, and the modulation rate can be 2.5 ps. The ultra-compact 2D OPA assembling with on-chip tunable laser arrays using hybrid integration could result in the application of a high-density, high-speed, and high-precision lidar system in the future.

Disease-free survival landmark analysis: a potential critical endpoint in triple-negative breast cancer

Taxanes plus carboplatin (TP) regimen may be an acceptable alternative adjuvant chemotherapy strategy in patients with triple-negative breast cancer (TNBC); however, the difference with the anthracycline-based regimen is yet to be clarified. Therefore, this study aimed to assess the difference between platinum-based and anthracycline-based regimens in prolonging the survival time in TNBC. Using exploratory landmark analysis, we found that the platinum-based TP regimen offers a longer disease-free survival (DFS) than the anthracycline-based regimen in TNBC patients with a DFS of > 4 years.

[Susceptibility of drug-resistant staphylococci isolated from different parts of the ocular anterior segment to common ophthalmic antibiotics]

Objectie To investigate the susceptibility of drug-resistant staphylococci isolated from different parts of the anterior segment to levofloxacin, tobramycin, cefazolin sodium, fusidic acid and clindamycin. Methods: Experimental Study. A total of 67 patients with anterior segment infection (33 cases of conjunctivitis, 6 cases of bacterial keratitis, 7 cases of blepharitis, 9 cases of neonatal dacryocystitis, 9 cases of neonatal dacryocystitis, 1 case of adult dacryocystitis and 11 cases of other infectious eye diseases) were collected from the conjunctival sac, cornea, eyelid margin and lacrimal sac. Minimum inhibitory concentration (MIC) determination of methicillin-resistant Staphylococcus (MRS) strains and β-lactamase-producing (β-Lac) strains by a micro-liquid-based method, according to the M100 standard of the American Institute for Clinical and Laboratory Standardization Susceptibility and resistance determinations were made. Data were statistically analyzed using Chi-square or Fisher's exact test. Results: Thirty-five MRS, 30 β-Lac and 2 β-Lac MRS isolates were identified from 67 multidrug-resistant Staphylococcus . There were 3, 9, 4, and 19 MRS isolates isolated from the lacrimal sac, cornea, eyelid margin and conjunctival sac, accounting for 3/4, 9/12, 4/8, 19/43 (44.2%) of the isolated sites respectively. There were 1, 3, 3, and 23 β-Lac isolates, accounting for 1/4, 3/12, 3/8 and 23/43 (53.5%) of the isolated sites, respectively. The highest proportion of β-Lac isolates isolated from patients with a diagnosis of conjunctivitis was 17 (25.3%) from the conjunctival sac. Among the MRS strains isolated from the cornea and lacrimal sac, 5 (7.5%) and 3 (4.5%) were from patients diagnosed with bacterial keratitis and neonatal tear, respectively. The number of MRS strains and β-Lac isolates isolated from patients with a diagnosis of blepharitis were both 3 (4.5%) from the lid margin.Among the strains isolated from the eyelid margin and the conjunctival sac, drug-resistant Staphylococcus epidermidis was the main strain, the drug-resistant Staphylococcus aureus was the major isolates in lacrimal sac and cornea. Among the 35 MRS isoaltes, 25, 24, 12, 12, and 11 were sensitive to cefazolin sodium, fusidic acid, levofloxacin, clindamycin and tobramycin, and the sensitivity rates were 71.4%, 68.6%, 34.3%, 34.3% and 31.4%, the difference was statistically significant (χ²=22.756, P<0.001), The sensitivity rates of levofloxacin, tobramycin, cefazolin sodium, fusidic acid and clindamycin against MRS isolates from the anterior segment were both statistically significant differences (χ²=18.493, 11.594, 8.906, 9.841, 16.059; all P<0.05). The susceptibility rates of MRS isolates against five antibiotics was statistically significant differences (χ²=33.080, P<0.001). Among the 30 β-Lac isolates, 27, 22, 19, 16, and 8 were sensitive to cefazolin sodium, fusidic acid, levofloxacin, tobramycin and clindamycin, and the sensitivity rates were 90.0 % , 73.3%, 63.3%, 53.3% and 26.7%, the difference was statistically significant (χ²=28.280, P<0.001). The sensitivity rates of five antibiotics against β-Lac isolates from the anterior segment were both statistically significant differences (χ²=50.971, 24.543, 48.147, 44.899, 18.676; all P<0.001). The susceptibility rates of β-Lac isolates against five antibiotics was statistically significant differences (χ²=23.383, P<0.001). The sensitivity of cefazolin sodium and fusidic acid against β-Lac isolates were higher than MRS isolates. Conclusions: Cefazolin sodium and fusidic acid may be the best choice for the treatment of drug-resistant Staphylococcus isolated from anterior conjunctival sac, cornea, eyelid margin and lacrimal sac, especially for β-Lac-producing drug-resistant Staphylococcus infection.

Artificial phosphatase upon premicellar nanoarchitectonics of lanthanum complexes with long-chained imidazole derivatives

Four novel long chain-containing tridentate imidazole derivatives (Lⁿ, n = 1, 2, 3, 4) were synthesized for in situ formation of mononuclear lanthanum(III) complexes as artificial phosphodiesterases. These in-situ formed La(III) complexes (named LaLⁿ) were used to catalyze the transesterification of 2-hydroxypropyl p-nitrophenyl phosphate (HPNP), a classic RNA model. Critical aggregation concentrations (CAC) were determined for the as-prepared tridentate imidazole derivatives as ligands and corresponding mixtures of equivalent ligand and La³⁺ ion with a mole rate of 1:1. It denotes that the introduction of La³⁺ ion increases the CAC values of imidazole derivatives by about 2 to 3 folds. Foaming test shows that the foam height is positively correlated with the length of hydrophobic chain. Transesterification of HPNP mediated by LaLⁿ nanoarchitectonics indicates that the introducing of hydrophobic chain benefits rate enhancement, showing excess three orders of magnitude acceleration under physiological conditions (pH 7.0, 25 °C). Moreover, catalytic reactivities of these La(III) complexes increased along with the increase in chain length: LaL¹ < LaL² < LaL³ < LaL⁴, suggesting a positive correlation to hydrophobic chain length.

Alpha power during task performance predicts individual language comprehension

Alpha power attenuation during cognitive task performing has been suggested to reflect a process of release of inhibition, increase of excitability, and thereby benefit the improvement of performance. Here, we hypothesized that changes in individual alpha power during the execution of a complex language comprehension task may correlate with the individual performance in that task. We tested this using magnetoencephalography (MEG) recorded during comprehension of German sentences of different syntactic complexity. Results showed that neither the frequency nor the power of the spontaneous oscillatory activity at rest were associated with the individual performance. However, during the execution of a sentences processing task, the individual alpha power attenuation did correlate with individual language comprehension performance. Source reconstruction localized these effects in left temporal-parietal brain regions known to be associated with language processing and their right-hemisphere homologues. Our results support the notion that in-task attenuation of individual alpha power is related to the essential mechanisms of the underlying cognitive processes, rather than merely to general phenomena like attention or vigilance.

Structural Analysis of Ino2p/Ino4p Mutual Interactions and Their Binding Interface with Promoter DNA

Gene expression is mediated by a series of regulatory proteins, i.e., transcription factors. Under different growth conditions, the transcriptional regulation of structural genes is associated with the recognition of specific regulatory elements (REs) in promoter DNA. The manner by which transcription factors recognize distinctive REs is a key question in structural biology. Previous research has demonstrated that Ino2p/Ino4p heterodimer is associated with the transcriptional regulation of phospholipid biosynthetic genes. Mechanistically, Ino2p/Ino4p could specifically recognize the inositol/choline-responsive element (ICRE), followed by the transcription activation of the phospholipid biosynthetic gene. While the promoter DNA sequence for Ino2p has already been characterized, the structural basis for the mutual interaction between Ino2p/Ino4p and their binding interface with promoter DNA remain relatively unexplored. Here, we have determined the crystalline structure of the Ino2p^DBD/Ino4p^DBD/DNA ternary complex, which highlights some residues (Ino2p^{His12/Glu16/Arg20/Arg44} and Ino4p^{His12/Glu16/Arg19/Arg20}) associated with the sequence-specific recognition of promoter DNA. Our biochemical analysis showed that mutating these residues could completely abolish protein–DNA interaction. Despite the requirement of Ino2p and Ino4p for interprotein–DNA interaction, both proteins can still interact—even in the absence of DNA. Combined with the structural analysis, our in vitro binding analysis demonstrated that residues (Arg35, Asn65, and Gln69 of Ino2p^DBD and Leu59 of Ino4p^DBD) are critical for interprotein interactions. Together, these results have led to the conclusion that these residues are critical to establishing interprotein–DNA and protein–DNA mutual interactions.

Durable Disease-free Survival in a Patient with Metastatic Triple-negative Breast Cancer Treated with Olaparib Monotherapy

BACKGROUND

Metastatic triple-negative breast cancer (mTNBC) has a poor prognosis and few effective targeted therapy options. Olaparib, a poly (ADP-ribose) polymerase (PARP) inhibitor, has been granted accelerated approval by FDA for patients with deleterious BRCA-mutated human epidermal growth factor receptor 2 (HER2)-negative advanced/metastatic breast cancer. However, there is little data demonstrating that patients with particular forms of germline and/or somatic BRCA1/2, such as large fragment variation, can benefit from PARP inhibitors.

CASE PRESENTATION

In 2011, a 40-year-old woman was diagnosed with TNBC having pT2N0M0 in the right breast, and a new irregular lesser tubercle in the left breast appeared after approximately 3 years, which was also diagnosed as TNBC. In 2017, computed tomography (CT) showed TNBC metastases to the lung and brain. A next-generation sequencing (NGS) was performed with a lung metastasis sample, and results showed a homologous recombination deficiency (HRD) score of 67, a germline large deletion of exon 2 in BRCA1, a novel somatic BRCA2-STARD13 rearrangement and copy number loss of RAD51. Since September 2017, the patient was treated with olaparib. Till the report date of this case, the patient underwent regular follow-up without disease recurrence.

CONCLUSION

To our knowledge, this is the first case describing a patient with lung- and brainmetastatic TNBC with combined germline and somatic large rearrangement and a high HRD score who achieved a long-term benefit from olaparib monotherapy. The use of NGS is promising in the treatment of TNBC in clinical practice.

Ultrafast soliton delivered by miniaturized mode-locker with MoTe2 and core-expanded fiber

Thermally expanded core (TEC) technology is an effective method of high-power fiber lasers. Miniaturization is also a major challenge for high-power lasers. We have proposed a miniaturized mode-locker based on TEC fiber and MoTe₂-polyvinyl alcohol (PVA) film. The proposed mode-locker is consisting of two TEC ferrules, a piece of MoTe₂-PVA film and a ceramic sleeve. The length of the proposed device is about 20 mm, and its outer diameter is about 2 mm. The relations between heating time, heating temperature, and mode field diameter (MFD) have been numerically simulated. The bending loss with respect to MFD has also been analyzed. The simulation results have revealed the trade-off relation between maximal tolerable intensity and low cavity loss, which means that there is an optimal MFD corresponding to optimal heating time and heating temperature. The proposed mode-locker has been applied in an integrated fiber laser, which has emitted ultrafast soliton with 3 times intensity larger than that of conventional sandwiched-type saturable absorber. The proposed mode-locker and fiber laser will find important applications in laser processing, laser ranging, and optical communication.

Abstract 5689: Effects of homologous recombination-related gene mutation subtypes on gene instability and the efficacy of platinum-containing regiments in triple-negative breast cancer

Background: Platinum-containing chemotherapy is treatment with high efficacy in homologous recombination (HR) deficient cancers that arise in carriers of mutations in the BRCA1/2 genes. However, previous reports have shown that TNBC patients carrying no BRCA1/2 mutations also could benefit from platinum therapy. This study aimed to explore the association between HR-related gene mutations and genomic instability, and further evaluate the effectiveness of platinum-containing chemotherapy preliminarily.

Methods: A total of 386 TNBC patients were screened from a surgical cohort (NCT01150513) and a metastatic cohort. Finally, 189 TNBC patients with clinical and tumor sequencing data availability were included, including 149 patients treated with radical surgery and adjuvant chemotherapy. All tumor samples were collected during the surgical operation and subjected to NGS for evaluating homologous recombination deficiency (HRD) score and 15 HR-related gene pathogenic or likely pathogenic mutations (including ATM, BARD1, BRCA1, BRCA2, BRIP1, CDK12, CHEK1, CHEK2, FANCL, PALB2, PPP2R2A, RAD51B, RAD51D, RAD51C, RAD54L). HRD score was an algorithmic assessment of three biomarkers of genomic instability as loss of heterozygosity, telomeric-allelic imbalance, large-scale state transitions and based on over 10,000 single-nucleotide polymorphisms in the human genome.

Results: In 189 TNBC cohort, 40 patients (21.1%) had BRCA1/2 deleterious mutations, with additional 26 patients (13.8%) carrying mutations in HR-related genes other than BRCA1/2. Compared with BRCA1/2-intact patients, those carrying BRCA1/2m displayed a significantly higher HRD score (median, 35.5 vs 20.0; P=0.02). However, patients with HRm obtained a similar HRD score with HRwt patients (median, 28.0 vs 21.0, P=0.83). TNBC patients with PALB2m (n=8) had a small trend higher HRD score compared with BRCA1/2m (median HRD score 39.0 and 35.5), and TNBC patients with RAD51 family (n=7), ATM (n=5) and other HR-related gene mutations had a numerical trend lower HRD score compared with BRCA1/2m (median HRD score 22.0, 4.0, 14.5 and 35.5). Of the 149 patients in surgical cohort, 74 received platinum-containing, and 75 underwent platinum-free adjuvant chemotherapy. We analyzed the associations between HR-related gene mutations and disease-free survival (DFS), and found that patients with RAD51Bm (n=3), RAD51Cm (n=1) or PPP2R2Am (n=1) displayed worse DFS for patients treated with adjuvant chemotherapy (P =0.012, P&lt;0.0001 or P&lt;0.0001, respectively).

Conclusions: In this study, we found that different HR-related genes mutation subtypes may exert distinct effects on genomic instability, and mutations in HR-related genes beyond the context of BRCA1/2 may serve as a biomarker for platinum-based adjuvant therapy for TNBC patients, which warrants further studies.

Citation Format: Xue Wang, Yimeng Chen, Feng Du, Jian Yue, Yiran Si, Xiaochen Zhao, Lina Cui, Bei Zhang, Ting Bei, Peng Yuan, Binghe Xu. Effects of homologous recombination-related gene mutation subtypes on gene instability and the efficacy of platinum-containing regiments in triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5689.

Abstract 5084: KMT2D and PIK3CA mutation as potential factors to predict adjuvant chemotherapy efficacy in surgical triple negative breast cancer

Background: Chemotherapy is the most common treatment strategy for triple negative breast cancer (TNBC) patients. Nevertheless, due to adverse drug reactionsthe molecular high heterogeneity of TNBC and no appropriate meaningful efficacy markers, it is still difficult to establish preferred therapeutic strategies and predict the outcomes for TNBC. This study was to investigate the potential predictors and therapeutic targets based on genetic features.

Methods: A total of 386 TNBC patients were randomized 1:1 to receive either six cycles of paclitaxel + cisplatin (TP) or four cycles of epirubicin + cyclophosphamide followed by four cycles of docetaxel (EC-T) adjuvant chemotherapy after surgery (NCT01150513), which were described previously. Finally, 149 TNBC patients with clinical and tumor sequencing data availability were retrospectively analysed by NGS for 733 cancer-related genes. All tumor samples were collected during the surgical operation and subjected to NGS for evaluating genomic mutations and the potential predictors. Cox regression model and Kaplan-Meier method were applied to evaluate disease-free survival (DFS).

Results: In the surgical cohort receiving adjuvant chemotherapy, 74 patients received platinum and 75 received platinum-free chemotherapy as adjuvant chemotherapy. The most frequently mutated genes in this surgical TNBC cohort were TP53 (84%), BRCA1 (18%), BRCA2 (15%), POL1 (13%), PTEN (12%), REV3L (11%), FANCC (10%), and PARP4 (10%). We analyzed the associations between 733 cancer-related gene mutations and DFS after adjuvant chemotherapy. For the TP group, PIK3CA mutation (19%, 14/74) was discovered to correlate with poor DFS for patients treated with platinum-containing adjuvant therapy (HR=3.2, P=0.037), and KMT2D mutation (15%, 11/75) display worse DFS for patients treated with EC-T platinum-free group (HR=3.0, p=0.039). However, BRCA1/2 mutation (24%, 35/149) was found to be associated with poor prognosis (HR=2.1 (95% CI: 1-4.6), p=0.047), irrespective of therapeutic regimen.

Conclusions: In this population of surgical TNBC patients, NGS analysis identified potential predictive markers. PIK3CA mutation in TP platinum-containing group and KMT2D mutation in EC-T platinum-free group were significantly associated to poor prognosis for adjuvant chemotherapy in triple negative breast cancer.

Citation Format: Xue Wang, Feng Du, Jian Yue, Yiran Si, Lina Cui, Bei Zhang, Xiaochen Zhao, Binghe Xu, Peng Yuan. KMT2D and PIK3CA mutation as potential factors to predict adjuvant chemotherapy efficacy in surgical triple negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 5084.

Combined analysis of receptor expression reflects inter-and intra-tumor heterogeneity in HR+/HER2+ breast cancer

BACKGROUND

Hormone receptor-positive and human epidermal growth factor receptor 2-positive (HR+/HER2+ breast cancer comprise approximately 5-10% of all invasive breast cancers. However, the lack of knowledge regarding the complexity of tumor heterogeneity in HR+/HER2+ disease remains a barrier to more accurate therapies. This study aimed to describe the tumor heterogeneity of HR+/HER2+ breast cancer and to establish a novel indicator to identify the HER2-enriched subtype in patients with HR+/HER2+ breast cancer.

METHODS

First of all, a comprehensive analysis was performed on HR+/HER2+ breast cancer samples from the TCGA (n = 141) and METABRIC (n = 104) databases. We determined the distribution of PAM50 intrinsic subtypes within the two cohorts and compared the somatic mutational profile and RNA expression features between HER2-enriched and non-HER2-enriched subtypes. From this, we constructed a novel marker termed rH/E, which was calculated as ERBB2 expression quantity/(ESR1 expression quantity + 1). Secondly, we performed multiplex immunofluorescence (mIF) to evaluate HER2 and estrogen receptor (ER) expression simultaneously in the third cohort, enrolling 43 cases of early HR+/HER2+ breast cancer from Cancer Hospital, Chinese Academy of Medical Sciences (CAMS). When using mIF, rH/E was adjusted to prH/E, which was calculated as HER2-positive cells%/(ER-positive cells + 1)%.

RESULTS

All four main intrinsic subtypes were identified in HR+/HER2+ breast cancer, of which the luminal B subtype was the most common, followed by the HER2-enriched and luminal A subtypes. Significantly increased TP53 and ERBB3 and decreased PIK3CA somatic mutation frequency were observed in the HER2-enriched subtype compared with the non-HER2-enriched subtype. In addition, the HER2-enriched subtype was characterized by significantly higher ERBB2 and lower ESR1 expression. We then constructed a marker termed rH/E to reflect the relative expression of ERBB2 to ESR1 in each patient. rH/E discriminates the HER2-enriched subtype from the better than the expression of ERBB2 or ESR1 alone. In the CAMS cohort, we observed four subtypes of tumor cells: ER+/HER2-, ER+/HER2+, ER-/HER2+, and ER-/HER2-. Tumor cell diversity was common, with 86% of patients having all four subtypes of tumor cells. Moreover, prH/E showed a significant prognostic association in the CAMS cohort.

CONCLUSIONS

This study furthers our understanding of the complexity of tumor heterogeneity in HR+/HER2+ breast cancer, and suggests that the combined analysis of ERBB2 and ESR1 expression may contribute to identifying patients with specific subtypes in this population.