Prognostic significance of circulating tumor cells and tumor related transcripts in small cell lung cancer: A step further to clinical implementation

Small-cell lung cancer (SCLC) is a fatal disease with limited treatment options. Circulating tumor cells (CTCs) in liquid biopsy samples may serve as predictive and prognostic biomarkers; but the analysis of CTCs is still challenging. By using microfluidic or density gradient CTC enrichment in combination with immunofluorescent (IF) staining or qPCR of CTC-related transcripts, we achieved a 60.8% to 88.0% positivity in SCLC blood samples. Epithelial and neuroendocrine transcripts including the druggable target DLL3 were associated with shorter overall survival (OS), indicating the clinical value of these markers in terms of differential diagnosis and treatment decisions. High CTC counts and the presence of CTC duplets detected by IF staining were prognostic for OS, and thus may serve as indicators of disease progression or therapy failure. In patient samples with high CTC load detected by IF staining, a concordance of the transcripts positivity in circulating free plasma RNA and CTCs was observed. Our data emphasize the role of CTCs and CTC-related transcripts and underline the clinical value of liquid biopsy analysis in SCLC.

FOLFIRINOX Pharmacodynamic Interactions in 2D and 3D Pancreatic Cancer Cell Cultures

The multi-drug combination regime, FOLFIRINOX, is a standard of care chemotherapeutic therapy for pancreatic cancer patients. However, systematic evaluation of potential pharmacodynamic interactions among multi-drug therapy has not been reported previously. Here, pharmacodynamic interactions of the FOLFIRINOX agents (5-fluorouracil (5-FU), oxaliplatin (Oxa) and SN-38, the active metabolite of irinotecan) were assessed across a panel of primary and established pancreatic cancer cells. Inhibition of cell proliferation was quantified for each drug, alone and in combination, to obtain quantitative, drug-specific interaction parameters and assess the nature of drug interactions. The experimental data were analysed assuming Bliss independent interactions, and nonlinear regression model fitting was conducted in SAS. Estimates of the drug interaction term, psi (ψ), revealed that the Oxa/SN-38 combination appeared synergistic in PANC-1 (ψ = 0.6, 95% CI = 0.4, 0.9) and modestly synergistic, close to additive, in MIAPaCa-2 (ψ = 0.8, 95% CI = 0.6, 1.0) in 2D assays. The triple combination was strongly synergistic in MIAPaCa-2 (ψ = 0.2, 95% CI = 0.1, 0.3) and modestly synergistic/borderline additive in PANC-1 2D (ψ = 0.8, 95% CI = 0.6, 1.0). The triple combination showed antagonistic interactions in the primary PIN-127 and 3D PANC-1 model (ψ > 1). Quantitative pharmacodynamic interactions have not been described for the FOLFIRINOX regimen; this analysis suggests a complex interplay among the three chemotherapeutic agents. Extension of this pharmacodynamic analysis approach to clinical/translational studies of the FOLFIRINOX combination could reveal additional pharmacodynamic interactions and guide further refinement of this regimen to achieve optimal clinical responses.

Abstract PO-028: Could pharmacodynamic modelling of FOLFIRINOX lead to more therapeutically advantageous treatment of pancreatic cancer?

Pancreatic cancer is one of the most fatal human cancers with a 5-year survival rate of approximately 6%. Pancreatic Ductal Adenocarcinoma (PDAC) is the predominant (~90%) histological type among pancreatic cancers. The poor prognosis of PDAC is due to a combination of factors including late stage diagnosis at a locally advanced or metastatic stage, due to its asymptomatic progression. PDAC is a highly chemoresistant malignancy owing to its genetic heterogeneity and dense stromal environment. FOLFIRINOX (FFX) is a combinatorial chemotherapeutic approach consisting of 5-Fluorouracil (5-FU)/Leucovorin (LV), Irinotecan and Oxaliplatin, and is a first-line treatment option for pancreatic cancer patients. Despite its superior clinical benefit for the treatment of metastatic PDAC compared to gemcitabine, its high toxicity profile limits its use to patients with high performance status. In-depth pharmacodynamic (PD) modelling of the interactions between the individual agents of the regimen is required. Here, the effect of the FFX regime was investigated using both established and primary pancreatic cancer cell-lines cultured as 2D and 3D models. Cells were exposed to a concentration range of each agent in single, double and triple combinations. Cell viability assayed after 5 days. The addition of LV to 5-FU had no effect in vitro in Panc-1, Mia-PaCa-2 and primary PT99 cells, and was excluded from further analysis. The active metabolite of Irinotecan, SN-38, was used in-vitro. The Bliss Independent method was used to fit the cell viability data for all cell lines using SAS 9.4 software. A psi value less than 1 suggests synergistic interactions. Of 4 cell lines tested, MIA-PaCa-2 cells were the most sensitive to the agents of the FFX regimen, with the triple combination demonstrating synergistic interactions with a psi value of 0.036. However, in Panc-1, BxPC-3 and PT127 cells the triple combination was antagonistic, with psi values of 5.167, 3.598 and 5.349 respectively. For the double combination, Ox + SN-38 was shown to have synergistic interactions in 3 of 4 cell lines. The 5-FU + SN-38 and 5-FU + Ox combinations were synergistic in 3 of 4 cell lines. The differences in cellular response observed between the cell lines mirrors the heterogeneity of patients in the clinic and highlights the importance of mathematical modelling to better understand the PD interactions of multidrug treatment regimens. While the triple combinations were determined as antagonistic, meaning the net effect is less than the additive effect of individual agents, it still resulted in greater cell kill than any agent alone. Therefore despite findings of antagonism this further supports the need for all 3 drugs. In conclusion, the results suggest a complex interplay between the three agents, and the PD data could be used to assess whether lower doses and/or alternate dosing schedules would be feasible. This potentially translatable finding may result in FFX being available to more PDAC patients.

Citation Format: Taylor Allen-Coyle, Jin Niu, Eva Welsch, Fiona O'Neill, Martin Clynes, Finbarr O'Sullivan, Donald E. Mager, Robert M. Straubinger, Sandra Roche. Could pharmacodynamic modelling of FOLFIRINOX lead to more therapeutically advantageous treatment of pancreatic cancer? [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2020 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2020;80(22 Suppl):Abstract nr PO-028.

In situ measurement on ultraviolet dielectric components by a pulsed top-hat beam thermal lens

A simple and sensitive mode-mismatched thermal lens (TL) technique with a pulsed top-hat beam excitation and a near-field detection scheme is developed to measure in situ the thermoelastic and the thermooptical responses of ultraviolet (UV) dielectric coatings as well as bulk materials under excimer laser (193- or 248-nm) irradiations. Owing to its high sensitivity, the TL technique can be used for measurements at fluences far below the laser-induced damage threshold (LIDT). We report on the measurement of both linear and nonlinear absorption of the UV dielectric coatings and bulk materials as well as the investigation of time-resolved predamage phenomena, such as laser conditioning of highly reflective dielectric coatings and irradiation-induced changes of a coating's various properties. The pulsed TL technique is also a convenient technique for accurate measurement of the LIDT of dielectric coatings and for distinguishing different damage mechanisms: thermal-stress-induced damage or melting-induced damage.

High-efficiency dielectric reflection gratings: design, fabrication, and analysis

We report on reflection gratings produced entirely of dielectric materials. This gives the opportunity to enhance the laser damage threshold over that occurring in conventional metal gratings used for chirped-pulse-amplification, high-power lasers. The design of the system combines a dielectric mirror and a well-defined corrugated top layer to obtain optimum results. The rules that have to be considered for the design optimization are described. We optimized the parameters of a dielectric grating with a binary structure and theoretically obtained 100% reflectivity for the -1 order in the Littrow mounting for a 45 degrees angle of incidence. Subsequently we fabricated gratings by structuring a low-refractive-index top layer of a multilayer stack with electron-beam lithography. The multilayer system was fabricated by conventional sputtering techniques onto a flat fused-silica substrate. The parameters of the device were measured and controlled by light scatterometer equipment. We measured 97% diffraction efficiency in the -1 order and damage thresholds of 4.4 and 0.18 J/cm(2) with 5-ns and 1-ps laser pulses, respectively, at a wavelength of 532 nm in working conditions.

Pulsed top-hat beam thermal-lens measurement for ultraviolet dielectric coatings

A mode-mismatched surface thermal-lens technique with pulsed top-hat beam excitation and a near-field detection scheme are developed to measure in situ the thermoelastic response of ultraviolet dielectric coatings to excimer-laser (193- or 248-nm) irradiation. The thermal-lens technique is demonstrated to be not only convenient for accurate determination of the laser-induced damage threshold (LIDT) but also sensitive to measurement of the thermoelastic response of dielectric coatings irradiated with fluence far below the LIDT, and hence is shown to be appropriate for time-resolved predamage investigation. A minimum detectable surface displacement of approximately 0.002 nm is achieved with a simple experimental configuration. Nonlinear absorption as well as the nonlinear effect in laser conditioning of a LaF(3)/MgF (2) highly reflective dielectric coating are observed for what is believed to be the first time.

Probe-beam diffraction in a pulsed top-hat beam thermal lens with a mode-mismatched configuration

The Fresnel diffraction integral is used directly to describe the thermal lens (TL) effect with a mode-mismatched collinear configuration. The TL amplitudes obtained with Gaussian, Airy, and top-hat beam excitations are computed and compared. Numerical results for beam geometries optimized for both near- and far-field detection schemes are presented, and the analytical results developed by Bialkowski and Chartier [Appl. Opt. 36, 6711 (1997)] for a Gaussian beam TL effect are summarized in simplified form. Both the numerical and the analytical results demonstrate that, under a beam geometry optimized for either near- or far-field detection, the Gaussian beam TL experiment has approximately the same maximum signal amplitude as does the photothermal-interference scheme. A comparison between the optimum near- and far-field detection beam geometries indicates that a practical mode-mismatched TL instrument should be based on the far-field detection geometry. The computation results further demonstrate that the optimum beam geometry and the TL amplitude depend largely on the excitation-beam profile. The top-hat beam TL experiment is approximately twice as sensitive as the Gaussian beam TL scheme.

Measuring the absolute absorptance of optical laser components

The precise determination of the absolute absorptance of a laser component is of high scientific and commercial importance. Our intention is to demonstrate that laser calorimetry can be a reliable and sensitive characterization tool for this purpose. Furthermore, the limitations of laser calorimetry are discussed and suggestions for possible revisions of the ISO 11551 (International Organization for Standardization, Geneva, Switzerland) standard are made. Finally, laser calorimetry is compared with photothermal deflection methods with respect to their practicability in different fields of laser optic characterization.

Photothermal measurements on optical thin films

An overview of the application of the photothermal technique for optical as well as thermophysical characterizations of thin films is given. The peculiarities of this technique are discussed in some detail, and selected important results are pointed out. Emphasis is placed on the influence of both residual absorption and randomly distributed inhomogeneities in thin films on their laser-damage resistance.

Accurate reflectance measurement of high performance laser mirrors using a photoacoustic technique

We have developed a photoacoustic technique to calculate high mirror reflectance using absorptance, transmittance, and scattering measurements.