Effects of Radiation Doses on Clinical Recurrence in Patients with Biochemically Recurrent Prostate Cancer after Prostatectomy

PURPOSE/OBJECTIVE(S)

Salvage radiotherapy (SRT) to the prostate bed is the only curative treatment for patients with biochemical recurrence (BCR) after radical prostatectomy (RP). Although several systematic reviews indicated that a dose escalation in the range of 60-70 Gy improved biochemical control, the effects of radiation doses on clinical relapse after SRT remain unclear. Our aim was to investigate the relationship between radiation doses and clinical relapse-free survival (cRFS) after SRT.

MATERIALS/METHODS

We identified 295 eligible patients receiving SRT for biochemically recurrent prostate cancer after RP between 2005 and 2018 at 15 institutions. Sixteen patients (5%) received short-term (< 6 months) androgen deprivation therapy (ADT) following RP and/or concurrently with SRT. SRT was delivered to the prostate and seminal vesicle bed using photon beams at a median (range) dose of 66 Gy (61-85) in 1.8-3.0 Gy fractions. The primary outcome was cRFS. Clinical relapse was identified on radiological imaging and/or biopsy and included local recurrence, lymph node metastasis, and distant metastasis. In all analyses, doses were recalculated as an equivalent dose in 2-Gy fractions (EQD2) with α/β = 1.5 Gy. Clinical RFS between the EQD2 ≥ 66 Gy (n = 229) and EQD2 < 66 Gy (n = 66) groups were compared using the Log-rank test, followed by univariate and multivariate Cox regression analyses and a subgroup analysis.

RESULTS

The median follow-up duration was 73 months. Among patients with BCR (n = 119), 79 of 96 (82%) in the EQD2 ≥ 66 Gy group and 21 of 23 (91%) in the EQD2 < 66 Gy group received second salvage ADT (p = 0.36). Among all patients (n = 295), clinical relapse was identified in 22 (7%) patients after SRT. Six-year biochemical relapse-free survival (bRFS), cRFS, cancer-specific survival (CSS), and overall survival (OS) rates were 58%, 93%, 98%, and 94%, respectively. Six-year cRFS rates were 94% (95% confidence interval [CI], 90-97) in the EQD2 ≥ 66 Gy group and 87% (95% CI, 75-93) in the EQD2 < 66 Gy group (p = 0.020). The multivariate analysis revealed that EQD2 < 66 Gy, Gleason score ≥ 8, seminal vesicle involvement, and PSA at BCR ≥ 0.5 ng/ml correlated with clinical relapse (p = 0.0016, 0.014, 0.011, and 0.027, respectively). The subgroup analysis showed the consistent benefit of EQD2 ≥ 66 Gy in patients across most subgroups including PSA at BCR after RP, extracapsular extension, and age at SRT.

CONCLUSION

This large multi-institutional observational study demonstrated that a higher SRT dose (EQD2 ≥ 66 Gy) resulted in superior cRFS. The present result supports the dose recommendations in the 2023 National Comprehensive Cancer Network guidelines (64-72 Gy) even in terms of clinical relapse. Prospective trial is warranted to investigate an upper threshold for optimal SRT dose.

Development of small-sized fluorescence detector for pipette tip-based biosensor for on-site diagnosis

A small-sized fluorescence detector (referred to as a pipette tip [PT]-reader) was developed for a pipette tip-based biosensor. The PT-reader allows us to measure the fluorescence intensity of a solution in a truncated cone-shaped pipette tip with only the tip inserted into the PT-reader. A pipette holder made from a mixture of polydimethylsiloxane (PDMS) and carbon black was capable of the rigorous position arrangement of a truncated cone shaped-pipette tip and the prevention of stray light. The detection performance of the PT-reader was evaluated by measurement of resorufin. The limit of detection (LOD; 3σ) and the relative standard deviation (RSD, n = 4) were estimated to be 0.46 μM and 0.47-4.1%, respectively. This performance was comparable to that of a desktop-type fluorescence microplate reader. In addition, the PT-reader was applied to the quantification of immunoglobulin A (IgA), and the LOD (3σ) of IgA was estimated to be 1.0 ng/mL. The quantitation values of IgA in human saliva obtained by the PT-based enzyme-linked immunosorbent assay (PT-ELISA) were in agreement with those obtained by conventional ELISA. The PT-reader is expected to be useful for low-cost and user-friendly measurements, and the technique of device development proposed in this study will contribute to the progress of on-site medical diagnosis.

A potent allele marker related to low bull conception rate in Japanese Black bulls

Over the years, there has been considerable variation in the bull conception rate (BCR) of Japanese Black cattle; moreover, several Japanese Black bulls with a low BCR of ≤10% have been identified. However, the alleles responsible for the low BCR are not determined yet. Therefore, in this study, we aimed to identify single-nucleotide polymorphisms (SNPs) for predicting low BCR. To this end, the genome of Japanese Black bulls was comprehensively examined by a genome-wide association study with whole-exome sequencing (WES), and the effect of the identified marker regions on BCR was determined. The WES analysis of six sub-fertile bulls with a BCR of ≤10% and 73 normal bulls with a BCR of ≥40% identified a homozygous genotype for low BCR in Bos taurus autosome 5 in the region between 116.2 and 117.9 Mb. The g.116408653G > A SNP in this region had the most significant effect on the BCR (P-value = 1.0 × 10^-23), and the GG (55.4 ± 11.2%) and AG (54.4 ± 9.4%) genotypes in the SNP had a higher phenotype than the AA (9.5 ± 6.1%) genotype for the BCR. The mixed model analysis revealed that g.116408653G > A was related to approximately 43% of the total genetic variance. In conclusion, the AA genotype of g.116408653G > A is a useful index for identifying sub-fertile Japanese Black bulls. Some positive and negative effects of SNP on the BCR were presumed to identify the causative mutations, which can help evaluate bull fertility.

Development of a surface plasmon resonance sensor using an optical fiber prepared by electroless displacement gold plating and its application to immunoassay

A simple and low-cost method of fabricating an optical fiber for a surface plasmon resonance (SPR) sensor was proposed. The method is based on the electroless nickel plating and subsequent displacement gold plating of the core of the optical fiber. The thickness of the nickel and gold thin films deposited on the core of the optical fiber could be controlled by measuring the reflected light intensity from the tip of the optical fiber during the plating processes. The sensitivity and resolution of the SPR sensor with the fabricated optical fiber in the refractive index range from 1.333 to 1.348 were 1324.3 nm/RIU and 7.6 × 10^-4 RIU, respectively. The developed SPR sensor was successfully used in the determination of immunoglobulin A (IgA) in human saliva. The IgA quantification results obtained by the SPR sensor were in excellent agreement with those obtained by conventional enzyme-linked immunosorbent assay using a 96-well microtiter plate.

Regioselective fabrication of gold nanowires using open-space laminar flow for attomolar protein detection

Gold nanowires are expected to be applied to biosensing due to their advantages, such as high stability and biocompatibility. However, it is still inconvenient to fabricate a single gold nanowire at a precise position, and without a special demanding environment. In this study, we present an open-space laminar flow approach for fabricating a single gold nanowire at a precise position under normal conditions. The fabricated gold nanowire demonstrated excellent biosensing of IgA with an extremely low limit of detection (1 aM).

Development of a fluorescence microplate reader using an organic photodiode array with a large light receiving area

We developed a small fluorescence microplate reader with an organic photodiode (OPD) array. The OPD array has nine OPDs that have a large light receiving area (9.62 mm² per one OPD). Since the OPD array is fabricated on a flat glass plate, it can be placed just below microwells and can detect fluorescence emitted through the entire surface of the microwell bottom. The analytical performance of the developed plate reader was evaluated by measuring an aqueous solution of resorufin. The limit of detection (LOD) for resorufin (0.01-0.05 μM) was lower than that obtained with a plate reader equipped with nine inorganic photodiodes developed in a previous study (0.30 μM) and a commercially available microplate reader (0.16 μM). These results indicate that the large light receiving area improves the detection performance of the system. In addition, the developed reader was successfully used to quantify immunoglobulin A (IgA) in human saliva. The LOD for IgA was estimated to be 1.2 ng/mL, which is low enough to objectively evaluate human stress.

O-220 An annotation-free embryo scoring system (iDAScore®) based on deep learning shows high performance for pregnancy prediction after single-vitrified blastocyst transfer

Study question

How is the performance of an automated embryo scoring system for pregnancy prediction after single-vitrified blastocyst transfer (SVBT) compared to other, annotation-dependent blastocyst grading systems?

Summary answer

Automatic embryo ranking by iDAScore shows a higher or equal performance, with regards to pregnancy prediction after SVBT, compared to manual, annotation-dependent grading systems.

What is known already

Blastocyst viability can be assessed by blastocyst morphology grades and/or morphokinetic parameters. However, morphological and morphokinetic embryo assessment is prone to both inter- and intra-observer variation. Recently, embryo ranking models have been developed based on artificial intelligence (AI) and deep learning. Such models rank embryos according to their potential for pregnancy only based on images and do not require any user-dependent annotation. So far, no study has independently assessed the performance of AI models compared to other embryo scoring models, including traditional morphological grading.

Study design, size, duration

A total of 3,014 SVBT cycles were retrospectively analysed. Embryos were stratified according to SART age groups. The quality and scoring of embryos were assessed by iDAScore v1.0 (iDAS, Vitrolife, Sweden), KIDScoreTM D5 v3 (KS; Vitrolife), and Gardner criteria. The performance of the pregnancy prediction for each embryo scoring model was compared using the area under curve (AUC) of the receiver operating characteristic curve for each maternal age group.

Participants/materials, setting, methods

Embryos were cultured in the EmbryoScope+ and EmbryoScopeFlex (Vitrolife). iDAS was automatically calculated using the iDAScore model running on the EmbryoViewer (Vitrolife). KS was calculated in EmbryoViewer after annotation of the required parameters. ICM and TE were annotated according to the Gardner criteria. The degree of expansion in all blastocysts was Grade 4 due to our freezing policy. Furthermore, Gardner’s scores were stratified into four grades (Excellent: AA, Good: AB BA, Fair: BB, Poor: others).

Main results and the role of chance

The AUCs of the &lt; 35 years age group (n = 389) for pregnancy prediction were 0.72 for iDAS, 0.66 for KS and 0.64 for Gardner criteria. The AUC of iDAS was significantly higher (P &lt; 0.05) compared to the other two models. For the 35–37 years age group (n = 514) the AUCs were 0.68, 0.68, and 0.65 for iDAS, KS and Gardner, respectively, and were not significantly different. The AUCs of the 38–40 years age group (n = 796) were 0.67 for iDAS, 0.65 for KS and 0.64 for Gardner criteria and where was not significantly different. The AUCs of the 41–42 years age group (n = 636) were 0.66, 0.66, and 0.63 for iDAS, KS and Gardner, respectively, and there was no significant difference among the pregnancy prediction models. For the &gt; 42 years age group (n = 389) AUCs were 0.76 for iDAS, 0.75 for KS and 0.75 for Gardner criteria and not significantly different. Thus, for all age groups, iDAS was either highest or equal to the highest AUC, although a significant difference was only observed for the youngest age group.

Limitations, reasons for caution

In this study, SVBT was performed after minimal stimulation and natural cycle in vitro fertilisation (IVF). Therefore, we had only few cycles with elective blastocyst transfer. However, there was also no bias in selecting the embryos for SVBT.

Wider implications of the findings

Our results showed that objective embryo assessment by a completely automatic and annotation-free model, iDAScore, does perform as good or even better than more traditional embryo assessment or an annotation-dependent ranking tool. iDAS could be an optimal pregnancy prediction model after SVBT, especially in young and advanced age patients.

Trial registration number

not applicable

In Situ Single-Cell Stimulation and Real-Time Electrochemical Detection of Lactate Response Using a Microfluidic Probe

Metabolism of a single cell, even within the same organization, differs from other cells by orders of magnitude. Single-cell analysis provides key information for early diagnosis of cancer as well as drug screening. Any slight change in the microenvironment may affect the state of a single cell. Timely and effective cell monitoring is conducive to better understand the behavior of single cells. The immediate response of a single cell described in this study is a liquid transfer-based approach for real-time electrochemical detection. The cell was in situ stimulated by continuous flow with glucose, and lactate secreted from the cell would diffuse into the microflow. The microflow was aspirated into the detection channel where lactate was then decomposed by coupled enzyme reactions and detected by an electrode. This work provides a novel approach for detecting lactate response from a single cell by noninvasive measurements, and the position resolution of the microfluidic probe reaches the level of a single cell and permits individual heterogeneity in cells to be explored in the diagnosis and treatment of cancer as well as in many other situations.

Film-Thickness-Controllable System for Preparing Silver Nanofilms through Absorbance Monitoring of the Thickness during a Silver-Mirror Reaction

An innovative technique is proposed for forming silver thin films of nanometer-order thickness via a silver-mirror reaction. This approach is made possible by the real-time monitoring of the thickness of a silver thin film formed on the edge surface of a fiber core during the silver-mirror reaction using a homemade absorbance measurement system. The monitored absorbance value increases as silver plating progresses, and the relationship between the absorbance values and the thickness of the silver thin film is linear in the thickness range from approximately 30 to 60 nm. This technique was applied to the preparation of a fiber-optic surface plasmon resonance (FO-SPR) sensor. The sensor was successfully used to measure sucrose solutions with concentrations of less than 16% (w/v). The sensitivity of the sensor probe was estimated to be 2205 nm/RIU in the refractive index range of 1.333 - 1.357. The relative standard deviation of the wavelength shift obtained from measurements using different sensor probes was estimated to be less than 3.3%.

Concentrating Single Cells in Picoliter Droplets for Phospholipid Profiling on a Microfluidic System

Cellular membranes are composed of a variety of lipids in different amounts and proportions, and alterations of them are usually closely related to various diseases. To reveal the intercellular heterogeneity of the lipid variation, an integrated microfluidic system is designed, which consists of droplet-based inkjet printing, dielectrophoretic electrodes, and de-emulsification interface to achieve on-line single-cell encapsulation, manipulation, and mass spectrometry (MS) detection. This integrated system effectively improves the single-cell encapsulation rate, and meanwhile reduces the matrix interference and continuous oil phase interference to the MS detection. Using this system, the heterogeneities between the normal and cancer cells are compared, and the heterogeneity of the same cells before and after the drug treatment changed obviously, indicating that this system can be used as a promising tool for studying the link between the alterations of lipid homeostasis and various diseases.

N-doped carbon dots/H2O2 chemiluminescence system for selective detection of Fe2+ ion in environmental samples

The nitrogen doped carbon dots (N-CDs) produces strong chemiluminescence (CL)-emission due to hydroxyl radical (^•OH) induced electron-hole transition in N-CDs. The Fe²⁺ has the ability to generate ^•OH from available hydrogen peroxide (H₂O₂). Therefore, a pre-mixed N-CDs/H₂O₂ solution was utilized for selective quantification of Fe²⁺ in solution via CL-emission. A linear increase in the CL-emission intensity was observed within increase in Fe²⁺ concentration. The N-CDs/H₂O₂ system enabled the detection of Fe²⁺ up to lower concentration of 0.2 × 10^-9 M with a linear dynamic range of 1.0 × 10^-9-1.0 × 10^-6 M. Significantly, no CL-emission was observed when other divalent cations, Al³⁺, Fe³⁺, or Cr³⁺ were injected to this system. Moreover, no interference was observed when a mixed solution of Fe²⁺ and other cations were introduced to N-CDs/H₂O₂. The practical evaluation of N-CDs/H₂O₂ system was demonstrated for detection of Fe²⁺ in tap, lotus pond, and canal water samples. The easy detection, high sensitivity, and selectivity make this method a significant tool for analysis of Fe²⁺ in solution.

Chemical operations on a living single cell by open microfluidics for wound repair studies and organelle transport analysis

We report a laminar flow based approach that is capable of precisely cutting off or treating a portion of a single cell from its remaining portion in its original adherent state.

Single cells are increasingly recognized to be capable of wound repair that is important for our mechanistic understanding of cell biology. The lack of flexible, facile, and friendly subcellular treatment methods has hindered single-cell wound repair studies and organelle transport analyses. Here we report a laminar flow based approach, we call it fluid cell knife (Fluid CK), that is capable of precisely cutting off or treating a portion of a single cell from its remaining portion in its original adherent state. Local operations on portions of a living single cell in its adherent culture state were applied to various types of cells. Temporal wound repair was successfully observed. Moreover, we successfully stained portions of a living single cell to measure the organelle transport speed (mitochondria as a model) inside a cell. This technique opens up new avenues for cellular wound repair and subcellular behavior analyses.

MoS2-quantum dot triggered reactive oxygen species generation and depletion: responsible for enhanced chemiluminescence

Activated MoS₂-QDs exhibit a promising capability for the generation of reactive oxygen species.

Reactive oxygen species (ROS) generation is of intense interest because of its crucial role in many fields. Here we demonstrate that MoS₂-QDs exhibit a promising capability for the generation of reactive oxygen species, which leads to enhanced chemiluminescence. We discovered that the unique performance is due to hydroxyl radical activation increasing the active catalytic sites on molybdenum sulphide quantum dots (MoS₂-QDs). The reactive oxygen species, such as hydroxyl radicals (˙OH), superoxide radicals (˙O₂^–) and singlet oxygen (¹O₂) have been efficiently generated from H₂O₂ solution in alkaline conditions. In particular, the maximum ˙OH yield was enhanced significantly (9.18 times) compared to the Fe(ii)/H₂O₂ Fenton system under neutral conditions. These findings not only enrich our understanding of the fascinating performance of MoS₂ QDs, but also provide a new pathway for ROS generation in all kinds of pH environment.

A novel approach for precisely controlled multiple cell patterning in microfluidic chips by inkjet printing and the detection of drug metabolism and diffusion

In this work we report the use of inkjet printing as a precise and convenient means for microscale cell patterning in microfluidic chips followed by cell co-culture, stimulation and analysis. A self-made inkjet printing device was manufactured with adjustable parameters, which was capable of multiple cell printing within biocompatible materials. Sodium alginate was used as a printing matrix for cell encapsulation, and precisely distributed cell arrays on glass slides were obtained by accurate software controlled printing. By covering a PDMS layer with the corresponding microchannels onto the cell array substrate and subsequently injecting an ion cross-linking reagent, the cells containing alginate arrays gelated immediately and were immobilized on the bottom of the microchip, which could be utilized for cell culture and analysis. HepG2 cells and U251 cells were successfully co-patterned in the microchip and used for drug metabolism and diffusion experiment to imitate the in vivo situation, as a means to ascertain the capability of the system for precise microscale cell patterning in a microchip. The prodrug tegafur was metabolized by HepG2 cells into the active anticancer compound 5-fluorouracil and this produced an adverse gradient effect on U251 cells according to the distance from the HepG2 cells. The developed approach presented a feasible way to integrate inkjet cell printing and microfluidic chips for the first time, which is proved to be capable of spatially controlled printing of multiple kinds of cells into a microchip for cell culture, stimulation and analysis, which could be applied to tissue engineering, drug testing and related areas. We envision that the approach will help significantly increase the cell patterning efficacy in microfluidic chips as well as reduce the extent of laborious experimental work.

Local surface modification at precise position using a chemical pen

Push-pull cannula system, which was first proposed by Gaddum, has grown to be an important method for the perfusion of brain and region-selective surface treatment. However, reported push-pull cannula systems only concerned on single reagent applications. Microfluidic system was then an exciting tool for multi-reagent treatment on substrate in closed microchannels. Nowadays, it is still a challenge to apply online mixing and reaction for surface pattern in an open environment. Here, we present a novel method using a chemical pen that enables region-selective online chemical reactions for the micro-surface modification/patterning. We utilized this method to fabricate labeling protein array using an online labeling strategy. Moreover, the device was applied for local modification of biomaterials surface by using a three-component reaction at precise position. This tool was the first demonstration of design to perform online reaction of two different reagents on a real solid sample in an open environment. It was demonstrated a useful method for protein array fabrication with online labeled protein.

Measurement of Cell-Matrix Adhesion at Single-Cell Resolution for Revealing the Functions of Biomaterials for Adherent Cell Culture

Cell adhesion is essential for a cell to maintain its functions, and biomaterials acting as the extracellular matrix (ECM) play a vital role. However, conventional methods for evaluating the functions of biomaterials become insufficient and sometimes incorrect when we give a deeper insight into single-cell research. In this work, we reported a novel methodology for the measurement of cell-matrix adhesion at single-cell resolution that could precisely evaluate the functions of biomaterials for adherent cell culture. A microfludic device, a live single-cell extractor (LSCE), was used for cell extraction. We applied this method to evaluate various modified biomaterials. The results indicated that poly(l-polylysine) (PLL)-coated glass and fibronection (FN)-coated glass slides showed the best biocompatibility for adherent cell culture following by the (3-aminopropyl)triethoxysilane (APTES)-coated glass, while piranha solution treated glass slide and octadecyltrichlorosilane (OTS)-coated glass showed weak biocompatibilities. Furthermore, APTES, PLL, and FN modifications enhanced the cell heterogeneity, while the OTS modification weakened the cell heterogeneity compare to the initial piranha solution treated glass. The method not only clarified the cell-matrix adhesion strength at single-cell resolution but also revealed the influences of biomaterials on cell-matrix adhesion and heterogeneity of cell-matrix adhesion for adherent cell culture. It might be a general strategy for precise evaluation of biomaterials.

Reversibly Switching Molecular Spectra

Manipulation of light transmission/absorbance and reflection/emission has a great significance in smart windows and displaying media like liquid crystal. Here, we report the usage of an external electric field to reversibly switch the molecular spectra of a model molecule on the basis of its interaction with an electroresponsible polymer brush. Both the UV-vis absorbance spectrum and the fluorescence emission spectrum of the model molecule were confirmed to be electroswitchable. The electroswitchable spectra were experimentally demonstrated to be induced by the electroswitchable statuses of medium anionic poly-allyloxy hydroxypropyl sulfonate (poly-AHPS) brush. Insightfully, the molecular aggregated status of model proflavine molecules could be electrically controlled via the electroresponsible poly-AHPS brushes and then the molecular spectra of the model proflavine molecule also could be electrically and controllably shifted. The success in the manipulation of molecular spectra opens up a wide range of applications not only for displaying but also for nonlinear optics, in vivo imaging, sensors, and environmental inspection.

Fluorescent carbon nanoparticles: mimicking hydrogen peroxide properties in a chemiluminescence system

Fluorescent carbon nanoparticles (FCNs), as novel luminescent reagents exhibiting hydrogen peroxide mimicking properties, can directly react with luminol, NaHCO₃ and NaHSO₃ in alkaline conditions to yield novel chemiluminescence, and show great potential towards further applications of ultra-weak chemiluminescence.

Elaborately programmed nanowires fabricated using a tapered push-pull nozzle system

Elaborately programmed silver nanowire arrays can be prepared using a tapered push-pull nozzle system (TPPNS), which is used to directly write micro-nano wires on a substrate via a two-reagent reaction in the diffusion mixing region. The wires could be precisely positioned on the substrate and their width could be freely controlled from the micro to the nano scale, indicating an advance in the methodologies of controlling and fabricating nanowires. The as-prepared silver three-electrode device can serve as a three-electrode sensor.

In Situ Scatheless Cell Detachment Reveals Correlation between Adhesion Strength and Viability at Single-Cell Resolution

Single-cell biology provides insights into some of the most fundamental processes in biology and promotes the understanding of life's mysteries. As the technologies to study single-cells expand, they will require sophisticated analytical tools to make sense of various behaviors and components of single-cells as well as their relations in the adherent tissue culture. In this paper, we revealed cell heterogeneity and uncovered the connections between cell adhesion strength and cell viability at single-cell resolution by extracting single adherent cells of interest from a standard tissue culture by using a microfluidic chip-based live single-cell extractor (LSCE). We believe that this method will provide a valuable new tool for single-cell biology.

Abstract OT1-02-01: Phase II neoadjuvant trial of nanoparticle almumin-bound paclitaxel and trastuzumab in patients with node-negative, Her-2 positive breast cancer (OMC-BC04)

Background: Neoadjuvant chemotherapy plus trastuzumab results in a 30% to 50% pathologic complete response (pCR) rate in HER-2 positive breast cancer and has been associated with improved therapeutic outcomes. Thus, the pCR rate can be useful in evaluating novel agents in this patient population. Albumin-bound (nab)-paclitaxel can reduce the toxicity of Paclitaxel while maintaining its efficacy. We reported that neoadjuvant therapy using Anthracycline based regimens (EC,AC,FEC) followed by a combination with nab-Paclitaxel and Trastuzumab was effective and safe by OMC-BC01 Study (Tanaka et al. Clin Breast Cancer 15:191-196). The pCR rate was 36% and 71% in the patients with estrogen receptor-positive and negative cancer, respectively. In addition, Tolaney et al. showed that adjuvant Paclitaxel and Trastuzumab for node-negative, HER-2 positive tumors measuring up to 3 cm in greatest dimension was associated with patients outcomes that were better than expected on the basis of historical data (Tolaney et al. N Engl J MED.2015 Jan 8:372(2):134-141). We conducted a clinical Phase II, multicenter, neoadjuvant trial of combination with nanoparticle albumin-bound Paclitaxel and Trastuzumab in patients with node-negative, Her-2 positive, estrogen receptor-negative breast cancer measuring up to 3 cm in greatest dimension.

Patients and Methods: nab-Paclitaxel and Trastuzumab as neoadjuvant therapy in patients with Her-2 positive, node-negative, estrogen receptor-negative breast cancer measuring up to 3 cm in greatest dimension. Patients are treated with neoadjuvant nab-Paclitaxel (260mg/m2) and Trastuzumab q21d x 4, and undergo surgery 4-6 weeks later from completing chemotherapy. The primary endpoint, pCR is defined as no evidence of invasive tumors in the final surgical sample both in the breast and axillary lymph nodes. Secondary endpoints include objective clinical response rate, histological response rate, disease-free interval, rate of breast conserving surgery, and the safety of the treatment.

Accrual: Presently, a total number of 1 patient have been included since start of the study. The expected end of accrual of 30 patients will be the last quarter 2018.

Citation Format: Iwamoto M, Tanaka S, Koda C, Kawaguchi K, Terasawa R, Sato N, Fujioka H, Kimura K, Uchiyama K. Phase II neoadjuvant trial of nanoparticle almumin-bound paclitaxel and trastuzumab in patients with node-negative, Her-2 positive breast cancer (OMC-BC04) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr OT1-02-01.

Microchemical Pen: An Open Microreactor for Region-Selective Surface Modification

Various micro surface-modification approaches including photolithography, dip-pen lithography and ink-jet systems have been developed and used to extend the functionalities of solid surfaces. While those approaches work in the "open space", push-pull systems which work in solutions have recently drawn considerable attention. However, the confining flows performed by push-pull systems have realized only the dispense process, while microscale, region-selective chemical reactions have remained unattainable. This study reports a microchemical pen that enables region-selective chemical reactions for the micro surface modification/patterning. The chemical pen is based on the principle of microfluidic laminar flows and the resulting mixing of reagents by the mutual diffusion. The tiny diffusion layer performs as the working region. This report represents the first demonstration of an open microreactor in which two different reagents react on a real solid sample. The multifunctional characteristics of the microchemical pen are confirmed by different types of reactions in many research areas, including inorganic chemistry, polymer science, electrochemistry and biological sample treatment.