Abstract LB172: APVO442: A bispecific T cell-engaging candidate utilizing the ADAPTIR-FLEXTMplatform technology with unique properties designed for optimal tumor distribution and cytotoxic response against PSMA-expressing solid tumors

Prostate-Specific Membrane Antigen (PSMA), is a tumor-associated antigen (TAA) that is expressed on prostate cancers, including metastatic castration-resistant prostate cancer (mCRPC). Current chemotherapeutic approaches for mCRPC are challenged by development of resistance resulting in limited clinical benefit. Immuno-oncology therapeutic candidates such as bispecifics re-directing T-cell responses to eliminate tumors, are a promising strategy to overcome the limitations of current approaches and provide benefit to patients with aggressive cancers. Here we present preclinical data demonstrating a potential new approach using low affinity targeting of CD3 and high affinity targeting of PSMA for treatment of a solid tumor cancer.APVO442 is Aptevo's bispecific candidate targeting PSMA and CD3. This candidate was designed to have unique pharmacokinetic and safety properties to potentially maximize potent anti-tumor responses against mCRPC. The APVO442 bispecific T-cell engager uses Aptevo's ADAPTIR-FLEX technology to generate a molecule with low-affinity monovalent CD3 engagement, paired with high-affinity bivalent PSMA binding designed to deliver a highly selective T-cell response at the tumor. The unique engineering of APVO442 reduces the potential of binding to CD3 expressed on peripheral T cells, thus minimizing the potential for on-target toxicity, such as cytokine release, and increasing the potential to deliver the effective concentration of the molecule localized to solid tumors.Preclinical testing demonstrated that APVO442 exhibits optimal manufacturability and functional characteristics for lead candidate selection. Anti-PSMA x anti-CD3 constructs with varying binding strengths to CD3 were evaluated for specificity of CD3 binding, ability to enhance T-cell activation, and ability to elicit T-cell-mediated cytotoxicity against PSMA-expressing tumor targets with varying levels of PSMA expression. APVO442 demonstrated 10-fold reduced binding to CD3 and EC50 compared to the highest affinity constructs tested while retaining equivalent binding to tumor cells expressing various levels of PSMA. The differences in CD3 affinity were associated in a slightly lower EC50 of potency however, the maximal responses for in vitro activation of CD4+ and CD8+ T cells including upregulation of CD25/CD69 expression, proliferation and in vitro tumor lysis were comparable between low and high affinity CD3 constructs. Finally, APVO442 induced reduced levels of multiple cytokines in vitro when compared to high affinity competitor molecules.In vivo, APVO442 elicited robust anti-tumor responses of human PSMA-expressing tumors in a murine xenograft tumor model. The in vivo activity of APVO442 was comparable to high affinity CD3 engaging comparators with similarly measured PK profiles. Additional in vivo characterization of APVO442 is ongoing and continued pre-clinical studies are planned for 2021.

Citation Format: Rebecca Gottschalk, Robert E. Miller, Lynda Misher, Michelle H. Nelson, Allison Chunyk, Brian Woodruff, Elizabeth Haglin, Gabriela Hernandez-Hoyos, Peter Pavlik, Catherine McMahan, Hilario J. Ramos, David Bienvenue. APVO442: A bispecific T cell-engaging candidate utilizing the ADAPTIR-FLEXTMplatform technology with unique properties designed for optimal tumor distribution and cytotoxic response against PSMA-expressing solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB172.

Abstract LB173: APVO603: A dual 4-1BB and OX40 bispecific approach utilizing ADAPTIRTMtechnology designed to deliver a conditional T cell/NK response against solid tumors

APVO603 is Aptevo's bispecific candidate targeting 4-1BB and OX40. It was designed to have unique properties with the potential to overcome some of the clinical challenges observed with monoclonal antibody targeting these receptors. APVO603 is engineered as an FcγR-signaling deficient bispecific antibody that utilizes Aptevo's ADAPTIR technology for a distinct approach for dual targeting of 4-1BB and OX40 in the absence of additional effector activity. The distinct characteristics of APVO603 may enable conditional activation of 4-1BB and OX40 via agonism of these receptors only when cross-linked via engagement of the other receptor via cis and/or trans cellular interactions. Thus, APVO603 is designed with the potential to overcome both the on-target toxicity and limited efficacy observed with 4-1BB and OX40 monoclonal antibody treatment in the clinic.

Anti-4-1BB and OX40 binding domains were optimized to increase affinity, function and stability, then incorporated into the ADAPTIR bispecific antibody platform to produce the APVO603 lead candidate. APVO603 was found to augment 4-1BB and OX40 activity in a dose-dependent manner and is strictly dependent on engagement of the reciprocal receptor to elicit 4-1BB or OX40 signaling in vitro. In preclinical assays using PBMCs sub-optimally stimulated with anti-CD3, APVO603 induces synergistic proliferation of CD4+, CD8+ T and NK cells when compared to anti-OX40 or 4-1BB antibodies with a wt Fc, included either individually or in combination. Additionally, APVO603 enhances proinflammatory cytokine production, granzyme B expression, and reduces the T cell exhaustion phenotype. The mechanistic activity of APVO603 resulted in dose-dependent control of in vivo tumor growth in a preclinical humanized murine xenograft model using established murine MB49 bladder tumors in human 4-1BB and OX40 double knock-in mice.

APVO603 is a dual-agonistic bispecific antibody that augments the effector function of activated CD4+ and CD8+ T cells and NK cells in a dose-dependent manner and reduces growth of established tumors in vivo. This preclinical data demonstrates conditional dual stimulation of 4-1BB and OX40 and supports further development of APVO603, a promising immuno-oncology therapeutic with potential for benefit in solid tumors. This program is progressing into IND-enabling studies later this year.

Citation Format: Michelle H. Nelson, Robert E. Miller, Secil Franke-Welch, Ruth Chenault, Hang Fang, Allison Chunyk, Gabriela Hernandez-Hoyos, Hilario J. Ramos, David Bienvenue, Catherine McMahan. APVO603: A dual 4-1BB and OX40 bispecific approach utilizing ADAPTIRTMtechnology designed to deliver a conditional T cell/NK response against solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr LB173.

ESMO recommendations on predictive biomarker testing for homologous recombination deficiency and PARP inhibitor benefit in ovarian cancer

BACKGROUND

Homologous recombination repair deficiency (HRD) is a frequent feature of high-grade serous ovarian, fallopian tube and peritoneal carcinoma (HGSC) and is associated with sensitivity to PARP inhibitor (PARPi) therapy. HRD testing provides an opportunity to optimise PARPi use in HGSC but methodologies are diverse and clinical application remains controversial.

MATERIALS AND METHODS

To define best practice for HRD testing in HGSC the ESMO Translational Research and Precision Medicine Working Group launched a collaborative project that incorporated a systematic review approach. The main aims were to (i) define the term 'HRD test'; (ii) provide an overview of the biological rationale and the level of evidence supporting currently available HRD tests; (iii) provide recommendations on the clinical utility of HRD tests in clinical management of HGSC.

RESULTS

A broad range of repair genes, genomic scars, mutational signatures and functional assays are associated with a history of HRD. Currently, the clinical validity of HRD tests in ovarian cancer is best assessed, not in terms of biological HRD status per se, but in terms of PARPi benefit. Clinical trials evidence supports the use of BRCA mutation testing and two commercially available assays that also incorporate genomic instability for identifying subgroups of HGSCs that derive different magnitudes of benefit from PARPi therapy, albeit with some variation by clinical scenario. These tests can be used to inform treatment selection and scheduling but their use is limited by a failure to consistently identify a subgroup of patients who derive no benefit from PARPis in most studies. Existing tests lack negative predictive value and inadequately address the complex and dynamic nature of the HRD phenotype.

CONCLUSIONS

Currently available HRD tests are useful for predicting likely magnitude of benefit from PARPis but better biomarkers are urgently needed to better identify current homologous recombination proficiency status and stratify HGSC management.

Abstract PO-089: The impact of Covid-19 on public generosity toward cancer-related crowdfunding efforts

Background: Many patients with cancer rely on public crowdfunding platforms to generate financial support toward costs associated with their medical care. It is unclear how financial uncertainties resulting from the Covid-19 pandemic may impact patient need and public support toward routine cancer-focused campaigns.

Methods: Using custom code for web scraping, we identified all campaigns that were generated on the crowdfunding platform GoFundMe.com in the “Medical, Illness and Healing” category between 8/17/2019 and 5/8/2020. This date represents six months of fundraising prior to the first official shelter-in-place order on 3/17/2020. We then abstracted campaigns that included the word “cancer,” originated in the United States, and had raised at least one dollar. Of these cancer-related campaigns, we collected the dollar amount raised in the first 30 days of campaign generation and the total raised to date. Campaigns generated between 2/17/2020 and 3/16/2020 were not included in pre/post-Covid calculations because these campaigns would potentially include contributions made after 3/17/2020 within their first 30-day values.

Results: 19,669 cancer campaigns were identified during the study period (16,823 between 8/17/19 and 2/17/20 and 2,846 between 3/17/20 and 5/8/20), raising on average 83% of total funds within the first 30 days of campaign generation. In the six months prior to the first shelter-in-place order (8/17/19-2/17/20), there were on average 91 new cancer campaigns generated daily. Within the first 30 days, these campaigns averaged $4,472 (median $1,815). After 3/17/20, an average of 54 campaigns were generated daily, representing a 40% decline in daily campaign generation. Within the first 30 days, these campaigns averaged $6,130 (median $2,950), representing a 36% and 60% increase from baseline respectively.

Conclusion: Public generosity has increased toward cancer fundraising campaigns since the Covid-19 pandemic, but fewer patients are creating new campaigns. Patients can be reassured that they will likely continue to benefit from public support and should not feel limited in asking for help during this period of economic uncertainty. As philanthropy sometimes increases during disaster periods, it is unclear if continued support will persist as longer-term economic changes take effect.

Citation Format: Katrina A. Fischer, Robert E. Miller, Sidharth Anand, John Glaspy. The impact of Covid-19 on public generosity toward cancer-related crowdfunding efforts [abstract]. In: Proceedings of the AACR Virtual Meeting: COVID-19 and Cancer; 2020 Jul 20-22. Philadelphia (PA): AACR; Clin Cancer Res 2020;26(18_Suppl):Abstract nr PO-089.

Abstract 1786: APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR™ molecule for redirected T-cell cytotoxicity, induces potent T-cell activation, proliferation and cytotoxicity with limited cytokine release

Introduction: Depletion of CD123 over-expressing malignant cells provides a potential new treatment option which may improve patient outcomes in several hematological malignancies. CD123 is over-expressed in AML, MDS, ALL, CML, HCL and BPDCN and infrequently expressed by normal cells making it an attractive target which is being pursued using a number of different approaches including T-cell engaging immunotherapy. Cytokine release syndrome is a significant concern with T-cell activating therapeutics which has led to severe complications in clinical trials. We have developed APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR molecule for redirecting T-cell cytotoxicity to CD123-expressing tumor cells. A potential advantage of the ADAPTIR platform is reduced cytokine release upon T-cell engagement compared to other formats (Mol Cancer Ther. 2016 Sep;15(9):2155-65). Here we present in vitro and in vivo activity of APVO436 and compare the activity of APVO436 to another anti-CD123 x anti-CD3 bispecific containing the amino acid sequence of MGD006.Methods: Binding, T-cell activation and proliferation were assessed using multi-color flow cytometry. Cytotoxic activity was determined using chromium release assays and flow cytometry. PBMC samples were obtained from normal donors and AML patients. In vivo studies were performed using NSG mice transplanted with human PBMC's. The CD123 and CD3 binding domain sequences for flotuzumab (MGD006) were obtained from patent W02015026892 engineered in Macrogenic's dual-affinity re-targeting format as reported in Sci Transl Med. 2015 May 27;7(289):289ra82.Results: Dose-dependent cytotoxicity of CD123 expressing tumor cell lines and primary AML cells was induced by APVO436 at low effector to target ratios, accompanied by T-cell activation and proliferation. APVO436 induced significantly lower levels of several T-cell cytokines including IFNγ, IL-2, and TNFα compared to the molecule in the dual-affinity re-targeting format. In vivo, APVO436 significantly reduced established tumor burden in xenograft murine models.Conclusions: APVO436 potently induces T-cell activation, proliferation and CD123+ cell depletion with AML and normal donor samples and CD123 expressing tumor cell lines with limited levels of T-cell cytokine release compared to another CD123 x CD3 targeting bispecific format suggesting a potential safety advantage. APVO436 inhibits tumor-growth in sub-cutaneous tumor models with IV-implanted human T cells, indicating migration and engagement of T cells at the tumor site. These data are supportive of further investigation of APVO436 as a potential treatment option for AML and other hematological malignancies. GLP toxicology studies have been completed in non-human primates and APVO436 is advancing to clinical testing.

Citation Format: Michael R. Comeau, Robert E. Miller, Robert Bader, Rebecca Gottschalk, Mollie Daugherty, Toddy Sewell, Lynda Misher, Lara Parr, Melissa DeFrancesco, David Bienvenue, Catherine J. McMahan, Gabriela H. Hoyos, Jane A. Gross. APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR™ molecule for redirected T-cell cytotoxicity, induces potent T-cell activation, proliferation and cytotoxicity with limited cytokine release [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1786.

Abstract B111: Characterization of APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR™ molecule for redirected T-cell cytotoxicity, in preclinical models of AML and nonhuman primates

Introduction: CD123 has emerged as a promising target for T-cell directed immunotherapy in acute myeloid leukemia due to its high level of expression on leukemic blasts and stem cells and low frequency of expression on normal cell types. CD123 is expressed by rare normal leukocyte populations, including basophils and plasmacytoid dendritic cells in circulation and hematopoietic progenitor cells in the bone marrow. We have developed APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR molecule for redirecting T-cell cytotoxicity to CD123-expressing tumor cells. Results are presented that examine the in vitro and in vivo activity of APVO436 in preclinical models of AML, as well as pharmacokinetics and tolerability in nonhuman primates. Methods: CHO-produced APVO436 protein was used for in vitro functional studies with CD123+ AML tumor cell lines and primary human T-cell populations. Cytotoxic activity was determined using chromium release assays. On-cell binding, T-cell activation and proliferation were assessed using multicolor flow cytometry. Cytokine levels were measured using multiplex assay kits. In vivo studies to examine tumor growth inhibition activity were performed using NSG mice with established AML tumors followed by treatment with APVO436 coadministered with T cells. Tumor growth was assessed by bioluminescent imaging. In vivo studies to determine pharmacokinetics of APVO436 following single intravenous injections were performed in healthy BALB/c mice and cynomolgus monkeys. Results: APVO436 bound to CD123 and CD3 expressing cells with high affinity. APVO436 induced concentration-dependent lysis of CD123+ AML cell lines with primary human T cells at low effector-to-target ratios, accompanied by T-cell activation and proliferation. These activities were dependent on the expression of CD123 by the tumor target cells. Treatment of established disseminated tumors in mice with APVO436 resulted in a significant reduction in tumor burden. A single 10 mg/kg IV injection of APVO436 in normal BALB/c mice demonstrated an extended elimination serum half-life of approximately 300 hours. Single IV injections of APVO436 ranging from 0.25 mg/kg to 1 mg/kg were well tolerated in cynomolgus monkeys. The observed elimination half-life in cynomolgus serum was up to 84 hours with normal clearance and volume distribution. Conclusions: These data demonstrate APVO436 has potent in vitro activity against a number of CD123-expressing tumor cell lines and in vivo significantly reduces established tumor burden in xenograft models. APVO436 demonstrates an extended serum half-life in normal mice and cynomolgus monkeys. These data are supportive of further investigation of APVO436 as a potential treatment option for AML and other hematologic malignancies.

Citation Format: Michael R. Comeau, Robert E. Miller, Jeannette Bannink, Starrla Johnson, Robert Bader, Rebecca Gottschalk, Lynda Misher, Danielle Mitchell, Lara Parr, Melissa DeFrancesco, David Bienvenue, Catherine J. McMahan, Gabriela H. Hoyos, Jane A. Gross. Characterization of APVO436, a bispecific anti-CD123 x anti-CD3 ADAPTIR™ molecule for redirected T-cell cytotoxicity, in preclinical models of AML and nonhuman primates [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2017 Oct 26-30; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2018;17(1 Suppl):Abstract nr B111.

Large-scale identification of clinical and genetic predictors of motor progression in patients with newly diagnosed Parkinson's disease: a longitudinal cohort study and validation

Background

Better understanding and prediction of PD progression could improve disease management and clinical trial design. We aimed to use longitudinal clinical, molecular, and genetic data to develop predictive models, compare potential biomarkers, and identify novel predictors for motor progression in PD. We also sought to assess the use of these models in the design of treatment trials in PD.

Methods

A Bayesian multivariate predictive inference platform was applied to data from the Parkinson’s Progression Markers Initiative (PPMI) study (NCT01141023). We used genetic data and baseline molecular and clinical variables from PD patients and healthy controls to construct an ensemble of models to predict the annualised rate of the Movement Disorder Society-Unified Parkinson’s Disease Rating Scale parts II and III combined. We tested our overall explanatory power, as assessed by the coefficient of determination (R²), and replicated novel findings in an independent clinical cohort of PD patients from the Longitudinal and Biomarker Study in PD (LABS-PD; NCT00605163). The potential utility of these models for clinical trial design was quantified by comparing simulated randomized placebo-controlled trials within the out-of sample LABS-PD cohort.

Findings

A total of 117 controls and 312 PD cases were available for analysis. Our model ensemble exhibited strong performance in-cohort (5-fold cross-validated R²=41%, 95% CI: 35% – 47%) and significant, though reduced, performance out-of-cohort (R²=9%, 95% CI: 4% – 16%). Individual predictive features identified from PPMI data were confirmed in the LABS-PD cohort of 317 PD patients. These included significant replication of higher baseline motor score, male sex, and increased age, as well as a novel PD-specific epistatic interaction all indicative of faster motor progression. Genetic variation was the most useful predictive marker of motor progression (2.9%, 95%CI: 1.5–4.3%). CSF biomarkers at baseline showed a more modest (0.3%; 95%CI: 0.1–0.5%), but still significant effect on motor progression prediction. The simulations (n=5000) showed that incorporating the predicted rates of motor progression into the final models of treatment effect reduced the variability in the study outcome allowing significant differences to be detected at sample sizes up to 20% smaller than in naïve trials.

Interpretation

Our model ensemble confirmed established and identified novel predictors of PD motor progression. Improving existing prognostic models through machine learning approaches should benefit trial design and evaluation, as well as clinical disease monitoring and treatment.

Funding

Michael J. Fox Foundation for Parkinson’s Research and National Institute of Neurological Disorders and Stroke (1P20NS092529-01).

Further Investigation of Contrast Sensitivity and Visual Acuity in Pilot Detection of Aircraft

Contrast sensitivity (CS) has been reported (Ginsburg et al., 1983) to be strongly related to pilots' aircraft detection performance; however, examination of their results shows a lack of consistency for the CS at any particular spatial frequency to correlate with detection, even for days with similar visibility conditions. To further investigate this relationship, sixty-seven (67) USAF pilots were divided among 8 groups, individually isolated in a bus near the end of a runway on separate days, and detected a T-38 jet aircraft during about 8 landings. CS was measured using the criterion-free two-alternative, temporal forced-choice (2 AFC) technique on the Optronix and with the Vistech VCTS 6500 chart. Visual acuity was assessed at three contrast levels using 3%, 6%, & 85% contrast Regan charts. The mean detection distance of each group ranged from 4.77 to 6.73 miles, and intersubject difference within any group was 0.64 to 2.21 miles. For these partly-cloudy to cloudy weather conditions, neither contrast sensitivity nor visual acuity correlated well with pilot detection of actual aircraft. There was a lack of consistency for the CS at any particular spatial frequency to correlate with detection distance. The best indicator of the pilots with worse detection distances was the performance on the 6% contrast visual acuity chart; with all 5 pilots in the lower 10% of visual performance also being the worst or second worst at aircraft detection in their group.

Abstract 4995: anti-ROR1 x anti-CD3 ADAPTIR™ molecule, ES425, redirects T-cell cytotoxicity and inhibits tumor growth in preclinical models of triple-negative breast cancer

Background: Effective treatment of metastatic, triple-negative breast cancer (TNBC) remains a highly unmet medical need. We have developed ES425, a bispecific ADAPTIR™ (modular protein technology) molecule that redirects T-cell cytotoxicity to tumor cells expressing ROR1 (receptor tyrosine kinase-like orphan receptor 1), an oncofetal antigen expressed on TNBC and other malignancies. Results are presented for studies run to examine in vitro and in vivo activity of ES425 in preclinical models of TNBC.

Materials and Methods: Target-dependent cytotoxic activity was examined in vitro by treating ROR1(+) cell lines and ROR1(−) cell lines with ES425 in the presence of purified human T cells or human peripheral blood mononuclear cells (PBMCs). Cytotoxic activity was determined using chromium release assays. T cells were assessed for activation and proliferation using multi-color flow cytometry. Pharmacokinetics of ES425 in NOD/SCID gamma (NSG) mice was determined using single intravenous dose of approximately 10 mg/kg. Serum concentrations at time points ranging from 15 minutes to 504 hours were used to calculate the terminal elimination half-life of ES425. To assess activity in vivo, NOD/SCID mice were implanted subcutaneously with the ROR1(+) TNBC tumor cell line MDA-MB-231 and purified human T cells and treated with ES425. This model was run twice with T cells from different human donors. Tumor growth was assessed by measuring tumor volume.

Results: ES425 efficiently redirected T cell cytotoxicity against ROR1(+) cell lines at low picomolar concentrations in vitro. Cytotoxic activity was dependent on expression of ROR1 by the target cells. T cells were activated and proliferated in response to ES425 in the presence of ROR1(+) target cells; proliferation was not observed in response to ROR1(−) cells. In vivo, pharmacokinetic analysis showed a serum half-life of approximately 7 days in NSG mice, and ES425 inhibited growth of MDA-MB-231 tumors in mouse xenografts. Repeat experiments showed similar inhibition of tumor growth and an improvement in overall survival.

Conclusions: These studies show that ES425 may be an efficient agent for redirecting T cell cytotoxicity in preclinical TNBC models and merits investigation as a potential therapeutic in TNBC and other malignancies.

Citation Format: John W. Blankenship, Lynda Misher, Danielle Mitchell, Nicole Zhang, Philip Tan, Gabriela H. Hoyos, Padma Ravikumar, Robert Bader, Catherine J. McMahan, Robert E. Miller, Jeannette Bannink, Hang Fang, Lara Parr, Maria Dasovich, David Bienvenue, Megan Aguilar, Carina Xu, Mollie Daugherty, Brian Woodruff, Jane A. Gross. anti-ROR1 x anti-CD3 ADAPTIR™ molecule, ES425, redirects T-cell cytotoxicity and inhibits tumor growth in preclinical models of triple-negative breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 4995.

MOR209/ES414, a Novel Bispecific Antibody Targeting PSMA for the Treatment of Metastatic Castration-Resistant Prostate Cancer

Treatment of metastatic, castration-resistant prostate cancer (mCRPC) remains a highly unmet medical need and current therapies ultimately result in disease progression. Immunotherapy is a rapidly growing approach for treatment of cancer but has shown limited success to date in the treatment of mCRPC. We have developed a novel humanized bispecific antibody, MOR209/ES414, built on the ADAPTIR (modular protein technology) platform, to redirect T-cell cytotoxicity toward prostate cancer cells by specifically targeting T cells through CD3ε to prostate cancer cells expressing PSMA (prostate-specific membrane antigen). In vitro cross-linking of T cells with PSMA-expressing tumor cells by MOR209/ES414 triggered potent target-dependent tumor lysis and induction of target-dependent T-cell activation and proliferation. This activity occurred at low picomolar concentrations of MOR209/ES414 and was effective at low T-effector to tumor target cell ratios. In addition, cytotoxic activity was equivalent over a wide range of PSMA expression on target cells, suggesting that as few as 3,700 PSMA receptors per cell are sufficient for tumor lysis. In addition to high sensitivity and in vitro activity, MOR209/ES414 induced limited production of cytokines compared with other bispecific antibody formats. Pharmacokinetic analysis of MOR209/ES414 demonstrated a serum elimination half-life in NOD/SCID γ (NSG) mice of 4 days. Administration of MOR209/ES414 in murine xenograft models of human prostate cancer significantly inhibited tumor growth, prolonged survival, and decreased serum prostate-specific antigen levels only in the presence of adoptively transferred human T cells. On the basis of these preclinical findings, MOR209/ES414 warrants further investigation as a potential therapeutic for the treatment of CRPC. Mol Cancer Ther; 15(9); 2155-65. ©2016 AACR.

Chemotherapy for metastatic castrate-sensitive prostate cancer

BACKGROUND

The role of docetaxel chemotherapy in combination with androgen deprivation therapy for metastatic castrate-sensitive prostate cancer is emerging.

METHODS

We reviewed the results from the pivotal randomized phase III trials in this area: GETUG15, CHAARTED and STAMPEDE.

RESULTS

All three studies demonstrated a benefit in progression-free survival with the use of docetaxel. However, two of the studies demonstrated a clinically meaningful overall survival benefit (CHAARTED and STAMPEDE), whereas the GETUG15 study did not demonstrate a major benefit.

CONCLUSIONS

Docetaxel is an important option to consider for men who are fit for chemotherapy with newly diagnosed metastatic prostate cancer commencing androgen deprivation therapy.

Impact of Different Methods of Feedback to Clinicians After Postprescription Antimicrobial Review Based on the Centers for Disease Control and Prevention's 12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults

Objectives.

To evaluate (1) the framework of the 12 Steps to Prevent Antimicrobial Resistance Among Hospitalized Adults that is part of the Centers for Disease Control and Prevention (CDC) Campaign to Prevent Antimicrobial Resistance in Healthcare Settings, with regard to steps addressing antimicrobial use; and (2) methods of feedback to clinicians regarding antimicrobial use after postprescription review.

Design.

Prospective intervention to identify and modify inappropriate antimicrobial therapy.

Setting.

A 1,000-bed, tertiary care teaching hospital.

Patients.

Inpatients in selected medicine and surgery units receiving broad-spectrum antimicrobials for 48-72 hours.

Interventions.

We created a computer-based clinical-event detection system that automatically identified inpatients taking broad-spectrum and “reserve” antimicrobials for 48-72 hours. Although prior approval was required for initial administration of broad-spectrum and reserve antimicrobials, once approval was obtained, therapy with the antimicrobials could be continued indefinitely at the discretion of the treating clinician. Therapy that was ongoing at 48-72 hours was reviewed by an infectious diseases pharmacist or physician, and when indicated feedback was provided to clinicians to modify or discontinue therapy. Feedback was provided via a direct telephone call, a note on the front of the medical record, or text message sent to the clinician's pager. The acceptance rate of feedback was recorded and recommendations were categorized according to the 12 steps recommended by the CDC.

Results.

Interventions were recommended for 334 (30%) of 1,104 courses of antimicrobial therapy reviewed. A total of 87% of interventions fit into one of the CDC's 12 steps of prevention: 39% into step 3 (“target the pathogen”), 1% into step 4 (“access experts”), 3% into steps 7 and 8 (“treat infection, not colonization or contamination”), 18% into step 9 (“say ‘no’ to vancomycin”), and 26% into step 10 (“stop treatment when no infection”). The rate of compliance with recommendations to improve antimicrobial use was 72%. No differences in compliance were seen with the different methods of feedback.

Conclusions.

Nearly one-third of antimicrobial courses did not follow the CDC's recommended 12 steps for prevention of antimicrobial resistance. Clinicians demonstrated high compliance with following suggestions made after postprescription review, suggesting that it is a useful approach to decreasing and improving antimicrobial use among inpatients.

External quality assurance performance of clinical research laboratories in sub-saharan Africa

Patient Safety Monitoring in International Laboratories (JHU-SMILE) is a resource at Johns Hopkins University that supports and monitors laboratories in National Institutes of Health-funded international clinical trials. To determine the impact of the JHU-SMILE quality assurance scheme in sub-Saharan African laboratories, we reviewed 40 to 60 months of external quality assurance (EQA) results of the College of American Pathologists (CAP) in these laboratories. We reviewed the performance of 8 analytes: albumin, alanine aminotransferase, creatinine, sodium, WBC, hemoglobin, hematocrit, and the human immunodeficiency virus antibody rapid test. Over the 40- to 60-month observation period, the sub-Saharan laboratories had a 1.63% failure rate, which was 40% lower than the 2011 CAP-wide rate of 2.8%. Seventy-six percent of the observed EQA failures occurred in 4 of the 21 laboratories. These results demonstrate that a system of remote monitoring, feedback, and audits can support quality in low-resource settings, even in places without strong regulatory support for laboratory quality.

Causal modeling using network ensemble simulations of genetic and gene expression data predicts genes involved in rheumatoid arthritis

Tumor necrosis factor α (TNF-α) is a key regulator of inflammation and rheumatoid arthritis (RA). TNF-α blocker therapies can be very effective for a substantial number of patients, but fail to work in one third of patients who show no or minimal response. It is therefore necessary to discover new molecular intervention points involved in TNF-α blocker treatment of rheumatoid arthritis patients. We describe a data analysis strategy for predicting gene expression measures that are critical for rheumatoid arthritis using a combination of comprehensive genotyping, whole blood gene expression profiles and the component clinical measures of the arthritis Disease Activity Score 28 (DAS28) score. Two separate network ensembles, each comprised of 1024 networks, were built from molecular measures from subjects before and 14 weeks after treatment with TNF-α blocker. The network ensemble built from pre-treated data captures TNF-α dependent mechanistic information, while the ensemble built from data collected under TNF-α blocker treatment captures TNF-α independent mechanisms. In silico simulations of targeted, personalized perturbations of gene expression measures from both network ensembles identify transcripts in three broad categories. Firstly, 22 transcripts are identified to have new roles in modulating the DAS28 score; secondly, there are 6 transcripts that could be alternative targets to TNF-α blocker therapies, including CD86 - a component of the signaling axis targeted by Abatacept (CTLA4-Ig), and finally, 59 transcripts that are predicted to modulate the count of tender or swollen joints but not sufficiently enough to have a significant impact on DAS28.

The collection and analysis of clinical data has played a key role in providing insights into the diagnosis, prognosis and treatment of disease. However, it is imperative that molecular and genetic data also be collected and integrated into the creation of network models, which capture underlying mechanisms of disease and can be interrogated to elucidate previously unknown biology. Bringing data from the clinic to the bench completes the cycle of translational research, which we demonstrate with this work. We built disease models from genetics, whole blood gene expression profiles and the component clinical measures of rheumatoid arthritis using a data-driven approach that leverages supercomputing. Genetic factors can be utilized as a source of perturbation to the system such that causal connections between genetics, molecular entities and clinical outcomes can be inferred. The existing TNF-α blocker treatments for rheumatoid arthritis are only effective for approximately 2/3 of the affected population. We identified novel therapeutic intervention points that may lead to the development of alternatives to TNF-α blocker treatments. We believe this approach will provide improved drug discovery programs, new insights into disease progression, increased drug efficacy and novel biomarkers for chronic and complex diseases.

Plant nutrient acquisition and utilisation in a high carbon dioxide world

Producing enough food to meet the needs of an increasing global population is one of the greatest challenges we currently face. The issue of food security is further complicated by impacts of elevated CO2 and climate change. In this viewpoint article, we begin to explore the impacts of elevated CO2 on two specific aspects of plant nutrition and resource allocation that have traditionally been considered separately. First, we focus on arbuscular mycorrhizas, which play a major role in plant nutrient acquisition. We then turn our attention to the allocation of resources (specifically N and C) in planta, with an emphasis on the secondary metabolites involved in plant defence against herbivores. In doing so, we seek to encourage a more integrated approach to investigation of all aspects of plant responses to eCO2.

U.s. Geological survey core drilling on the atlantic shelf

The first broad program of scientific shallow drilling on the U.S. Atlantic continental shelf has delineated rocks of Pleistocene to Late Cretaceous age, including phosphoritic Miocene strata, widespread Eocene carbonate deposits that serve as reflective seismic markers, and several regional unconformities. Two sites, off Maryland and New Jersey, showed light hydrocarbon gases having affinity to mature petroleum. Pore fluid studies showed that relatively fresh to brackish water occurs beneath much of the Atlantic continental shelf, whereas increases in salinity off Georgla and beneath the Florida-Hatteras slope suggest buried evaporitic strata. The sediment cores showed engineering properties that range from good foundation strength to a potential for severe loss of strength through interaction between sediments and man-made structures.

Abstract LB-156: A RANKL inhibitor but not a bisphosphonate, zoledronic acid, reduces mammary tumor formation in a carcinogen- and hormone-dependent mouse model

RANKL and its target receptor, RANK, are key factors in bone remodeling and pathologic bone destruction associated with bone metastasis. Denosumab, a fully human monoclonal antibody that specifically inhibits RANKL, inhibits osteoclastogenesis and osteoclast-mediated bone destruction. In clinical trials, denosumab robustly reduced bone loss due to postmenopausal osteoporosis and prevented skeletal-related events in patients with metastatic bone lesions. It is currently being studied for the prevention of bone metastasis and disease recurrence in early breast and prostate cancer.

RANKL and RANK not only have critical roles in bone resorption, but are also essential for the development of lobulo-alveolar structures in mouse mammary gland during pregnancy. RANKL expression in mouse mammary epithelia is regulated by progesterone, prolactin, and parathyroid hormone-related protein (PTHrP). Using a hormone (medroxyprogesterone, MPA)- and carcinogen (7,12-dimethylbenz[a]anthracene, DMBA)-induced model of mammary tumorigenesis, we have demonstrated that transgenic MMTV-RANK overexpression results in more rapid onset of preneoplastic lesions and mammary tumors relative to wild type (WT) mice. Using immunohistochemistry, we observed that RANKL expression in mammary epithelia increased after MPA treatment and was elevated in epithelial cells at the stage of early preneoplastic mammary intraepithelial neoplasia (MIN) lesions and in adenocarcinomas. RANK is highly expressed in the epithelial component of preneoplasias and adenocarcinoma.

Using the same MPA and DMBA-induced mammary tumor model in WT mice, treatment with RANK-Fc at the initiation of DMBA treatment delayed the time to mammary tumor formation vs. control-treated mice (P<0.0001, log rank test). RANK-Fc treatment also decreased the incidence of palpable mammary tumors at 32 weeks post last DMBA (22% in RANK-Fc treated mice vs. 94% in control-treated mice, n>19 mice per group). We also tested three different doses of the bisphosphonate zoledronic acid (ZA at 0.025, 0.2 and 0.5 mg/kg given weekly beginning at initiation of DMBA) in WT mice for anti-tumor activity. Zoledronic acid had no effect at any dose on time to tumor formation compared to control. In addition, ZA had no effect at any dose on mammary tumor incidence at 32 weeks post last DMBA (92%,100% and 95% mammary tumor incidence for 0.5 mg/kg, 0.2 mg/kg and 0.025 mg/kg ZA-treated groups respectively, n>19 mice per group). Inhibition of bone resorption (as evident by increases in bone mineral density) was demonstrated in mice treated with either RANK-Fc or ZA (all doses). These data indicate that in this model, RANK-Fc reduces mammary tumorigenesis by inhibiting local RANKL in the normal mammary epithelial and/or preneoplasias and tumors and warrant further analysis of RANKL actions in tumor development, progression, and metastasis.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr LB-156.

Identification of Ikr kinetics and drug binding in native myocytes

Determining the effect of a compound on I_Kr is a standard screen for drug safety. Often the effect is described using a single IC₅₀ value, which is unable to capture complex effects of a drug. Using verapamil as an example, we present a method for using recordings from native myocytes at several drug doses along with qualitative features of I_Kr from published studies of HERG current to estimate parameters in a mathematical model of the drug effect on I_Kr. I_Kr was recorded from canine left ventricular myocytes using ruptured patch techniques. A voltage command protocol was used to record tail currents at voltages from −70 to −20 mV, following activating pulses over a wide range of voltages and pulse durations. Model equations were taken from a published I_Kr Markov model and the drug was modeled as binding to the open state. Parameters were estimated using a combined global and local optimization algorithm based on collected data with two additional constraints on I_KrI–V relation and I_Kr inactivation. The method produced models that quantitatively reproduce both the control I_Kr kinetics and dose dependent changes in the current. In addition, the model exhibited use and rate dependence. The results suggest that: (1) the technique proposed here has the practical potential to develop data-driven models that quantitatively reproduce channel behavior in native myocytes; (2) the method can capture important drug effects that cannot be reproduced by the IC₅₀ method. Although the method was developed for I_Kr, the same strategy can be applied to other ion channels, once appropriate channel-specific voltage protocols and qualitative features are identified.

Use of low-molecular-weight heparin to decrease mortality in mice after intracardiac injection of tumor cells

Intracardiac injection of human tumor cells into anesthetized nude mice is an established model of bone metastasis. However, intracardiac injection of some human tumor cell lines cause acute neurologic signs and high mortality, making some potentially relevant tumor cell lines unusable for investigation. We showed that intracardiac injection of tumor cells can induce a hypercoagulable state leading to platelet consumption and thromboemboli formation and that pretreatment with intravenous injection of low-molecular-weight heparin (LMWH; enoxaparin) blocks this state. In addition, intravenous injection of enoxaparin before intracardiac injection with 2 different small-cell lung carcinoma lines, H1975 and H2126, dramatically decreased mouse mortality while still generating bone metastases. Therefore, reduction of mortality by pretreatment with LMWH increases the types of cells that can be studied in this metastasis model and decreases the number of animals used.

A comparison of the diffusion of two innovations -- a pilot study: telemicroscopy versus teleradiology

Despite speculation that Telemicroscopy and Digital Microscopy will follow the same diffusion curves as their counterparts in the world of Radiology - Teleradiology and Filmless Radiology, no study has offered definitive evidence in support of this hypothesis. To address this gap in the informatics knowledge base, dual survey instruments were created to measure current opinions on both technologies among Pathologists and Radiologists and disseminated to Pathologists and Radiologists at two major academic medical centers.

RANK ligand inhibition plus docetaxel improves survival and reduces tumor burden in a murine model of prostate cancer bone metastasis

Tumor cells induce excessive osteoclastogenesis, mediating pathologic bone resorption and subsequent release of growth factors and calcium from bone matrix, resulting in a "vicious cycle" of bone breakdown and tumor proliferation. RANK ligand (RANKL) is an essential mediator of osteoclast formation, function, and survival. In metastatic prostate cancer models, RANKL inhibition directly prevents osteolysis via blockade of osteoclastogenesis and indirectly reduces progression of skeletal tumor burden by reducing local growth factor and calcium concentrations. Docetaxel, a well-established chemotherapy for metastatic hormone-refractory prostate cancer, arrests the cell cycle and induces apoptosis of tumor cells. Suppression of osteoclastogenesis through RANKL inhibition may enhance the effects of docetaxel on skeletal tumors. We evaluated the combination of the RANKL inhibitor osteoprotegerin-Fc (OPG-Fc) with docetaxel in a murine model of prostate cancer bone metastasis. Tumor progression, tumor area, and tumor proliferation and apoptosis were assessed. OPG-Fc alone reduced bone resorption (P < 0.001 versus PBS), inhibited progression of established osteolytic lesions, and reduced tumor area (P < 0.0001 versus PBS). Docetaxel alone reduced tumor burden (P < 0.0001 versus PBS) and delayed the development of osteolytic lesions. OPG-Fc in combination with docetaxel suppressed skeletal tumor burden (P = 0.0005) and increased median survival time by 16.7% (P = 0.0385) compared with docetaxel alone. RANKL inhibition may enhance docetaxel effects by increasing tumor cell apoptosis as evident by increased active caspase-3. These studies show that inhibition of RANKL provides an additive benefit to docetaxel treatment in a murine model of prostate cancer bone metastasis and supports clinical evaluation of this treatment option in patients.

RANKL acts directly on RANK-expressing prostate tumor cells and mediates migration and expression of tumor metastasis genes

BACKGROUND

Metastases to bone are a frequent complication of human prostate cancer and result in the development of osteoblastic lesions that include an underlying osteoclastic component. Previous studies in rodent models of breast and prostate cancer have established that receptor activator of NF-kappaB ligand (RANKL) inhibition decreases bone lesion development and tumor growth in bone. RANK is essential for osteoclast differentiation, activation, and survival via its expression on osteoclasts and their precursors. RANK expression has also been observed in some tumor cell types such as breast and colon, suggesting that RANKL may play a direct role on tumor cells.

METHODS

Male CB17 severe combined immunodeficient (SCID) mice were injected with PC3 cells intratibially and treated with either PBS or human osteprotegerin (OPG)-Fc, a RANKL antagonist. The formation of osteolytic lesions was analyzed by X-ray, and local and systemic levels of RANKL and OPG were analyzed. RANK mRNA and protein expression were assessed on multiple prostate cancer cell lines, and events downstream of RANK activation were studied in PC3 cells in vitro.

RESULTS

OPG-Fc treatment of PC3 tumor-bearing mice decreased lesion formation and tumor burden. Systemic and local levels of RANKL expression were increased in PC3 tumor bearing mice. PC3 cells responded to RANKL by activating multiple signaling pathways which resulted in significant changes in expression of genes involved in osteolysis and migration. RANK activation via RANKL resulted in increased invasion of PC3 cells through a collagen matrix.

CONCLUSION

These data demonstrate that host stromal RANKL is induced systemically and locally as a result of PC3 prostate tumor growth within the skeleton. RANK is expressed on prostate cancer cells and promotes invasion in a RANKL-dependent manner.

Receptor activator of NF-kappa B ligand inhibition suppresses bone resorption and hypercalcemia but does not affect host immune responses to influenza infection

Receptor activator of NF-kappaB (RANK) and its ligand (RANKL) are essential for osteoclast formation, function, and survival. Osteoprotegerin (OPG) inhibits RANK signaling by sequestering RANKL. This study evaluated the antiosteoclast and immunoregulatory effects of mouse rRANK-Fc, which, similar to OPG, can bind RANKL. The effect of RANKL inhibition by RANK-Fc on osteoclast function was determined by inhibition of vitamin D(3) (1,25(OH)(2)D(3))-induced hypercalcemia. Mice were injected with a single dose of 0, 10, 100, 500, or 1000 microg of RANK-Fc; 100 microg of OPG-Fc; or 5 microg of zoledronate 2 h before 1,25(OH)(2)D(3) challenge on day 0, and sacrificed on days 1, 2, 4, 6, 8, 12, 16, and 20. RANK-Fc doses of 100 or 500 microg were tested in a mouse respiratory influenza virus host-resistance model. A single dose of RANK-Fc > or =100 microg suppressed elevation of serum calcium levels and suppressed the bone turnover marker serum pyridinoline at day 4 and later time points, similar to those observed with OPG-Fc and zoledronate (p < or = 0.01 vs controls). By day 6, both immature and mature osteoclasts were depleted by high doses of RANK-Fc (500 and 1000 microg) or 100 microg of OPG-Fc. RANK-Fc doses of 100 or 500 microg had no detectable effect on immune responses to influenza infection, as measured by activation of cytotoxic T cell activity, influenza-specific IgG response, and virus clearance. RANK-Fc inhibition of RANKL has antiosteoclast activity at doses that have no detectable immunoregulatory activity, suggesting that RANKL inhibitors be further studied for their potential to treat excess bone loss.

Variation in defence strategies in two species of the genus Beilschmiedia under differing soil nutrient and rainfall conditions

The relationships between various leaf functional traits that are important in plant growth (e.g., specific leaf area) have been investigated in recent studies; however, research in this context on plants that are highly protected by chemical defences, particularly resource-demanding nitrogen-based defence, is lacking. We collected leaves from cyanogenic (N-defended) Beilschmiedia collina B. Hyland and acyanogenic (C-defended) Beilschmiedia tooram (F. M. Bailey) B. Hyland at high- and low-soil nutrient sites in two consecutive years that varied significantly in rainfall. We then measured the relationships between chemical defence and morphological and functional leaf traits under the different environmental conditions. We found that the two species differed significantly in their resource allocation to defence as well as leaf morphology and function. The N defended species had a higher leaf nitrogen concentration, whereas the C-defended species had higher amounts of C-based chemical defences (i.e., total phenolics and condensed tannins). The C-defended species also tended to have higher force to fracture and increased leaf toughness. In B. collina, cyanogenic glycoside concentration was higher with higher rainfall, but not with higher soil nutrients. Total phenolic concentration was higher at the high soil nutrient site in B. tooram, but lower in B. collina; however, with higher rainfall an increase was found in B. tooram, while phenolics decreased in B. collina. Condensed tannin concentration decreased in both species with rainfall and nutrient availability. We conclude that chemical defence is correlated with leaf functional traits and that variation in environmental resources affects this correlation.

Infrared laser spectroscopy of the CH3–HCN radical complex stabilized in helium nanodroplets

The CH3-HCN and CD3-HCN radical complexes have been formed in helium nanodroplets by sequential pickup of a CH3 (CD3) radical and a HCN molecule and have been studied by high-resolution infrared laser spectroscopy. The complexes have a hydrogen-bonded structure with C3v symmetry, as inferred from the analysis of their rotationally resolved nu = 1 <-- 0 H-CN vibrational bands. The A rotational constants of the complexes are found to change significantly upon vibrational excitation of the C-H stretch of HCN within the complex, DeltaA = A'-A" = -0.04 cm(-1) (for CH3-HCN), whereas the B rotational constants are found to be 2.9 times smaller than that predicted by theory. The reduction in B can be attributed to the effects of helium solvation, whereas the large DeltaA is found to be a sensitive probe of the vibrational averaging dynamics of such weakly bound systems. The complex has a permanent electric dipole moment of 3.1 +/- 0.2 D, as measured by Stark spectroscopy. A vibration-vibration resonance is observed to couple the excited C-H stretching vibration of HCN within the complex to the lower-frequency C-H stretches of the methyl radical. Deuteration of the methyl radical was used to detune these levels from resonance, increasing the lifetime of the complex by a factor of 2. Ab initio calculations for the energies and molecular parameters of the stationary points on the CN+CH4 --> HCN+CH3 potential-energy surface are also presented.

Infrared laser spectroscopy of CH3⋯HF in helium nanodroplets: The exit-channel complex of the F+CH4 reaction

High-resolution infrared laser spectroscopy is used to study the CH3...HF and CD3...HF radical complexes, corresponding to the exit-channel complex in the F + CH4 --> HF + CH3 reaction. The complexes are formed in helium nanodroplets by sequential pickup of a methyl radical and a HF molecule. The rotationally resolved spectra presented here correspond to the fundamental v = 1 <-- 0 H-F vibrational band, the analysis of which reveals a complex with C(3v) symmetry. The vibrational band origin for the CH3...HF complex (3797.00 cm(-1)) is significantly redshifted from that of the HF monomer (3959.19 cm(-1)), consistent with the hydrogen-bonded structure predicted by theory [E. Ya. Misochko et al., J. Am. Chem. Soc. 117, 11997 (1995)] and suggested by previous matrix isolation experiments [M. E. Jacox, Chem. Phys. 42, 133 (1979)]. The permanent electric dipole moment of this complex is experimentally determined by Stark spectroscopy to be 2.4+/-0.3 D. The wide amplitude zero-point bending motion of this complex is revealed by the vibrational dependence of the A rotational constant. A sixfold reduction in the line broadening associated with the H-F vibrational mode is observed in going from CH3...HF to CD3...HF. The results suggest that fast relaxation in the former case results from near-resonant intermolecular vibration-vibration (V-V) energy transfer. Ab initio calculations are also reported (at the MP2 level) for the various stationary points on the F + CH4 surface, including geometry optimizations and vibrational frequency calculations for CH3...HF.

Randomized, controlled, double-blind trial of daily oral azithromycin in adults for the prophylaxis of Plasmodium vivax malaria in Western Thailand

We assessed the prophylactic efficacy of azithromycin (250 mg/day) against malaria in 276 adults in western Thailand in a randomized, double-blind, placebo-controlled trial. After antimalarial suppressive treatment, volunteers were randomized in a 2:1 ratio to either the azithromycin or placebo, respectively. Study medication was given for an average of 74 days. The azithromycin group (n = 179) had five endpoint parasitemias (1 Plasmodium vivax and 4 P. falciparum), and the placebo group (n = 97) had 28 endpoint parasitemias (21 P. vivax, 5 P. falciparum, and 2 mixed infections). Adverse events and compliance and withdrawal rates were similar in both groups. The protective efficacy (PE) of azithromycin was 98% for P. vivax (95% confidence interval [CI] = 88-100%). There were too few cases to reliably estimate the efficacy of azithromycin for P. falciparum (PE =71%, 95% C =-14-94%). We conclude that daily azithromycin was safe, well-tolerated, and had a high efficacy for the prevention of P. vivax malaria.

Finite-temperature quasicontinuum: molecular dynamics without all the atoms

Using a combination of statistical mechanics and finite-element interpolation, we develop a coarse-grained (CG) alternative to molecular dynamics (MD) for crystalline solids at constant temperature. The new approach is significantly more efficient than MD and generalizes earlier work on the quasicontinuum method. The method is validated by recovering equilibrium properties of single crystal Ni as a function of temperature. CG dynamical simulations of nano-indentation reveal a strong dependence on temperature of the critical stress to nucleate dislocations under the indenter.

Construction and evaluation of cDNA libraries for large-scale expressed sequence tag sequencing in wheat (Triticum aestivum L.)

A total of 37 original cDNA libraries and 9 derivative libraries enriched for rare sequences were produced from Chinese Spring wheat (Triticum aestivum L.), five other hexaploid wheat genotypes (Cheyenne, Brevor, TAM W101, BH1146, Butte 86), tetraploid durum wheat (T. turgidum L.), diploid wheat (T. monococcum L.), and two other diploid members of the grass tribe Triticeae (Aegilops speltoides Tausch and Secale cereale L.). The emphasis in the choice of plant materials for library construction was reproductive development subjected to environmental factors that ultimately affect grain quality and yield, but roots and other tissues were also included. Partial cDNA expressed sequence tags (ESTs) were examined by various measures to assess the quality of these libraries. All ESTs were processed to remove cloning system sequences and contaminants and then assembled using CAP3. Following these processing steps, this assembly yielded 101,107 sequences derived from 89,043 clones, which defined 16,740 contigs and 33,213 singletons, a total of 49,953 "unigenes." Analysis of the distribution of these unigenes among the libraries led to the conclusion that the enrichment methods were effective in reducing the most abundant unigenes and to the observation that the most diverse libraries were from tissues exposed to environmental stresses including heat, drought, salinity, or low temperature.

Rotational and vibrational dynamics of ethylene in helium nanodroplets

Rotationally resolved infrared spectra are reported for the asymmetric C-H stretching fundamental bands of C(2)H(4) in helium nanodroplets, as well as two weak combination bands. The J=2 rotor levels are strongly shifted from the energies estimated from a rigid rotor calculation and can be accounted for with two centrifugal distortion constants. The excited states of the three bands with B(3u) symmetry are strongly coupled in the gas phase and exhibit lifetimes >100 ps in helium, with the upper member of the polyad exhibiting the shortest lifetime. In contrast, the nu(9) band (B(2u) symmetry) exhibits very broad, homogeneously broadened line profiles (full width at half maximum approximately 0.5 cm(-1)) corresponding to an excited state lifetime of approximately 10 ps. This short lifetime is presumed to be due to an efficient, solvent mediated vibration-to-vibration relaxation process. In addition, the absence of transitions to the 2(21) and 2(20) rotor levels in the nu(9) band suggests they form rotational resonances with the elementary modes of helium, resulting in very short excited state lifetimes of less than 2 ps.

Multiple tautomers of cytosine identified and characterized by infrared laser spectroscopy in helium nanodroplets: probing structure using vibrational transition moment angles

Infrared laser spectroscopy in helium nanodroplets is used to identify and characterize several distinct tautomers of cytosine. The experimentally observed species correspond to the lowest-energy structures obtained from ab initio calculations, also reported here. The assignment of the infrared vibrational bands in the spectra is aided by the measurement of the corresponding vibrational transition moment angles, which are also calculated using ab initio methods. In the present study we confirm the existence of three primary tautomers and provide tentative assignments for even higher-energy forms of cytosine in helium nanodroplets.

The isomers of HF–HCN formed in helium nanodroplets: Infrared spectroscopy and ab initio calculations

Binary complexes containing hydrogen cyanide and hydrogen fluoride are formed in helium nanodroplets, and studied using high-resolution infrared laser spectroscopy. Rotationally resolved spectra are reported for the H-F and C-H stretches of the linear HCN-HF complex, a system that has been thoroughly studied in the gas phase. We report the high-resolution spectra of the higher energy, bent HF-HCN isomer, which is also formed in helium. Stark spectra are reported for both isomers, providing dipole moments of these complexes. The experimental results are compared with ab initio calculations, also reported here. Spectra are reported for several ternary complexes, including (HCN)2-HF, HCN-(HF)2, HF-(HCN)2, and HF-HCN-HF.

Multiple isomers of uracil–water complexes: infrared spectroscopy in helium nanodroplets

Infrared laser spectroscopy is used to show that four structural isomers of the uracil-water binary complex are formed in helium nanodroplets. The assignment of the infrared spectra is aided by measurements of vibrational transition moment angles (VTMAs) for various vibrational modes of these complexes. The experimental results are in excellent agreement with ab initio calculations, which had previously predicated the existence of the same four isomers. The results suggest that the relative abundances of the various isomers formed in helium droplets have more to do with the widths of the valleys in the potential surface that funnel into a particular local minimum than on the associated energetics.

Development of an expressed sequence tag (EST) resource for wheat (Triticum aestivum L.): EST generation, unigene analysis, probe selection and bioinformatics for a 16,000-locus bin-delineated map

This report describes the rationale, approaches, organization, and resource development leading to a large-scale deletion bin map of the hexaploid (2n = 6x = 42) wheat genome (Triticum aestivum L.). Accompanying reports in this issue detail results from chromosome bin-mapping of expressed sequence tags (ESTs) representing genes onto the seven homoeologous chromosome groups and a global analysis of the entire mapped wheat EST data set. Among the resources developed were the first extensive public wheat EST collection (113,220 ESTs). Described are protocols for sequencing, sequence processing, EST nomenclature, and the assembly of ESTs into contigs. These contigs plus singletons (unassembled ESTs) were used for selection of distinct sequence motif unigenes. Selected ESTs were rearrayed, validated by 5' and 3' sequencing, and amplified for probing a series of wheat aneuploid and deletion stocks. Images and data for all Southern hybridizations were deposited in databases and were used by the coordinators for each of the seven homoeologous chromosome groups to validate the mapping results. Results from this project have established the foundation for future developments in wheat genomics.

Structures of HCN-Mgn (n=2–6) complexes from rotationally resolved vibrational spectroscopy andab initiotheory

High-resolution infrared laser spectroscopy has been used to determine the structures of HCN-Mgn complexes formed in helium nanodroplets. The magnesium atoms are first added to the droplets to ensure that the magnesium complexes are preformed before the HCN molecule is added. The vibrational frequencies, structures, and dipole moments of these complexes are found to vary dramatically with cluster size, illustrating the nonadditive nature of the HCN-magnesium interactions. All of the complexes discussed here have the nitrogen end of the HCN pointing towards the magnesium clusters. For Mg3, the HCN binds to the "threefold" site, yielding a symmetric top spectrum. Although the HCN-Mg4 complex also has C3v symmetry, the HCN sits "on-top" of a single magnesium atom. These structures are confirmed by both ab initio calculations and measurements of the dipole moments. Significant charge transfer is observed in the case of HCN-Mg4, indicative of charge donation from the lone pair on the nitrogen of HCN into the lowest unoccupied molecular orbital of the Mg4.

Infrared–infrared double resonance spectroscopy of cyanoacetylene in helium nanodroplets

Infrared-infrared double resonance spectroscopy is used as a probe of the vibrational dynamics of cyanoacetylene in helium droplets. The nu1 C-H stretching vibration of cyanoacetylene is excited by an infrared laser and subsequent vibrational relaxation results in the evaporation of approximately 660 helium atoms from the droplet. A second probe laser is then used to excite the same C-H stretching vibration downstream of the pump, corresponding to a time delay of approximately 175 micros. The hole burned by the pump laser is narrower than the single resonance spectrum, owing to the fact that the latter is inhomogeneously broadened by the droplet size distribution. The line width of the hole is characteristic of another broadening source that depends strongly on droplet size.

Vibrational predissociation in the HCl dimer

We present results of a combined theoretical and experimental study on the vibrational predissociation of the HCl dimer. On the theoretical side, photodissociation linewidths and product-state distributions for monomer stretch excited states with total angular momentum J=0 were computed, using the Fermi golden rule approximation. The resonances investigated include excitation of the hydrogen bond donor and acceptor stretches, as well as combinations of one of these modes with the intermolecular stretch and geared bend modes, for both even and odd permutation symmetry. Line strengths for the transitions from the J=1, K=0 ground state to excited states with J=0 were computed using quasibound states. On the experimental side, the photofragment angular distribution method was employed to obtain complete final-state distributions for the monomer stretch excited states. Three different transitions were probed, all starting from the lower tunneling component of the ground state: the (R)Q(0)(1) transition for excitation of the acceptor stretch and the (Q)R(0)(0) transition and unresolved (R)Q(0) branch for the donor stretch excitation. We find that, in contrast to the HF dimer, the excited-state alignment of the HCl dimer, resulting from excitation using a polarized laser beam, is completely lost on the time scale of the dissociation. The agreement between theory and experiment for the product-state distributions and line strengths is reasonable. The computed lifetimes are 1-2 orders of magnitude too small, which is attributed to a deficiency in the potential energy surface.

Comprehensive functional specifications and design for IT support of clinical research at an academic medical center

We present a framework for understanding and developing an Information Technology (IT) infrastructure for human subject research. First, we review the process of clinical research in an academic medical center. Next,we describe the entities,roles,and functional relationships within the clinical research enterprise to define a conceptual data model. Finally, we address design and implementation issues for an IT infrastructure that can be adapted to the local needs of research institutions.