Prognostic and predictive value of interstitial lung abnormalities and EGFR mutation status in patients with non-small cell lung cancer

BACKGROUND

To determine the predictive value of interstitial lung abnormalities (ILA) for epidermal growth factor receptor (EGFR) mutation status and assess the prognostic significance of EGFR and ILA in patients with non-small cell lung cancer (NSCLC).

METHODS

We reviewed 797 consecutive patients with a histologically proven diagnosis of primary NSCLC from January 2013 to October 2018. Of these, 109 patients with NSCLC were found to have concomitant ILA. Multivariate logistic regression analysis was used to identify the significant clinical and computed tomography (CT) findings in predicting EGFR mutations. Cox proportional hazard models were used to identify significant prognostic factors.

RESULTS

EGFR mutations were identified in 22 of 109 tumors (20.2%). Multivariate analysis showed that the models incorporating clinical, tumor CT and ILA CT features yielded areas under the receiver operating characteristic curve (AUC) values of 0.749, 0.838, and 0.849, respectively. When combining the three models, the independent predictive factors for EGFR mutations were non-fibrotic ILA, female sex, and small tumor size, with an AUC value of 0.920 (95% confidence interval[CI]: 0.861-0.978, p < 0.001). In the multivariate Cox model, EGFR mutations (hazard ratio = 0.169, 95% CI = 0.042-0.675, p = 0.012; 692 days vs. 301 days) were independently associated with extended overall survival compared to the wild-type.

CONCLUSION

Non-fibrotic ILA independently predicts the presence of EGFR mutations, and the presence of EGFR mutations rather than non-fibrotic ILA serves as an independent good prognostic factor for patients with NSCLC.

Alloying enhanced negative Poisson's ratio in two-dimensional aluminum gallium nitride (AlxGa1-xN)

The negative Poisson's ratio (NPR) effect usually endows materials with promising ductility and shear resistance, facilitating a wider range of applications. It has been generally acknowledged that alloys show strong advantages in manipulating material properties. Thus, a thought-provoking question arises: how does alloying affect the NPR? In this paper, based on first-principles calculations, we systematically study the NPR in two-dimensional (2D) GaN and AlN, and their alloy of AlxGa1-xN. It is intriguing to find that the NPR in AlxGa1-xN is significantly enhanced compared to the parent materials of GaN and AlN. The underlying mechanism mainly originates from a counter-intuitive increase of the bond angle θ. We further study the microscopic origin of the anomalies by electron orbital analysis as well as electron localization functions. It is revealed that the distribution and movement of electrons change with the applied strain, providing a fundamental view on the effect of strain on lattice parameters and the NPR. The physical origin as revealed in this study deepens the understanding of the NPR and shed light on the future design of modern nanoscale electromechanical devices with fantastic functions based on the auxetic nanomaterials and nanostructures.

Superhydrophilic Poly(2-hydroxyethyl methacrylate) Hydrogel with Nanosilica Covalent Coating: A Promising Contact Lens Material for Resisting Tear Protein Deposition and Bacterial Adhesion

Tear protein deposition and bacterial adhesion are the main drawbacks of the hydrogel contact lens. In this study, we developed a novel superhydrophilic poly(2-hydroxyethyl methacrylate) (NSCC-pHEMA) hydrogel with nanosilica covalent coating by the combination of colloidal silica immersion and dehydration treatment. The infrared spectroscopy and energy dispersive X-ray spectroscopy analyses confirmed the successful formation of Si-O covalent bonding between nanosilica and pHEMA hydrogel. This coating was highly stable against powerful sonication or long-term shaking immersion treatment. Among various NSCC-pHEMA hydrogels with different colloidal silica concentrations, the 7%NSCC-pHEMA hydrogel generated a superhydrophilic micro wrinkle surface with a root-mean-square roughness of 43.10 nm, which dramatically reduced the deposition of lysozyme and bovine serum albumin by 65% and 57%, respectively, and decreased the adhesion of S. aureus and E. coli by 59% and 66%, respectively, in comparison to the pHEMA hydrogel. However, the nanosilica coating had little effect on the mechanical properties, light transmittance, oxygen permeability, and equilibrium water content of the pHEMA hydrogel. NSCC-pHEMA hydrogels were nontoxic to both mouse fibroblasts (L929) and human immortalized keratinocytes (HaCaT). Thus, the superhydrophilic NSCC-pHEMA hydrogel is a potential contact lens material for resisting tear protein deposition and bacterial adhesion.

Phase III study of HR-positive/HER2-negative/lymph node-positive breast cancer non-responsive to primary chemotherapy: a randomized trial

There are few studies focus on post-neoadjuvant treatment in hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2-)/lymph node-positive (LN+) breast cancer, a multi-center, open-label, randomized, controlled phase III trial was conducted to evaluate pathological response-guided non-cross-resistant adjuvant chemotherapy in patients with HR+/HER2-/LN+ breast cancer who were non-responsive to primary chemotherapy. Patients received four cycles of non-cross-resistant adjuvant chemotherapy plus endocrine therapy (ET), or ET alone. Forty patients responsive to neoadjuvant chemotherapy and with Miller and Payne G4 or G5 and LN- status were assigned to the observation group. Distant disease-free survival was the primary endpoint. The final intention-to-treat analysis comprised 379 patients. After a median follow-up period of 72.4 months, the 5-year distant disease-free survival was 92% and 90% in the chemotherapy plus ET and ET-alone groups, respectively. Comparatively, the observation group showed a trend towards better distant disease-free survival. For patients non-responsive to neoadjuvant chemotherapy, adjuvant non-cross-resistant chemotherapy did not significantly improve distant disease-free survival compared to ET alone.

Extremely promising monolayer materials with robust ferroelectricity and extraordinary piezoelectricity: δ-AsN, δ-SbN, and δ-BiN

Low-dimensional ferroelectric materials, the mainstay of current high-density non-volatile memory devices, sensors, and nanoscale electronics, have attracted tremendous attention recently. Through employing an evolutionary algorithm and first-principles calculations, we report three novel and stable two-dimensional (2D) ferroelectric materials δ-AsN, δ-SbN, and δ-BiN with spontaneous polarization of up to 5.72 × 10^-10, 5.20 × 10^-10, and 4.45 × 10^-10 C m^-1, respectively. The ab initio molecular dynamics (AIMD) simulations further show that the failure temperature of ferroelectricity of δ-AsN, δ-SbN, and δ-BiN is as high as 2000 K, 2000 K, and 1700 K, demonstrating their strong robustness. More interestingly, the three novel materials also exhibit extraordinary piezoelectricity with relaxation ion piezoelectric coefficients d₁₁ of 5.39, 19.55, and 43.87 pm V^-1, respectively. The external strain effect found can effectively modulate their spontaneous polarization, ferroelectric switching energy barrier, and piezoelectric properties. These fascinating ferroelectricity and piezoelectricity features endow δ-AsN, δ-SbN, and δ-BiN with significant potential application in future miniaturized and integrated multi-functional electronic devices.

CT Radiomics for Predicting Pathological Complete Response of Axillary Lymph Nodes in Breast Cancer After Neoadjuvant Chemotherapy: A Prospective Study

BACKGROUND

The diagnostic effectiveness of traditional imaging techniques is insufficient to assess the response of lymph nodes (LNs) to neoadjuvant chemotherapy (NAC), especially for pathological complete response (pCR). A radiomics model based on computed tomography (CT) could be helpful.

PATIENTS AND METHODS

Prospective consecutive breast cancer patients with positive axillary LNs initially were enrolled, who received NAC prior to surgery. Chest contrast-enhanced thin-slice CT scan was performed both before and after the NAC (recorded as the first and the second CT respectively), and on both of them, the target metastatic axillary LN was identified and demarcated layer by layer. Using pyradiomics-based software that was independently created, radiomics features were retrieved. A pairwise machine learning workflow based on Sklearn (https://scikit-learn.org/) and FeAture Explorer was created to increase diagnostic effectiveness. An effective pairwise auto encoder model was developed by the improvement of data normalization, dimensionality reduction, and features screening scheme as well as the comparison of the prediction effectiveness of the various classifiers.

RESULTS

A total of 138 patients were enrolled, and 77 (58.7%) in the overall group achieved pCR of LN after NAC. Nine radiomics features were finally chosen for modeling. The AUCs of the training group, validation group, and test group were 0.944 (0.919-0.965), 0.962 (0.937-0.985), and 1.000 (1.000-1.000), respectively, and the corresponding accuracies were 0.891, 0.912, and 1.000.

CONCLUSION

The pCR of axillary LNs in breast cancer following NAC can be precisely predicted using thin-sliced enhanced chest CT-based radiomics.

Observation effectiveness of dose-dense neoadjuvant anthracycline sequential weekly paclitaxel for triple-negative breast cancer patients

INTRODUCTION/BACKGROUND

To investigate the differences in pathological response and survival outcomes between dose-dense and conventional-interval neoadjuvant chemotherapy (NAC) in patients with triple-negative breast cancer (TNBC).

PATIENTS AND METHODS

Patients with TNBC who received NAC including epirubicin plus cyclophosphamide followed by weekly paclitaxel were included. A total of 494 patients were divided into either the dose-dense anthracycline (ddEC-wP) group or conventional interval anthracycline (EC-wP) group.

RESULTS

The breast pathological complete response (bpCR, ypT0/is) rate was 45.3% (n = 101) in the dose-dense group and 34.3% (n = 93) in the conventionally scheduled group, which was a significant difference (P = .013), and in the 251 pN+ cases, the lymph node pathological complete response (LNpCR, ypN0) rate was 57.9% (n = 62) in the dose-dense group and 43.7% (n = 63) in the conventionally scheduled group, which was a significant difference (P = .026) in the univariate analysis. In the multivariate logistic regression analysis, 3 variables were predictive of bpCR: pathological type, surgical methods and type of chemotherapy, with P values of .012, .001 and .021, respectively. Two variables were predictive of LNpCR: type of chemotherapy and Her-2 expression, with P values of .039 and .020, respectively. After a median follow-up of 54 months, there was no significant difference in survival for disease-free survival (DFS) (hazard ratio [HR], 0.788; 95% confidence interval [CI], 0.508 to 1.223; P = .288), distant disease-free survival (DDFS) (HR, 0. 709; 95% CI, 0.440 to 1.144; P = .159) or overall survival (OS) (HR, 0. 750; 95% CI, 0.420 to 1.338; P = .330) between the 2 groups.

CONCLUSION

Our study demonstrated that TNBC achieved a higher bpCR rate and LNpCR rate after dose-dense neoadjuvant chemotherapy than the conventional scheme. The survival benefit of the 2 groups did not reach statistical difference.

Impact of Sentinel Lymph Node Biopsy on Treatment Decision and Survival in Patients Aged ≥70 Years with Breast Cancer: A Retrospective Study

Background: Whether sentinel lymph node biopsy should be performed in patients ≥70 years old with early-stage invasive breast cancer is controversial. We examined the effect of sentinel lymph node biopsy on the treatment and outcomes in this population. Materials and Methods: In this retrospective study, patients aged ≥70 years who were treated for invasive breast cancer with sentinel lymph node biopsy followed by mastectomy or lumpectomy between 2010 and 2019 were identified from our database. Patients were compared according to sentinel lymph node status. Outcomes were analyzed using the Kaplan-Meier method and Cox multivariate analysis. Results: Of the 376 patients enrolled in this study, 311 (82.7%) were sentinel lymph node-negative and 65 (17.3%) were sentinel lymph node-positive. The median follow-up duration for all patients was 70 months. Systemic treatment and radiation were similar between sentinel lymph node-negative and -positive groups. Disease-free survival, distant disease-free survival, breast cancer-specific survival, overall survival were not significantly different between groups (88.2% vs 87.6%, 96.7% vs 94.8%, 96.2% vs 93.6%, and 93.5% vs 90.0%, respectively). Sentinel lymph node status, tumor size, chemotherapy, endocrine therapy, and adjuvant radiation were included in Cox multivariate analysis. None of the variables were found to significantly affect disease-free survival, distant disease-free survival, breast cancer-specific survival, and overall survival. Conclusions: Our analysis indicated that sentinel lymph node status may not affect systemic treatment decisions or survival in patients aged ≥70 years with breast cancer.

Constructing brain functional network by Adversarial Temporal-Spatial Aligned Transformer for early AD analysis

Introduction

The brain functional network can describe the spontaneous activity of nerve cells and reveal the subtle abnormal changes associated with brain disease. It has been widely used for analyzing early Alzheimer's disease (AD) and exploring pathological mechanisms. However, the current methods of constructing functional connectivity networks from functional magnetic resonance imaging (fMRI) heavily depend on the software toolboxes, which may lead to errors in connection strength estimation and bad performance in disease analysis because of many subjective settings.

Methods

To solve this problem, in this paper, a novel Adversarial Temporal-Spatial Aligned Transformer (ATAT) model is proposed to automatically map 4D fMRI into functional connectivity network for early AD analysis. By incorporating the volume and location of anatomical brain regions, the region-guided feature learning network can roughly focus on local features for each brain region. Also, the spatial-temporal aligned transformer network is developed to adaptively adjust boundary features of adjacent regions and capture global functional connectivity patterns of distant regions. Furthermore, a multi-channel temporal discriminator is devised to distinguish the joint distributions of the multi-region time series from the generator and the real sample.

Results

Experimental results on the Alzheimer's Disease Neuroimaging Initiative (ADNI) proved the effectiveness and superior performance of the proposed model in early AD prediction and progression analysis.

Discussion

To verify the reliability of the proposed model, the detected important ROIs are compared with clinical studies and show partial consistency. Furthermore, the most significant altered connectivity reflects the main characteristics associated with AD.

Conclusion

Generally, the proposed ATAT provides a new perspective in constructing functional connectivity networks and is able to evaluate the disease-related changing characteristics at different stages for neuroscience exploration and clinical disease analysis.

Risk of ipsilateral breast tumor recurrence and contralateral breast cancer in patients with and without TP53 variant in a large series of breast cancer patients

Background

The association between breast cancer patients with a TP53 pathogenic variant and risk of local recurrence and contralateral breast cancer remains largely unknown.

Methods

The study population of 11093 patients was derived from two cohorts at the Breast Center of Peking University Cancer Hospital in China from November 2003, to March 2018. TP53 germline variants were determined for all patients.

Results

In the study, forty-one (0.37%) carried a TP53 germline pathogenic variant, and 11052 were non-carriers (99.63%). Nineteen TP53 carriers (46.3%) and 4173 non-carriers (37.8%) were treated with breast-conserving therapy (BCT), while the remaining were treated with mastectomy. After a median follow-up of 6.7 years, the rate of ipsilateral breast tumor recurrence (IBTR) in TP53 carriers was significantly higher than that in non-carriers when treated with BCT (21.1% vs 3.8%, P = 0.006). No difference in the rate of IBTR was found between TP53 carriers and non-carriers when treated with mastectomy (0.0% vs 2.6%, P = 1.0). Furthermore, the rate of IBTR in TP53 carriers treated with BCT was significantly higher than that in those treated with mastectomy (21.1% vs 0.0%, P = 0.038). The 10-year cumulative risk of contralateral breast cancer in TP53 carriers was significantly higher than that in non-carriers (17.9% vs 3.6%, hazard ratio (HR) = 7.0, 95% CI: 3.3–14.9, P < 0.001).

Conclusions

Patients with TP53 variants have a high risk of IBTR when treated with BCT, and exhibit a very high risk of contralateral breast cancer. TP53 carriers may not be suitable for BCT and prophylactic contralateral mastectomy might be considered.

•

Patients with a TP53 variant have a high risk of IBTR when treated with BCT.

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TP53 carriers exhibit a very high risk of contralateral breast cancer.

•

TP53 carriers may not be suitable for BCT.

•

Prophylactic contralateral mastectomy may be considered for TP53 carriers.

Ultralow thermal conductivity and anisotropic thermoelectric performance in layered materials LaMOCh (M = Cu, Ag; Ch = S, Se)

In layered materials with the stacking axis perpendicular to the basal plane, anharmonicity strongly affects phonon propagation due to weak interlayer coupling, which is helpful to reduce the lattice thermal conductivity and improve the thermoelectric (TE) performance significantly. By combining first-principles calculations and the Boltzmann transport equation, we systematically analyzed and evaluated the lattice thermal conductivity and TE properties of LaMOCh (M = Cu, Ag; Ch = S, Se). The results indicate that these layered materials exhibit ultralow lattice thermal conductivities of 0.24-0.37 W m^-1 K^-1 along the interlayer direction at room temperature. The low lattice thermal conductivities have been analyzed from some inherent phonon properties, such as low acoustic phonon group velocity, large Grüneisen parameters, and a short phonon relaxation time. Originating from their natural layered crystal structure, the thermal and electronic transports (i.e., thermal conductivity, Seebeck coefficient, and electrical conductivity) are both highly anisotropic between their intralayer and interlayer directions. Finally, we obtained ZT values of 1.17 and 1.26 at 900 K along the interlayer direction for n-type LaCuOSe and LaAgOSe, respectively. Generally, LaMOSe exhibit larger anisotropy than LaMOS, in both n- and p-types of doping. Our findings of low thermal conductivities and large anisotropic TE performances of these layered systems should stimulate much attention in BiCuOSe and alike layered TE families.

Robust pure spin current induced by the photogalvanic effect in half-silicane with spatial inversion symmetry

The spin-dependent photogalvanic (PG) effect in low-dimensional spin semiconductors has attracted great interest recently. Here, we have studied the spin semiconducting feature and spin-dependent photocurrent in a two-dimensional (2D) silicene-based device with spatial inversion symmetrical half-hydrogenation, in which half of the silicene is hydrogenated on the upper surface and half is hydrogenated on the lower surface. Because of the unique spin semiconductor properties and symmetry of the system, pure spin current can be robustly produced in both the zigzag and armchair directions for linearly and elliptically polarized light. The behavior of the spin-dependent photoresponse in the spin PG effect is highly anisotropic and can be tuned by the polarization/phase angles or photon energy (E_ph). Moreover, the produced pure spin current in such a half-silicane device with spatial inversion symmetry via the PG effect is several orders of magnitude larger than that obtained in metal/semiconductor/metal systems. These findings suggest a promising approach for generating pure spin current by the PG effect and provide a new possibility for the application of 2D half-silicane in spintronics.

Neoadjuvant endocrine therapy for strongly hormone receptor-positive and HER2-negative early breast cancer: results of a prospective multi-center study

PURPOSE

For estrogen receptor (ER)-positive breast cancer, neoadjuvant endocrine therapy (NET) has been shown to be as effective as neoadjuvant chemotherapy (NACT). We evaluated the prognostic significance of Preoperative Endocrine Prognostic Index (PEPI).

METHODS

We conducted a prospective, multi-center, non-randomized, controlled trial that enrolled postmenopausal early-stage strongly ER-positive (≥ 50%) and HER2-negative breast cancer patients. All patients were given 4-month NET before surgery. The primary objective was to investigate the 5-year recurrence-free survival (RFS) in patients who had PEPI 0-1 or pathological complete response (pCR) without chemotherapy. Patients who had PEPI 0-1 or pCR were recommended to receive adjuvant endocrine therapy only and patients had PEPI ≥ 2 may receive adjuvant chemotherapy at the discretion of the treating physician.

RESULTS

A total of 410 patients were included and 352 patients constituted the per-protocol population. Overall, 9 patients (2.5%) had pCR (ypT0/is ypN0), 128 patients (36.4%) had PEPI = 0, and 56 patients (15.9%) had PEPI = 1. After a median follow-up of 60 months (4-104 months), patients who had PEPI 0-1 or pCR showed an improved 5-year RFS [99.5% (95% CI 98.5-99.9%) for PEPI 0-1 or pCR group vs. 93.7% (95% CI 89.6-97.8%) for PEPI ≥ 2 group, P = 0.028]. No survival difference was detected between patients received adjuvant chemotherapy vs. no chemotherapy among PEPI ≥ 2 cases.

CONCLUSION

PEPI 0-1 or pCR may be used to define a group of ER-positive and HER2-negative postmenopausal early breast cancer patients with low relapse risk for whom adjuvant chemotherapy can be safely withheld. Studies on the identification and alternative treatment options for endocrine-resistant tumors are warranted.

CLINICAL TRIAL REGISTRATION

NCT01613560.

A Quantitative Subarachnoid Hemorrhage Grading System, Including Supratentorial and Infratentorial Cisterns, With Multiplanar Computed Tomography Reformations

Background

Subarachnoid hemorrhage (SAH) grading scales typically evaluate a limited number of cisterns on the axial plane. The goal of our study is to apply a simple quantitative yet comprehensive SAH grading scale to all major intracranial cisterns, including the infratentorial cisterns, with multiplanar computed tomography (CT) reformations.

Methodology

We performed a retrospective review of 94 consecutive cases of spontaneous SAH presenting within 72 hours of onset. SAH was categorized into five grades based on the short-axis thickness of SAH in 20 intracranial cisterns measured on the axial, coronal, and sagittal planes. Statistical analysis was performed for inter-rater agreement with kappa statistics, for inter-plane agreement by Spearman correlation statistics, and for inter-rater and inter-plane agreement by Pearson correlation statistics.

Results

The extended kappa coefficient for the three reviewers across all 20 cisterns varied from 0.38 (0.27, 0.50) to 0.59 (0.52, 0.65) on the axial plane. The kappa coefficient for two reviewers varied from 0.46 (0.33, 0.59) to 0.70 (0.60, 0.80) on the coronal plane and from 0.35 (0.20, 0.49) to 0.87 (0.77, 0.96) on the sagittal plane. The average grade of cisterns per case demonstrated mostly excellent correlation between the imaging planes with Spearman correlation statistics (≥0.70). Pairwise concordance correlation coefficient of the total SAH score revealed agreement ranging from 0.81 to 0.90 in all three planes. Pearson correlation statistics of the average total SAH scores revealed excellent correlation among the three planes (≥0.91).

Conclusion

A simple quantitative SAH grading scale can be successfully applied to the supratentorial and infratentorial cisterns in three standard CT imaging planes.

Immune Checkpoint Inhibitors for Advanced Hepatocellular Carcinoma: Monotherapies and Combined Therapies

Hepatocellular carcinoma (HCC) is an important cause of cancer death and is considered the 3rd most lethal around the world. Hepatectomy, liver transplantation, and ablation therapy are considered curative treatments for early-stage HCC. Transarterial chemoembolization is the preferred therapy for intermediate stage HCC. Ssystemic therapy is recommended for advanced HCC. For more than a decade, sorafenib and lenvatinib were used as the first-line treatment for the advanced HCC. For the great success of immunotherapy in melanoma and lung cancer, some immune-based treatments, such as immune checkpoint inhibitors (ICIs), have been applied in the treatment of HCC. The anti-programmed cell death protein 1 (PD1) antibodies, including nivolumab and pembrolizumab, have been approved by the Food and Drug Administration for sorafenib-pretreated patients. Moreover, due to the results of durable antitumor responses attained from the phase 3 trials, atezolizumab in combination with bevacizumab is now the standard therapy for advanced HCC. Recently, there are a lot of clinical trials involving the ICIs, as monotherapy or combination therapy, with tyrosine kinase inhibitors, antiangiogenic drugs, cytotoxic agents, and locoregional treatments, providing a promising outcome for advanced HCC. Thus, this review summarized the role of ICIs for HCC patients with monotherapy or combination therapy. The success and failures of monotherapy and combination therapy involving ICIs have provided advanced insights into HCC treatment and led to novel avenues to improve therapy efficacy in HCC.

Tumor feeding artery contraction and metastasis inhibition after transarterial chemoembolization combined with apatinib for hepatocellular carcinoma: A propensity score matching study

AIM

To investigate the change of tumor feeding artery diameter and the efficacy of metastasis inhibition after transarterial chemoembolization (TACE) combined with apatinib or TACE monotherapy for patients with advanced hepatocellular carcinoma who without metastasis.

MATERIALS AND METHODS

A total of 616 consecutive patients who received the treatment of TACE-apatinib or TACE in our center was enrolled. Propensity score matching (PSM) analysis was used to reduce bias. The overall survival (OS), OS-after-metastasis (OSM), time to progression (TTP), time to metastasis (TTM), time to vessel or organ metastasis (TVOM), time to lymph node metastasis, and tumor feeding artery diameter between the two treatment groups were compared.

RESULTS

A total of 113 pairs of patients were eligible after the PSM. Time to lymph node metastasis between the two groups was not significantly different (P > 0.05). The tumor feeding artery diameter was significantly smaller after TACE-apatinib management (P < 0.001). Median OS (P < 0.001) and OSM (P < 0.001) were significantly longer in the TACE-apatinib group compared with the TACE group. Median TTP (P < 0.001), TTM (P < 0.001), and TVOM (P < 0.001) were significantly prolonged in TACE-apatinib group.

CONCLUSION

TACE-apatinib treatment could improve the prognosis compared with TACE alone, and inhibit metastasis after TACE procedure with contracted tumor feeding artery for advanced HCCs without metastasis.

Abstract P2-12-06: Pathological response-guided postoperative treatment strategy for positive HR/negative HER2 and positive lymphnodes breast cancer patients with non-responsive pathological results to neoadjuvant chemotherapy

Objective: No consensus up to date suggesting whether patients with positive HR/negative HER-2 and positive lymph nodes breast cancer should receive additional adjuvant chemotherapy following a poor response to neoadjuvant chemotherapy to acquire a better DDFS. The main aim of this trial is to compare the 5-year DDFS between additional adjuvant chemotherapy plus endocrine therapy group and endocrine alone group following 4 cycles neoadjuvant chemotherapy. Method: A multicenter, open-label, randomized, controlled, phase 3 trial was conducted. All patients enrolled in the study were HR+ HER2- LN+ breast cancer patients completing four cycles neoadjuvant chemotherapy, with a non-responsive pathological result to neoadjuvant chemotherapy. The non-responsive criterion was defined as Miller and Payne staging grade1 to grade 3, or any grade of Miller and Payne staging but residual positive lymph nodes were found in surgical specimen. All enrolled patients were randomly assigned to receive four cycles non-cross resistant regimen plus endocrine therapy, or endocrine therapy alone. The primary endpoint was DDFS, and the secondary endpoint was iDFS and OS. Result: From October 2010 to September 2018, a total of 391 patients were enrolled for eligibility. The final ITT analysis compromised 379 patients (187 in adjuvant chemotherapy plus endocrine therapy group, and 192 in endocrine therapy alone group). After a median follow-up of 72.4 months, the 5-year distant disease free survival estimate was 92% (95% CI 88-96) in the adjuvant chemotherapy group and 90% (86-94) in the endocrine therapy alone group (HR 0.79, 95% CI 0.45-1.37) (P=0.401). In the prespecified CEF subgroup, the 5-year DDFS was 94% (95% CI 90-98) in adjuvant chemotherapy group, and 91% (95% CI 87-94) in endocrine group (HR 0.68, 95% CI 0.36-1.30) (P=0.249). In the exploratory analysis, we found a better 5-year DDFS trend in adjuvant chemotherapy group in ypN+ patients in CEF subgroup (P=0.196). Conclusion: A better 5-year DDFS trend in additional adjuvant chemotherapy plus endocrine therapy can be found for patients with positive HR/negative HER-2 and positive lymph nodes following a poor response to neoadjuvant chemotherapy.

Citation Format: Yang Yang, Xue Chen, Zhaoqing Fan, Yingjian He, Yuntao Xie, Jinfeng Li, Tianfeng Wang, Tao Ouyang. Pathological response-guided postoperative treatment strategy for positive HR/negative HER2 and positive lymphnodes breast cancer patients with non-responsive pathological results to neoadjuvant chemotherapy [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P2-12-06.

Single-Center Experience With Endovascular Treatment for Splenic Artery Aneurysms in Long-Term Follow-Up: A Retrospective Study

Objectives

To reveal a single-center experience with endovascular treatment for splenic artery aneurysm (SAA) and analyze the safety and efficacy of the operation in the long-term follow-up.

Materials and Methods

A total of 49 patients with SAAs (21 men, 28 women; mean age, 52.4 ± 11.5 years) were enrolled in this study from July 2010 to December 2020. Baseline and characteristics of SAAs were collected. Parent artery coil embolization or combined with sac coil embolization of SAAs, graft-stent implantation, or bare-stent-assisted coil embolization were performed for the treatment of SAAs. Adverse events and follow-up data were recorded.

Results

The average diameter of SAAs was 3.3 ± 2.5 cm (range, 1.0–13.6 cm). An individual-tailed modality was conducted for three patients. A 100% technical success rate was achieved. No re-intervention procedure was performed in all patients. No major treatment-related adverse events were observed, and no expansion or rupture of SAAs occurred in the average follow-up period of 57.9 ± 27.3 months (19–125 months).

Conclusion

Endovascular treatment of SAA, including the individual-tailed therapy for three cases, is safe, effective, and minimally invasive with high technical success rates and satisfactory outcomes during the long-term follow-up period.

Multiplanar CT evaluation of aneurysm rupture signs in subarachnoid hemorrhage

PURPOSE

In subarachnoid hemorrhage, noncontrast CT features are used to guide the localization of ruptured aneurysms on CT angiography and DSA. Multiplanar CT may improve the localization of aneurysm rupture sites over axial plane CT alone.

METHODS

Multiplanar CT in three orthogonal planes was used to evaluate 94 cases of SAH. Two investigators independently evaluated each imaging plane for focal thick SAH with mass effect, intracerebral hemorrhage, focal edema, filling defect, subdural hemorrhage, and dominant intraventricular hemorrhage. Also, rupture site was qualitatively identified by combining these variables in each plane and combination of three planes. DSA served as the gold standard to locate the rupture sites.

RESULTS

Interobserver agreement was k 0.60 to 0.79 for axial, k 0.43 to 0.86 for coronal and k 0.43 to 0.74 for sagittal planes. Good to substantial agreement was observed for the localization of rupture site in three planes (focal SAH with mass effect - k 0.78 to 0.85; filling defect - k 0.95 to 1.0; intracerebral hemorrhage - k 1.0; focal edema k 1.0; subdural hemorrhage - k 0.61 to 0.83). Dominant intraventricular hemorrhage revealed significant association with DSA to locate ruptured aneurysms (Fisher's exact test - Pr <  = P (< 0.001)). With non-missing data, frequency of correct ratings to locate rupture site was 66/67 (99%) in axial plane, 59/66 (89%) in coronal plane, 64/67 (96%) in sagittal plane and 77/77 (100%) in combined 3 planes.

CONCLUSIONS

Multiplanar CT head is more successful than axial plane CT alone for the localization of aneurysm rupture sites in SAH.

Effect of Local Versus General Anesthesia in Breast-Conserving Surgery on Cancer Recurrence and Cost

Background

The association between the type of anesthesia used and the recurrence of cancer remains controversial. This study aimed to compare the effects of local vs general anesthesia on recurrence-free survival and cost after breast-conserving surgery.

Materials and Methods

We reviewed the data of 2778 patients who underwent breast-conserving surgery followed by radiation at our center between 1999 and 2014. We analyzed the data of 994 patients with hormone receptor-positive and Her2-negative tumors who underwent breast-conserving surgery without axillary lymph node dissection under local or general anesthesia. Patients were grouped according to whether local or general anesthesia was used for the surgery.

Results

Of the 994 patients enrolled in this study, 367 received local anesthesia and 627 patients received general anesthesia. The median follow-up duration for all patients was 93 months. The Kaplan–Meier survival curves did not reveal significant differences between the recurrence-free survival of the two groups, with 5-year recurrence-free survival rates of 96.3% (95% CI, 94.3–98.3%) in the local anesthesia group and 97.3% (95% CI, 95.9–98.7%) in the general anesthesia group. The total cost of hospitalization in the local anesthesia group was significantly lower than that in the general anesthesia group (P <.001). The difference in the cost between the two groups remained significant, irrespective of the type of hospitalization, after excluding 165 patients receiving chemotherapy during their hospitalization.

Conclusions

Our analysis indicated no association between the type of anesthesia used during breast-conserving surgery and the long-term prognosis of breast cancer. However, breast-conserving surgery under local anesthesia may be a less expensive option than that under general anesthesia.

Drug-Eluting Bead Transarterial Chemoembolization versus Conventional Transarterial Chemoembolization Both Combined Apatinib for Hepatocellular Carcinoma: A Retrospective, Propensity-Score Matched Study

Purpose

This study aims to compare the efficacy of drug-eluting bead transarterial chemoembolization (DEB-TACE) versus conventional TACE (cTACE), both combined with apatinib, and to establish predictive nomograms to support individualized survival prediction in hepatocellular carcinoma (HCC) patients.

Patients and Methods

This retrospective study assessed HCC patients from June 2015 to December 2019. Patients were classified as DEB-TACE plus apatinib (D-apatinib) and cTACE plus apatinib (c-apatinib). The endpoints were overall survival (OS) and progression-free survival (PFS). The nomograms were constructed, and the C-index, receiver operating characteristic (ROC) curve, and calibration curves were used to validate the nomograms. Propensity score matching (PSM) analysis was applied to reduce patient selection bias.

Results

A total of 174 patients were included. After PSM analysis, 58 pairs of patients were selected. Before PSM analysis, the median OS and PFS were 21.0 and 8.0 months in the D-apatinib group, respectively, which were better than the 18.0 and 5.0 months observed in the c-apatinib group (P < 0.05). The complete response (CR) rate and objective response rate (ORR) of the D-apatinib group were higher than those of the c-apatinib group. The C-index values of the nomograms in the D-apatinib group and the c-apatinib group were 0.826 and 0.802, and the area under the curve (AUC) values in the ROC curve were 0.934 and 0.892. After PSM analysis, the survival of patients treated with D-apatinib was better than that of patients treated with c-apatinib (P < 0.05). The C-index values were 0.854 and 0.794 in the D-apatinib group and the c-apatinib group, respectively, and the AUC values were 0.960 and 0.890. The incidence of adverse events was higher in the c-apatinib group.

Conclusion

DEB-TACE in combination with apatinib showed better treatment effectiveness for unresectable HCC. The nomograms can identify HCC patients who may benefit most from the treatment.

High-Throughput Screening of Two-Dimensional Planar sp2 Carbon Space Associated with a Labeled Quotient Graph

The configurational space of two-dimensional planar sp² carbon has been systematically scanned by a random strategy combined with group and graph theory, and 1114 new carbon allotropes have been identified. These allotropes are energetically more favorable than most of the previously predicted 120 carbon allotropes. By fitting the HSE06 band structures of six old structures, we optimize the parameters for a general and transferable tight-binding model for high-throughput band structure calculations. We identified that there are 190 Dirac semimetals, 241 semiconductors, and 683 normal metals among the new allotropes. Interestingly, several stable low-energy carbon systems with exotic electronic properties are proposed, such as type III, type I/II mixed, and type I/III mixed semimetals, which are very rare in planar carbon systems. In particular, one nodal-line semimetal has been discovered among these thousands of allotropes, which is the first nodal-line semimetal in sp² carbon systems. Our discoveries greatly enrich our knowledge of the structures and electronic properties of the two-dimensional carbon family.

Ultra-high thermal conductivities of tetrahedral carbon allotropes with non-simple structures

Pursuing high thermal conductivity is of great significance to enhance the performance and working stability of microelectronics in terms of efficient heat dissipation. Traditionally, ultra-high thermal conductivity is thought to exist only in simple crystals with few atoms in the primitive cell, such as diamond and boron arsenide, where the phonon-phonon scattering is weak. In this study, we report an innovation from conventional knowledge based on state-of-the-art first-principles calculations. It is found that the thermal conductivities of three carbon allotropes of C₃₂, C₃₆, and C₉₄ with non-simple structures can be as high as 1152.75, 1075.70, and 860.07 W m^-1 K^-1, respectively, despite a large number of atoms in the primitive cell. Through comparative analysis, it is revealed that there exist certain competitive mechanisms, where the weak phonon anharmonicity is found to dominate the high thermal conductivity. Our study not only uncovers excellent carbon-based candidates with ultra-high thermal conductivity for enhancing heat dissipation with potential applications in electronics, but also provides insights into the thermal transport, which will shed light on future studies.

Prognostic Value of Plasma Epstein-Barr Virus DNA Levels Pre- and Post-Neoadjuvant Chemotherapy in Patients With Nasopharyngeal Carcinoma

Background

In this study, we evaluated the prognostic value of the plasma levels of Epstein-Barr virus (EBV) DNA in patients with nasopharyngeal carcinoma (NPC) at different treatment stages.

Methods

We retrospectively analyzed the Data of 206 patients with NPC. Pre-neoadjuvant chemotherapy (pre-NACT), post-NACT, post-radiotherapy, and post-treatment plasma EBV DNA levels were used to establish prognostic nomograms. The concordance index (C-index) and calibration curves were used to compare the prognostic accuracy of the nomograms. The results were confirmed in a validation cohort consisting of patients who were tested for EBV DNA levels at all four stages of treatment. The Kaplan-Meier method was used to calculate the progression-free survival (PFS) and overall survival (OS). Survival differences were calculated using the log-rank test.

Results

EBV DNA-positive patients had worse 3-year PFS and 5-year OS than EBV DNA-negative patients; this was true for pre-NACT (PFS: 82.7% vs. 57.3%, P < 0.001; OS: 90.9% vs. 68.7%, P = 0.08) and post-NACT (PFS: 85.0% vs. 50.6%, P < 0.001; OS: 91.7% vs. 65.7%; P = 0.001) EBV DNA levels but not for post-radiotherapy (PFS: 72.2% vs. 60.9%, P = 0.192; OS: 73.1% vs. 77.2%, P = 0.472) or post-treatment (PFS: 77.3% vs. 59.2%, P = 0.063; OS: 77.5% vs. 79.7%, P = 0.644) levels. Nomograms combining pre-NACT and post-NACT EBV DNA levels had a superior prognostic ability than those of post-radiotherapy and post-treatment EBV DNA levels.

Conclusion

Pre-NACT EBV DNA levels combined with post-NACT EBV DNA levels can more reliably predict survival outcomes in patients with NPC.

Unique Arrangement of Atoms Leads to Low Thermal Conductivity: A Comparative Study of Monolayer Mg2C

Two-dimensional Mg₂C, one of the typical representative MXene materials, is attracting lots of attention due to its outstanding properties. In this study, we find the thermal conductivity of monolayer Mg₂C is more than 2 orders of magnitude lower than graphene and is even lower than MoS₂ despite the relatively lighter atoms of Mg and C. Based on the comparative analysis with graphene, silicene, and MoS₂, the underlying mechanism is found lying in the unique arrangement of atoms (lighter atoms in the middle plane) and large electronegativity difference in Mg₂C. The phonon anharmonicity is strong due to the resonant bonding. In addition, dual band gaps emerge in the phonon dispersion of Mg₂C, which limit the phonon-phonon scattering and reduce the phonon relaxation time. This study reveals a new mechanism responsible for low thermal conductivity, which would be helpful for designing thermal functional materials and pave the way for applications in thermoelectrics.

Transcriptome analysis of host response to porcine epidemic diarrhea virus nsp15 in IPEC-J2 cells

BACKGROUND

Porcine epidemic diarrhea virus (PEDV) is an enveloped positive-sense ssRNA virus which is highly lethal to piglets, causing enormous economic losses to swine industry worldwide. Nsp15 protein is an endoribonuclease of PEDV and plays an indispensable role in the viral proliferation. We reported the transcription files of nsp15 transfected IPEC-J2 cells for the first time to broaden our understanding of PEDV pathogenesis.

METHODS

RNA-seq was performed to compare gene expression profiles between pCAGGS-HA-nsp15 transfected IPEC-J2 cells and pCAGGS-HA (empty vector) transfected IPEC-J2 cells. Immune-related genes and pathways were identified and analyzed to deepen our understanding of nsp15 for PEDV pathogenicity. IPEC-J2 cells transfected with pCAGGS-HA-CCL5/CXCL8/CXCL10 were infected with CV777 and the virus load of PEDV was detected by qRT-PCR.

RESULTS

A total of 21,654 genes were obtained by RNA-Seq and 415 differential expressed genes (DEGs) were identified, including 136 up-regulated and 279 down-regulated genes. A number of effect genes involved in immune responses and inflammation were differentially expressed. GO and KEGG enrichment analysis showed that 32 GO terms were significantly enriched and the DEGs were mainly enriched in immune-related pathways such as TNF signaling pathway, RIG-I-like receptor signaling pathway and Cytosolic DNA-sensing pathway. qRT-PCR results indicated the overexpression of selected chemokines, CCL5/CXCL8/CXCL10, can inhibit PEDV proliferation in IPEC-J2 cells.

CONCLUSIONS

Our transcriptome profile illustrated a number of genes involving in immune responses and inflammation were inhibited by nsp15, such as CCL5, CXCL8, CXCL10, OAS, MXs, STAT1 and IRF9. The results suggested that nsp15 can antagonize IFNs and block chemokine system to provide an adequate intracellular environment for viral proliferation.

Correction: Ultra-high thermal conductivities of tetrahedral carbon allotropes with non-simple structures

Correction for 'Ultra-high thermal conductivities of tetrahedral carbon allotropes with non-simple structures' by Qiang Chen et al., Phys. Chem. Chem. Phys., 2021, DOI: 10.1039/d1cp02347k.

New Two-Dimensional Wide Band Gap Hydrocarbon Insulator by Hydrogenation of a Biphenylene Sheet

Based on first-principles calculations, the ground state configuration (Cmma-CH) of a hydrogenated biphenylene sheet ( Science 2021, 372, 852) is carefully identified from hundreds of possible candidates generated by RG² code ( Phys. Rev. B. 2018, 97, 014104). Cmma-CH contains four inequivalent benzene molecules in its crystalline cell due to its Cmma symmetry. Hydrogen atoms bond to carbon atoms in each benzene with a boat-like (DDUDDU) up/down sequence and reversed boat-1 (UUDUUD) sequence in adjacent benzene rings. Cmma-CH is energetically less stable than the proposed allotropes of hydrogenated graphene, but the formation energy for hydrogenating a biphenylene sheet is remarkably lower than that for hydrogenating graphene to graphane. Our results of mechanical and dynamical stability also confirm that Cmma-CH is a stable 2D hydrocarbon, which is expected to be realized experimentally. Especially, biphenylene undergoes a transition from normal metal to a wide band gap insulator (4.645 eV) by hydrogenation to Cmma-CH, which has potential applications in nanodevices at elevated temperatures and high voltages.

Tunable topologically nontrivial states in newly discovered graphyne allotropes: from Dirac nodal grid to Dirac nodal loop

By means of quotient-graph associated crystal prediction method, a new graphyne allotrope with unique Dirac nodal grid state is reported in this work. It is named as 191-E24Y24-1 according to its hexagonal lattice (with P6/mmm symmetry, No. 191) containing 24 sp²-hybridized carbon atoms and 24 sp-hybridized ones. The first-principles results show that the total energy of 191-E24Y24-1 is more favorable than that of recent synthesizedβ-graphdiyne and carbon ene-yne. It is also demonstrated to be dynamically, thermally, and mechanically stable. Interestingly, the 191-E24Y24-1 harbors intrinsic semimetal features showing intriguing hexagonal Dirac nodal grid state in the reciprocal space. Such unique electronic state is stable against small external tensile strains, and it is tunable under compression strains which will transform to new triangle Dirac nodal grid state. Moreover, a new metastable graphyne allotrope named 191-E12Y36-4 with Dirac nodal loop state is also observed in the process of stretching 191-E24Y24-1 with large tensile strains. The results presented in this work reveal two novel graphyne allotropes with exotic electronic properties. These discoveries are not only physical interesting, but also provide potential material candidates for carbon-based high performance electronic nanodevices.

Sorafenib Versus Apatinib Both Combined Transarterial Chemoembolization for Hepatocellular Carcinoma With Portal Vein Tumor Thrombosis: A Comparative Retrospective Study

Objective

To compare the efficacy and safety of transarterial chemoembolization (TACE) combining with sorafenib or apatinib for hepatocellular carcinoma (HCC) patients with portal vein tumor thrombosis (PVTT).

Methods

From June 2015 to March 2020, a total of 89 consecutive advanced HCC patients with PVTT who were treated with sorafenib-TACE (S-TACE) or apatinib-TACE (A-TACE) in our center were enrolled. The overall survival (OS), time to progression (TTP), tumor response, and adverse events in the two groups were compared.

Results

There were 32 and 41 patients included in the S-TACE group and A-TACE group, respectively. The median follow-up was 10.0 months (range, 3.0–36.0 months) in the whole study. The median OS (11.0 vs. 10.0 months, P = 0.419), median TTP (5.0 vs. 6.0 months, P = 0.073), and tumor response (P = 0.529) between the S-TACE group and the A-TACE group were not significantly different. The adverse events related to sorafenib or apatinib were tolerable.

Conclusion

S-TACE and A-TACE exhibited comparable prognosis for HCC patients with PVTT, which provide another effective and safe method of A-TACE for these patients except for conventional S-TACE.

Efficacy of apatinib in patients with sorafenib-transarterial chemoembolization refractory hepatocellular carcinoma: a retrospective study

PURPOSE

To investigate the efficacy of sequential apatinib treatment in patients with unresectable hepatocellular carcinoma (HCC) refractory to sorafenib-transarterial chemoembolization (TACE).

MATERIALS AND METHODS

This respective study was conducted on 95 consecutive patients with sorafenib-TACE-refractory unresectable HCC in our center from January 2014 to December 2019. According to the response to sorafenib-TACE treatment and the subsequent management, the eligible patients were assigned into three groups: sorafenib-TACE (ST) group, sorafenib-TACE-apatinib (STA) group, and sorafenib-TACE-supportive care (STS) group. The differences in overall survival (OS) and tumor response were compared among the three groups. Risk factors related to prognosis were analyzed.

RESULTS

A total of 58 patients were enrolled in the study, with 11, 15, and 28 patients in ST, STA, and STS group, respectively. The median OS of the STA group was significantly improved when compared with the STS group, either from the start of sorafenib-TACE resistance or the initiation of sorafenib-TACE therapy (14.0 versus 4.0 months, p = 0.003; 19.0 versus 9.0 months, p < 0.001; respectively). Additionally, from the start of sorafenib-TACE treatment, the median OS of the STA group was longer than that of the ST group without statistical difference (19.0 versus 15.0 months, p = 0.28), so did the comparison of median OS between the ST group and the STS group (15.0 versus 9.0 months, p = 0.06). Extrahepatic metastases were an independent risk factor for poor prognosis.

CONCLUSION

In patients with sorafenib-TACE-refractory HCC, subsequent apatinib treatment significantly improved the OS when compared with supportive care, and produced comparative outcomes with those sorafenib-TACE responders.

[Effect of axillary lymph node status on prognosis of different types of invasive breast cancer]

Objective: To investigate the effect of axillary lymph node status on the prognosis of different types of invasive breast cancer. Methods: Patients with invasive breast cancer of different molecular subtypes diagnosed in the breast cancer prevention and treatment center of Beijing Cancer Hospital from January 2000 to July 2011 were collected as a historical cohort, and the influence of lymph node status on the prognosis of different types of breast cancer was analyzed. Results: A total of 4 269 female breast cancer patients with molecular subtypes [aged (50.8±11.2) years] information and 3 824 female breast cancer patients with complete axillary lymph node status information [aged (50.5±10.9) years] were included in the study, including 3 135 cases with both molecular subtypes and lymph node status information. The 10-year event free survival (EFS) rates of hormone receptor (HR)⁺/human epidermal growth factor receptor-2(HER2)^-, HR^-/HER2^-and HER2⁺were 82.2%, 79.0% and 76.8%, respectively; the 10-year overall survival (OS) rates were 88.1%, 83.1% and 84.4%, respectively, and the differences of 3 molecular subtypes in EFS and OS were statistically significant (both P<0.001). The 10-year EFS rate of lymph node positive and negative patients was 68.8% and 88.2%, respectively; the 10-year OS rate was 76.7% and 92.5%, respectively, and the differences of lymph node status in EFS and OS were statistically significant (both P<0.001). In lymph node negative subgroup, 3 subtypes showed similar EFS and OS rate (both P>0.05); In lymph node positive subgroup, 3 subtypes showed significantly different EFS and OS (both P<0.05). No modification effect was detected of lymph node status on the correlation of molecular subtypes and EFS, DDFS and OS(all P_interactive>0.1). Conclusions: Different molecular subtypes of breast cancer have different prognosis. Compared with molecular subtype, lymph node status may be a more important prognostic factor.

Type-II lateral SnSe/GeTe heterostructures for solar photovoltaic applications with high efficiency

Recently, lateral heterostructures based on two-dimensional (2D) materials have provided new opportunities for the development of photovoltaic nanodevices. In this work, we propose a novel lateral SnSe/GeTe heterostructure (LHS) with high photovoltaic performance and systematically investigate the structural, electronic and optical properties of the lateral heterostructure by using first-principles calculations. Our results show that this type of heterostructure processes excellent stability due to the small lattice mismatch and formation energy and also covalent bonding at the interface, which is greatly beneficial for the epitaxial growth of heterostructures. These heterostructures are semiconductors with type-II band alignment and their electronic properties can be effectively tuned by the size and composition ratio of the heterostructures. More importantly, it is found that these heterostructures possess high absorption over a wide range of visible light and high power conversion efficiency (up to 22.3%). These extraordinary properties make the SnSe/GeTe lateral heterostructures ideal candidates for photovoltaic applications.

Impact of dose-dense neoadjuvant chemotherapy on pathologic response and survival for HER2-positive breast cancer patients who receive trastuzumab

To compare outcomes in patients with human epidermal growth factor receptor-2 (HER2)-positive breast cancer who received either dose-dense neoadjuvant chemotherapy (NAC) with trastuzumab or standard-interval chemotherapy with trastuzumab. Patients with HER2-positive breast cancer who received NAC, including epirubicin and cyclophosphamide followed by paclitaxel with trastuzumab were included. Patients were divided into either the dose-dense or standard-interval group. We compared pathologic complete remission (pCR), distant disease-free survival (DDFS), event-free survival (EFS), and breast cancer-specific survival (BCSS) between the two groups. Two hundred (49.6%) patients received dose-dense NAC, and 203 (50.4%) received standard-interval NAC. The pCR rate was 38.4% in the dose-dense group and 29.2% in the standard-interval group (P = 0.052). In patients with lymph node (LN) metastases, the LN pCR rate was 70.9% in the dose-dense group and 56.5% in the standard-interval group (P = 0.037). After a median follow-up of 54.6 months, dose-dense chemotherapy presented an improvement on DDFS (hazard ratio [HR] = 0.49, 95% confidence interval [CI]: 0.19–1.28, EFS (HR = 0.54, 95% CI: 0.24–1.21), and BCSS (HR = 0.41, 95% CI: 0.11–1.51), but the difference was not significant. Compared with standard-interval chemotherapy, dose-dense chemotherapy resulted in a superior 5-year DDFS (100% vs. 75.3%, P = 0.017) and 5-year EFS (96.9% vs. 78.3%, P = 0.022) in patients younger than 40 years. HER2-positive patients can achieve a higher LN pCR rate with dose-dense NAC than with standard-interval NAC with trastuzumab. Better survival may also be achieved with dose-dense chemotherapy with trastuzumab than with standard-interval chemotherapy with trastuzumab among young patients (age ≤ 40 years).

Treatment-Related Serious Adverse Events of Immune Checkpoint Inhibitors in Clinical Trials: A Systematic Review

Background

Immune Checkpoint Inhibitors (ICI) have been progressively used in cancer treatment and produced unique toxicity profiles. This systematic review aims to comprehend the patterns and occurrence of treatment-related adverse events (trAEs) based on ICI.

Methods

PICOS/PRISMA methods were used to identify published English-language on PubMed, Web of Science, and Scopus from 2015 to 2020. Published clinical trials on ICI monotherapy, combined ICIs, and ICI plus other treatment with tabulated data on grade≥3 trAEs were included. Odds ratio (OR), χ² tests were used to analyze for effect size and associations.

Results

This review included 145 clinical trials involving 21786 patients. Grade 3-5 trAEs were more common with ICI when they were plused with other treatments compared with ICI monotherapy(54.3% versus 17.7%, 46.1%, p<0.05). Grade 3-5 trAEs were also more common with CTLA-4 mAbs compared with anti-PD-1 and anti-PD-L1 (34.2% versus 15.1%, 13.6%, p<0.05). Hyperthyroidism (OR 3.8, 95%CI 1.7–8.6), nausea (OR 3.7, 95%CI 2.5–5.3), diarrhea (OR 2.7, 95%CI 2.2–3.2), colitis (OR 3.4, 95%CI 2.7–4.3), ALT increase (OR 4.9, 95%CI 3.9–6.1), AST increase (OR 3.8, 95%CI 3.0–4.9), pruritus (OR 2.4, 95%CI 1.5–3.9), rash (OR 2.8, 95%CI 2.1–3.8), fatigue (OR 2.8, 95%CI 2.2–3.7), decreased appetite (OR 2.4, 95%CI 1.5–3.8), and hypophysitis (OR 2.0, 95%CI 1.2–3.3) were more frequent with combined ICIs. Diarrhea (OR 8.1, 95%CI 6.4–10.3), colitis (OR 12.2, 95%CI 8.7–17.1), ALT increase (OR 5.1, 95%CI 3.5–7.4), AST increase (OR 4.2, 95%CI 2.8–6.3), pruritus (OR 4.1, 95%CI 2.0–8.4), rash (OR 4.4, 95%CI 2.9–6.8), hypophysitis (OR 12.1, 95%CI 6.3–23.4) were more common with CTLA-4 mAbs; whereas pneumonitis (OR 4.7, 95% CI 2.1–10.3) were more frequent with PD-1 mAbs.

Conclusions

Different immune checkpoint inhibitors are associated with different treatment-related adverse events profiles. A comprehensive data in this systematic review will provide comprehensive information for clinicians.

The efficacy of radiofrequency ablation versus cryoablation in the treatment of single hepatocellular carcinoma: A population-based study

BACKGROUND

Radiofrequency ablation (RFA) is an effective treatment for single hepatocellular carcinoma (HCC), but it is difficult to use against tumors in some locations and often leads to incomplete ablation as a result of the heat-sink effect. This study was conducted to evaluate the efficacy of cryoablation compared with that of RFA in the treatment of single HCC.

METHODS

This retrospective study was conducted based on the Surveillance, Epidemiology, and End Results (SEER) database. From 2004 to 2015, patients aged 40 to 79 diagnosed with HCC were included in the study. A propensity score matching (PSM) model was used to reduce selection biases.

RESULTS

Before PSM, the median overall survival (mOS) and median cancer-specific survival (mCSS) in the RFA group were slightly longer than those in the cryoablation group (p > 0.05). In the subgroup analysis, the mOS and mCSS of patients with tumor sizes <3, 3-5, and >5 cm who received RFA treatment were longer than those of patients given cryoablation treatment, but there was no significant difference (p > 0.05). Similar results were presented in patients at American Joint Committee on Cancer (AJCC) stages I and II. After PSM, the mOS and mCSS were slightly better in the RFA group than the cryoablation group but without significant differences. Univariate and multivariate analysis showed that cryoablation treatment was not an unfavorable factor for OS and CSS before or after PSM (p > 0.05). In the multivariable competing risk model, non-cancer-specific death was taken as a competing factor and cryoablation was also not unfavorable for the survival of patients before and after PSM (p > 0.05).

CONCLUSION

Cryoablation is non-inferior to RFA therapy for single HCC patients without lymph node invasion or distant metastasis.

Novel Japanese encephalitis virus NS1-based vaccine: Truncated NS1 fused with E. coli heat labile enterotoxin B subunit

BACKGROUND

Current vaccines against Japanese encephalitis virus (JEV) of flaviviruses have some disadvantages, such as the risk of virulent reversion. Non-structural protein NS1 is conserved among flaviviruses and confers immune protection without the risk of antibody-dependent enhancement (ADE). Therefore, NS1 has become a promising vaccine candidate against flaviviruses.

METHODS

A NS1-based vaccine (LTB-NS1_∆63) with a truncated NS1 protein (NS1_∆63) fused to E. coli heat-labile enterotoxin B subunit (LTB) was expressed in E.coli and explored for its ability to induce immune responses. Safety of LTB-NS1_∆63 was assessed by determining its toxicity in vitro and in vivo. Protective capability of LTB-NS1_∆63 and its-induced antisera was evaluated in the mice challenged with JEV by analyzing mortality and morbidity.

FINDINGS

LTB-NS1_∆63 induced immune responses to a similar level as LTB-NS1, but more robust than NS1_∆63 alone, particularly in the context of oral immunization of mice. Oral vaccination of LTB-NS1_∆63 led to a higher survival rate than that of NS1_∆63 or live-attenuated JEV vaccine SA14-14-2 in the mice receiving lethal JEV challenge. LTB-NS1_∆63 protein also significantly decreases the morbidity of JEV-infected mice. In addition, passive transfer of LTB-NS1_∆63-induced antisera provides a protection against JEV infection in mice.

INTERPRETATION

NS1_∆63 bears JEV NS1 antigenicity. Besides, LTB-NS1_∆63 could serve as a novel protein-based mucosa vaccine targeting JEV and other flaviviruses.

FUNDING

This work was supported by the National Natural Science Foundation, Jiangxi Province Science and Technology Committee, Education Department of Jiangxi Province.

Machine Learning Models to Improve the Differentiation Between Benign and Malignant Breast Lesions on Ultrasound: A Multicenter External Validation Study

Purpose

This study aimed to establish and evaluate the usefulness of a simple, practical, and easy-to-promote machine learning model based on ultrasound imaging features for diagnosing breast cancer (BC).

Materials and Methods

Logistic regression, random forest, extra trees, support vector, multilayer perceptron, and XG Boost models were developed. The modeling data set of 1345 cases was from a tertiary class A hospital in China. The external validation data set of 1965 cases were from 3 tertiary class A hospitals and 2 primary hospitals. The area under the receiver operating characteristic curve (AUC) was used as the main evaluation index, and pathological biopsy was used as the gold standard for evaluating each model. Diagnostic capability was also compared with that of clinicians.

Results

Among the six models, the logistic model showed superior diagnostic efficiency, with an AUC of 0.771 and 0.906 and Brier scores of 0.181 and 0.165 in the test and validation sets, respectively. The AUCs of the clinician diagnosis and the logistic model were 0.913 and 0.906. Their AUCs in the tertiary class A hospitals were 0.915 and 0.915, respectively, and were 0.894 and 0.873 in primary hospitals, respectively.

Conclusion

The externally validated logical model can be used to distinguish between malignant and benign breast lesions in ultrasound images. Compared with clinician diagnosis, the logistic model has better diagnostic efficiency, making it potentially useful to assist in screening, particularly in lower level medical institutions.

Trial Registration

http://www.clinicaltrials.gov. ClinicalTrials.gov ID: NCT03080623.

Improved photovoltage of printable perovskite solar cells via Nb5+ doped SnO2 compact layer

The state-of-the-art perovskite solar cells (PSCs) with SnO₂ electron transporting material (ETL) layer displays the probability of conquering the low electron mobility and serious leakage current loss of the TiO₂ ETL layer in photoelectronic devices. The rapid development of SnO₂ ETL layer has brought perovskite efficiencies >20%. However, high density of defect states and voltage loss of high temperature SnO₂ are still latent impediment for the long-term stability and hysteresis effect of photovoltaics. Herein, Nb⁵⁺ doped SnO₂ with deeper energy level is utilized as a compact ETL for printable mesoscopic PSCs. It promotes carrier concentration increase caused by n-type doping, assists Fermi energy level and conduction band minimum to move the deeper energy level, and significantly reduces interface carrier recombination, thus increasing the photovoltage of the device. As a result, the use of Nb⁵⁺ doped SnO₂ brings high photovoltage of 0.92 V, which is 40 mV higher than that of 0.88 V for device based on SnO₂ compact layer. The resulting PSCs displays outstanding efficiency of 13.53%, which contains an ∼10% improvements compared to those without Nb⁵⁺ doping. Our study emphasizes the significance of element doping for compact layer and lays the groundwork for high efficiency PSCs.

Comparison of Survival After Breast-Conserving Therapy vs Mastectomy Among Patients With or Without the BRCA1/2 Variant in a Large Series of Unselected Chinese Patients With Breast Cancer

IMPORTANCE

Whether patients with breast cancer who carry a BRCA1/2 variant can safely undergo breast-conserving therapy (BCT) remains controversial.

OBJECTIVE

To compare survival rates after BCT vs mastectomy in BRCA1/2 variant carriers and noncarriers in a large series of unselected patients with breast cancer.

DESIGN, SETTING, AND PARTICIPANTS

In this cohort study, a large consecutive series of 8396 unselected patients with primary breast cancer underwent either BCT, mastectomy with radiotherapy, or mastectomy alone from October 1, 2003, to May 31, 2015, at the Breast Center of Peking University Cancer Hospital in China. All patients were assessed for BRCA1/2 germline variant status. Statistical analysis was performed from May 1 to September 30, 2020.

MAIN OUTCOMES AND MEASURES

The primary outcomes were breast cancer-specific survival (BCSS) and overall survival (OS); secondary outcomes included recurrence-free survival, distant recurrence-free survival, and ipsilateral breast tumor recurrence.

RESULTS

Of these 8396 Chinese patients (8378 women [99.8% women]; mean [SD] age, 50.8 [11.4] years; 187 BRCA1 carriers, 304 BRCA2 carriers, and 7905 noncarriers), 3135 (37.3%) received BCT, 1511 (18.0%) received mastectomy with radiotherapy, and 3750 (44.7%) received mastectomy alone. After a median follow-up of 7.5 years (range, 0.3-16.6 years), both BRCA1 and BRCA2 variant carriers treated with BCT had similar rates of survival compared with those treated with mastectomy with radiotherapy (BCSS: hazard ratio [HR] for BRCA1, 0.58 [95% CI, 0.16-2.10]; P = .41; HR for BRCA2, 0.46 [95% CI, 0.15-1.41]; P = .17; OS: HR for BRCA1, 0.61 [95% CI, 0.18-2.12]; P = .44; HR for BRCA2, 0.72 [95% CI, 0.26-1.96]; P = .52) or mastectomy alone (BCSS: HR for BRCA1, 0.70 [95% CI, 0.22-2.20]; P = .54; HR for BRCA2, 0.59 [95% CI, 0.18-1.93]; P = .39; OS: HR for BRCA1, 0.77 [95% CI, 0.27-2.21]; P = .63; HR for BRCA2, 0.62 [95% CI, 0.22-1.73]; P = .37) after adjusting for clinicopathologic factors and adjuvant therapy. For noncarriers, patients receiving BCT had significantly better survival than those receiving mastectomy with radiotherapy (BCSS: HR, 0.45 [95% CI, 0.36-0.57]; P < .001; OS: HR, 0.46 [95% CI, 0.37-0.58]; P < .001) or mastectomy alone (BCSS: HR, 0.71 [95% CI, 0.57-0.89]; P = .003; OS: HR, 0.71 [95% CI, 0.58-0.87]; P < .001) in multivariable analyses.

CONCLUSIONS AND RELEVANCE

This study suggests that BRCA1/2 variant carriers treated with BCT have survival rates at least comparable to those treated with mastectomy with radiotherapy or mastectomy alone and that BCT could be an option for BRCA1/2 variant carriers when the tumor is clinically appropriate for BCT.

Single-Cell RNA Sequencing Reveals the Cellular Origin and Evolution of Breast Cancer in BRCA1 Mutation Carriers

The cell of origin and the development of breast cancer are not fully elucidated in BRCA1 mutation carriers, especially for estrogen receptor (ER)-positive breast cancers. Here, we performed single-cell RNA sequencing (RNA-seq) on 82,122 cells isolated from the breast cancer tissues and adjacent or prophylactic normal breast tissues from four BRCA1 mutation carriers and three noncarriers. Whole-exome sequencing was performed on breast tumors from the four BRCA1 mutation carriers; for validation, bulk RNA-seq was performed on adjacent normal breast tissues from eight additional BRCA1 mutation carriers and 14 noncarriers. Correlation analyses suggested that breast cancers in BRCA1 mutation carriers might originate from luminal cells. The aberrant luminal progenitor cells with impaired differentiation were significantly increased in normal breast tissues in BRCA1 mutation carriers compared with noncarriers. These observations were further validated by the bulk RNA-seq data from additional BRCA1 mutation carriers. These data suggest that the cell of origin of basal-like breast tumors (ER^neg) in BRCA1 mutation carriers might be luminal progenitor cells. The expression of TP53 and BRCA1 was decreased in luminal progenitor cells from normal breast tissue in BRCA1 mutation carriers, which might trigger the basal/mesenchymal transition of luminal progenitors and might result in basal-like tumor development. Furthermore, ER^high luminal tumors might originate from mature luminal cells. Our study provides in-depth evidence regarding the cells of origin of different breast cancer subtypes in BRCA1 mutation carriers. SIGNIFICANCE: Single-cell RNA-seq data indicate that basal-like breast cancer (ER^neg) might originate from luminal progenitors, and ER^high luminal breast cancer might originate from mature luminal cells in BRCA1 mutation carriers.

High stability of photovoltaic cells with phenethylammonium iodide-passivated perovskite layers and printable copper phthalocyanine-modified carbon electrodes

Defects caused by the structural disorder of perovskites and voltage loss resulting from mismatched band structure are important issues to address to improve the performance of carbon-based perovskite solar cells. Different from the conventional approaches of additive-based passivation of perovskite precursors and introducing a hole-transport layer between the perovskite layer and carbon electrode, herein we report a defect-healing method using phenethyl ammonium iodide (PEAI) treatment and band-structure modification using high-work-function inorganic copper phthalocyanine (CuPc). Because of its relatively smoother surfaces and lower defect content, the optimized device after PEAI-based passivation of the perovskite achieves a power conversion efficiency (PCE) of 11.74%. The PCE is further raised to 13.41% through the auxiliary energy-level matching and high hole extraction abilities of the CuPc-modified carbon electrode. The best-performing device exhibits excellent moisture tolerance and thermal stability with minor current density-voltage hysteresis.

miR-21 inhibition reverses doxorubicin-resistance and inhibits PC3 human prostate cancer cells proliferation

Many approaches have been examined to reversing multidrug resistance (MDR), but sub-optimal target-based strategies have limited their efficacy. Herein, we investigate microRNA (miR-21) suppression on the doxorubicin (DOX)-sensitisation of the DOX-resistant (PC3/DOX) cell line in prostate cancer (PCa). Expression levels of miR-21, P-glycoprotein (P-gp), MDR-1 and PTEN evaluated in PC3/DOX cancer cells by qRT-PCR and western blot analyses. The cytotoxic effects of transfected of miR-21 were assessed by MTT assay for 72 hr. Rhodamine123 (Rh123) assay was employed to define the activity of P-gp. Apoptosis was detected by Flow cytometry. As expected, miR-21 was expressed highly in PC3/DOX cells (p < 0.05). It was shown that miRNA-21 suppression considerably hindered PC3/DOX cell viability. miR-21 suppression dramatically downregulated P-gp expression and activity in DOX-resistance cells and abolished MDR by an increment of intracellular accumulation of DOX in PC3/DOX cells (p < 0.05). PTEN is a key modulator of the PI3K/Akt/P-gp cascade, which miR-21 suppression led to the upregulation of PTEN and sequentially lower-expression of P-gp that reversed MDR. Also, miR-21 repression enhanced the apoptosis rate of PC3/DOX cells. The findings of this paper contribute to the current understanding of the functions of miR-21 in MDR-reversing in PCa.

[Long-term recurrence rate and survival in different aged patients with breast cancer undergoing breast conserving therapy]

Objective: To examine the difference of long-term recurrence rate and survivals between the young patients and the old patients undergoing breast conserving therapy (BCT). Methods: Women with primary invasive breast cancer receiving BCT between December 1999 and December 2014 were selected retrospectively from the database of Breast Cancer Center, Peking University Cancer Hospital & Institute. The median age of all patients was 47 years (range: 21 to 91 years). The cases were categorized according to age at diagnosis into two subgroups: the ≤40 years group and the>40 years group. A total of 2 778 patients were included: 677 patients in the ≤40 years group and 2 101 patients in the >40 years group. Clinicopathological characteristics between two groups were compared. The recurrence rate and survival were calculated using the Kaplan-Meier method. The differences of outcomes were compared in different aged groups using the Log-rank test. Factors affecting local recurrence, distant disease-free survival (DDFS), disease-free survival (DFS), and breast cancer-specific survival (BCSS) were assessed by multivariable Cox proportional hazard models. Results: Proportions of T1 (301/677 vs. 1 160/2 101, χ²=37.660, P<0.01), involved lymph node (314/677 vs. 713/2 101, χ²=34.966, P<0.01) hormone receptor-negative (490/677 vs. 1 581/2 101, χ²=6.981, P=0.030) and neoadjuvant chemotherapy (413/677 vs. 1 010/2 101, χ²=34.272,P<0.01)in the ≤40 years group were higher than that in the>40 years group. Median follow-up duration was 102 months. No significant difference in 10-year local recurrence was found between the two groups (2.5% vs. 1.6%, P=0.147). Ten-year DDFS rate in the ≤40 years group and in the>40 years group was 90.6% and 95.3%, respectively (P<0.01). Ten-year DFS rate in the ≤40 years group and in the>40 years group was 86.5% and 91.1%, respectively (P=0.001). Ten-year BCSS rate in the ≤40 years group and in the >40 years group was 91.0% and 93.7%, respectively (P=0.105). Age was not the prognosis factor of local recurrence. Lymph node status (positive vs. negative: HR=2.73, 95%CI: 1.94 to 3.84, P<0.01), age (≤40 years vs.>40 years: HR=1.73, 95%CI: 1.24 to 2.42, P=0.001) and T stage (>2 cm vs. ≤2 cm: HR=1.61, 95%CI: 1.14 to 2.28, P=0.001) were the prognosis factors of DDFS, and also for DFS. Hormone receptor status (positive vs. negative: HR=0.54, 95%CI: 0.39 to 0.74, P<0.01), lymph node status (positive vs. negative: HR=2.94, 95%CI: 2.12 to 4.07, P<0.01) and T stage (>2 cm vs. ≤2 cm: HR=1.45, 95%CI: 1.05 to 2.01, P=0.025) were the prognosis factors of BCSS. Conclusions: The risk of local recurrence was similar between ≤40 years patient and >40 years patients receiving breast conserving therapy. Worse survivals in the ≤40 years group were found comparing to those in the >40 years group.

Newly discovered graphyne allotrope with rare and robust Dirac node loop

Two-dimensional (2D) carbon allotropes with topologically nontrivial states are drawing considerable attention owing to their unique physical properties and great potential applications in the next generation of micro-nano devices. In contrast to the numerous Dirac points predicted in 2D carbon allotropes, systems featuring Dirac nodal lines (loops) are still quite rare. Here, by means of first-principles calculation, we report our newly discovered carbon monolayer 123-E8Y24-1 with robust Dirac nodal line states, which possesses a tetragonal lattice with P4/mmm symmetry and contains 8 sp² carbon atoms (graphene: E8) and 24 sp carbon atoms (grapheyne: Y24) in the crystalline cell. This 2D material is as energetically stable as the recently experimentally synthesized β-graphdiyne, and it is further predicted to be dynamically, mechanically, and also thermodynamically stable. Owing to its intrinsic geometric characteristics, 123-E8Y24-1 also exhibits obvious Young's modulus anisotropy, with a sizable ratio between the maximum and minimum value of up to 5.8. Remarkably, 123-E8Y24-1 presents a semimetal nature and possesses Dirac nodal line states in the electronic band structure, and such behavior could be kept well under external strain between -10.0% and 8.0%. The electronic properties of 123-E8Y24-1 can be carefully confirmed by constructing a tight-binding (TB) model. The findings presented in this paper reveal a novel 2D Dirac nodal loop carbon sheet, providing a new candidate for carbon-based high-speed electronic devices.

Two-Dimensional Carbon Allotropes and Nanoribbons based on 2,6-Polyazulene Chains: Stacking Stabilities and Electronic Properties

The previously predicted phagraphene [Wang et al., Nano Lett. 15, 6182 (2015)] and a recently proposed TPH-graphene have been synthesized from fusion of 2,6-polyazulene chain (5-7 chain) in a recent experiment [Fan et al., J. Am. Chem. Soc., 141, 17713 (2019)]. Theoretically, phagraphene and TPH-graphene can be considered as the combinations of the 5-7 chains with distinct 6-6-6 and 4-7-7 interfacial stacking manners, respectively. In this work, we propose another new graphene allotrope, named as penta-hex-hepta-graphene (PHH-graphene), which can be constructed by coupling the synthesized 5-7 chains with a new type of 5-7-6 stacking interface. It is found that the PHH-graphene is dynamically and thermally stable, and especially notable, the total energy of PHH-graphene is lower than that of synthesized TPH-graphene. Thus, it is highly possible that PHH-graphene can be realized through assembly of 5-7 chains. We have systematically investigated the electronic properties of these three graphene allotropes and their nanoribbons. The results show that PHH-graphene is a type-I semimetal with a highly anisotropic Dirac cone similar to phagraphene, while TPH-graphene is a metal. Their nanoribbons exhibit different electronic band structures as the number (n) of 5-7 chains increases. For TPH-graphene nanoribbons, they become metal rapidly as n ≥ 2. The nanoribbons of the semimetallic phagraphene and PHH-graphene are narrow band gap semiconductors with gaps decreasing as n increases, which are similar to the graphene nanoribbons. We also find that the band gaps of PHH-graphene nanoribbons exhibit two distinct families with n = 2i and n = 2i + 1, which can be understood by the width-dependent symmetries of the system.

Applications of Mesenchymal Stem Cells in Liver Fibrosis: Novel Strategies, Mechanisms, and Clinical Practice

Liver fibrosis is a common result of most chronic liver diseases, and advanced fibrosis often leads to cirrhosis. Currently, there is no effective treatment for liver cirrhosis except liver transplantation. Therefore, it is important to carry out antifibrosis treatment to reverse liver damage in the early stage of liver fibrosis. Mesenchymal stem cells (MSCs) are the most widely used stem cells in the field of regenerative medicine. The preclinical and clinical research results of MSCs in the treatment of liver fibrosis and cirrhosis show that MSC administration is a promising treatment for liver fibrosis and cirrhosis. MSCs reverse liver fibrosis and increase liver function mainly through differentiation into hepatocytes, immune regulation, secretion of cytokines and other nutritional factors, reduction of hepatocyte apoptosis, and promotion of hepatocyte regeneration. Recently, many studies provided a variety of new methods and strategies to improve the effect of MSCs in the treatment of liver fibrosis. In this review, we summarized the current effective methods and strategies and their potential mechanisms of MSCs in the treatment of liver fibrosis, as well as the current research progress in clinical practice. We expect to achieve complete reversal of liver injury with MSC-based therapy in the future.