Positive response to trastuzumab deruxtecan in a patient with HER2-mutant NSCLC after multiple lines therapy, including T-DM1: a case report

Human epidermal growth factor 2 (HER2) mutations are uncommon in non-small cell lung cancer (NSCLC), and the lack of established, effective, targeted drugs has resulted in a persistently poor prognosis. Herein, we report the case of a non-smoking, 58-year-old man diagnosed with lung adenocarcinoma (cT3N0M1c, stage IVB) harboring a HER2 mutation (Y772_A775dupYVMA) and PD-L1 (-). The patient's Eastern Cooperative Oncology Group performance status (PS) score was assessed as 1. He commenced first-line treatment with chemotherapy, followed by immuno-chemotherapy, and with disease progression, he received HER2-targeted therapy and chemotherapy with an anti-angiogenic agent. However, HER2-targeted therapy, including pan-HER tyrosine kinase inhibitors (afatinib, pyrotinib, and pozitinib) and antibody-drug conjugate (T-DM1), produced only stable disease (SD) as the best response. After the previously described treatment, primary tumor recurrence and multiple brain metastases were observed. Despite the patient's compromised overall physical condition with a PS score of 3-4, he was administered T-DXd in addition to whole-brain radiotherapy (WBRT). Remarkably, both intracranial metastases and primary lesions were significantly reduced, he achieved a partial response (PR), and his PS score increased from 3-4 to 1. He was then treated with T-DXd for almost 9 months until the disease again progressed, and he did not discontinue the drug despite the occurrence of myelosuppression during this period. This is a critical case as it exerted an effective response to T-DXd despite multiple lines therapy, including T-DM1. Simultaneously, despite the occurrence of myelosuppression in the patient during T-DXd, it was controlled after aggressive treatment.

Triple-negative breast cancer: from none to multiple therapeutic targets in two decades

Triple-negative breast cancers (TNBCs) are more likely to occur in younger patients and have a poor prognosis. They are highly heterogeneous tumors consisting of different molecular subtypes. The only common characteristic among them is the absence of targets for endocrine therapy and human epidermal growth factor receptor 2 (HER2) blockade. In the past two decades, there has been an increased understanding of these tumors from a molecular perspective, leading to their stratification according to new therapeutic strategies. TNBC has ushered breast carcinomas into the era of immunotherapy. The higher frequency of germline BRCA mutations in these tumors enables targeting this repair defect by drugs like PARP inhibitors, resulting in synthetic lethality in neoplastic cells. Additionally, we have the identification of new molecules to which this generation of smart drugs, such as antibody-drug conjugates (ADCs), are directed. In this review, we will discuss the trajectory of this knowledge in a systematic manner, presenting the molecular bases, therapeutic possibilities, and biomarkers.

Design, Ground Testing and On-Orbit Performance of a Sun Sensor Based on COTS Photodiodes for the UPMSat-2 Satellite

This paper presents the development of the UPMSat-2 sun sensor, from the design to on-orbit operation. It also includes the testing of the instrument, one of the most important tasks that needs to be performed to operate a sensor with precision. The UPMSat-2 solar sensor has been designed, tested, and manufactured at the Universidad Politécnica de Madrid (UPM) using 3D printing and COTS (photodiodes). The work described in this paper was carried out by students and teachers of the Master in Space Systems (Máster Universitario en Sistemas Espaciales—MUSE). The solar sensor is composed of six photodiodes that are divided into two sets; each set is held and oriented on the satellite by its corresponding support printed in Delrin. The paper describes the choice of components, the electrical diagram, and the manufacture of the supports. The methodology followed to obtain the response curve of each photodiode is simple and inexpensive, as it requires a limited number of instruments and tools. The selected irradiance source was a set of red LEDs and halogen instead of an AM0 spectrum irradiance simulator. Some early results from the UPMSat-2 mission have been analyzed in the present paper. Data from magnetometers and the attitude control system have been used to validate the data obtained from the sun sensor. The results indicate a good performance of the sensors during flight, in accordance with the data from the ground tests.

Design and Simulation of a High-Speed Star Tracker for Direct Optical Feedback Control in ADCS

Star Trackers are often the most accurate instrument in an Attitude Determination and Control Systems, but often present a slow update rate, requiring additional sensor and sensor fusion algorithms to provide a smoother and faster output. However, the available rate gyros are either noisy, or expensive and heavy. The proposed work investigates the feasibility of high-speed star trackers with modern optics, sensors, and computing systems. Firstly, we investigate the sensitivity of an optoelectrical acquisition system stimulated by dim stars, secondly, we propose and evaluate an algorithm designed to operate at high speed and to be compatible with an Field-Programmable Gate Array implementation, before evaluating the performance of the implementation on FPGA. Finally, we debate the usability of such a system, both in terms of compatibility with a mission and CubeSat ecosystems, and in terms of performance. As a result, aside from removing the need for a rate gyro, Attitude Determination and Control Systems overall pointing performances can be increased. The proposed attitude determination system achieved a 0.001° accuracy, with a 99.1% sky coverage and an ability to reject false-positive while performing a single-frame lost-in-space star identification at a 50 Hz update rate with a total delay of 19 ms, including 13 ms.

Plasmodium Para-Aminobenzoate Synthesis and Salvage Resolve Avoidance of Folate Competition and Adaptation to Host Diet

Folate metabolism is essential for DNA synthesis and a validated drug target in fast-growing cell populations, including tumors and malaria parasites. Genome data suggest that Plasmodium has retained its capacity to generate folates de novo. However, the metabolic plasticity of folate uptake and biosynthesis by the malaria parasite remains unresolved. Here, we demonstrate that Plasmodium uses an aminodeoxychorismate synthase and an aminodeoxychorismate lyase to promote the biogenesis of the central folate precursor para-aminobenzoate (pABA) in the cytoplasm. We show that the parasite depends on de novo folate synthesis only when dietary intake of pABA by the mammalian host is restricted and that only pABA, rather than fully formed folate, is taken up efficiently. This adaptation, which readily adjusts infection to highly variable pABA levels in the mammalian diet, is specific to blood stages and may have evolved to avoid folate competition between the parasite and its host.