P11.75.B Survival benefit of radiotherapy and surgery in patients with lung cancer brain metastases with poor prognosis factors

Background

Radiotherapy and surgery are the standard treatments for lung cancer brain metastases (BMs). However, limitted studies focused on the treatments for patients with lung cancer BMs with poor prognosis factors. The purpose of this study was to investigate the effects of radiotherapy and surgery in patients with lung cancer BMs with poor prognosis factors, providing reference for clinical strategies.

Material and Methods

We analyzed retrospectively 714 patients with lung cancer BMs. A 1:1 propensity score matching (PSM) was performed to balance potential confounders. Analyses of overall survival (OS) and risk factors for OS were assessed by log-rank test and Cox proportional hazard model.

Results

Age ≥65 years, Karnofsky Performance Scale (KPS) score ≤70, anaplastic large-cell lymphoma kinase (ALK)/epidermal growth factor receptor (EGFR) wild type, extracranial metastases, non-surgery and non-radiotherapy led to poor prognosis. Patients were stratified according to these factors. Radiotherapy and surgery showed no survival benefit in patients with aged ≥65 years or pretreatment KPS score ≤70 before and after PSM. Before PSM, whole brain radiotherapy (WBRT) improved the OS and predicted good prognosis in patients with ALK/EGFR wild type or extracranial metastases. WBRT also predicted good prognosis in patients with non-surgery. Stereotactic radiosurgery (SRS) improved the OS and predicted good prognosis in patients with ALK/EGFR wild type or non-surgery. WBRT plus SRS improved the OS and predicted good prognosis in patients with extracranial metastases or non-surgery. WBRT plus SRS also predicted good prognosis in patients with ALK/EGFR wild type. Surgery improved the OS and predicted good prognosis in patients with non-radiotherapy. After PSM, SRS improved the OS and predicted good prognosis in patients with non-surgery. WBRT plus SRS improved the OS and predicted good prognosis in patients with non-surgery or extracranial metastases. WBRT plus SRS also predicted good prognosis in patients with ALK/EGFR wild type. Surgery improved the OS of patients with non-radiotherapy. We defined that the treatment would provide significant survival benefit if it both prolonged the OS and predicted good prognosis. Meanwhile, the results after PSM were more convincing than the results before PSM.

Conclusion

Radiotherapy has significant survival benefit in patients with lung cancer BMs with poor prognosis factors, including patients with ALK/EGFR wild type or extracranial metastases or non-surgery. Surgery only has significant survival benefit in patients with non-radiotherapy.

Selective effects of perinatal estrogen on proliferation and new neurons in hippocampus and piriform cortex of rats at weaning

BACKGROUND

A recent report links heightened prenatal amniotic estrogen levels to an increased risk of autism spectrum disorder (ASD). In this study, we examined the developmental effects of perinatal estrogen treatment on stem cell activity in weaned rats.

METHODS

Sprague-Dawley rats received ethinyl estradiol (EE2, 10µg/kg/day) or vehicle orally from gestational day 6 until parturition. Offspring were then treated with the same daily dose from postnatal days (PNDs) 1-21. The effects of perinatal estrogen treatment on stem cell activities in the subgranular zone (SGZ) of the hippocampus and the piriform cortex were evaluated in male and female rat pups.

RESULTS

EE₂ treatment increased the total Ki67-immunoreactive (Ki67-ir) cell counts in the SGZ of males and females (p<0.05). However, no treatment or sex differences were detectable in the density of the doublecortin (DCX)-immunoreactive (DCX-ir) deposits in the hippocampus. In the piriform cortex, no treatment or sex differences were detected in Ki67-ir cell counts. However, the EE₂ treatment significantly reduced the DCX-ir cell count in male, but not female rats (male EE₂ group=29₂±22/mm², male vehicle group=402±19/mm², female EE² group=34₂±15/mm², female vehicle group=331±9/mm²).

CONCLUSIONS

Perinatal estrogen treatment increased hippocampal Ki67-ir cell counts in both sexes and selectively reduced DCX-ir cell counts in the piriform cortex of males. These data suggest that exposure to abnormally high levels of estrogens early in life may have an impact on neural cell development. Alterations in development so early in life may have long-term cognitive impact.

[The efficacy and prognostic factors of immunotherapy in advanced non-small cell lung cancer patients with different driver gene mutations]

Objective: To explore the efficacy and prognostic factors of immunotherapy in advanced non-small cell lung cancer (NSCLC) patients with different driver gene mutations. Methods: Medical records of advanced NSCLC patients who harbored driver gene mutations (EGFR, KRAS, ALK and etc.) and received PD-1 inhibitors in Henan Cancer Hospital from April 2016 to May 2021 were collected. Treatment patterns, progression free survival (PFS), overall survival (OS) and prognostic factors of patients with driver gene mutations were estimated. Results: A total of 120 patients were included. There were 70 males and 50 females, with a median age [M(Q₁,Q₃)] of 57 (50, 65) years. Of these, 52 patients harbored KRAS mutations, 42 patients harbored EGFR mutations, 16 patients harbored ERBB2 mutations, 5 patients harbored MET mutations or amplifications, 5 patients harbored ROS-1 mutations, 2 patients harbored BRAF mutations, and the last 2 patients harbored ALK and RET mutations, respectively. The PFS and OS [M (95%CI)] were 6.4 (5.1-7.8) and 31.2 (22.0-40.3) months in 120 participated patients. Patients with KRAS mutations showed the greatest survival benefit from Immune checkpoint inhibitors (ICIs) with the PFS of 9.7 (4.8-14.6) months and OS of 31.2 (19.4-50.6) months. They mostly received the first-line (34.6%, 18/52) and second-line (38.5%, 20/52) ICIs. The PFS and OS of EGFR mutant patients were 3.9 (1.8-6.1) months and 18.0 (12.1-23.8) months, respectively. They tended to receive ICIs after resistance to EGFR-tyrosine kinase inhibitors (TKIs), and the proportion of second-, third-, fourth or further-line drugs was 38.1% (16/42), 11.9% (5/42), and 47.6% (20/42), respectively. PD-L1 expression level (negative vs ≥50% positive: HR=3.710, 95%CI: 1.372-10.031, P=0.010; 1%-49% positive vs ≥50% positive: HR=2.738, 95%CI: 0.841-8.912, P=0.094), age (every additional year: HR=0.957, 95%CI: 0.933-0.982, P=0.001) and different driver mutations status (EGFR vs KRAS: HR=2.676, 95%CI: 1.317-5.436, P=0.006; ERBB2 vs KRAS: HR=3.411, 95%CI: 1.493-7.792, P=0.004; other mutations vs KRAS: HR=0.727, 95%CI: 0.322-1.643, P=0.444) were prognostic factors for PFS. While PD-L1 expression level (negative vs ≥50% positive: HR=2.305, 95%CI: 0.748-7.103, P=0.146; 1%-49% positive vs ≥50% positive: HR=1.286, 95%CI: 0.337-4.913, P=0.713), and treatment lines of ICIs (first-line vs ≥ third-line: HR=0.322, 95%CI: 0.114-0.914, P=0.033; second-line vs ≥ third-line: HR=0.375, 95%CI: 0.178-0.789, P=0.010) were prognostic factors for OS. Conclusions: KRAS mutant NSCLC patients mostly receive ICIs at the front line, and have best survival benefits from immunotherapy. While EGFR mutant NSCLC patients tend to receive ICIs at the back line, and obtain reasonable survival benefits. PD-L1 expression level, age, and different driver mutations status are prognostic factors for PFS, and PD-L1 expression level and treatment lines of ICIs are prognostic factors for OS.

[Identification of factors affecting Oncomelania hupensis density in Eastern Dongting Lake regions]

OBJECTIVE

To evaluate the impact of water pollutants, water levels and meteorological factors on the Oncomelania hupensis density in Eastern Dongting Lake regions, so as to provide insights into schistosomiasis control.

METHODS

O. hupensis snails were surveyed using a systematic sampling method in snail-infested marshlands in Eastern Dongting Lake regions from 2007 to 2014, and data pertaining to water pollutants, water levels and meteorological factors were collected. The duration of submergence and the date of the start of submergence were calculated. The snail density and its influencing factors were descriptively analyzed, and a linear mixed model was generated to examine the impacts of variables on the snail density. In addition, smooth curves were fitted to investigate the relationship between snail density and variables.

RESULTS

The snail density appeared a fluctuation in Eastern Dongting Lake regions during the period from 2007 to 2014, with the highest density on October, 2010 (52.79 snails/0.1 m²) and the lowest density on January 2009 (2.15 snails/0.1 m²). Linear mixed-model analysis showed that permanganate index, total phosphorus and the date of the start of submergence affected the snail density (t = 6.386, -2.920 and -3.892, all P values < 0.01). Smooth curve analysis revealed that the associations of the snail density with the permanganate index and total phosphorus appeared an approximately quadratic curve. After the end of April, the earlier date of the start of submergence resulted in a higher snail density.

CONCLUSIONS

Permenganate index, total phosphorus and the date of the start of submergence affect the O. hupensis snail density in Eastern Dongting Lake regions.

P13.15 Pre-clinical trial of T601 oncolytic virus for high grade glima via intra-tumoral injection

BACKGROUND

An effective therapeutic method still hasn’t been devised for lethal high grade glioma. Thus, a method with high anti-tumoral efficiency, tumoral targeting, and acceptable side effect needs to be designed. Oncolytic virotherapy which can specifically lyse tumor cells via mass replication and deleting nucleotide metabolism related gene, like TK, required in viral replication and overexpressed in tumor cells, provides hope for patients. However, the virus only contained TK deletion is unable to show sufficient specificity of anti-tumoral response in tumor cells. Here, the adapted strain of vaccinia virus with high tumoral specificity due to TK and RR deletion and FUC1 insertion, named T601, is chosen in this project. In clinical application, intra-tumoral injection showed improved anti-tumoral efficiency and acceptable side effect. However, intra-tumoral viral injection in orthotropic glioma model is rare. In this project, various biosafety and antitumoral efficiency parameter would be tested for confirming the biosafety and reliability of intra-tumoral T601 viral injection for future clinical trials.

MATERIAL AND METHODS

For measuring the IC50 of T601, 10 different amounts of virus was tested in vitro via calculating cell viability with CCK-8(cell counting kit-8). For measuring the further antitumoral response of FCU1, different concentration of the 5-FC was added into the medium with IC50 viral amount. To ensure the biosafety of T601, MTD (maximum tolerance dose) was measured. Based on the MTD result, for evaluating the anti-tumoral efficiency, 106 pfu,105 pfu,104 pfu of virus was intra-tumoral injected in orthotopic GBM bearing mice. Tumor size was measured once a week through in vivo bioimaging system.

RESULTS

0.022 MOI, the IC50 of T601, showed high cytotoxicity of T601. Moreover, the significantly decreased cell viability under the combined treatment of 5-FC and 0.22MOI T601 showed intact anti-tumoral function. In MTD assay, except for 107 group, no significant weight loss was found. However, in 107 pfu group, mean body weight decreased around 10% and animal fatality happened on day 9. According to the MTD result, certain amount of virus was intra-tumorally injected. In all treatment group, the tumor size was significantly shrined. At the same time, the survival rate of mice under viral treatment was significantly extended.

CONCLUSION

In summary, T601 exhibited efficient anti-tumoral function and acceptable side effect. T601 treatment prolonged the survival period of GBM mice with acceptable neurotoxicity, demonstrating that T601 contains necessary criterial for intra-tumoral injection. Ultimately, this project provided basic reference information of dose for future clinical trial.

Effect of supplementing hydroxy selenomethionine on meat quality of yellow feather broiler

This study was conducted to evaluate the effect of supplementing hydroxy selenomethionine (OH-SeMet) on performance, selenium (Se) deposition in the breast muscle, quality and oxidative stability, and expression of selenoprotein encoding genes of breast meat of the native slow-growing yellow-feathered broiler birds. A total of 375 one-day-old local yellow male birds were randomly assigned into 5 dietary treatments, supplemented with Se 0.0, 0.2, 0.4, 0.6, and 0.8 mg/kg in the form of OH-SeMet. Each treatment consisted of 5 replicates and each replicate had 15 birds, the birds were fed on basal diet containing corn and soybean meal, and the experiment lasted for 63 d. The results showed that dietary Se supplementation linearly increased (P < 0.001) Se contents in both serum and muscle, no significant changes (P > 0.05) were observed on growth performance, yield of breast, meat color, and intramuscular fat deposition of the breast muscle. Dietary Se addition improved water-holding capacity, the pH_24h value, and tenderness of breast muscle, evidenced by a linear decreases of shear force (P < 0.05), accompanied by lower thiobarbituric acid reactive substances and higher glutathione reductase activity. The mRNA abundance of selenoprotein encoding genes also responded to dietary Se levels. It is concluded that, dietary supplementation with OH-SeMet improved muscular Se deposition and meat quality of the native yellow birds, with enhanced antioxidant capability and regulation in selenogenome.

[Modulatory effect of 2-arachidonoylglycerol on voltage-gated sodium currents in rat caudate nucleus neurons with kainic acid-induced injury]

OBJECTIVE

To investigate the modulatory effect of 2-arachidonoylglycerol (2-AG) on voltage-gated sodium currents(VGSCs) in rat caudate nucleus (CN) neurons with kainic acid (KA)-induced injury and explore the molecular mechanism underlying the neuroprotective effect of 2-AG.

METHODS

Primary cultures of CN neurons isolated from neonatal SD rats were treated with KA, 2-AG+KA, RIM (a CB1 receptor antagonist) +2-AG+KA, or vehicle only (as control).After 7 days in primary culture, the neurons were treated with corresponding agents for 12 h (RIM and 2-AG were added at the same time; KA was added 30 min later) before recording of current density changes, current-voltage characteristics, activation and inactivation kinetics of VGSCs (I_Na) using whole-cell patch clamp technique.

RESULTS

In cultured CN neurons, KA significantly increased current density of VGSCs (P=0.009) as compared with vehicle treatment.KA also produced a hyperpolarizing shift in the activation curve of I_Na and significantly increased the absolute value of V_1/2 for activation (P=0.008).Addition of 2-AG in the culture medium obviously prevented KA-induced increase of I_Na (P=0.009) and hyperpolarizing shift in the activation curve of I_Na, and significantly reduced the value of V_1/2 for activation(P=0.009)in a CB1 receptor-dependent manner.2-AG alone did not affect the density, activation or deactivation of VGSCs in rat CN neurons.

CONCLUSION

In excitotoxic events, endogenous 2-AG can offer neuroprotection by modulating VGSCs in the CN neurons through a CB1 receptor-dependent pathway.

DNA polymerase β may be involved in protecting human bronchial epithelial cells from the toxic effects induced by methyl tert-butyl ether exposure

Methyl tert-butyl ether (MTBE), a widely used gasoline additive and a ubiquitous environmental pollutant in many countries and regions, can cause various kinds of toxic effects on human health. However, the molecular mechanism underlying its toxic effects remains elusive. The present study aimed to explore the cytotoxicity, DNA damage and oxidative damage effects of MTBE on human bronchial epithelial cells (16HBE) and the possible role of DNA polymerase β (pol-β) in this process. RNA interference (RNAi) was used to obtain pol-β gene knocked-down cells (pol-β^-). CCK-8 assay was adopted to analyze the cell viability. Alkaline single-cell gel electrophoresis (SCGE) was performed to detect the DNA damage effects of MTBE. The enzyme activity of GSH-Px, SOD, CAT and the level of MDA were assessed. The data indicated that when treated with MTBE at the concentration exceeding 50 μmol/L and for the time exceeding 24 h, the pol-β^- exhibited significantly decreased cell viability and increased DNA damage effects, as compared to the control (P < 0.05). Furthermore, there was significant difference in the levels of GSH-pX, SOD, CAT and MDA between the pol-β^- and the control (P < 0.05). Our investigation suggests that MTBE can cause obvious cytotoxicity, DNA damage and oxidative damage effects on 16HBE cells. DNA polymerase β may be involved in protecting 16HBE cells from the toxic effects induced by MTBE exposure. These findings provide a novel insight into the molecular mechanism underlying the toxic effects of MTBE on human cells.

Design and implementation of a portable diagnostic system for Thomson scattering and optical emission spectroscopy measurements

A diagnostic system, which has a design goal of high-portability, has been designed at Oak Ridge National Laboratory (ORNL). This project aims at providing measurements of key plasma parameters (n_e, T_e, n_i, T_i) for fusion-relevant devices, utilizing Thomson scattering (TS) and optical emission spectroscopy (OES). The innovative design employs mostly commercial off-the-shelf instrumentation and a traveling team of researchers to conduct measurements at various magnetic-confinement plasma devices. The TS diagnostic uses a Quantel Q-smart 1500 Nd:YAG laser with a 2ω harmonic generator to produce up to 850 mJ of 532 nm laser pulses at 10 Hz. Collection optics placed at the detection port consists of an 11 × 3 optical fiber bundle, where the TS diagnostic uses an 11 × 1 subset array of the fibers, the OES diagnostic uses another 11 fibers, and the remaining fibers are available to the host institution. The detection system is comprised of two separate IsoPlane-320 spectrometers with triple-grating turrets of various line spacing and two PI-MAX 4 intensified CCD detectors, used simultaneously to measure a broad range of ion, impurity, and electron parameters. The self-contained diagnostic package also includes a data processing and storage system. The design and initial implementation of the TS-OES diagnostic system are described. The experiments from the proof-of-principle operation of the portable package on a high density (∼2.5 × 10²² m^-3) and low-temperature (∼5 eV) electrothermal arc source at ORNL are also discussed.