Identification of driver mutations in tumor specimens from 1,000 patients with lung adenocarcinoma: The NCI’s Lung Cancer Mutation Consortium (LCMC)

CRA7506

Background: The ability to detect driver mutations like EGFR and EML4-ALK in tumor specimens from patients with lung cancer and administer agents targeting those molecular lesions has revolutionized the management of adenocarcinoma of the lung. The availability of multiplexed assays to detect mutations permits the identification of multiple driver mutations from tumors at diagnosis. The number of molecular lesions and new agents to target them continues to grow. To exploit this, we created the LCMC to determine 10 driver mutations in tumors from 1,000 patients and to give the results to clinicians for care and entry onto targeted therapeutic trials based on these findings. Methods: The 14 member LCMC is prospectively enrolling patients to test tumors from patients with lung adenocarcinoma in CLIA laboratories for KRAS, EGFR, HER2, BRAF, PIK3CA, AKT1, MEK1, and NRAS using standard multiplexed assays and fluorescence in situ hybridization (FISH) for ALK rearrangements and MET amplifications. All are stage IIIB/IV, PS 0-2, have available tissue, and signed consent. Results: 830 patients have been registered with 50 enrolling monthly. We detected a driver mutation in 60% (252/422, 95% CI 55 to 65%) of tumors thus far. Mutations found: KRAS 107 (25%, 95% CI 21 to 30%), EGFR 98 (23%, 95% CI 19 to 27%), ALK rearrangements 14 (6%, 95% CI 4 to11%), BRAF 12 (3%, 95% CI 1 to 5%), PIK3CA 11 (3%, 95% CI 1 to 5%), MET amplifications 4 (2%, 95% CI 0.5 to 5%), HER2 3, (1%, 95% CI 0.1 to 2%), MEK1 2 (0.4%, 95% CI 0.1 to 2%), NRAS 1 (0.2%, 95% CI 0.01 to 1%), AKT1 0 (0%, 95% CI 0 to 1%). 95% of molecular lesions were mutually exclusive. Conclusions: We detected an actionable driver mutation in 60% of tumors from prospectively studied patients with lung adenocarcinoma. Results of EGFR mutation testing are given to treating physicians to select erlotinib as initial treatment per NCCN and ASCO guidelines. Patients with other driver mutations are offered participation in LCMC-linked trials of agents targeting the mutation identified, e.g. crizotinib with EML4-ALK. At half of LCMC sites, multiplexed testing for all mutations is now routine practice in their pathology departments. Supported by 1RC2CA148394-01.

Raman scattering and isotopic phonon effects in dodecaborides

The Raman spectra of numerous dodecaborides have been measured on high-quality single crystals at ambient conditions with high spectral resolution and signal-to-noise ratio. Besides the strong Raman-active modes, numerous Raman-inactive modes occur in the spectra, indicating distortions of the structures. Ab initio calculation of the phonon spectra on ZrB(12) excellently agrees with the experimental results. Force constants are theoretically calculated and force parameters are estimated from the Raman frequencies. The influence of the surface range on the Raman spectra is evident. The different isotopic effects (virtual crystal approximation, the polarization effect and the effect of isotopic disorder) on the phonon frequencies are determined, separated and discussed.

Improvement of cardio-ankle vascular index by glimepiride in type 2 diabetic patients

AIMS

Glimepiride, a third generation sulfonylurea (SU), is known to have extrapancreatic effects, but its vascular effect is unclear. We investigated the efficacy of glimepiride in improving arterial stiffness assessed by cardio-ankle vascular index (CAVI) in type 2 diabetic patients, compared with glibenclamide, a conventional SU.

METHODS

Forty type 2 diabetic patients were randomly assigned to two groups. One group was administered glimepiride 1.5 mg/day, and the other group was administered glibenclamide 1.25 mg/day for 6 months.

RESULTS

No significant difference in hypoglycaemic effect was observed between two groups. CAVI significantly decreased only in glimepiride group (9.4 ± 1.4→8.9 ± 0.8, p < 0.05). Decrease in CAVI was greater in glimepiride group than in glibenclamide group (-0.50 ± 0.98 vs. -0.04 ± 0.57, p = 0.048). Urinary 8-hydroxy-2'-deoxyguanosine (8-OHdG) decreased in glimepiride group and increased in glibenclamide group, and the changes were significantly different between groups (-1.5 ± 3.5 vs. + 1.8 ± 3.6, p = 0.009); whereas serum lipoprotein lipase mass increased in glibenclamide group and decreased in glibenclamide group, and the changes tended to be different between groups (+ 2.1 ± 19.1 vs. -7.4 ± 19.2, p = 0.096). Change in urinary 8-OHdG was a significant independent predictor for change in CAVI in all subjects.

CONCLUSIONS

These results suggest that glimepiride improves CAVI compared with glibenclamide. Reduced oxidative stress and improved insulin resistance may contribute to the improvement of CAVI by glimerpiride.

Prescribing plans (PP) of American Oncologists for first-line therapy (Rx) for patients with stage III (wet)/IV non-small cell lung cancer (NSCLC) and PS 2: Overall selection and impact of gender and smoking status

e19046

Background: Selection of oral EGFR inhibitors or chemotherapy as 2nd line in patients with NSCLC may be influenced by patients’ performance status (PS), smoking status, gender; tumor histology; tolerance/response to 1st-line Rx; and patient expectations/desires. Methods: Between February ’07 and October ’08, we used a core case scenario of stage IV mucin positive adenocarcinoma (Adeno ca) of lung in a 68-year-old former smoker (FS; stopped 6 years ago) with PS 2, to study patient related variations in PP of almost 800 American medical oncologists during 10 live research events [393 MDs/5 events during 2008]. Impact of gender or/and smoking history on 1st-line Rx selection was assessed. Results: In 2007–08, 97%/97%% MDs planned anti-tumor Rx: 53%/63% combination; 44%/34% single agent. PP for 2008 is shown in the table . [2007 PP data for erlotinb use included]. PP for erlotinib in these 4 scenarios are stable over the 2007 - 08 testing interval. Impact of smoking status dominates over gender. For a female NS with Adeno ca /PS2, ≥2/3 of MDs plan erlotinib 1st-line. In the absence of testing results for EGFR expression by IHC, EGFR gene copy number by FISH, EGFR gene mutation testing, or kras mutation testing, our data show a direct correlation of patient “phenotype” and PP for erlotinib as 1st-line Rx, a setting not specifically an approved indications for this agent. The impact of recently reported progression free survival data from an Asian phase III trial (IPASS: gefitinib or chemotherapy or as 1st-line therapy in non or former light-smoking patients with lung adenoca) on future prescribing plans in this clinical setting will be of great interest. Conclusions: By our observations, smoking status dominates over gender in PP of oncologists when treating wet IIIB/IV Adeno ca of lung. Therefore we plan to continue to assess American oncologists’ PP for this NSCLC setting during 2009.

[Table: see text]

[Table: see text]

Chitosan selectivity for removing cadmium (II), copper (II), and lead (II) from aqueous phase: pH and organic matter effect

The aim of this study was to investigate the selectivity of chitosan for cadmium, copper and lead in the presence and absence of natural organic matter (NOM) in different pH solutions. Adsorption isotherms of one and three adsorbates at initial concentration of 5-100mg/L were carried out in batch reactors at pH 4, 5, or 7 and 25 degrees C in reactive and clarified water. The chitosan employed had a MW of 107.8 x 10(3)g/mol and degree of acetylation (DA) of 33.7%. The chitosan adsorption capacity at pH 4 in reactive water was 0.036, 0.016, 0.010mmol/g for Pb(2+), Cd(2+), and Cu(2+), respectively, and it decreased for Pb(2+) and Cd(2+) in clarified water. Conversely, experiments carried out in clarified water showed that the cadmium adsorption capacity of chitosan was enhanced about three times by the presence of NOM at pH 7: an adsorption mechanism was proposed. Furthermore, it was found that the biosorbent selectivity, in both reactive and clarified water at pH 4, was as follows Cu(2+)>Cd(2+)>Pb(2+). Finally, the preliminary desorption experiments of Cd(2+) conducted at pH 2 and 3 reported 68 and 44.8% of metal desorbed, which indicated that the adsorption mechanism occurred by electrostatic interactions and covalent bonds.

A new structure of Cu complex in Si and its photoluminescence

A recent discovery of complicated isotope shifts of the PL 1014 meV line in Cu-containing silicon, which was made by Thewalt's group, indicates that existing models of Cu pairs are not appropriate for accounting for the luminescence center. A new structural model has been studied. First-principles calculations show that the most probable form of the complex is a four-membered complex which is composed of a substitutional Cu associated with three neighboring interstitial Cu atoms. The symmetry is C(3v). The formation mechanism of this complex is discussed. For interpreting the complicated splitting for the Γ(4) exciton peak, involvement of a non-totally symmetric mode is proposed. The pattern of splitting obtained by this model is almost in agreement with the experiment. Selection rules beyond the usual treatments are necessary to connect a specific exciton peak to the corresponding phonon.