Surface elemental microanalysis with submicron lateral resolution by the laser-ablation laser-induced fluorescence technique

In order to realize surface elemental microanalysis of solid samples with submicron lateral resolution, laser-ablation (LA) combined with high sensitive laser-induced fluorescence (LIF) detection was investigated. A 532 nm or 266 nm nanosecond laser pulse with low pulse energy was used to realize submicron laser-ablation on the surface of a copper alloy, and LIF technique was used to sensitively detect a minor lead element in the ablated samples. ~344 nm and ~267 nm lateral resolutions could be achieved experimentally under 532 nm and 266 nm laser ablations under the current experimental condition, respectively. This demonstrated the feasibility of using a LA-LIF technique for surface elemental microanalysis of solid samples with submicron spatial resolution. The potentials of continually improving the spatial resolution of this technique to nanoscale were discussed.

Chronic sun exposure is associated with distinct histone acetylation changes in human skin

BACKGROUND

Photoageing is attributed to continuous sunlight or artificial ultraviolet exposure and manifests as clinical and histological changes in skin. Epigenetic changes have been found to be involved in the pathogenesis of photoageing. However, the underlying mechanisms are unclear.

OBJECTIVES

To analyse histone modification patterns in sun-exposed and nonexposed skin, and to identify the abnormally histone-modified genes related to photoageing.

METHODS

Skin biopsies were collected from both the outer forearm (sun-exposed area) and the buttock (sun-protected area) in 20 healthy middle-aged female volunteers. Global histone H3/H4 acetylation and H3K4/H3K9 methylation statuses were assessed by enzyme-linked immunosorbent assay. Expression levels of histone acetyltransferases and histone deacetylases were measured by reverse-transcriptase quantitative polymerase chain reaction (qPCR) and Western blot. Chromatin immunoprecipitation combined with DNA microarray (ChIP-chip) assay with anti-acetyl-histone H3 antibody in a sun-exposed pool (combining six sun-exposed skin samples) and a nonexposed pool (combining six nonexposed skin samples) was conducted to explore the abnormally acetylated histone H3 genes related to photoageing; ChIP-qPCR was then used to verify the results of ChIP-chip.

RESULTS

We observed higher global histone H3 acetylation levels increased EP300 and decreased HDAC1 and SIRT1 expression in sun-exposed skin compared with matched nonexposed skin. Furthermore, the ChIP-chip assay showed that 227 genes displayed significant hyperacetylation of histone H3, and 81 genes displayed significant hypoacetylation of histone H3 between the two groups. Histone H3 acetylation levels on the promoters of PDCD5, ITIH5, MMP1 and AHR were positively correlated with the mRNA expression of the corresponding gene.

CONCLUSIONS

Chronic sun exposure-induced histone H3 hyperacetylation may play a critical role in the pathogenesis of skin photoageing.

Characteristics, management, and outcome of primary hyperparathyroidism at a single clinical center from 2005 to 2016

This study presents the clinical and biochemical profiles of patients with PHPT between 2005 and 2016 at our center. Most PHPT patients in China show symptomatic features. The number of symptomatic and asymptomatic patients increased during that time, and the number of individuals with parathyroid carcinoma is now increasing.

INTRODUCTION

Over the last decade, the prevalence of primary hyperparathyroidism (PHPT) has increased sharply, and the number of individuals with parathyroid cancer is still trending upward. Little is known about the clinical outlook of the disease over the last decade in China. The aim of this study was to describe the clinical characteristics of PHPT patients at our center from January 2005 to December 2016.

METHODS

Two hundred sixty patients with PHPT visiting Shanghai Jiao Tong University Affiliated Sixth People's Hospital were enrolled retrospectively. The clinical manifestations and biochemical abnormalities of these patients were analyzed.

RESULTS

Among all patients, 73.1% had symptomatic PHPT, while the number of symptomatic and asymptomatic patients increased 1 to 2.5 times and 1.5 to 3 times, respectively, from 2005 to 2016. Bone pain and single adenoma were the most frequent signs and pathological results. The patients with parathyroid carcinoma over the last 5 years accounted for 90% (9/10) of all parathyroid carcinoma patients from 2005 to 2016, and parathyroid carcinoma patients had higher levels of serum calcium, parathyroid hormone (PTH), and serum creatinine (P < 0.05) than parathyroid hyperplasia and parathyroid adenoma patients.

CONCLUSIONS

Most patients with PHPT in China still exhibit classic clinical and biochemical features. Both symptomatic and asymptomatic patients have increased over the last 12 years. Although the proportion of parathyroid carcinoma was small, a noticeable upward tendency was observed at our center.

Abstract OT1-01-03: A phase II multi-center study of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable or metastatic triple negative breast cancer (TNBC) or triple negative inflammatory breast cancer (TN-IBC)

Background. The AXL receptor tyrosine kinase is associated with poor overall survival in breast cancer. AXL signaling is an important regulator of tumor plasticity related to epithelial-to-mesenchymal transition (EMT) and stem cell traits that drive metastasis and drug resistance. Upregulation of AXL has been associated with reduced response to anti-PD-1 therapy. Signaling via AXL is also a key suppressor of the anti-tumor innate immune response, and AXL is expressed on several cells associated with the tumor immune microenvironment. Hence AXL signaling contributes uniquely to both tumor cell intrinsic and microenvironmental anti-tumor immune suppression mechanisms. We show that AXL is required for tumor immune evasion in the 4T1/Balb/C mammary adenocarcinoma model and that blocking AXL signaling with BGB324, a selective clinical-stage small molecule AXL kinase inhibitor, enhanced the effect of immune checkpoint blockade. BGB324 + anti-CTLA-4/anti-PD-1 treated tumors displayed enhanced infiltration of cytotoxic T lymphocytes and Natural Killer cells. Importantly, responding animals rejected orthotopic 4T1 tumor cell re-challenge, demonstrating sustained tumor immunity. These data provided a translational rationale for combining AXL targeted therapy with immune checkpoint inhibitors to enhance anti-cancer immune response.

Study Design. BGBC007 (NCT03184558) is an open-label, single arm, multi-center phase II study designed to assess the anti-tumor activity of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable, or metastatic TNBC or TN-IBC. Secondary objectives include safety and pharmacokinetic profile of BGB324 and pembrolizumab in combination. A single arm, extension of Simon's 2-stage design is employed with an interim and final analysis. Up to 56 evaluable patients will be enrolled. Recruitment will be halted once 28 evaluable patients have been entered to determine the Objective Response Rate (ORR, complete response and partial response). If 5 or fewer responses are observed in up to 28 patients, the trial will be terminated in favor of the null for futility. If 11 or more responses are observed, then the trial will be stopped in favor of the alternative for demonstration of activity. If 6 to 10 patients have an observed response then a further 28 patients may be evaluated. This design provides an overall power of 80.6% to test the stated null and alternative hypothesis. BGB324 will be administered orally, once daily, in a fasted state. Days 1, 2 and 3 of BGB324 administration consists of a 'loading' dose of 400 mg followed by a dose of 200 mg daily. A fixed dose of 200 mg pembrolizumab will be given by intravenous infusion over 30 minutes every 3 weeks. BGB324 and pembrolizumab will be given until disease progression, unacceptable dose toxicity, or until 106 weeks (35 cycles). Efficacy endpoints including ORR, Duration of Response, Progression Free Survival are based on tumor imaging evaluation by RECIST 1.1. Tumor specimens will be taken to assess AXL and PD-L1 expression.

Citation Format: Yule M, Wnuk-Lipinska K, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie M, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Milde Nævdal E, Deyna P, Boniecka A, Straume O, Thiery J-P, Chouaib S, Brekken RA, Gausdal G, Lorens JB. A phase II multi-center study of BGB324 in combination with pembrolizumab in patients with previously treated, locally advanced and unresectable or metastatic triple negative breast cancer (TNBC) or triple negative inflammatory breast cancer (TN-IBC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT1-01-03.

Dendrites fragmentation induced by oscillating cavitation bubbles in ultrasound field

The fragmentation of the dendrites of succinonitrile (SCN)-2-wt.% acetone organic transparent alloy caused by ultrasound-induced cavitation bubbles was studied by using ultra-high-speed digital camera with a rate of 40,000fps. Real-time imaging reveals that the vibrating cavitation bubbles can fragment not only secondary arms but also the primary ones under high ultrasound power. The secondary arms always broke at their roots as a result of stress concentration induced by oscillated cavitation bubble and then ripped off from their primary arms. Generally the fragment process takes tens of milliseconds from bending to breaking, while the break always occurs immediately in less than 25μs.

Effects of black cohosh and estrogen on core body and tail-skin temperatures in ovariectomized rats by telemetric monitoring with dual thermistor probes

OBJECTIVES

To investigate the effects of black cohosh and estrogen on the temperature in ovariectomized rats, the core body temperature (CBT) and tail-skin temperature (TST) were simultaneously monitored and the relationship between these two temperatures was explored.

METHODS

Twenty-four female Sprague-Dawley rats aged 8 weeks were randomly divided into four groups: sham-operated (SHAM), ovariectomized (OVX), OVX treated with estradiol valerate (OVX + E), and OVX treated with isopropanolic black cohosh extract (OVX + ICR). Rats were sham-operated or ovariectomized and were implanted with telemetry transmitters with dual thermistor probes. Two weeks after surgery, the animals were treated with drugs for 4 weeks. During the last week of the treatments, the dynamic temperature profiles of the CBT and TST were collected.

RESULTS

The average CBT and TST, TST fluctuation frequency, and the average amplitude fluctuation were significantly higher in OVX than in SHAM rats. In addition, dramatic fluctuations of TST in OVX rats occurred at the time points of the day when the CBTs were lower in OVX rats than in SHAM rats. Treatment of OVX rats with estradiol valerate or isopropanolic black cohosh extract markedly decreased the average CBT and TST, TST fluctuation frequency, and the average amplitude fluctuation. Moreover, CBT was found to be significantly higher, while TST was lower in OVX + E than in OVX + ICR rats.

CONCLUSIONS

Both black cohosh and estradiol treatments ameliorated the abnormal thermoregulation in OVX rats. In particular, black cohosh reduced CBT better than estradiol and estradiol reduced TST better than black cohosh.

Stable ultra-thin CdTe crystal: a robust direct gap semiconductor

Employing density functional theory based calculations, we investigate structural, vibrational and strain-dependent electronic properties of an ultra-thin CdTe crystal structure that can be derived from its bulk counterpart. It is found that this ultra-thin crystal has an 8-atom primitive unit cell with considerable surface reconstructions. Dynamic stability of the structure is predicted based on its calculated vibrational spectrum. Electronic band structure calculations reveal that both electrons and holes in single layer CdTe possess anisotropic in-plane masses and mobilities. Moreover, we show that the ultra-thin CdTe has some interesting electromechanical features, such as strain-dependent anisotropic variation of the band gap value, and its rapid increase under perpendicular compression. The direct band gap semiconducting nature of the ultra-thin CdTe crystal remains unchanged under all types of applied strain. With a robust and moderate direct band gap, single-layer CdTe is a promising material for nanoscale strain dependent device applications.

Effect of Lactobacillus rhamnosus HN001 in Pregnancy on Postpartum Symptoms of Depression and Anxiety: A Randomised Double-blind Placebo-controlled Trial

Background

Probiotics may help to prevent symptoms of anxiety and depression through several putative mechanisms.

Objective

The aim of this study was to evaluate the effect of Lactobacillus rhamnosus HN001 (HN001) given in pregnancy and postpartum on symptoms of maternal depression and anxiety in the postpartum period. This was a secondary outcome, the primary outcome being eczema in the offspring at 12 months of age.

Design, Setting, Participants

A randomised, double-blind, placebo-controlled trial of the effect of HN001 on postnatal mood was conducted in 423 women in Auckland and Wellington, New Zealand. Women were recruited at 14–16 weeks gestation.

Intervention

Women were randomised to receive either placebo or HN001 daily from enrolment until 6 months postpartum if breastfeeding.

Outcome Measures

Modified versions of the Edinburgh Postnatal Depression Scale and State Trait Anxiety Inventory were used to assess symptoms of depression and anxiety postpartum.

Trial Registration

Australia NZ Clinical Trials Registry: ACTRN12612000196842.

Findings

423 women were recruited between December 2012 and November 2014. 212 women were randomised to HN001 and 211 to placebo. 380 women (89.8%) completed the questionnaire on psychological outcomes, 193 (91.0%) in the treatment group and 187 (88.6%) in the placebo group. Mothers in the probiotic treatment group reported significantly lower depression scores (HN001 mean = 7·7 (SD = 5·4), placebo 9·0 (6·0); effect size -1·2, (95% CI -2·3, -0·1), p = 0·037) and anxiety scores (HN001 12·0 (4·0), placebo 13·0 (4·0); effect size -1·0 (-1·9, -0·2), p = 0·014) than those in the placebo group. Rates of clinically relevant anxiety on screening (score > 15) were significantly lower in the HN001 treated mothers (OR = 0·44 (0·26, 0·73), p = 0·002).

Interpretation

Women who received HN001 had significantly lower depression and anxiety scores in the postpartum period. This probiotic may be useful for the prevention or treatment of symptoms of depression and anxiety postpartum.

Funding Source

Health Research Council of New Zealand (11/318) and Fonterra Co-operative Group Ltd.

•

The microbiome-gut-brain axis may be important for mental health.

•

We conducted a study of probiotic supplementation in pregnancy and 6 months after delivery if breastfeeding.

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The probiotic treatment group reported significantly lower depression and anxiety scores than those in the placebo group.

There is mounting evidence from animal studies that the microbiome-gut-brain axis may be important for mental health. Depression and anxiety in pregnancy and after birth affects 10–15% of women, although many are not recognised or treated. We conducted a double-blind placebo-controlled study of probiotic (Lactobacillus rhamnosus HN001) supplementation (from early pregnancy through to 6 months after delivery if breastfeeding) on postnatal symptoms of depression and anxiety in a group (n = 380) of healthy women. Mothers in the probiotic treatment group reported significantly lower depression and anxiety scores than those in the placebo group.

Promotion of LncRNA HOXA11-AS on the proliferation of hepatocellular carcinoma by regulating the expression of LATS1

OBJECTIVE

To investigate the expression levels of lncRNA HOXA11-AS in HCC tissues and cells, and to explore its biological role in the development and progression of HCC.

PATIENTS AND METHODS

We detected the relative expression level of HOXA11-AS in 72 HCC tissues and cells by the real-time quantitative PCR (qRT-PCR) assay. After interference with HOXA11-AS expression in HCC cells, 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT), clone formation, flow cytometry and an established nude mice transplanted tumor model were used to detect the biological behavior of HCC cells. qRT-PCR and Western blotting assays were used to detect the expression level of large tumor suppressor kinases 1 (LATS1). The subcellular localization of HOXA11-AS in HCC was detected by separating nuclei from the cytoplasm. The molecular mechanism of HOXA11-AS was regulated by ribonucleoprotein immunoprecipitation-microarray (RIP-Chip) experiments.

RESULTS

qRT-PCR assays showed that HOXA11-AS was relatively highly expressed in HCC tissues and cells. In vivo and in vitro experiments showed that HOXA11-AS could inhibit the proliferation of HCC cells, promote their apoptosis and retard the cell cycle progression from G1 to G0 phase. qRT-PCR and Western blotting assays results showed that LATS1 genes were the downstream target genes of HOXA11-AS. RIP and CHIP experiments showed that HOXA11-AS inhibited the expression of LATS1 genes by binding enhancer of zeste homolog 2 (EZH2) proteins.

CONCLUSIONS

HOXA11-AS inhibited the malignant transcription of the LATS1 genes and promoted the malignant proliferation of HCC cells. Interactions among HOXA11-AS, PRC2, and LATS1 may provide a new target for the treatment of HCC.

A prospective clinical study of regenerative endodontic treatment of traumatized immature teeth with necrotic pulps using bi-antibiotic paste

AIM

To evaluate the treatment outcomes of a revitalization endodontic technique (RET) for the management of traumatized immature teeth with necrotic pulps in children.

METHODOLOGY

Fifteen healthy children (age range = 7-10 years) with traumatized immature maxillary incisors with necrotic pulps treated with bi-antibiotic revitalization endodontic technique were prospectively assessed over approximately two years (mean = 22 months). One operator undertook all treatments, clinical reviews and standardized radiographic exposures with radiographic analysis being carried out by two calibrated experienced clinicians. Crown colour change was assessed using an objective published methodology. Wilcoxon signed-rank test was used to compare root lengths, root dentinal widths and apical foramen widths over time.

RESULTS

Interoperator measurement reliability was consistently strong for all measurements. There was no significant difference in root lengths or root dentinal wall widths following RET. A significant difference in apical foramen widths was observed after 2 years (P = 0.013) with resolution of clinical signs of infection in all cases. Despite omitting minocycline and using Portland cement (nonbismuth containing cement), a noticeable crown colour change (yellower, redder and lighter), as measured by an objective colour measurement system with ΔE = 7.39, was recorded. Most patients, however, were satisfied with the aesthetic outcome.

CONCLUSION

Traumatized immature teeth with necrotic pulps treated with revitalization endodontic technique did not demonstrate continuation of root development or dentine formation when assessed by periapical radiographs. However, apical closure and periodontal healing were observed. A measurable change in crown colour (yellower, redder and lighter), with mostly no aesthetic concern to the patients/parents, was also observed.

Randomized Controlled Trial of Postoperative Sensitivity with Warm and Room Temperature Composite

Physical properties of composite improve when it is preheated prior to polymerization. However, postoperative sensitivity may be considered a potential complication. A review of the literature revealed no reported randomized controlled trials (RCTs) of postoperative sensitivity when using preheated composite resin. The objective of the study was to determine if preheating composite leads to changes in postoperative sensitivity in a parallel RCT. In total, 120 eligible, consenting adults were recruited in private dental practice and randomized into 2 groups of 60 patients. One group had room temperature composite restorations placed and the second had composite preheated to 39°C. The primary outcome was sensitivity after 24 h by the visual analog scale (VAS), recorded blind by patients. Secondary outcomes were VAS scores recorded over a month. Blind statistical analysis used the Mann-Whitney U test to compare the 24-h VAS score between groups and repeated-measures analysis of variance to assess the change over time. Potential confounders were tested using regression models. A total of 115 patients completed the trial: 57 in the heated composite group and 58 in the room temperature group. Analysis of 24-h VAS scores found no statistically significant difference between the 2 groups ( P = 0.162). Examining the potential confounders confirmed the nonsignificant difference between heated and room temperature groups on the 24-h VAS score, after controlling teeth type and preoperative pulp test (effect size = 0.173, P = 0.317). Analysis of the secondary outcomes found significant changes (within-subject effect) in VAS scores over the review period ( F statistic = 4.7, P = 0.002) but not a significant (between-subject effect) difference between heated and room temperature groups over time (effect size = 0.102, P = 0.197). There was a significant correlation between preoperative VAS score and postoperative VAS score ( P < 0.001). For the restorations in this study, there was no detectable difference in postoperative VAS score between preheated and room temperature composite. Postoperative sensitivity decreased throughout the first month. Postoperative sensitivity was correlated to preoperative sensitivity (ISRCTN 76727312). Knowledge Transfer Statement: The results of this study can be used by clinicians when considering the advantages and disadvantages of preheated composite. The study found no evidence of any change in postoperative sensitivity when using preheated composite. Since preheated composite has superior physical properties, its use for routine care can be considered good practice.

[Therapeutic effects of histone deacetylase inhibitor givinostat on air inflammation and high airway resistance in a murine asthma model]

Objective: To investigate the therapeutic effects of givinostat, a histone deacetylase inhibitor (HDACI), on the development of chronic asthma with airway inflammation, airway remodeling and airway hyperresponsiveness (AHR). Methods: BALB/C mice were randomly divided into control group, asthma group, dexamethasone group and givinostat group (n=12 per group). AHR was assessed. Total cell numbers and differential counts, interleukin-4(IL-4), interleukin-5(IL-5) and interferon-γ (IFNγ) levels in the bronchoalveolar lavage fluid (BALF) were measured in the above 4 groups. The pathology of lung tissue was evaluated. Immunohistochemical (IHC) staining and Western blot were used to detect α smooth muscle actin(α-SMA) and transforming growth factor-β1(TGFβ1). Results: Compared with the asthma only group, givinostat treatment relieved airway resistance (2.96±1.01 vs 6.50±0.79, P<0.05). Total inflammatory cells [(33.04±5.62)×10(4)/ml vs (98.04±9.27)×10(4)/ml, P<0.01], eosinophil cells [(9.17±2.33)×10(4)/ml vs(37.64±6.98)×10(4)/ml, P<0.01], IL-4 [(10.12±2.98)ng/ml vs (16.88±2.78)ng/ml, P<0.05] and IL-5 [(27.09±3.62)ng/ml vs (37.86±7.34)ng/ml, P<0.05] levels were all reduced in givinostat group, while IFNγ [(91.86±23.73)pg/ml vs (60.49±11.88)pg/ml, P>0.05] was enhanced in BALF. Inflammatory cell infiltration around the airway was reduced, with decreased inflammatory cell score[(1.60±0.69)points vs (3.40±0.68) points, P<0.01] and inflammatory cell number (111.65±31.41 vs 601.25±186.85, P<0.01). The goblet cell metaplasia [(26.36±2.33)% vs (57.21±11.56)%] and collagen deposition area [(52.77±7.58)μm(2)/μm vs (111.81±12.40)μm(2)/μm] were obviously reduced (P<0.01). The expressions of α-SMA and TGFβ1 in the lung tissue were both significantly decreased (P<0.01). Conclusion: Givinostat treatment can reduce airway inflammation, airway remodeling and airway hyperresponsiveness in chronic asthma. Its effect is comparable to that of glucocorticoid hormone treatment.

Complete genome sequence of the Bifidobacterium animalis subspecies lactis BL3, preventive probiotics for acute colitis and colon cancer

We report the genome sequence of Bifidobacterium animalis subspecies lactis BL3, which has preventive properties on acute colitis and colon cancer. The genome of BL3, which was isolated from Korean faeces, consisted of a 1 944 323 bp size single chromosome, and its G+C content was 60.5%. Genome comparison against the closest Bifidobacterium animalis strain revealed that BL3 had particularly different regions of four areas encoding flavin-nucleotide-binding protein, transposase, multidrug ABC transporter and ATP binding protein.

Abstract P2-04-08: BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy in mammary adenocarcinoma

The AXL receptor tyrosine kinase is associated with poor overall survival in breast cancer. Axl signaling is an important regulator of tumor plasticity related to epithelial-to-mesenchymal transition (EMT) and stem cell traits that drive metastasis and drug resistance. Signaling via AXL is also a key suppressor of the anti-tumor innate immune response. AXL is expressed on several cells associated with the tumor immune microenvironment including natural killer cells, dendritic cells and tumor-associated macrophages. AXL is required for tumor immune evasion in mammary adenocarcinoma models and EMT-mediated resistance to cytotoxic T cell and natural killer (NK)-cell mediated cell killing. Hence AXL signaling contributes uniquely to both tumor cell intrinsic and microenvironmental anti-tumor immune suppression mechanisms in breast cancer. We evaluated whether blocking AXL signaling with BGB324, a selective clinical-stage small molecule Axl kinase inhibitor, enhances the effect of immune checkpoint blockade in the aggressive mammary adenocarcinoma (4T1) syngeneic (Balb/C) mouse modelthat display limited immunogenicity.

Immune therapy with anti-CTLA-4/anti-PD-1 increased AXL and EMT-marker expression in 4T1 tumors, and correlated with lack of response to immune therapy. Combination treatment with BGB324 (50 mg/kg bid) significantly enhanced responsiveness to anti-CTLA-4/anti-PD-1 treatment (10 mg/kg of each, 4 doses) in Balb/C mice bearing established 4T1 tumors. The combination of BGB324 + anti-CTLA-4/anti-PD-1 resulted in durable primary tumor clearance in 23 % of treated mice versus 5.6% obtained with anti-CTLA-4/anti-PD-1 alone (p=0.0157). In a separate study, BGB324 + anti-CTLA-4 treated resulted in 22% long-term primary tumor clearance while no response was observed with anti-CTLA4 treatment alone. The extensive metastasis to the lung, liver and spleen characteristic of this model were concomitantly abrogated in the animals responding to the combination treatment. In addition, BGB324 + anti-CTLA-4/anti-PD-1 treated tumors displayed enhanced infiltration of cytotoxic T lymphocytes (CTLs). Enhanced presence of CTLs was also detected in spleens from animals responding to treatment. BGB324 + anti-CTLA-4/anti-PD-1 treatment increased the number of NK cells, macrophages and polymorphonuclear neutrophils, but decreased the number of mMDSC. Importantly, responding animals rejected orthotopic 4T1 tumor cell re-challenge, demonstrating sustained tumor immunity.

Together with recent results in other tumor types that support a prominent role for AXL in resistance to immune therapy and encouraging results from ongoing clinical trials with BGB324, support combining BGB324 with immune checkpoint inhibitors to improve treatment of breast cancer.

Citation Format: Lorens JB, Lipinska KW, Davidsen K, Blø M, Hodneland L, Engelsen A, Kang J, Lie MK, Bougnaud S, Aguilera K, Ahmed L, Rybicka A, Nævdal EM, Deyna P, Boniecka A, Straume O, Chouaib S, Brekken RA, Gausdal G. BGB324, a selective small molecule inhibitor of the receptor tyrosine kinase AXL, enhances immune checkpoint inhibitor efficacy in mammary adenocarcinoma [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-04-08.