Debonding of Leucite-reinforced Glass-ceramic Veneers Using Er, Cr:YSGG Laser Device: Optimizing Speed with Thermal Safety

CLINICAL RELEVANCE

Removing laminate veneers on anterior teeth by using an Er,Cr:YSGG dental laser can be completed faster than previously reported while maintaining thermal safety.

SUMMARY

Pulsatile MEK inhibition improves anti-tumor immunity and T cell function in Kras mutant lung cancer

KRAS is one of the most commonly identified driver oncogene in non-small cell lung cancer (NSCLC) and is commonly associated with disease refractory to current available modalities of treatment. Targeted therapy to inhibit MEK has shown promising tumor growth control in preclinical models, but is followed by quick rebound of tumor growth. Recently, immune checkpoint blockade has shown clinical activity by dis-inhibiting T cells that are suppressed in the tumor microenvironment. We sought to identify the most effective therapy for the treatment of KRAS mutant NSCLC patients by targeting cancer cells and activating infiltrating immune cells concurrently. We focused on studying the impact of pulsatile MEK inhibition on the immune microenvironment. We found that pulsatile MEK inhibition maintained T cell activation better than continuous treatment ex vivo and in vivo. Treatment with two different MEK inhibitors (selumetinib and trametinib) each resulted in higher CTLA-4 and PD-1 expression in tumor-infiltrating T cells using pulsatile treatment, compared to continuous treatment in Kras mutant lung cancer mice. In addition, the pulsatile schedule showed a superior anti-tumor effect and delayed drug resistance compared to the continuous schedule. Further, combination of pulsatile MEK inhibitor treatment and CTLA-4 blockade resulted in the longest survival of Kras tumor-bearing mice. Similar experiments in immune deficient mice confirmed that this prolonged survival is conferred by adaptive immunity. Our findings set the foundation for a combinatorial therapeutic strategy using pulsatile targeted therapy together with immunotherapy in patients to optimally enhance tumor apoptosis and promote immune response simultaneously.