Improved reverse Monte Carlo analysis of optical property of Fe and Ni from reflection electron energy loss spectroscopy spectra

The energy loss functions (ELFs) of Fe and Ni have been derived from measured reflection electron energy loss spectroscopy (REELS) spectra by a reverse Monte Carlo analysis in our previous work. In this work, we present further improvements of ELFs for these metals. For Fe, we have updated ELFs at primary electron energies of 2 keV and 3 keV in a wider photon energy region (0-180 eV) with a better accuracy, which is verified by sum rules. Regarding to Ni, we supplement the ELF at primary energy of 5 keV and we also improve the data accuracy at 3 keV. Applying these new and more accurate ELFs we present the optical constants and dielectric functions for the two metals. The improvements were highlighted by comparing our present results with the previous data.

Reaction extent or advancement of reaction: A definition for complex chemical reactions

The concept of reaction extent (the progress of a reaction, advancement of the reaction, conversion, etc.) was introduced around 100 years ago. Most of the literature provides a definition for the exceptional case of a single reaction step or gives an implicit definition that cannot be made explicit. There are views that the reaction extent somehow has to tend to 1 when the reaction goes to completion as time tends to infinity. However, there is no agreement on which function should tend to 1. Starting from the standard definition by IUPAC and following the classical works by De Donder, Aris, and Croce, we extend the definition of the reaction extent for an arbitrary number of species and reaction steps. The new general, explicit definition is also valid for non-mass action kinetics. We also studied the mathematical properties (evolution equation, continuity, monotony, differentiability, etc.) of the defined quantity, connecting them to the formalism of modern reaction kinetics. Our approach tries to adhere to the customs of chemists and be mathematically correct simultaneously. To make the exposition easy to understand, we use simple chemical examples and many figures, throughout. We also show how to apply this concept to exotic reactions: reactions with more than one stationary state, oscillatory reactions, and reactions showing chaotic behavior. The main advantage of the new definition of reaction extent is that by knowing the kinetic model of a reacting system one can now calculate not only the time evolution of the concentration of each reacting species but also the number of occurrences of the individual reaction events.

Phase Ib open-label study to evaluate safety, tolerability, immunogenicity, and efficacy of multiple subcutaneous injections of PolyPEPI1018 vaccine as an add-on immunotherapy to TAS-102 in participants with late-stage microsatellite-stable metastatic colorectal cancer (MSS mCRC; OBERTO-201)

147

Background: PolyPEPI1018 is an off-the-shelf, multi-peptide vaccine containing 12 immunogenic epitopes derived from 7 cancer testis antigens (CTAs) frequently expressed in patients with colorectal cancer (CRC). PolyPEPI1018 successfully induced anticancer immunity and triggered recruitment and infiltration of cytotoxic T cells into the tumor of MSS mCRC subjects demonstrating also early evidence of clinical activity, in first-line mCRC. Here we report the initial results of the phase Ib study of PolyPEPI1018 vaccine plus trifluridine/tipiracil (TAS-102) in late-stage mCRC patients. Methods: Patients with MSS mCRC who have progressed on ≤2 lines of prior chemotherapy regimen for mCRC received PolyPEPI1018 subcutaneously on days 1 and 15 and TAS-102 orally twice daily on days 1-5 and 8-12 of a 28-day cycle. Treatment continued for up to 7 cycles until disease progression or unacceptable toxicity. Immunomonitoring was performed at both blood and tumor levels prior to- and on study treatment. The primary endpoint of the study was safety and tolerability. Data on objective response rate (ORR), disease control rate (DCR), progression-free survival (PFS), overall survival (OS) and correlation studies will be also presented. Results: 15 patients (67% male) started treatment. At baseline, median age was 55 years (range 31–71), 73% had liver metastases and the primary tumor site was colon-sigmoid in 40% and rectum in 33%. The combination was well-tolerated; most common side effect related to PolyPEPI1018 was Grade (Gr) 1-2 local skin reactions in 93% of patients. Gr 3 events. There were no Gr 4 or 5 events. The ORR was 0% and the DCR was 50%. The mPFS was 2.5 months (95%CI 2.1-NR). At the data cut-off (September 7, 2022), the mOS has not been reached; median follow-up was 4.0 months (95% CI 2.2-4.4). Post-treatment, vaccine-specific T cell responses were detected ex vivo in the PBMC of 4/5 subjects tested. In addition, one subject who had no detectable T cell response at peripheral level, responded at the tumor level with more than 300% increase of both CD3+ and CD8+ tumor-infiltrating lymphocytes compared to baseline. Patients with increased PFS (≥ 16 weeks) had robust vaccine-specific T cell responses. Conclusions: To our knowledge, this is the first phase Ib study investigating combination of a cancer vaccine with TAS-102 chemotherapy in advanced MSS mCRC. Our results show that PolyPEPI1018 plus TAS-102 was well-tolerated with few grade 3 AEs beyond what is expected with TAS-102 monotherapy. PolyPEPI1018 induced immunological responses at both peripheral and tumor level, albeit no objective tumor responses could be detected. The study is on-going for the collection of overall survival data. Clinical trial information: NCT05130060 .

T cell immunity ameliorates COVID-19 disease severity and provides post-exposure prophylaxis after peptide-vaccination, in Syrian hamsters

Background

The emergence of novel SARS-CoV-2 variants that resist neutralizing antibodies drew the attention to cellular immunity and calls for the development of alternative vaccination strategies to combat the pandemic. Here, we have assessed the kinetics of T cell responses and protective efficacy against severe COVID-19 in pre- and post-exposure settings, elicited by PolyPEPI-SCoV-2, a peptide based T cell vaccine.

Methods

75 Syrian hamsters were immunized subcutaneously with PolyPEPI-SCoV-2 on D0 and D14. On D42, hamsters were intranasally challenged with 10² TCID₅₀ of the virus. To analyze immunogenicity by IFN-γ ELISPOT and antibody secretion, lymphoid tissues were collected both before (D0, D14, D28, D42) and after challenge (D44, D46, D49). To measure vaccine efficacy, lung tissue, throat swabs and nasal turbinate samples were assessed for viral load and histopathological changes. Further, body weight was monitored on D0, D28, D42 and every day after challenge.

Results

The vaccine induced robust activation of T cells against all SARS-CoV-2 structural proteins that were rapidly boosted after virus challenge compared to control animals (~4-fold, p<0.05). A single dose of PolyPEPI-SCoV-2 administered one day after challenge also resulted in elevated T cell response (p<0.01). The vaccination did not induce virus-specific antibodies and viral load reduction. Still, peptide vaccination significantly reduced body weight loss (p<0.001), relative lung weight (p<0.05) and lung lesions (p<0.05), in both settings.

Conclusion

Our study provides first proof of concept data on the contribution of T cell immunity on disease course and provide rationale for the use of T cell-based peptide vaccines against both novel SARS-CoV-2 variants and supports post-exposure prophylaxis as alternative vaccination strategy against COVID-19.

Industrial symbiosis and agri-food system: Themes, links, and relationships

Industrial symbiosis is an eco-innovative system concept that is based on a circular economy and industrial ecology ideas. This process comprises the movement of materials, energy, and skills across enterprises located within eco-industrial parks, and strives to provide economic, environmental, and social competitive advantages for all the involved parties. Considering that the agri-food system creates a vast quantity of by-products along the supply chain, it is a sector that has huge potential within material and energy recovery systems and fits well into eco-industrial parks. The current study is a literature review that aims to evaluate the interest exhibited so far by scientific research in the topic of industrial symbiosis in the agri-food sector and to highlight the primary analytical techniques that have been used for this topic. Using the paradigm of multiple correspondence analysis, a content analysis was conducted from which the major themes of the researched phenomena emerged. The results indicate that the topic areas are unrelated and somewhat distant from each other. The analyzed case studies have revealed that the authors had neglected the communicative and collaborative elements among stakeholders, and instead focused on the potential use of some tools and approaches. Furthermore, it has been hypothesized that the hiding of information within a supply chain prevents industrial symbiosis procedures from being implemented. This research suggests the necessity of creating communication and cooperation platforms among stakeholders, which would promote the introduction of new techniques and tools for the development of circular production systems.

Safety and Activity of PolyPEPI1018 Combined with Maintenance Therapy in Metastatic Colorectal Cancer: an Open-Label, Multicenter, Phase Ib Study

PURPOSE

Although chemotherapy is standard of care for metastatic colorectal cancer (mCRC), immunotherapy has no role in microsatellite stable (MSS) mCRC, a "cold" tumor. PolyPEPI1018 is an off-the-shelf, multi-peptide vaccine derived from 7 tumor-associated antigens (TAA) frequently expressed in mCRC. This study assessed PolyPEPI1018 combined with first-line maintenance therapy in patients with MSS mCRC.

PATIENTS AND METHODS

Eleven patients with MSS mCRC received PolyPEPI1018 and Montanide ISA51VG adjuvant subcutaneously, combined with fluoropyrimidine/biologic following first-line induction with chemotherapy and a biologic (NCT03391232). In Part A of the study, 5 patients received a single dose; in Part B, 6 patients received up to three doses of PolyPEPI1018 every 12 weeks. The primary objective was safety; secondary objectives were preliminary efficacy, immunogenicity at peripheral and tumor level, and immune correlates.

RESULTS

PolyPEPI1018 vaccination was safe and well tolerated. No vaccine-related serious adverse event occurred. Eighty percent of patients had CD8+ T-cell responses against ≥3 TAAs. Increased density of tumor-infiltrating lymphocytes were detected post-treatment for 3 of 4 patients' liver biopsies, combined with increased expression of immune-related gene signatures. Three patients had objective response according to RECISTv1.1, and 2 patients qualified for curative surgery. Longer median progression-free survival for patients receiving multiple doses compared with a single dose (12.5 vs. 4.6 months; P = 0.017) suggested a dose-efficacy correlation. The host HLA genotype predicted multi-antigen-specific T-cell responses (P = 0.01) indicative of clinical outcome.

CONCLUSIONS

PolyPEPI1018 added to maintenance chemotherapy for patients with unresectable, MSS mCRC was safe and associated with specific immune responses and antitumor activity warranting further confirmation in a randomized, controlled setting.

Eco-Innovations Transition of Agri-food Enterprises Into a Circular Economy

Eco-innovations that reduce the environmental effect of manufacturing and consumption are seen as critical components of sustainable development and a critical component of the transition to a circular economy. Food systems address the issue of food waste, which is generally acknowledged as a cost to the economy, the environment, and society. Eco-innovations seem to be critical for the food system's transformation to a more circular model centered on sustainable food production and processing. The goal of this paper was to determine the variables that influenced the introduction of product, process, organizational, and marketing innovations in European Union agri-food enterprises between 2012 and 2014. According to a preliminary analysis of the data, 57.40% of agribusinesses did not implement any form of innovation, which prompted the authors to study the difficulties surrounding innovation development over the 3-year reference period. Several key factors emerge as significant influences on the introduction of product innovations (0.055**); contractual requirements as significant influences on the introduction of process innovations (−0.081***); and environmental incentives as significant influences on the introduction of marketing innovations (0.062***). Additionally, product (0.704***) and process (1.051***) innovations tend to have a greater influence on enterprises' views of circular benefits. The investigation also demonstrates how enterprises and end users interpret the effect of various forms of innovation differently. Indeed, end users, in contrast to how enterprises understand it, believe that organizational (0.611***) and marketing (0.916***) innovations are critical in pursuing circular benefits.

Valorizing the Unexplored Filtration Waste of Brewing Industry for Green Silver Nanocomposite Synthesis

The brewing industry generates a substantial amount of by-products rich in polyphenols, carbohydrates, sugars, sulfates, nitrogen compounds, organic carbon, and several elements, including chlorine, magnesium, and phosphorus. Although limited quantities of these by-products are used in fertilizers and composts, a large amount is discarded as waste. Therefore, it is crucial to identify different ways of valorizing the by-products. Research regarding the valorization of the brewery by-products is still in its nascent stage; therefore, it still has high potential. Herein, we report the valorization of the brewery by-product from the filtration stage of the brewing process (BW9) to synthesize silver nanocomposites as this waste has remained largely unexplored. The BW9 nanocomposites have been compared to those obtained from the brewery product B. The chemical composition analysis of BW9 and B revealed several organic moieties capable of reducing metal salts and capping the formed nanoparticles. Therefore, the brewery waste from stage 9 was valorized as a precursor and added to silver-based precursor at various temperatures (25, 50, and 80 °C) and for various time periods (10, 30, and 120 min) to synthesize silver nanocomposites. The nanocomposites obtained using BW9 were compared to those obtained using the main product of the brewing industry, beer (B). Synthesized nanocomposites composed of AgCl as a major phase and silver metal (Ag_met) was incorporated in minor quantities. In addition, Ag₃PO₄ was also found in B nanocomposites in minor quantities (up to 34 wt.%). The surface morphology depicted globular nanoparticles with layered structures. Small ball-like aggregates on the layer representative of Ag₃PO₄ were observed in B nanocomposites. The surface of nanocomposites was capped with organic content and functional groups present in the brewery products. The nanocomposites demonstrated high antibacterial activity against Escherichia coli (E. coli), with BW9 nanocomposites exhibiting a higher activity than B nanocomposites.

Valorization of Brewery Wastes for the Synthesis of Silver Nanocomposites Containing Orthophosphate

Brewery wastes from stage 5 (Wort precipitate: BW5) and stage 7 (Brewer's spent yeast: BW7) were valorized for the synthesis of silver phosphate nanocomposites. Nanoparticles were synthesized by converting silver salt in the presence of brewery wastes at different temperatures (25, 50, and 80 °C) and times (10, 30, and 120 min). Unexpectedly, BW7 yielded Ag3PO4 nanoparticles with minor contents of AgCl and Ag metal (Agmet). Contrastingly, BW5 produced AgCl nanoparticles with minor amounts of Ag3PO4 and Agmet. Nanocomposites with different component ratios were obtained by simply varying the synthesis temperature and time. The morphology of the nanocomposites contained ball-like structures representative of Ag3PO4 and stacked layers and fused particles representing AgCl and Agmet. The capping on the nanoparticles contained organic groups from the brewery by-products, and the surface overlayer had a rich chemical composition. The organic overlayers on BW7 nanocomposites were thinner than those on BW5 nanocomposites. Notably, the nanocomposites exhibited high antibacterial activity against Escherichia coli ATCC 25922. The antibacterial activity was higher for BW7 nanocomposites due to a larger silver phosphate content in the composition and a thin organic overlayer. The growth of Agmet in the structure adversely affected the antimicrobial property of the nanocomposites.

A Peptide Vaccine Candidate Tailored to Individuals' Genetics Mimics the Multi-Targeted T Cell Immunity of COVID-19 Convalescent Subjects

Long-term immunity to coronaviruses likely stems from T cell activity. We present here a novel approach for the selection of immunoprevalent SARS-CoV-2-derived T cell epitopes using an in silico cohort of HLA-genotyped individuals with different ethnicities. Nine 30-mer peptides derived from the four major structural proteins of SARS-CoV-2 were selected and included in a peptide vaccine candidate to recapitulate the broad virus-specific T cell responses observed in natural infection. PolyPEPI-SCoV-2-specific, polyfunctional CD8+ and CD4+ T cells were detected in each of the 17 asymptomatic/mild COVID-19 convalescents' blood against on average seven different vaccine peptides. Furthermore, convalescents' complete HLA-genotype predicted their T cell responses to SARS-CoV-2-derived peptides with 84% accuracy. Computational extrapolation of this relationship to a cohort of 16,000 HLA-genotyped individuals with 16 different ethnicities suggest that PolyPEPI-SCoV-2 vaccination will likely elicit multi-antigenic T cell responses in 98% of individuals, independent of ethnicity. PolyPEPI-SCoV-2 administered with Montanide ISA 51 VG generated robust, Th1-biased CD8+, and CD4+ T cell responses against all represented proteins, as well as binding antibodies upon subcutaneous injection into BALB/c and hCD34+ transgenic mice modeling human immune system. These results have implications for the development of global, highly immunogenic, T cell-focused vaccines against various pathogens and diseases.

A fully automated system with an optical immersion probe (OIP) for high-precision spectrophotometric measurements

A new and fully automated system with the interconnection of an Optical Immersion Probe (OIP) - pH meter - peristaltic pump was used to study the spectral and protolytic properties of carbocyanine the dyes 1,1',3,3,3',3'-hexamethylindocarbocyanine chloride (HIC); 1,1',3,3,3',3'-hexamethylindodicarbocyanine iodide (HIDC); and 3,3'-diethyloxadicarbocyanine iodide (DODC). This system can measure a large number of experimental points in a short time period. The effect of 32 various organic solvents on the UV-ViS spectra of the dyes was studied. The solvatochromic behaviour of studied dyes was characterized by positive solvatochromism for HIDC and negative solvatochromism for HIC and DODC. Through the application of a large number of experimental points, the protonation and hydrolysis constants of dyes were determined with high precision, where the confidence interval of the рK values is ±(0.001-0.005), compared with a confidence interval of ±(0.04-0.10) for standard procedures. The fully automated system presented is accurate, fast, environmentally friendly and promising for multiple analytical applications.

Complementary Manipulator Tool Development for Safe Cobot-Assisted Hydroponics

Human-robot collaboration is gaining ground in Manufacturing, Healthcare and Logistics but also in Agriculture. Different types of applications in the latter field are becoming more common. However, in all scenarios, safety assessment and verification are crucial to cope with the related standards and specifications. In this paper, the development and safety testing of a complementary manipulator tool (Clip) is presented which can by design limit the physical interaction energy in a hazardous collaborative robot (cobot) scenario, namely when loading the plant of a Hydroponic System.

Evaluation of safety, immunogenicity, and preliminary efficacy of PolyPEPI1018 off-the-shelf vaccine with fluoropyrimidine/bevacizumab maintenance therapy in metastatic colorectal cancer (mCRC) patients

4048

Background: PolyPEPI1018 is an off-the-shelf, multi-peptide vaccine containing 12 immunogenic epitopes derived from 7 cancer testis antigens (CTAs) frequently expressed in patients with CRC. Here we report the final results of the phase I study of PolyPEPI1018 vaccine as an add-on to maintenance therapy in mCRC patients. Methods: 11 patients with MSS mCRC were vaccinated with PolyPEPI1018 just after the transition to maintenance therapy with fluoropyrimidine/bevacizumab after first-line combo chemotherapy and bevacizumab. Part A: n = 5, single dose; Part B: n = 6, 3 doses, Q12W. Primary endpoint was safety. Immunomonitoring was performed at both blood and tumor levels, as well as prospectively predicted. Results: The vaccine was well tolerated; most common side effects were transient skin reactions. No vaccine-related SAE occurred. Pre-existing immune responses were boosted by the vaccine for 7/10 patients. De novo responses were also induced, overall, 80% of patients had CD8+ T cell responses against at least 3 CTAs. The magnitude of immune responses as well as the density and the ratio of CD8+/CD3+ tumor infiltrating T cells increased with multiple vaccine doses. Three patients had objective tumor response according to RECIST v1.1: one of them in the single dose group and two of them in the 3 doses group. Both patients in the 3 doses group qualified for curative surgery. One of them had no viable tumor cells in his primary tumor at the time of surgery. Post-trial follow-up revealed PFS of at least 12 months for 3 patients. mPFS was longer for patients receiving multiple doses (9.9 months) compared to single dose (6.1 months). Both measured and predicted multiantigenic immune responses tend to correlate with PFS and tumor volume reduction. Conclusions: PolyPEPI1018 was effective in restoring immunological responses to CTAs in patients’ with spontaneous immunity against. Treatment with PolyPEPI1018 vaccine and maintenance therapy was safe and demonstrated evidence of early clinical activity in MSS mCRC tumors. Data support further randomized trials with PolyPEPI1018. Clinical trial information: NCT03391232 .

Surface Study of Fe3O4 Nanoparticles Functionalized With Biocompatible Adsorbed Molecules

Surfaces of iron oxide of ferrimagnetic magnetite (Fe₃O₄) nanoparticles (MNPs) prepared by Massart's method and their functionalized form (f-MNPs) with succinic acid, L-arginine, oxalic acid, citric acid, and glutamic acid were studied by dynamic light scattering (DLS), Fourier transform infrared spectroscopy (FTIR-S), UV-vis, thermogravimetric analysis (TGA)/differential scanning calorimetry (DSC), X-ray photoelectron spectroscopy (XPS), and reflection electron energy loss spectroscopy (REELS). The XPS analysis of elements and their chemical states at the surface of MNPs and f-MNPs revealed differences in chemical bonding of atoms, content of carbon–oxygen groups, iron oxide forms, iron oxide magnetic properties, adsorbed molecules, surface coverage, and overlayer thickness, whereas the Auger parameters (derived from XPS and Auger spectra) and elastic and inelastic scattering probabilities of electrons on atoms and valence band electrons (derived from REELS spectra) indicated modification of surface charge redistribution, electronic, and optical properties. These modified properties of f-MNPs influenced their biological properties. The surfaces biocompatible for L929 cells showed various cytotoxicity for HeLa cells (10.8–5.3% of cell death), the highest for MNPs functionalized with oxalic acid. The samples exhibiting the largest efficiency possessed smaller surface coverage and thickness of adsorbed molecules layers, the highest content of oxygen and carbon–oxygen functionalizing groups, the highest ratio of lattice O²⁻ and OH⁻ to C sp² hybridizations on MNP surface, the highest ratio of adsorbed O⁻ and OH⁻ to C sp² hybridizations on adsorbed molecule layers, the closest electronic and optical properties to Fe₃O₄, and the lowest degree of admolecule polymerization. This high cytotoxicity was attributed to interaction of cells with a surface, where increased content of oxygen groups, adsorbed O⁻, and OH⁻ may play the role of additional adsorption and catalytic sites and a large content of adsorbed molecule layers of carboxylic groups facilitating Fenton reaction kinetics leading to cell damage.

Determination of the immunogenetic risk of developing cancer

e13132

Background: Association between certain HLA types and cancer is well known. We hypothesized that the number of epitopes of tumor antigens presented by autologous HLAs characterizes a patient’s capacity to kill tumor cells. These CD8+ T cell epitopes are presented by 6 out of >13,000 known HLA class I alleles and induce extremely variable tumor-specific T-cell responses. Methods: We predicted HLA-binding epitopes from 48 frequently expressed tumor antigens in subjects characterized with 6 HLA class I alleles. To develop the “HLA Score” cancer risk predictor we used epitopes binding to multiple HLAs of a subject. The predictor was trained on 5,789 non-American subjects. To identify populations with high and low immunogenetic risk to develop cancer we compared the HLA Score of American cancer subjects to a general population of American subjects (1,400 subjects). The performance of the predictor was characterized with AUC and Risk Ratio. Due to Bonferroni correction, AUC values with p-value p<0.007 was accepted as significant. Results: “HLA Score” predictor significantly separated cancer patients from the general population in six out of the seven investigated cancer types. The Risk Ratios between the most protected and most at risk subpopulations ranged between 2.38 and 5.67 (Table). Cancer risk prediction with HLA Score. Conclusions: Subjects with certain HLA class I alleles have high risk of developing cancer. The novel “HLA Score” predictor we introduced here could complement current testing used for determination of the genetic risk of cancer.[Table: see text]

A phase I study of PolyPEPI1018 vaccine plus maintenance therapy in patients with metastatic colorectal cancer with a predictive biomarker (OBERTO)

3557

Background: The goal of this study was to evaluate the safety, tolerability and immunogenicity of a single dose of PolyPEPI1018 as an add-on to maintenance therapy in subjects with metastatic colorectal cancer (mCRC). PolyPEPI1018 is a peptide vaccine containing 12 unique epitopes derived from 7 conserved cancer testis antigens (CTAs) frequently expressed in mCRC. These epitopes were designed to be Personal EPItopes (PEPIs), i.e. predicted by our novel PEPI test to bind to at least three autologous HLA alleles and more likely to induce T-cell responses than epitopes presented by a single HLA. Methods: mCRC patients in the first line setting received the vaccine (dose: 0.2 mg/peptide) just after the transition to maintenance therapy with a fluoropyrimidine and bevacizumab. Vaccine-specific T-cell responses were first predicted by the PEPI test (using the patient’s complete HLA genotype and antigen expression rate) and then measured by ELISpot after one cycle of vaccination. Results: Eleven patients were vaccinated with PolyPEPI1018. The most common adverse events were transient skin reactions (local inflammation at the site of the injections, e.g. erythema, redness and itchiness) and flu-like syndrome. No grade 3 or higher adverse events related to the vaccine occurred. Initial analysis on 4 patients demonstrated that T-cell responses were elicited by 96% of vaccine peptides. The overall percentage agreement between PEPI test-predicted and Elispot-measured CD8+ T cell responses was 71%, consistent with our retrospective analysis on 64 vaccine clinical trials involving 1,790 patients. Two of these 4 patients had unexpected tumor size reduction. Based on these encouraging results, the trial was amended to administer 3 doses of PolyPEPI1018 given 12 weeks apart. Conclusions: PolyPEPI1018 combined with maintenance therapy was safe and well-tolerated in mCRC patients. Unprecedented immune responses were induced after single dose, with broad CRC-specific T cell responses and high accuracy prediction of CD8+ T cell responses. This promising activity in mCRC patients led to a trial amendment to administer 3 doses of PolyPEPI1018 in combination with systemic therapy. Clinical trial information: NCT03391232.

Human model to predict the outcome of cancer vaccine clinical trials

e14298

Background: Cancer vaccines activate T-cells with peptides presented by HLA alleles. We hypothesized that peptides binding to multiple HLA alleles of a patient are more likely to induce T-cell responses than epitopes presented by a single HLA. To prove this hypothesis we predicted the outcome of vaccine clinical trials in a Model Population of subjects with complete HLA genotype. Methods: We collected the immune- and objective response rate (IRR, ORR) results from 64 clinical trials conducted in 1,790 patients treated with 42 different vaccines. From these 42 vaccines, we identified personal epitopes (PEPIs) with strong binding affinity to at least 3 HLA alleles of each subject in the Model Population and calculated the proportion of subjects with PEPIs (PEPI Score), multiple PEPIs (MultiPEPI-Score) and PEPIs against multiple vaccine antigens (MultiAg PEPI-Score). Results: Highly significant correlation between the PEPI Score and IRR (p = 0.001) suggests that peptides binding to at least 3 HLA alleles of the subject induce T-cell responses. MultiPEPI-Score correlated with ORR when the tumor of patients expressed the target antigen (p = 0.01). MultiAg PEPI-Score correlated with ORR of clinical trials conducted with vaccines containing multiple antigens (p = 0.01). Conclusions: Our results suggest that (i) a patient’s HLA genotype is the main determinant of vaccine response and (ii) T-cell responses against multiple antigens expressed in the patient’s tumor favors tumor shrinkage. We introduced a novel pre-clinical human model that accurately predicts the outcome of clinical trials, will reduce the risk, cost and time of vaccine development for the prevention and treatment of cancer.

Prediction the clinical outcomes of cancer patients after peptide vaccination

e14295

Background: Neoantigen vaccines can activate T-cells that specifically kill tumor cells. However, most vaccine peptides, selected either as HLA-binders or as HLA-presented epitopes, do not induce T-cell responses in HLA allele-matched individuals. We hypothesized that personal-epitopes (PEPIs) binding to multiple autologous HLA-alleles induce potent T-cell responses. Methods: Epitopes binding to single HLA and PEPIs binding to 3 autologous HLA-alleles were identified with our novel and validated PEPI Test (CE Marked) and correlated with CD8+ and CD4+ T-cell responses of (pre)malignant patients vaccinated with Synthetic Long Peptides (SLPs) in 2 clinical trials. A Model Population of 433 HLA-genotyped individuals was used to determine the percentage of subjects with PEPIs from SLPs (PEPI-Score). As a proof of principle, a personal vaccine was developed matching with 14 HLA-alleles of a cancer patient with PEPIs from 12 tumor-antigens. T-cell reactivities were tested by interferon-γ ELISPOT. Results: There was no correlation between single HLA-binding epitopes and HPV-specific T-cell responses of patients. In contrast, there was 90% and 69% agreement between HLA-class-I PEPIs and CD8+ T-cell responses (p < 0.001) and HLA-class-II PEPIs and CD4+ T-cell responses (p = 0.005), respectively. PEPI-Score predicted the T-cell response rate of SLP vaccine clinical trials. As predicted by the PEPI Test, personal vaccine treatment activated tumor-specific T-cells: 91% and 100% of the vaccine peptides elicited CD8+ and CD4+ T-cell responses, respectively. Conclusions: A patient’s HLA genotype is a major determinant of vaccine responses and PEPIs are genetic biomarkers of T-cell responses. PEPI Test prediction of vaccine responses can be utilized by clinicians for selecting the vaccine treatment and for the development of highly immunogenic personal vaccines matched to a patient’s complete HLA genotype (NCT03391232).

Correlation of Biochemical Tumor Markers with Conventional Pathological Features in Primary Breast Cancer

In this prospective study the correlation of pathological with biological prognostic factors and serum tumor markers has been investigated in 574 patients with primary invasive breast cancer. The p53 protein and Bax level correlated positively with tumor size, lymph node status and histological grade. The serum levels of CEA, CA 15.3, TPA-M and TK correlated with tumor extent. There was a significant difference between pre- and postmenopausal breast cancer patients in serum levels of TPA-M and cytosol levels of Bax. Whether these correlations can help in predicting the prognosis of breast cancer by providing additional information with respect to the conventional factors, will have to be investigated by several years of careful clinical follow-up.

Immunohistochemistry and Reverse Transcriptase Polymerase Chain Reaction on Sentinel Lymph Nodes can Improve the Accuracy of Nodal Staging in Breast Cancer Patients

In this study the nodal staging sensitivity of sentinel lymph node biopsy (SLNB) with detailed pathological and molecular biological examination has been investigated and compared to that of axillary lymph node dissection (ALND) with routine histological evaluation. Sentinel lymph nodes (SLNs) were removed by the dual-agent injection technique in 68 patients with primary, clinically node-negative breast cancer. Forty-seven patients had negative SLNs according to hematoxylin and eosin (H&E) staining. These H&E-negative SLNs were serially sectioned and examined at 250 μm levels by anticytokeratin immunohistochemistry (IHC). In 14 patients the SLNs were also investigated by cytokeratin 20 (CK20) reverse transcriptase polymerase chain reaction (RT-PCR). SLNB with IHC increased the node-positive rate by 26% (by 40% in tumors less than or equal to 2 cm in size (pT1) and by 9% in tumors more than 2 cm but less than or equal to 5 cm in size (pT2)). The sensitivity of SLNB with IHC was superior to that of ALND with routine histology in pT1 tumors and identical in pT2 tumors. The concordance between histology and RT-PCR was only 21%, and in two of three cases with positive histological results RT-PCR was negative. In conclusion, SLNB with detailed pathological and/or molecular biological evaluation can improve the sensitivity of regional staging. ALND can probably be abandoned in patients with pT1 SLN-negative breast cancer. Further prospective studies are required to determine the clinical significance of these detailed SLN evaluation techniques, but at present these methods are still investigational.

Transpalpebrale Bulbusentfernung am stehenden Pferd

Ziel: Überprüfung der Praktikabilität einer transpalpebralen Bulbusentfernung am stehenden Pferd. Material und Methoden: Auswertung der Krankengeschichte von 14 Patienten, bei denen aufgrund unterschiedlicher Befunde eine Enucleatio bulbi durchgeführt werden musste. Ergebnisse: Die transpalpe - brale Entfernung des Bulbus oculi kann am stehenden Pferd mit ausreichender Sicherheit vorgenommen werden. Keines der Pferde zeigte während der Vorbereitung, der Enukleation oder der Naht Schmerzreaktionen. Die Voraussetzungen für ein sauberes Arbeiten sind eine sichere Fixierung des Patienten in einem Zwangsstand, eine ausreichend tiefe Sedation und eine vollständige Analgesie. Dazu werden systemisch verabreichte synthetische Opioide und eine Lokalanästhesie motorischer und sensorischer Nerven kombiniert. Die Operation selbst kann wie am narkotisierten Patienten vorgenommen werden. Von Vorteil ist die am stehenden Pferd weniger stark ausgeprägte Blutungsneigung. Dies erlaubt einen Eingriff unter guten Sichtverhältnissen und reduziert die Häufigkeit blutungsbedingter Wundheilungsstörungen. Schlussfolgerung und klinische Relevanz: Augenoperationen am stehenden Pferd wurden von zahlreichen Autoren beschrieben. Der erste Bericht über die Bulbusentfernung am stehenden Pferd stammt aus dem Jahr 2004. Durch eine tiefe Sedation in Kombination mit einer ausreichenden Schmerzausschaltung im Operationsbereich bestehen die gleichen Voraussetzungen für einen schnellen und sicheren Eingriff wie am narkotisierten Patienten. Bei alten Pferden, tragenden Stuten oder wenn das Narkoserisiko aus anderen Gründen besonders hoch erscheint, sollte das Verfahren in Betracht gezogen werden.

[Detection of leptospira by culture of vitreous humor and detection of antibodies against leptospira in vitreous humor and serum of 225 horses with equine recurrent uveitis]

In the ongoing discussion regarding the aetiopathogenesis of equine recurrent uveitis (ERU) it was the aim of the present study to elucidate the relationship of leptospira infection and ERU. In a population of 225 horses leptospira were examined in vitreous humor by culture and leptospira antibody were detected in vitreous humor and serum samples. Preoperative serum samples were collected from 221/225 ERU patients of different age, gender and breed. Undiluted vitreous humor was aseptically taken from 198/225 patients that underwent pars plana vitrectomy at the beginning of surgery and from 27/225 patients' eyeball after enucleation: Serum and vitreous humor were tested for specific leptospiral antibodies by microscopic agglutination test (MAT). Furthermore, vitreous humor was examined by culture. 20 patients which were euthanized due to a live-threatening disease other than ERU served as a control group. A total of 127/221 (57.5%) horses had serum antibodies (≥ 1:100). Most frequently antibodies against L. interrogans serovar Grippotyphosa were detected (79/127), followed by L. interrogans serovar lcterohaemorrhagiae (34/127) and L. interrogans serovar Bratislava (29/127). Only 79/225 horses (35.1%) had leptospiral antibodies in vitreous humor, in which L. interrogans serovar Grippotyphosa (67/79) was identified most frequently followed by L. interrogans serovar Pomona (18/79) and L. interrogans serovar lcterohaemorrhagiae (8/79) which was identified as single or multiple reaction. Isolation of leptospira from vitreous humor was positive in 34/212 horses (16%). 10/20 control horses had a positive antibody titer against leptospira in serum and 2/20 horses in vitreous humor, whereas there was no leptospira detected in culture. The result of 84% negative cultures from vitreous humor of 212 ERU patients is decisive for the diagnosis and therapy of ERU.

[Genetic information from tumor-infiltrating B lymphocytes as a driver tool ("GPS") for anti-tumor T cell CARs]

The rapidly growing field of gene therapy techniques to modify T cells with chimeric antigen receptors (CARs) for cancer care solutions, reached considerable achievements. However, there is an urgent need of reliable, well tolerable tumor-associated antigen specific antibodies. Tumor-infiltrating B (TIL-B) cell originated single chain Fv (scFv) gene regions could be selected with tumor specificity. DNA sequences of these antibody variable regions were subjects to get engineered into new CAR constructs. Our novel strategy harnesses tumor-infiltrating B cells' unique capacity to reveal highly tumor-associated disialylated glycosphingolipids (GD3 gangliosides). We used these human antibody fragments for generating GD3 ganglioside specific CAR gene constructs for potential usage in solid tumors.

[The cost of surgical and endovascular treatment of abdominal aortic aneurysm - a retrospective comparative study]

INTRODUCTION

A comparison of the costs of a surgery and an endovascular treatment of abdominal aortic aneurysms (AAA) for the General Health Insurance Company (VšZP) in 2009-2010.

MATERIAL AND METHODS

Between 2009 and 2010, VšZP paid for treatment of 211 patients with AAA with an average age of 69 years (range: 41-91 years). Out of these, 174 patients underwent surgical treatment and 37 patients were treated by endovascular means. In both groups, we observed a total cost of treatment, payment for hospitalization (UH) and separately charged material (ZM), the cost of blood and reimbursement for CT (computer tomography) examinations and the patient age. For statistical comparison, we used the nonparametric Mann-Whitney U test, the limit of statistical significance was <0.01. The data were processed and compared by means of contingency tables in MS Excel and then statistically processed in the program StatSoft, Inc.. (2011). STATISTICA (data analysis software system), version 10th www.statsoft.com.

RESULTS

The total two-year costs of VšZP for the treatment of AAA were € 1 212 188 - out of which 37% were represented by the OR costs (open repair) and 63% for EVAR (endovascular aneurysm repair) (p <0.01). In terms of the ZM use (p <0.01), and the use of CT examinations (p <0.01), EVAR is cost demanding. OR is cost demanding in terms of the blood consumption levels (p <0.01). The average total cost per admission was € 21,038 for EVAR and € 2,493 for OR, representing only 12% of the total EVAR costs. The age of patients has no impact on the costs (p> 0.01). The decisive impact on the total costs is represented by ZM, which presents 90 % of costs of EVAR method and 44% of OR method.

CONCLUSION

OR and EVAR are effective modalities for the treatment of AAA. EVAR is a minimally invasive method, but the treatment costs are more than 8 times higher than the costs of surgical treatment. In terms of the VšZP cost control for the treatment of AAA, there must be clearly defined explicit indication criteria for EVAR. In terms of the costs for the treatment of AAA with "good risk" patients and those cases where there are no local obstacles for the surgical treatment (eg, colostoma, hostile abdomen, ren arcuatus and other), the surgical therapy is a "gold" standard. The health insurance company is a crucial regulator of the system of payment for provided medical care. The development of medical technology and the financial burden, on one hand, and the limited and scarce resources, on the other hand, are a source of "tension" between the health care providers and the regulators (insurance, Ministry of Health). One way to slow the "opening of the scissors" is to establish clear rules for the entry of new technologies into clinical practice, clearly defined costs (COI - cost of illness), and the usefulness and cost-effectiveness (CEA - cost-effectiveness analysis, ICER - incremental cost-effectiveness ratio, QALY - quality-adjusted life year). Despite the fact that it has beenmore than 20 years after the "velvet revolution", implementing the principles of health economics and health technology into practice has been managed in a rather weak way. The comparison of the costs of treatment is applicable in many areas of clinical medicine, and in the case of well-defined data it can be a source for the determination of ICER, CEA and QALYs. Key words: abdominal aortic aneurysms - surgery and endovascular treatment - costs.

Comparison of mastectomy with breast-conserving surgery in invasive lobular carcinoma: 15-Year results

BACKGROUND

Invasive lobular cancer (ILC) is biologically distinct from invasive ductal cancer and there is disagreement regarding appropriate local management of this disease.

AIM

The current study reports long term results comparing mastectomy with breast-conserving surgery (BCS) in the treatment of ILC.

MATERIAL AND METHODS

Study includes 235 women with ILC treated between 1983 and 1987. All of them underwent axillary dissection and either mastectomy (n = 163) or BCS (n = 72). 50 Gy adjuvant radiotherapy (RT) was given for 53 BCS and 81 mastectomy patients. The BCS group was compared with the mastectomy group.

RESULTS

Patients treated with mastectomy or BCS had a similar outcome at 15 years with regard to distant metastasis-free (62% vs. 70%; p, 0.2017) and breast cancer-specific (62% vs. 70%; p, 0.1728) survival. In the BCS group the actuarial rate of ipsilateral in breast recurrences was 10% with and 53% without RT at 15 years (relative risk [RR], 0.10; p < 0.0001). In the mastectomy group the actuarial rate of chest wall recurrences was 16% with and 13% without RT at 15 years (RR, 1.45; p, 0.3965). Isolated ipsilateral in breast recurrence did not (RR, 1.73; p, 0.2767) but isolated chest-wall recurrence did (RR, 2.65; p, 0.0089) adversely affect cause-specific survival.

CONCLUSION

Breast cancer specific survival is not affected by the type of surgical treatment. BCS and RT is a safe option to control local disease in patients with ILC.

Expression of invasion-related extracellular matrix molecules in human glioblastoma versus intracerebral lung adenocarcinoma metastasis

Tumor cell invasion into the surrounding brain tissue is mainly responsible for the failure of radical surgical resection, with tumor recurrence in the form of microdisseminated disease. Extracellular matrix (ECM)-related molecules and their receptors predominantly participate in the invasion process, including cell adhesion to the surrounding microenvironment and cell migration. The extent of infiltration of the healthy brain by malignant tumors strongly depends on the tumor cell type. Malignant gliomas show much more intensive peritumoral invasion than do metastatic tumors. In this study, the mRNA expression of 30 invasion-related molecules (twenty-one ECM components, two related receptors, and seven ECM-related enzymes) was investigated by quantitative reverse transcriptase-polymerase chain reaction. Fresh frozen human tissue samples from glioblastoma (GBM), intracerebral lung adenocarcinoma metastasis, and normal brain were evaluated. Significant differences were established for 24 of the 30 molecules. To confirm our results at the protein level, immunohistochemical analysis of seven molecules was performed (agrin, neurocan, syndecan, versican, matrix metalloproteinase 2 [MMP-2], MMP-9, and hyaluronan). Determining the differences in the levels of invasion-related molecules for tumors of different origins can help to identify the exact molecular mechanisms that facilitate peritumoral infiltration by glioblastoma cells. These results should allow the selection of target molecules for potential chemotherapeutic agents directed against highly invasive malignant gliomas.