In this prospective trial, patients with enhanced clinical risk and omitted chemotherapy on the basis of RS ≤ 11 had excellent 3-year survival. The substantial discordance observed between traditional prognostic markers and RS emphasizes the need for standardized assessment and supports the potential integration of standardized, well-validated genomic assays such as RS with clinicopathologic prognostic factors for chemotherapy indication in early hormone receptor-positive BC.

B-cell antigen receptor (BCR) expression is an important feature of chronic lymphocytic leukaemia (CLL), one of the most prevalent B-cell neoplasias in Western countries. The presence of stereotyped and quasi-identical BCRs in different CLL patients suggests that recognition of specific antigens might drive CLL pathogenesis. Here we show that, in contrast to other B-cell neoplasias, CLL-derived BCRs induce antigen-independent cell-autonomous signalling, which is dependent on the heavy-chain complementarity-determining region (HCDR3) and an internal epitope of the BCR. Indeed, transferring the HCDR3 of a CLL-derived BCR provides autonomous signalling capacity to a non-autonomously active BCR, whereas mutations in the internal epitope abolish this capacity. Because BCR expression was required for the binding of secreted CLL-derived BCRs to target cells, and mutations in the internal epitope reduced this binding, our results indicate a new model for CLL pathogenesis, with cell-autonomous antigen-independent signalling as a crucial pathogenic mechanism.

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Herein, we examine the influence of adding functionalized graphene (FG), distinct expanded graphites and carbon nanofillers such as carbon black and multiwall carbon nanotubes on mechanical properties, morphology, pyrolysis, response to small flame and burning behavior of a V-2 classified flame-retarded polypropylene (PP). Among carbon fillers, FG and multilayer graphene (MLG) containing fewer than 10 layers are very effectively dispersed during twin-screw extrusion and account for enhanced matrix reinforcement. In contrast to the other fillers, no large agglomerates are detected for PP-FR/FG and PP-FR/MLG, as verified by electron microscopy. Adding FG to flame-retardant PP prevents dripping due to reduced flow at low shear rates and shifts the onset of thermal decomposition to temperatures 40°C higher. The increase in the onset temperature correlates with the increasing specific surface areas (BET) of the layered carbon fillers. The reduction of the peak heat release rate by 76% is attributed to the formation of effective protection layers during combustion. The addition of layered carbon nanoparticles lowers the time to ignition. The presence of carbon does not change the composition of the evolved pyrolysis gases, as determined by thermogravimetric analysis combined with online Fourier-transformed infrared measurements. FG and well-exfoliated MLG are superior additives with respect to spherical and tubular carbon nanomaterials.

Rational design of nanocarriers for drug delivery approaches requires an unbiased knowledge of uptake mechanisms and intracellular trafficking pathways. Here we dissected these processes using a quantitative proteomics approach. We isolated intracellular vesicles containing superparamagnetic iron oxide polystyrene nanoparticles and analyzed their protein composition by label-free quantitative mass spectrometry. The proteomic snapshot of organelle marker proteins revealed that an atypical macropinocytic-like mechanism mediated the entry of nanoparticles. We show that the entry mechanism is controlled by actin reorganization, atypical macropinocytic signaling, and ADP-ribosylation factor 1. Additionally, our proteomics data demonstrated a central role for multivesicular bodies and multilamellar lysosomes in trafficking and final nanoparticle storage. This was confirmed by confocal microscopy and cryo-TEM measurements. By quantitatively analyzing the protein composition of nanoparticle-containing vesicles, our study clearly defines the routes of nanoparticle entry, intracellular trafficking, and the proteomic milieu of a nanoparticle-containing vesicle.

BackgroundAdjuvant treatment decision-making based on conventional clinical/pathological and prognostic single molecular markers or genomic signatures is a therapeutic area in which over-/under-treatment are still key clinical problems even though substantial and continuous improvement of outcome has been achieved over the past decades. Response to therapy is currently not considered in the decision-making procedure.ADAPT is one of the first new generation (neo)adjuvant trials dealing with individualization of (neo)adjuvant decision-making in early breast cancer and aims to establish early predictive surrogate markers, e.g., Ki-67, for therapy response under a short induction treatment in order to maximally individualize therapy and avoid unnecessary toxicity by ineffective treatment.Methods/designThe prospective, multi-center, controlled, non-blinded, randomized, investigator initiated phase II/III ADAPT trial has an innovative “umbrella” protocol design. The “umbrella” is common for all patients, consisting of dynamic testing of early therapy response. ADAPT will recruit 4,936 patients according to their respective breast cancer subtype in four distinct sub-trials at 80 trial sites in Germany; 4,000 patients with hormone receptor positive (HR+) and HER2 negative disease will be included in the ADAPT HR+/HER2- sub-trial, where treatment decision is based on risk assessment and therapy response to induction therapy, and 380 patients will be included in ADAPT HER2+/HR+. A further 220 patients will be included in ADAPT HER2+/HR- and 336 patients will be recruited for ADAPT Triple Negative. These three sub-trials focus on identification of early surrogate markers for therapy success in the neoadjuvant setting. Patients will be allocated to the respective sub-trial according to the result of their diagnostic core biopsy, as reported by local/central pathology for HR and HER2 status.DiscussionRecent trials, such as the GeparTrio, have shown that response-guided therapy using clinical response may improve outcome. For chemotherapy or HER2-targeted treatment, pathologic complete response in a neoadjuvant setting is an excellent predictor of outcome. For endocrine therapy, response to short induction treatment – as defined by decrease in tumor cell proliferation – strongly correlates with outcome. ADAPT now aims to combine static prognostic and dynamic predictive markers, focusing not just on single therapeutic targets, but also on general markers of proliferation and cell death. Biomarker analysis will help to optimize selection of subtype-specific treatment.Trial registrationClinicalTrials.gov: ADAPT Umbrella: NCT01781338; ADAPT HR+/HER2-: NCT01779206; ADAPT HER2+/HR+: NCT01745965; ADAPT HER2+/HR-: NCT01817452; ADAPT TN:NCT01815242.

The characteristic influences of increasing concentrations of graphene, expanded graphite (EG), carbon black (CB), and multiwall carbon nanotubes (MWNT) are investigated on pyrolysis, reaction to small flame, burning behavior, and on electrical, thermal, and rheological properties of flame retarded polypropylene (PP-FR). The property-concentration dependency is different for the various material properties, as threshold, linear, and leveling off functions were observed. Increasing concentrations of carbon nanoparticles resulted in a decrease in the electrical resistivity of the polymer by crossing the percolation threshold. The developing nanoparticle network changes melt flow behavior for small shear rates, increases thermal conductivity and therefore, affects the UL 94 classification and oxygen index. The onset temperature of PP decomposition is shifted to temperatures up to 37 C higher; the peak heat release rate is reduced by up to 74% compared to PP-FR. Both effects leveled off with increasing particle concentration. Among the four carbon nanomaterials tested, graphene presents superior influence on composite properties over the tested concentration range and outperforms commercial CB, MWNT, and EG.

A novel family of optically transparent acrylic nanocomposites containing up to 30 wt % silica nanoparticles with an average diameter of 20 nm was developed for application in structural light modulation (SLM) and stereolithography (SL) technologies. The uniform dispersion of nanoparticles affords a significantly improved toughness/stiffness‐balance of the photopolymerized and postcured nanocomposites. It is possible to increase stiffness, as expressed by Young's modulus, from 1290 to 1700 MPa without encountering the embrittlement typical for many other conventional filled polymers. Fracture behaviour is examined by means of fracture mechanics investigation and SEM analyses of fracture surfaces. According to TEM analyses and measurement of optical transmittance remarkable uniform dispersion of silica nanoparticles was achieved. The silica nanoparticle concentrations up to 17 wt % give only marginally higher viscosities and do not affect transmittance, while slightly increasing the exposure times needed in photopolymerization. Moreover, the silica nanoparticles afford materials with reduced shrinkage and improved properties. The green effective ankle splay out (EASO) measured on H‐shaped diagnostic specimens, is significantly reduced for the nanocomposite materials from 1.38 mm for the unfilled material to 0.82 mm for nanocomposites containing 30 wt % nanosilica. The building accuracy is increased significantly with increasing content of silica nanofillers.