BACKGROUND Adding radiotherapy (RT) to systemic therapy improves progression-free survival (PFS) and overall survival (OS) in oligometastatic non-small cell lung cancer (NSCLC). Whether these findings translate to EGFR-mutated NSCLC remains unknown. The SINDAS trial (NCT02893332) evaluated first-line tyrosine kinase inhibitor (TKI) therapy for EGFR-mutated synchronous oligometastatic NSCLC, and randomized to up-front RT vs. no RT; we now report the pre-specified interim analysis at 68% accrual. METHODS Inclusion criteria were biopsy-proven EGFR-mutated adenocarcinoma (per amplification refractory mutation system or next generation sequencing), with synchronous (newly-diagnosed, treatment-naïve) oligometastatic (≤5 metastases; ≤2 lesions in any one organ) NSCLC without brain metastases. All patients received a first-generation TKI (gefitinib, erlotinib, or icotinib), and randomization was between no RT vs. RT (25–40 Gy in 5 fractions depending on tumor size/location) to all metastases and the primary tumor/involved regional lymphatics. The primary endpoint (intention-to-treat) was PFS. Secondary endpoints included OS and toxicities. All statistical tests were 2-sided. RESULTS A total of 133 patients (n = 65 TKI only, n = 68 TKI+RT) were enrolled (2016–2019). The median follow-up was 23.6 months. The respective median PFS was 12.5 months vs. 20.2 months (p < .001), and the median OS was 17.4 months vs. 25.5 months (p < .001) for TKI only vs TKI+RT. Treatment yielded no grade 5 events and a 6% rate of symptomatic grade 3–4 pneumonitis in the TKI+RT arm. Based on the efficacy results of this pre-specified interim analysis, the ethics committee recommended premature cessation of this trial. CONCLUSIONS As compared to a first-line TKI alone, addition of up-front local therapy using RT statistically significantly improved PFS and OS for EGFR-mutated NSCLC.
Two methylphenylsiloxane monomers with crosslinkable benzocyclobutene functionalities at the terminal positions, 1,1,5,5‐dimethyldiphenyl‐1,1,5,5‐di[2′‐(4′‐benzocyclobutenyl)vinyl]‐3,3‐diphenyltrisiloxane (BCB‐1) and 1,1,3,3‐dimethyl‐diphenyl‐1,1,3,3‐di[2′‐(4′‐benzocyclobutenyl)vinyl]disiloxane (BCB‐2) were prepared and characterized. By heating the solution of BCB‐1 and BCB‐2 in mesitylene, two partially polymerized resins of BCB‐1B and BCB‐2B with high molecular weight were also achieved. The monomers and their oligomers fully cured at temperatures above 250 °C. Cured BCB‐1 and BCB‐2 exhibited high Tg (257 and 383 °C) and good thermal stability (T5% > 472 °C both in N2 and in air). They also demonstrated low dielectric constants (2.69 and 2.66), low dissipation factors (2.36 and 2.23), and low water absorptions (0.20% and 0.17%). Moreover, a negative photosensitive formulation derived from BCB‐1B in combination with 2,6‐bis(4‐azidobenzylidene)‐4‐methylcyclohexanone (BAC‐M) as a photosensitive agent has been developed. The photosensitive composition, BCB‐1B containing 5 wt % BAC‐M, showed a sensitivity of 550 mJ/cm2 and a contrast of 1.96 when it was exposed to a 365 nm light (i‐line) and developed with cyclohexanone at 25 °C. A fine negative image of 10 μm line‐and‐space pattern was also printed in a film which was exposed to 700 mJ/cm2 of i‐line by contact‐printing mode. The negative image can be maintained without any pattern deformation in the curing process. © 2009 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 47: 6246–6258, 2009
Mitochondrial pyruvate carrier 1 (MPC1), a key factor that controls pyruvate transportation in the mitochondria, is known to be frequently dysregulated in tumor initiation and progression. However, the clinical relevance and potential molecular mechanisms of MPC1 in lung adenocarcinoma (LAC) progression remain to be illustrated. Herein, MPC1 was lowly expressed in LAC tissues and significantly associated with favorable survival of patients with LAC. Functionally, MPC1 markedly suppressed stemness, invasion, and migration in vitro and spreading growth of LAC cells in vivo. Further study revealed that MPC1 could interact with mitochondrial signal transducer and activator of transcription 3 (mito-STAT3), disrupting the distribution of STAT3 and reducing cytoplasmic signal transducer and activator of transcription 3 (cyto-STAT3) as well as its phosphorylation, while the activation of cyto-STAT3 by IL-6 reversed the attenuated malignant progression in MPC1-overexpression LAC cells. Collectively, we reveal that MPC1/STAT3 axis plays an important role in the progression of LAC, and our work may promote the development of new therapeutic strategies for LAC.
A novel addition-curable novolac resin with phthalonitrile groups (PN) was successfully synthesized by a simple nucleophilic substitution reaction between the novolac resin and 4-nitrophthalonitrile. The final product was characterized with gel permeation chromatography (GPC), Fourier transform infrared (FT-IR) spectrometry, and proton nuclear magnetic resonance ( 1 H-NMR) spectroscopy. Processing capability and cure behavior of PN resin was investigated by rheometer and differential scanning calorimetry (DSC), respectively. Rheometric studies showed PN resin possessed a broad processing window between 140 and 225 C with a low viscosity from 0.4 to 4 Pa.s. DSC results showed PN resin can be cured at about 220 C via thermal polymerization of phthalonitrile groups. An ultrahigh curing temperature (such as 375 C) that was typical for the other phthalonitrile functional prepolymers was not necessary for this resin and 250 C was used as a maximum post-cure temperature to achieve the desired properties. Thermogravimetric analysis (TGA) showed T 5% (temperature of 5% weight loss) of the final cured products in nitrogen was 448.7 C, and the char yield was 70.29% at 900 C. Furthermore, T 5% of cured PN resin in air was 455.2 C, and the char yield in air was 34.48% at 700 C,revealing that the cured resin possessed excellent thermo-oxidative stability. Dynamic mechanical analysis (DMA) showed the inflection point of tan d was 371.9 C. The excellent processability and thermal stabilities proved PN resin as a promising candidate for advanced composite matrices.
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