There have been no major advances for the treatment of metastatic urothelial bladder cancer (UBC) in the last 30 years. Chemotherapy is still the standard of care. Patient outcomes, especially for those in whom chemotherapy is not effective or is poorly tolerated, remain poor. One hallmark of UBC is the presence of high rates of somatic mutations. These alterations may enhance the ability of the host immune system to recognize tumour cells as foreign owing to an increased number of antigens. However, these cancers may also elude immune surveillance and eradication through the expression of programmed death-ligand 1 (PD-L1; also called CD274 or B7-H1) in the tumour microenvironment. Therefore, we examined the anti-PD-L1 antibody MPDL3280A, a systemic cancer immunotherapy, for the treatment of metastatic UBC. MPDL3280A is a high-affinity engineered human anti-PD-L1 monoclonal immunoglobulin-G1 antibody that inhibits the interaction of PD-L1 with PD-1 (PDCD1) and B7.1 (CD80). Because PD-L1 is expressed on activated T cells, MPDL3280A was engineered with a modification in the Fc domain that eliminates antibody-dependent cellular cytotoxicity at clinically relevant doses to prevent the depletion of T cells expressing PD-L1. Here we show that MPDL3280A has noteworthy activity in metastatic UBC. Responses were often rapid, with many occurring at the time of the first response assessment (6 weeks) and nearly all were ongoing at the data cutoff. This phase I expansion study, with an adaptive design that allowed for biomarker-positive enriched cohorts, demonstrated that tumours expressing PD-L1-positive tumour-infiltrating immune cells had particularly high response rates. Moreover, owing to the favourable toxicity profile, including a lack of renal toxicity, patients with UBC, who are often older and have a higher incidence of renal impairment, may be better able to tolerate MPDL3280A versus chemotherapy. These results suggest that MPDL3280A may have an important role in treating UBC-the drug received breakthrough designation status by the US Food and Drug Administration (FDA) in June 2014.

F Hoffmann-La Roche, Genentech.

Freeze casting, also known as ice templating, is a particularly versatile technique that has been applied extensively for the fabrication of well‐controlled biomimetic porous materials based on ceramics, metals, polymers, biomacromolecules, and carbon nanomaterials, endowing them with novel properties and broadening their applicability. The principles of different directional freeze‐casting processes are described and the relationships between processing and structure are examined. Recent progress in freeze‐casting assisted assembly of low dimensional building blocks, including graphene and carbon nanotubes, into tailored micro‐ and macrostructures is then summarized. Emerging trends relating to novel materials as building blocks and novel freeze‐cast geometries—beads, fibers, films, complex macrostructures, and nacre‐mimetic composites—are presented. Thereafter, the means by which aligned porous structures and nacre mimetic materials obtainable through recently developed freeze‐casting techniques and low‐dimensional building blocks can facilitate material functionality across multiple fields of application, including energy storage and conversion, environmental remediation, thermal management, and smart materials, are discussed.

Minimally invasive approaches to detect residual disease after surgery are urgently needed to select patients at highest risk for metastatic relapse for additional therapies. Circulating tumour DNA (ctDNA) holds promise as a biomarker for molecular residual disease (MRD) and relapse, 1-3 but its clinical value has yet to be demonstrated in a randomised clinical trial. We evaluated outcomes in post-surgical ctDNA-positive (+) patients in a randomised phase III trial of adjuvant atezolizumab versus observation. IMvigor010 enrolled 809 patients with muscle-invasive urothelial carcinoma and did not meet its primary endpoint of disease-free survival (DFS) in the intent-to-treat population. Within the study, an exploratory planned analysis of prospectively collected plasma was performed, which tested the utility of ctDNA to identify patients who may benefit from adjuvant atezolizumab treatment. ctDNA was measured at the start of therapy (cycle 1 day 1; C1D1) and at week 6 (cycle 3 day 1; C3D1), and 581 patients were evaluable for ctDNA. The prevalence of ctDNA positivity at C1D1 was 37% (n=214), and ctDNA positivity identified patients with poor prognosis (observation arm DFS HR= 6.19 (4.29, 8.91), p<0.0001).Here we show that ctDNA(+) patients had improved DFS and overall survival (OS) with atezolizumab versus observation (DFS HR= 0.56 (0.41-0.77); p=0.0003 and OS HR= 0.58 (0.4-0.86); p=0.0063). No difference in DFS or OS between arms was noted for ctDNA-negative patients. The rate of ctDNA clearance was higher with atezolizumab (18%) versus observation (4%) (p=0.0041). Transcriptomic analysis revealed that tumours from ctDNA(+) patients had higher expression of cell cycle and keratin genes. Within the ctDNA(+) patient population in the atezolizumab arm, non-relapsing patients were further enriched in prominent immune response signatures including PD-L1, IFNG, CXCL9, and high tumour mutational burden, whereas relapse was associated with angiogenesis and fibroblast-transforming growth factor- signatures (F-TBRS). TCGA molecular subset analysis revealed increased efficacy of atezolizumab in patients with basal-squamous tumours, consistent with underlying tumour-immune contexture.Together these findings suggest that adjuvant atezolizumab may be associated with improved outcomes compared with observation in this high-risk ctDNA(+) population. These findings, if validated in other settings, would shift approaches to post-operative cancer care.

No abstract

Rechargeable batteries are considered one of the most effective energy storage technologies to bridge the production and consumption of renewable energy. The further development of rechargeable batteries with characteristics such as high energy density, low cost, safety, and a long cycle life is required to meet the ever‐increasing energy‐storage demands. This Review highlights the progress achieved with halide‐based materials in rechargeable batteries, including the use of halide electrodes, bulk and/or surface halogen‐doping of electrodes, electrolyte design, and additives that enable fast ion shuttling and stable electrode/electrolyte interfaces, as well as realization of new battery chemistry. Battery chemistry based on monovalent cation, multivalent cation, anion, and dual‐ion transfer is covered. This Review aims to promote the understanding of halide‐based materials to stimulate further research and development in the area of high‐performance rechargeable batteries. It also offers a perspective on the exploration of new materials and systems for electrochemical energy storage.

Pathogenicity islands (PAIs), a distinct type of genomic island (GI), play important roles in the rapid adaptation and increased virulence of pathogens. 89K is a newly identified PAI in epidemic Streptococcus suis isolates that are related to the two recent large-scale outbreaks of human infection in China. However, its mechanism of evolution and contribution to the epidemic spread of S. suis 2 remain unknown. In this study, the potential for mobilization of 89K was evaluated, and its putative transfer mechanism was investigated. We report that 89K can spontaneously excise to form an extrachromosomal circular product. The precise excision is mediated by an 89K-borne integrase through site-specific recombination, with help from an excisionase. The 89K excision intermediate acts as a substrate for lateral transfer to non-89K S. suis 2 recipients, where it reintegrates site-specifically into the target site. The conjugal transfer of 89K occurred via a GI type IV secretion system (T4SS) encoded in 89K, at a frequency of 10−6 transconjugants per donor. This is the first demonstration of horizontal transfer of a Gram-positive PAI mediated by a GI-type T4SS. We propose that these genetic events are important in the emergence, pathogenesis and persistence of epidemic S. suis 2 strains.

Rechargeable magnesium batteries (RMB) have been regarded as an alternative to lithium‐based batteries because of their abundant elemental resource, high theoretical volumetric capacity, and multi‐electron redox reaction without the dendrite formation of magnesium metal anode. However, their development is impeded by their poor electrode/electrolyte compatibility and the strong Coulombic effect of the multivalent Mg2+ ions in cathode materials. Herein, copper sulfide material is developed as a high‐energy cathode for RMBs with a non‐corrosive Mg‐ion electrolyte. Given the benefit of its optimized interlayer structure, good compatibility with the electrolyte, and enhanced surface area, the as‐prepared copper sulfide cathode exhibits unprecedented electrochemical Mg‐ion storage properties, with the highest specific capacity of 477 mAh g−1 and gravimetric energy density of 415 Wh kg−1 at 50 mA g−1, among the reported cathode materials of metal oxides, metal chalcogenides, and polyanion‐type compounds for RMBs. Notably, an impressive long‐term cycling performance with a stable capacity of 111 mAh g−1 at 1 C (560 mA g−1) is achieved over 1000 cycles. The results of the present study offer an avenue for designing high‐performance cathode materials for RMBs and other multivalent batteries.