Prognostic Factors and Outcomes in Advanced Stage Lung Cancer Patients with COVID-19 Omicron Variant Infection.

Background: We study the characteristics and outcomes in lung cancer patients with COVID-19 Omicron variant infection. Methods: Hospitalized lung cancer patients with advanced-stage disease and laboratory-confirmed COVID-19 Omicron infection were included. Pneumonitis involving at least 25% of lung parenchyma on CT scans, accompanied by symptoms and oxygen saturation below 93%, were criteria for enrollment. Pneumonitis severity was graded using CTCAE v5.0. Treatment included Paxlovid, prednisolone, anticoagulation, and ventilation. Initial data, radiographic findings, and outcomes were compared. Logistic regression was employed to determine risk factors for in-hospital mortality. Results: Fifteen patients (median age: 65 years; 80.0% males) were included. 73.3% improved and were discharged, 20.0% died, and 6.7% remained intubated. Initial symptoms included cough (100.0%), fever (73.3%), and shortness of breath (53.3%). Symptoms resolved in discharged patients. Median fever duration was 3.5 days, and respiratory symptom recovery took 26 days. Three patients died due to respiratory failure from Omicron pneumonia. Lower oxygen saturation, reduced lymphocyte/neutrophil ratio on day 7, and diffuse bilateral lung lesions were poor prognostic factors. Conclusion: This study underscores the importance of prompt intervention and early diagnosis for lung cancer patients infected with the COVID-19 Omicron variant. Lower oxygen saturation, decreased lymphocyte/neutrophil ratio on day 7, and diffuse lung lesions on CT scans were associated with worse outcomes. Clinicians should prioritize timely and comprehensive management to improve survival rates in this population.

Osimertinib combined with bevacizumab as the first-line treatment in non-small cell lung cancer patients with brain metastasis harboring epidermal growth factor receptor mutations.

BACKGROUND: The efficacy and safety of osimertinib combined with bevacizumab in non-small cell lung cancer (NSCLC) patients with brain metastasis harboring epidermal growth factor receptor (EGFR) mutations have not been fully studied. METHODS: Treatment-naïve NSCLC patients with brain metastasis harboring EGFR-activating mutations were treated with osimertinib 80 mg oral daily and bevacizumab 15 mg/kg intravenously on day 1, repeated every 21 days, until disease progression, intolerable toxicity, or death. The primary endpoint was the median progression-free survival (mPFS), and the secondary endpoints were the median overall survival (mOS), response rates, and toxicities. This study has been registered in ClinicalTrials.gov (NCT05104281) and is ongoing. RESULTS: A total of 52 Chinese patients were enrolled, of whom 17 harbored EGFR 19 del and 35 harbored EGFR L858R mutation. The objective response rate (ORR) was 75.0% and the disease control rate (DCR) was 96.2%; the mPFS was 17.0 months (95% CI: 11.46-22.54), while the mOS was not reached. The mPFS was 20.0 months (95% CI: 14.56-25.44) and was 17.0 months (95% CI: 13.28-20.72) for patients harboring EGFR 19 del and EGFR L858R mutation (p = 0.844), respectively. The intracranial ORR was 82.7%, and the intracranial mPFS was 22.0 months (95% CI: 2.92-41.08).The main adverse events were mild-to-moderate hand-foot syndrome, diarrhea, hypertension, and proteinuria. Three patients developed grade III proteinuria, while five patients developed grade III hypertension; they permanently discontinued bevacizumab treatment. CONCLUSIONS: Osimertinib combined with bevacizumab shows promising results in EGFR-mutated NSCLC patients with brain metastasis, and the side effects are tolerable.

Toripalimab Plus Chemotherapy for Patients With Treatment-Naive Advanced Non-Small-Cell Lung Cancer: A Multicenter Randomized Phase III Trial (CHOICE-01).

PURPOSE: The CHOICE-01 study investigated the efficacy and safety of toripalimab in combination with chemotherapy as a first-line treatment for advanced non-small-cell lung cancer (NSCLC). PATIENTS AND METHODS: Patients (N = 465) with treatment-naive, advanced NSCLC without EGFR/ALK mutations were randomly assigned 2:1 to receive toripalimab 240 mg (n = 309) or placebo (n = 156) once every 3 weeks in combination with chemotherapy for 4-6 cycles, followed by the maintenance of toripalimab or placebo once every 3 weeks plus standard care. Stratification factors included programmed death ligand-1 expression status, histology, and smoking status. The primary end point was progression-free survival (PFS) by investigator per RECIST v1.1. Secondary end points included overall survival and safety. RESULTS: At the final PFS analysis, PFS was significantly longer in the toripalimab arm than in the placebo arm (median PFS, 8.4 v 5.6 months, hazard ratio = 0.49; 95% CI, 0.39 to 0.61; two-sided P < .0001). At the interim OS analysis, the toripalimab arm had a significantly longer OS than the placebo arm (median OS not reached v 17.1 months, hazard ratio = 0.69; 95% CI, 0.53 to 0.92; two-sided P = .0099). The incidence of grade ≥ 3 adverse events was similar between the two arms. Treatment effects were similar regardless of programmed death ligand-1 status. Genomic analysis using whole-exome sequencing from 394 available tumor samples revealed that patients with high tumor mutational burden were associated with significantly better PFS in the toripalimab arm (median PFS 13.1 v 5.5 months, interaction P = .026). Notably, patients with mutations in the focal adhesion-PI3K-Akt signaling pathway achieved significantly better PFS and OS in the toripalimab arm (interaction P values ≤ .001). CONCLUSION: Toripalimab plus chemotherapy significantly improves PFS and OS in patients with treatment-naive advanced NSCLC while having a manageable safety profile. Subgroup analysis showed the OS benefit was mainly driven by the nonsquamous subpopulation.

Investigation of the synergistic effect of melt-extension and nanofiller on the crystal-crystal phase transition from form II to I of isotactic polybutene-1.

New questions and conjectures are raised on the crystal-crystal phase transition of isotactic polybutene-1 (iPB-1) containing nanofiller in the flow field. In this work, we investigate the phase transition from flow-induced oriented form II to I in iPB-1 blends with multi-walled carbon nanotubes (MWCNTs) with a homemade two-drum extensional rheometer combined with in situ wide-angle X-ray diffraction (WAXD) measurements. The MWCNTs show a limited promoting effect on the phase transition kinetics under quiescent conditions, while the phase transition kinetic is highly accelerated with the impose of melt-extension. When the loading extension strain is 0.5 or 2.0, the half time of phase transition (t1/2) is shortened from tens of hours to a few hours, depending on the melt-extension strain and the MWCNTs content in iPB-1. When the extension strain increases to 3.5, t1/2 decreases to about 30 min, which is independent of the MWCNTs content in all iPB-1 blends except in blends with MWCNTs content of 1%, where the phase transition rate in the middle and late stages is restrained. It's speculated that flow-induced molecular orientation or shish-kebab morphology affects the internal stress or stress transfer. The addition of a nanofiller enlarged the effect of melt-extension through strengthening the localized intensity of flow field. In general, the combination of nanofiller and melt-extension can obviously promote the phase transition kinetics.

MXene-Coated Wrinkled Fabrics for Stretchable and Multifunctional Electromagnetic Interference Shielding and Electro/Photo-Thermal Conversion Applications.

Stretchability and multifunctional heating abilities are highly desired for wearable electromagnetic interference (EMI) shielding fabrics to tackle the growing electromagnetic pollution for special crowd, such as pregnant women. Herein, we fabricated stretchable MXene-coated thermoplastic polyurethane (TPU) fabrics by simple uniaxial prestretching and spraying methods. The obtained unique wrinkled structure endowed the film with effective strain-invariant electrical conductivity and EMI shielding properties. Specifically, the prepared stretchable film with an extremely low MXene loading (0.417 mg cm-2) exhibited a stable EMI shielding effectiveness of approximately 30 dB under 50% tensile strain and durability during stretching and bending cycles. More importantly, owing to the high electrical conductivity and localized surface plasmon resonance (LSPR) effect of the MXene layer, the stretchable fabrics exhibited excellent Joule heating (up to 104 °C at a voltage of 5 V) and superior photothermal conversion abilities. Moreover, the unique wrinkled MXene-coating layer not only endows the fabrics with stretchable heat abilities but also enhances the photothermal conversion performance by increasing the light absorption area and travel path. We believe that this study offers a novel strategy for the versatile design of stretchable and multifunctional wearable shielding fabrics.

Development and validation of a prognostic nomogram for malignant esophageal fistula based on radiomics and clinical factors.

BACKGROUND: The current study aimed to comprehensively analyze the clinical prognostic factors of malignant esophageal fistula (MEF). Furthermore, this study sought to establish and validate prognostic nomograms incorporating radiomics and clinical factors to predict overall survival and median survival after fistula for patients with MEF. METHODS: The records of 76 patients with MEF were retrospectively analyzed. A stepwise Cox proportional hazards regression model was employed to screen independent prognostic factors and develop clinical nomograms. Radiomic features were extracted from prefistula CT images and post fistula CT images. Least absolute shrinkage and selection operator (LASSO) regression and Cox regression algorithm was used to filter radiomic features and avoid overfitting. Radiomic signature was a linear combination of optimal features and corresponding coefficients. The joint prognostic nomograms was constructed by radiomic signatures and clinical features. All models were validated by Harrell's concordance index (C-index), caliberation and bootstrap validation. RESULTS: For overall survival, age, prealbumin, KPS and interval between diagnosis of esophageal cancer and fistula were identified as independent prognostic factors and incorporated into the clinical nomogram. Age, prealbumin, serum albumin, KPS and neutrophil proportion were selected for the clinical nomogram of post fistula survival. The C-index of overall survival nomogram was 0.719 (95% CI: 0.645-0.793) and that was 0.722 (95% CI: 0.653-0.791) in the post fistula survival nomogram. The radiomic signature developed by radiomic features of prefistula CT showed a significant correlation with both overall survival and post fistula survival. The C-index of joint nomogarm for overall survival and post fistula survival was 0.831 (95% CI: 0.757-0.905) and 0.77 (95% CI: 0.686-0.854), respectively. The calibration curve showed the joint nomograms outperformed the clinical ones. CONCLUSIONS: The study presents nomograms incorporating independent clinical risk factors and radiomic signature to predict the prognosis of MEF. This prognostic classification system has the potential to guide therapeutic decisions for patients with malignant esophageal fistulas.

Highly Thermal Conductive Poly(vinyl alcohol) Composites with Oriented Hybrid Networks: Silver Nanowire Bridged Boron Nitride Nanoplatelets.

With the increasing demand for thermal management materials in the highly integrated electronics area, building efficient heat-transfer networks to obtain advanced thermally conductive composites is of great significance. In the present work, highly thermally conductive poly(vinyl alcohol) (PVA)/boron nitride nanoplatelets@silver nanowires (BNNS@AgNW) composites were fabricated via the combination of the electrospinning and the spraying technique, followed by a hot-pressing method. BNNS are oriented along the in-plane direction, while AgNWs with a high aspect ratio can help to construct a thermal conductive network effectively by bridging BNNS in the composites. The PVA/BNNS@AgNW composites showed high in-plane thermal conductivity (TC) of 10.9 W/(m·K) at 33 wt % total fillers addition. Meanwhile, the composite shows excellent thermal dispassion capability when it is taken as a thermal interface material of a working light-emitting diode (LED) chip, which is certified by capturing the surface temperature of the LED chip. In addition, the out-of-plane electrical conductivity of the composites is below 10-12 S/cm. The composites with outstanding thermal conductive and electrical insulating properties hold promise for application in electrical packaging and thermal management.

Irinotecan combined with oxaliplatin and S-1 in patients with metastatic pancreatic adenocarcinoma: a single-arm, three-centre, prospective study.

OBJECTIVE: To study the efficacy and toxicity of irinotecan combined with oxaliplatin and S-1 in patients with metastatic pancreatic adenocarcinoma. PATIENTS AND METHODS: Previously untreated patients with cytologically or histologically confirmed metastatic pancreatic adenocarcinoma underwent a treatment regimen consisting of an intravenous infusion of irinotecan 165 mg/m2 and oxaliplatin 85 mg/m2 on day 1, and oral S-1 40 mg/m2 twice daily on days 1-14, repeating the regimen every 21 days until one of the following occurred: disease progression, intolerable toxicity, or patient death. The primary endpoint was overall survival (OS), and the secondary endpoints were progression-free survival (PFS), response rate, toxicity, and quality of life. This ongoing study had been registered on ClinicalTrials.gov, NCT03726021. RESULTS: A total of 41 patients were enrolled in this study, 18 men and 23 women. The median PFS was 4.33 months [95% confidence interval (CI): 2.83-5.88] and the median OS was 11.00 months (95% CI: 9.16-12.84). There were no instances of a complete response; the partial response, stable disease, and disease progression rates were 39.02% (16/41), 29.27% (12/41), and 31.71% (13/41), respectively.The most common adverse side effects were mild to moderate nausea, vomiting, neutropenia, and thrombocytopenia. Grade 3 or 4 neutropenia and thrombocytopenia were observed in 29.27% (12/41) and 12.20% (5/41) of the patients, respectively. No treatment-related death was observed. CONCLUSION: Irinotecan combined with oxaliplatin and S-1 is a safe and effective treatment for metastatic pancreatic adenocarcinoma, and any toxicities are mild to moderate and tolerable. A larger study population is needed for further evaluation.

Polymorph selection during melt crystallization of the isotactic polybutene-1 homopolymer depending on the melt state and crystallization pressure.

This work investigated the crystalline forms obtained from melt crystallization in the isotactic polybutene-1 (iPB-1) homopolymer via manipulation of the temperature at which samples were melted (Tmelt) and crystallization pressure (Pcry). Unlike the results under atmospheric conditions where the molten sample crystallized into the pure form II and the crystallization temperature and kinetics were affected obviously by Tmelt, the melted sample crystallized into forms II or I' under high pressure, depending on Tmelt and Pcry. The content of form I' decreases with increasing Tmelt or decreasing Pcry. Meanwhile, the critical pressure for the formation of pure form I' increases with increasing Tmelt. The formation of form I' is attributed to the memory effect of the melt which preserved some ordered sequence of crystal and the high pressure (Pcry) which suppressed the nucleation and growth of the kinetically favored form II, which results in the formation of form I'. In addition, the melt crystallized form II transforms to form I under high pressure conditions; thus forms I, I' and II are observed. The relative contents of the three crystalline forms on samples for different Tmelt and Pcry are obtained in this work. The result shows that the crystalline forms in melt crystallization of iPB-1 can be customized by regulating the melt state and crystallization conditions.

S-1 Maintenance Therapy in Extensive Stage Small-Cell Lung Cancer-A Randomized Clinical Study.

Small-cell lung cancer (SCLC) is a recalcitrant cancer for its dismal prognosis although extensive research had been done. Four to 6 cycles platinum-based chemotherapy is the mainstay treatment for the extensive-stage disease; but the role of maintenance treatment is not fully understood. This is a phase 2, open-label study. Patients with extensive-stage SCLC reaching an objective response or stable disease (SD) after induction chemotherapy were randomly assigned (1:1) with a minimization procedure. One group received oral S-1 and the other group received placebo as maintenance treatment until disease progression or unacceptable toxicities. The primary end point of this study was progression-free survival (PFS), and the secondary end points were overall survival (OS), response rates, and toxicities. This study was based on earlier work, the preliminary results was reported on 2019 ASCO annual meeting. A total of 89 patients were enrolled, of whom 45 received S-1 maintenance therapy and 44 received placebo. The median PFS and OS were 6.35 months and 10.82 months in the S-1 group, as compared to 5.98 months and 10.09 months in the placebo group. The PFS was 7.2 months and 5.3 months, and OS was 12.9 months and 10.9 months in patients with an objective response compared to in patients with SD after induction chemotherapy, respectively. S-1 maintenance therapy did not prolong PFS or OS in patients with extensive-stage SCLC; tumor regression rate was the prognostic factor of PFS or OS. Further research with novel agents in the maintenance setting is warranted.

E2F1 Induces KIF26A Transcription and Promotes Cell Cycle Progression via CDK-RB-E2Fs Feedback Loop in Breast Cancer.

OBJECTIVE: The aim of this study was to investigate the role of KIF26A in breast cancer. METHOD: qRT-PCR and immunohistochemistry were conducted to explore KIF26A expression and functional contribution to breast cancer development. MTS, EDU, colony formation assays, and flow cytometry analysis were conducted to assess cell proliferation characteristics and cell cycle progression. A series of 5'-flanking region deletion plasmids and mutating the binding site, with the luciferase reporter assay, were used to identify the core promotor region of KIF26A. The prediction by software and construction of the transcriptional factor plasmids were used to identify the transcriptional factor. Chromatin immunoprecipitation assay could demonstrate transcriptional factor directly binding to the KIF26A promoter. Human Genome Oligo Microarray Assay and gene ontology (GO) and pathway analyses were used to predict the downstream pathway. RESULTS: Our results showed that in breast cancer tissues, elevated KIF26A expression was significantly correlated with lymph node metastasis. KIF26A could promote proliferation and G0/G1 phase cell cycle progression in breast cancer cells. The core promoter region of the human KIF26A gene was located upstream of the transcription start site at position -395 to -385. The transcriptional factor E2F1 was shown to activate KIF26A expression. Furthermore, KIF26A was shown to inhibit the expression of p21, then activate CDK-RB-E2Fs pathway. The elevated E2F1 can activate the cell cycle progression and the KIF26A expression, forming feedback loop. CONCLUSIONS: The present study demonstrated that KIF26A, directly upregulated by E2F1, promoted cell proliferation and cell cycle progression via CDK-RB-E2Fs feedback loop in breast cancer.

A Nomogram to Predict Distant Metastasis for Patients with Esophageal Cancer.

BACKGROUND: Distant metastasis of esophageal cancer (EC) is prone to be neglected, so it is necessary to screen out the high-risk population for more sensitive and rigorous pretreatment imaging evaluations. OBJECTIVE: The aim of this study was to evaluate the risk factors for distant metastasis in patients with EC and to construct a clinical nomogram. METHODS: Eligible patients diagnosed from 2010 to 2015 were selected from the Surveillance, Epidemiology and End Results (SEER) database. Multivariable logistic regression analysis was applied to establish a prediction nomogram. Discrimination, calibration, clinical usefulness, and reproducibility were assessed by C-index, receiver-operating characteristic curve/the area under the curve (AUC), calibration plot, decision curve analysis (DCA), and bootstrapping validation. DCA was also used to compare the novel model with the conventional predictive methods. RESULTS: A total of 9,026 patients were included for analysis. The nomogram incorporated the predictors: age, sex, race, grade, T stage, N stage, histology, tumor location, and pathological grading. The prediction model presented good discrimination with an AUC of 0.738 and a concordance index of 0.747 (95% confidence interval: 0.734-0.760), which was confirmed to be 0.745 through bootstrapping validation. Calibration plot and DCA showed satisfactory calibration and good net benefit, respectively. Comparing with the conventional prediction methods, the nomogram yielded superior net benefit. CONCLUSIONS: We constructed and validated a novel nomogram to help clinicians access the risk of distant metastasis in patients with EC.

Transparent Conductive Flexible Trilayer Films for a Deicing Window and Self-Recover Bending Sensor Based on a Single-Walled Carbon Nanotube/Polyvinyl Butyral Interlayer.

A flexible transparent conductive film (TCF) is an important component in many modern smart devices. Recent TCF is always fabricated based on indium tin oxide (ITO). However, the drawbacks of ITO (e.g., brittle nature, high cost, and resource scarcity) and the complex preparation process of TCF limit the massive production and further application of TCF. Herein, a facile and low-cost method is proposed to prepare flexible TCF. Rolls of single-walled carbon nanotubes (SWCNTs)/polyvinyl butyral (PVB) interlayer film were first fabricated by the roll-to-roll (R2R) spraying method. Then, the interlayer film was laminated between polycarbonate (PC) films (0.1 mm in thickness) to fabricate a transparent (80% optical transmittance) but flexible trilayer film. Such a prepared trilayer film shows multifunctional applications. For example, on the one hand, high conductivity and uniform distribution of resistance ensure that it can work as a deicing window with good performance at a low voltage. On the other hand, its flexibility, rapid self-recovery, and stable response enable it to be used as a bending sensor, which shows remarkable stability, repeatability, and durability. This study provides a facile method to fabricate TCF based on commercial but low-cost materials, which is suitable for industrial production and wide practical applications.

A randomized clinical study to compare intrapleural infusion with intravenous infusion of bevacizumab in the management of malignant pleural effusion in patients with non-small-cell lung cancer.

BACKGROUND: To compare the efficiency and toxicity of bevacizumab by intrapleural or intravenous infusion in the management of malignant pleural effusion in patients with non-small-cell lung cancer (NSCLC). METHODS: Sensitizing mutation negative NSCLC patients with malignant pleural effusion were randomized into two groups in 1:1 ratio. The pleural effusion was completely drained in 24 hours; one group received intrapleural infusion and the second group received intravenous infusion of bevacizumab at a dose of 7.5 mg per kg bodyweight. The serum vascular endothelial growth factor (VEGF) was tested before and 72 hours after injection of bevacizumab. Computerized tomography (CT) scan to evaluate pleural effusions was carried out at four weeks for each patient and their survival followed-up. RESULTS: A total of 67 patients were screened and 43 enrolled into the study. The response rate was 80% (16 of 20) in the intrapleural group and 66.7% (14 of 21) in the intravenous group. The median duration of response (DoR) of pleural effusion was 4.50 months and 3.70 months, respectively. The median serum VEGF level at 72 hours decreased 67.25% in the intrapleural group and 57.19% in the intravenous group compared to baseline level (P = 0.276). The median serum VEGF level at 72 hours decreased 52.02% compared to baseline level in patients' DoR less than three months and 68.33% in patients' DoR longer than three months, respectively (P = 0.014). The main side effects noted were mild to moderate hypertension, proteinuria and epistaxis. CONCLUSIONS: Bevacizumab intrapleural infusion had higher efficiency and higher safety than intravenous infusion in the management of malignant pleural effusion caused by NSCLC. The decreased level of serum VEGF at 72 hours after bevacizumab treatment was closely related to the response rate and duration of the response of pleural effusion.

Risk Factors for Esophageal Fistula in Esophageal Cancer Patients Treated with Radiotherapy: A Systematic Review and Meta-Analysis.

OBJECTIVE: Esophageal fistula is a critical and fatal complication of esophageal cancer. The aim of this meta-analysis was to explore the risk factors for esophageal perforation in esophageal cancer patients treated with radiotherapy. METHODS: Data from the PubMed and Embase databases were retrieved for clinical research published between 1990 and 2018. The Newcastle-Ottawa Scale was used to evaluate the quality of the articles. A meta-analysis was performed using the RevMan 5.3 software provided by the Cochrane Collaboration Network. RESULTS: Seventeen articles were eligible for the meta-analysis. In these articles, over 35 risk factors for esophageal fistula formation were described and 17 risk factors were analyzed. Significant differences in the odds of developing an esophageal perforation were found with regard to age (OR 2.34, 95% CI 1.08-5.03, p = 0.001), ulcerative type (OR 2.72, 95% CI 1.43-5.16, p = 0.002), histology (OR 4.16, 95% CI 1.14-15.12, p = 0.03), T stage (OR 2.66, 95% CI 1.44-4.91, p = 0.002), short-term response (OR 2.21, 95% CI 1.06-4.62, p = 0.03), chemotherapy regimen (OR 2.80, 95% CI 1.38-5.68, p = 0.005), and stenosis (OR 2.00, 95% CI 1.03-3.89, p = 0.04). CONCLUSIONS: An age of <60-65 years, ulcerative type, squamous cell cancer, T4 stage, incomplete response, fluorouracil-based regimen, and stenosis were associated with an increased risk of esophageal fistula during or after radiotherapy. However, further, large-scale prospective studies are needed to establish the validity of this associ-ation.

Preparation of Polyethylene and Ethylene/Methacrylic Acid Copolymer Blend Films with Tunable Surface Properties through Manipulating Processing Parameters during Film Blowing.

Polymer films based on polyethylene (PE) and ionomer ethylene/methacrylic acid (EMAA) copolymer blend were prepared by film blowing, whose surface properties were tuned by varying processing parameters, i.e., take up ratio (TUR). Blends of PE/EMAA copolymer were firstly prepared by the melt-mixing method, before being further blown to films. The wettability of the film was investigated by measuring the contact angle/water-film encounter time, and optical properties, i.e., the haze and transmittance. The wettability was found to be enhanced with the increase of TUR. So too was the haze, while the transmittance was found to be almost independent of TUR. The XPS and AFM results directly show the increasing polar functional groups (-COO-) on the surface and roughness with increasing TUR. Further analysis of the 2D SAXS and WAXS unveiled the origin of the invariant transmittance, which resulted from the minor change of the crystallinity and the monotonic increase of the haze, with TUR resulting from the evolution of crystal orientation. In addition to other post-modification methods, the current study provides an alternative route to prepare large-scale PE films as the template for the advanced potential applications, i.e., covering in the layer of roof, the privacy of protective windows, and multitudes of packaging.

Bevacizumab Combined with Icotinib Overcomes Osimertinib Resistance in a Patient of Non-Small Cell Lung Cancer.

A 61-year-old Chinese woman was diagnosed as primary pulmonary adenocarcinoma of left superior lobe with epidermal growth factor receptor (EGFR) 19 del mutation positive. Treatment with icotinib was given, but her disease progressed after 6 months remission. CT-guide needle biopsy for the new lesion in inferior lobe of left lung demonstrated intrapulmonary metastasis, and EGFR gene panel by Amplification Refractory Mutation System Polymerase Chain Reaction (ARMS-PCR) confirmed EGFR T790M mutation. Treatment with osimertinib was initiated. After 2 months remission, the disease progressed. Re-biopsy was performed for the tumor in the inferior lobe of left lung, and ARMS-PCR demonstrated no other gene mutation except EGFR 19 del. Icotinib was re-challenged, but disease progressed continuously. Bevacizumab was added, and partial response was achieved after 2-cycle of combination therapy. The non-small cell lung cancer (NSCLC) in this case maintained EGFR activating mutation and lost EGFR T790M mutation was a genetic change after osimertinib treatment. This case suggests the re-challenge of the first-generation EGFR-TKIs combined with bevacizumab may overcome the tumor resistance and prolong survival of NSCLC patient.

Treatment of Skin Reaction Induced by Nivolumab Combined with Radiotherapy in Non-small Cell Lung Cancer: A Case Report.

Skin reaction or dermatological toxicities induced by immunotherapy is common. It usually manifests skin rash or erythema and can be cured by skin lotion or steroid. Nivolumab, a human IgG4 programmed cell death protein 1 (PD-1) inhibitor, blocks T cells activation preventing signal and allows the immune system to clear cancer cells. Nivolumab was approved in the second-line therapy in squamous cell lung cancer by FDA, with less than 10% unusual skin reaction, like sensory neuropathy, peeling skin, erythema multiforme, vitiligo, and psoriasis. Radiotherapy could aggravate this skin reaction through inflammatory response and promotion of immunity. The combined treatment of anti-PD-1 and radiotherapy represented a new promising therapeutic approach in many studies, but the risk of side effects may be high. We reported a patient with advanced squamous cell lung cancer who suffered from serious skin immune-related adverse events when he was treated with nivolumab and radiotherapy. The immune overreaction of the treatment of anti-PD-1 treatment and radiotherapy might cause these serious skin adverse events. Our report warranted careful workup to reduce the risk of side effects by combinative therapy with anti-PD-1 and radiotherapy.