Comprehensive genomic landscape and precision therapeutic approach in biliary tract cancers.

Biliary tract cancers have dismal prognoses even when cytotoxic chemotherapy is administered. There is an unmet need to develop precision treatment approaches using comprehensive genomic profiling. A total of 121 patients with biliary tract cancers were analyzed for circulating-tumor DNA (ctDNA) and/or tissue-based tumor DNA (tissue-DNA) using clinical-grade next-generation sequencing: 71 patients (59%) had ctDNA; 90 (74%), tissue-DNA; and 40 (33%), both. Efficacy of targeted therapeutic approaches was assessed based upon ctDNA and tissue-DNA. At least one characterized alteration was detected in 76% of patients (54/71) for ctDNA [median, 2 (range, 0-9)] and 100% (90/90) for tissue-DNA [median, 4 (range, 1-9)]. Most common alterations occurred in TP53 (38%), KRAS (28%), and PIK3CA (14%) for ctDNA vs TP53 (44%), CDKN2A/B (33%) and KRAS (29%) for tissue-DNA. In 40 patients who had both ctDNA and tissue-DNA sequencing, overall concordance was higher between ctDNA and metastatic site tissue-DNA than between ctDNA and primary tumor DNA (78% vs 65% for TP53, 100% vs 74% for KRAS and 100% vs 87% for PIK3CA [But not statistical significance]). Among 80 patients who received systemic treatment, the molecularly matched therapeutic regimens based on genomic profiling showed a significantly longer progression-free survival (hazard ratio [95%confidence interval], 0.60 [0.37-0.99]. P = .047 [multivariate]) and higher disease control rate (61% vs 35%, P = .04) than unmatched regimens. Evaluation of ctDNA and tissue-DNA is feasible in biliary tract cancers.

Population-Based Epidemiology and Mortality of Small Malignant Gastrointestinal Stromal Tumors in the USA.

BACKGROUND AND AIMS: Gastrointestinal stromal tumors (GISTs) have significant variability in size and malignant behavior. Our current understanding is limited to pathological analyses, autopsy studies, and small case series. The aim of the current study is to define the risk factors, incidence, and mortality rates of GIST <2 cm in the National Cancer Institute's Surveillance, Epidemiology, and End Results database. METHODS: Patients with histologically confirmed malignant GIST <2 cm were studied from 2001 to 2011. GIST was defined by GI tumor site codes and GIST-specific histology codes. RESULTS: We identified 378 patients with GIST <2 cm. The average age at diagnosis was 64.0 years with equal sex distribution. The most common tumor location was the stomach (62.2 %), followed by the small intestine (23.3 %), colon (5.6 %), and rectum (3.4 %). Most patients had localized disease (79.4 %), but 11.4 % had regional/distant metastatic disease. The annual incidence rate was 4.2 per 10,000,000 (10M). This was the highest among Blacks (7.6 per 10M). Among patients with GIST and no additional cancers, the 5-year GIST-specific mortality was 12.9 %. Moreover, there was a significantly increased 5-year GIST-specific mortality in those patients who had regionally advanced (34.0 %) or metastatic GIST (34.3 %), as compared to those patients with localized GIST (5.6 %). CONCLUSIONS: This study represents the first population-based analysis of malignant GIST <2 cm. While quite rare, these tumors have an underappreciated disease-specific mortality. Further studies are needed to define the underlying reasons for the identified racial differences, to develop novel risk assessment schema for patients with these small tumors, and to determine appropriate indications for resection and/or medical therapy.

Templated synthesis of ZnSe nanostructures using lyotropic liquid crystals.

We report a technique for controlled synthesis of zero-, one-, and two-dimensional compound semiconductor nanostructures by using cubic, hexagonal, and lamellar lyotropic liquid crystals as templates, respectively. The liquid crystals were formed by self-assembly in a ternary system consisting of a poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) amphiphilic block copolymer as the surfactant, heptane as the non-polar dispersed phase, and formamide as the polar continuous phase. ZnSe quantum dots and nanowires with diameters smaller than 10 nm, as well as free-standing, disc-like quantum wells, were grown inside the spherical, cylindrical, and planar nanodomains, respectively, by reacting diethylzinc that was dissolved in the heptane domains with hydrogen selenide gas that was brought into contact with the liquid crystal in a sealed chamber at room temperature and atmospheric pressure. The shape and size of the resulting nanostructures can be manipulated by selecting the templating phase of the liquid crystal, the size of the dispersed nanodomains that is controlled by the composition of the template, and the concentration of diethylzinc in them.

Electrical spin injection from an n-type ferromagnetic semiconductor into a III-V device heterostructure.

The use of carrier spin in semiconductors is a promising route towards new device functionality and performance. Ferromagnetic semiconductors (FMSs) are promising materials in this effort. An n-type FMS that can be epitaxially grown on a common device substrate is especially attractive. Here, we report electrical injection of spin-polarized electrons from an n-type FMS, CdCr(2)Se(4), into an AlGaAs/GaAs-based light-emitting diode structure. An analysis of the electroluminescence polarization based on quantum selection rules provides a direct measure of the sign and magnitude of the injected electron spin polarization. The sign reflects minority rather than majority spin injection, consistent with our density-functional-theory calculations of the CdCr(2)Se(4) conduction-band edge. This approach confirms the exchange-split band structure and spin-polarized carrier population of an FMS, and demonstrates a litmus test for these FMS hallmarks that discriminates against spurious contributions from magnetic precipitates.