INSIGHT 2: a phase II study of tepotinib plus osimertinib in MET-amplified NSCLC and first-line osimertinib resistance.

MET amplification (METamp), a mechanism of acquired resistance to EGFR tyrosine kinase inhibitors, occurs in up to 30% of patients with non-small-cell lung cancer (NSCLC) progressing on first-line osimertinib. Combining osimertinib with a MET inhibitor, such as tepotinib, an oral, highly selective, potent MET tyrosine kinase inhibitor, may overcome METamp-driven resistance. INSIGHT 2 (NCT03940703), an international, open-label, multicenter phase II trial, assesses tepotinib plus osimertinib in patients with advanced/metastatic EGFR-mutant NSCLC and acquired resistance to first-line osimertinib and METamp, determined centrally by fluorescence in situ hybridization (gene copy number ≥5 and/or MET/CEP7 ≥2) at time of progression. Patients will receive tepotinib 500 mg (450 mg active moiety) plus osimertinib 80 mg once-a-day. The primary end point is objective response, and secondary end points include duration of response, progression-free survival, overall survival and safety. Trial registration number: NCT03940703 (clinicaltrials.gov).

Osimertinib is used to treat a type of lung cancer that has specific changes (mutations) in a gene called EGFR. Although tumors will usually shrink (respond) during treatment with osimertinib, they can stop responding, or become resistant, to osimertinib. A common cause of resistance is 'MET amplification', which describes when extra copies of a gene called MET are present. Lung cancer that is resistant to osimertinib due to MET amplification could be treated by combining osimertinib with a treatment that blocks MET, such as tepotinib. INSIGHT 2 is an ongoing study that is designed to learn about the effects and safety of tepotinib combined with osimertinib, in patients with lung cancer that has stopped responding to osimertinib because of MET amplification. A plain language version of this article is available and is published alongside the paper online: www.futuremedicine.com/doi/suppl/10.2217/fon-2021-1406.

Human embryonic stem cells differentiate into functional renal proximal tubular-like cells.

Renal cells are used in basic research, disease models, tissue engineering, drug screening, and in vitro toxicology. In order to provide a reliable source of human renal cells, we developed a protocol for the differentiation of human embryonic stem cells into renal epithelial cells. The differentiated stem cells expressed markers characteristic of renal proximal tubular cells and their precursors, whereas markers of other renal cell types were not expressed or expressed at low levels. Marker expression patterns of these differentiated stem cells and in vitro cultivated primary human renal proximal tubular cells were comparable. The differentiated stem cells showed morphological and functional characteristics of renal proximal tubular cells, and generated tubular structures in vitro and in vivo. In addition, the differentiated stem cells contributed in organ cultures for the formation of simple epithelia in the kidney cortex. Bioreactor experiments showed that these cells retained their functional characteristics under conditions as applied in bioartificial kidneys. Thus, our results show that human embryonic stem cells can differentiate into renal proximal tubular-like cells. Our approach would provide a source for human renal proximal tubular cells that are not affected by problems associated with immortalized cell lines or primary cells.

Hydrodynamic spinning of hydrogel fibers.

Hydrogel scaffolds are highly hydrated polymer networks that allow cells to adhere, proliferate and differentiate in the treatment of diseased or injured tissues and organs. Using hydrodynamic shaping and in situ cross-linking of hydrogel precursors, we have developed a highly efficient "hydrodynamic spinning" approach for synthesizing hydrogel fibers of different diameters in a multiphase coaxial flow. A triple-orifice spinneret has been created, and three different types of hydrogel precursors have been examined. Without changing the spinning head, hollow and solid hydrogel fibers with different diameters have been spun by simply manipulating the ratio of input flow rates. Together with the ability of simultaneous cell-seeding in the hydrogel matrix, hydrodynamic spinning can be broadly applied to many hydrogel materials, providing a powerful technique in the preparation of fiber-like and tubule-like hydrogel constructs for tissue engineering.

Cell immobilization in gelatin-hydroxyphenylpropionic acid hydrogel fibers.

Gelatin-hydroxyphenylpropionic acid (Gtn-HPA) hydrogels are highly porous and biodegradable materials. Herein we report a fiber spinning method that can produce cell-seeded solid and hollow hydrogel fibers by enzymatically cross-linking Gtn-HPA in solutions flowing within a capillary tube. The cell-immobilized hydrogel fibers, with feature sizes down to 20 microm, are formed as a result of continuous cross-linking of cell-mixed hydrogel precursors in a multiphase laminar flow. This fiber formation process is mild enough to retain the cell viability. The continuous fiber formation, simultaneous cell encapsulation, as well as versatile combination of fiber structures provided by this approach make it a promising and effective technique for the preparation of cell-seeded hydrogel scaffolds and carriers for tissue engineering.

Polyelectrolyte complex membranes for specific cell adhesion.

The presentation of bioactive ligands on biomaterial surfaces is often confounded by the adsorption of proteins present in the biological milieu, rendering any type of cellular response nonspecific. We have engineered a polyelectrolyte complex membrane that demonstrates specific adhesion of various cell types for both two-dimensional (2D) and three-dimensional (3D) cell culture systems. Specific cell adhesion is achieved by a three-tiered structure: a silica cross-linked polycation as the bottom (first) tier, a nonfouling polyanion-poly(ethylene glycol) (PEG) conjugate as the intermediate (second) tier, and the cell-adhesion ligand as the top (third) tier. Each tier of the membrane was characterized in terms of chemical composition and dimensions. Epithelial cells (primary human cortical renal cells and a hepatocellular carcinoma cell line) cultured on the membranes exhibited little cell attachment on the polyanion-PEG second tier and good cell adhesion on the RGD-modified third tier. Thus, the second tier allowed the effect of cell adhesion due to the ligand (third tier) to be isolated and distinguished from nonspecific cell attachment to the first tier. For the culturing of cells in three dimensions, the three-tiered membrane system was applied using a highly swellable chitosan membrane as the first tier. The resulting cell-membrane construct was uniformly dispersed and centrifuged to form a matrix that interacted intimately with cells in the form of a pellet. Presentation of RGD in the latter format enhanced the viability of human mesenchymal stem cells (hMSCs) over controls without RGD.