FDA Approval Summary: Fruquintinib for the Treatment of Refractory Metastatic Colorectal Cancer.

On November 8, 2023, the FDA approved fruquintinib, an inhibitor of vascular endothelial growth factor receptor (VEGFR)-1, -2, and -3, for the treatment of patients with metastatic colorectal cancer (mCRC) who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF therapy, and if RAS wild-type and medically appropriate, an anti-EGFR therapy. Approval was based on Study FRESCO-2, a globally conducted, double-blind, placebo-controlled randomized trial. The primary endpoint was overall survival (OS). The key secondary endpoint was progression-free survival. A total of 691 patients were randomly assigned (461 and 230 into the fruquintinib and placebo arms, respectively). Fruquintinib provided a statistically significant improvement in OS with a hazard ratio (HR) of 0.66 [95% confidence interval (CI), 0.55, 0.80; P < 0.001]. The median OS was 7.4 months (95% CI, 6.7, 8.2) in the fruquintinib arm and 4.8 months (95% CI, 4.0, 5.8) for the placebo arm. Adverse events observed were generally consistent with the known safety profile associated with the inhibition of VEGFR. The results of FRESCO-2 were supported by the FRESCO study, a double-blind, single-country, placebo-controlled, randomized trial in patients with refractory mCRC who have been previously treated with fluoropyrimidine-, oxaliplatin-, and irinotecan-based chemotherapy. In FRESCO, the OS HR was 0.65 (95% CI, 0.51, 0.83; P < 0.001). FDA concluded that the totality of the evidence from FRESCO-2 and FRESCO supported an indication for patients with mCRC with prior treatment with fluoropyrimidine, oxaliplatin-, and irinotecan-based chemotherapy, an anti-VEGF biological therapy, and if RAS wild-type and medically appropriate, an anti-EGFR therapy.

From imaging to clinical outcome: dual-region CT radiomics predicting FOXM1 expression and prognosis in hepatocellular carcinoma.

Background: Liver cancer, especially hepatocellular carcinoma (HCC), remains a significant global health challenge. Traditional prognostic indicators for HCC often fall short in providing comprehensive insights for individualized treatment. The integration of genomics and radiomics offers a promising avenue for enhancing the precision of HCC diagnosis and prognosis. Methods: From the Cancer Genome Atlas (TCGA) database, we categorized mRNA of HCC patients by Forkhead Box M1 (FOXM1) expression and performed univariate and multivariate studies to pinpoint autonomous HCC risk factors. We deployed subgroup, correlation, and interaction analyses to probe FOXM1's link with clinicopathological elements. The connection between FOXM1 and immune cells was evaluated using the CIBERSORTx database. The functions of FOXM1 were investigated through analyses of Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG). After filtering through TCGA and the Cancer Imaging Archive (TCIA) database, we employed dual-region computed tomography (CT) radiomics technology to noninvasively predict the mRNA expression of FOXM1 in HCC tissues. Radiomic features were extracted from both tumoral and peritumoral regions, and a radiomics score (RS) was derived. The performance and robustness of the constructed models were evaluated using 10-fold cross-validation. A radiomics nomogram was developed by incorporating RS and clinical variables from the TCGA database. The models' discriminative abilities were assessed using metrics such as the area under the curve (AUC) of the receiver operating characteristic curves (ROC) and precision-recall (PR) curves. Results: Our findings emphasized the overexpression of FOXM1 as a determinant of poor prognosis in HCC and illustrated its impact on immune cell infiltration. After selecting arterial phase CT, we chose 7 whole-tumor features and 3 features covering both the tumor and its surroundings to create WT and WP models for FOXM1 prediction. The WT model showed strong predictive capabilities for FOXM1 expression by PR curve. Conversely, the WP model did not demonstrate the good predictive ability. In our study, the radiomics score (RS) was derived from whole-tumor regions on CT images. The RS was significantly associated with FOXM1 expression, with an AUC of 0.918 in the training cohort and 0.837 in the validation cohort. Furthermore, the RS was correlated with oxidative stress genes and was integrated with clinical variables to develop a nomogram, which demonstrated good calibration and discrimination in predicting 12-, 36-, and 60-month survival probabilities. Additionally, bioinformatics analysis revealed FOXM1's potential role in shaping the immune microenvironment, with its expression linked to immune cell infiltration. Conclusion: This study highlights the potential of integrating FOXM1 expression and radiomics in understanding HCC's complexity. Our approach offers a new perspective in utilizing radiomics for non-invasive tumor characterization and suggests its potential in providing insights into molecular profiles. Further research is needed to validate these findings and explore their clinical implications in HCC management.

Zn-Induced Synthesis of Porous Fe-N,S-C Electrocatalyst with Iron-Based Active Sites Containing Sulfides, Oxides and Nitrides for Efficient Oxygen Reduction and Zinc-Air Batteries.

There is an urgent need to design and synthesize non-noble metal electrocatalysts (NNMEs) for the replacement of platinum-based electrocatalysts to enhance the sluggish oxygen reduction reaction (ORR) for Zn-air batteries and fuel cells. Herein, Fe-N,S-C materials were fabricated through two steps: first, reprecipitating hemin by adjusting the pH and, then, decorating it with melamine and cysteine in the presence of Zn2+. The resulting Fe-N,S-C-950 (Zn) was prepared after pyrolysis at 950 °C. Using this method, abundant iron-based active species with good dispersion were obtained. The fabrication of more micropores in Fe-N,S-C-950 (Zn) plays a positive role in the improvement of ORR activity. On comparison, Fe-N,S-C-950 (Zn) outperforms Fe-N,S-C-950 and Fe-N-C-950 (Zn) with respect to the ORR due to its larger specific surface area, porous structure, multiple iron-based active sites and N- and S-doped C. Fe-N,S-C-950 (Zn) achieves outstanding ORR performances, including a half-wave potential (E1/2) of 0.844 V and 0.715 V versus a reversible hydrogen electrode (RHE) in 0.1 M KOH and 0.1 M HClO4 solution, respectively. In addition, Fe-N,S-C-950 (Zn) shows an outstanding Zn-air battery performance with an open-circuit voltage (OCV) of 1.450 V and a peak power density of 121.9 mW cm-2, which is higher than that of 20 wt% Pt/C. As a result, the as-prepared electrocatalyst in this work shows the development of the Zn-assisted strategy combined with the assembly of porphyrins as NNMEs for the enhancement of the ORR in both alkaline and acidic solutions.

Synthesis and bioactivity evaluation of pachymic acid derivatives as potential cytotoxic agents.

Pachymic acid, a well-known natural lanostane-type triterpenoid, exhibits various pharmacological properties. In this study, 18 derivatives of pachymic acid were synthesized by modifying their molecular structures and evaluated for their anticancer activity against two human cancer cell lines using the CCK-8 assay. Structure-activity relationship studies according to the in vitro cytotoxicity unexpectedly found one promising derivative A17 (namely tumulosic acid, also found in Poria cocos), which had stronger anti-proliferative activity than the positive drug cisplatin against HepG2 and HSC-2 cell lines with IC50 values of 7.36 ± 0.98 and 2.50 ± 0.15 µM, respectively. Further pharmacological analysis demonstrated that A17 induced HSC-2 cell cycle arrest at the S phase, cell apoptosis, and autophagy. Western blotting confirmed the regulatory effects of A17 on cell cycle arrest-, apoptosis-, and autophagy-related proteins expression. In addition, A17 regulated the AKT and AMPK pathways in HSC-2 cells. These results demonstrated that A17 possesses great potential as an anticancer agent.

FDA Approval Summary: Mobocertinib for Metastatic Non-Small Cell Lung Cancer with EGFR Exon 20 Insertion Mutations.

On September 15, 2021, the FDA granted accelerated approval to mobocertinib (Exkivity, Takeda Pharmaceuticals USA, Inc.) for the treatment of adult patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by an FDA-approved test, whose disease has progressed on or after platinum-based chemotherapy. The approval was based on data from Study AP32788-15-101 (NCT02716116), an international, non-randomized, multi-cohort clinical trial that included patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutations. The overall response rate in 114 patients whose disease had progressed on or after platinum-based chemotherapy was 28% [95% confidence interval (CI), 20%-37%] with a median duration of response of 17.5 months (95% CI, 7.4-20.3). The most common adverse reactions (>20%) were diarrhea, rash, nausea, stomatitis, vomiting, decreased appetite, paronychia, fatigue, dry skin, and musculoskeletal pain. Product labeling includes a Boxed Warning for QTc prolongation and torsades de pointes. This is the first approval of an oral targeted therapy for patients with advanced EGFR exon 20 insertion mutation-positive NSCLC.

Prevention of sports injuries during physical training of volleyball players / Prevenção de lesões esportivas durante o treinamento físico dos jogadores de vôlei / Prevención de lesiones deportivas durante el entrenamiento físico de jugadores de voleibol

ABSTRACT Introduction Volleyball is a popular sport among Chinese college students. Almost all professional sports colleges and universities have set up volleyball majors courses. To improve the basic physical fitness of volleyball players, it is necessary to strengthen their physical training. Objective Analyze the causes and types of sports injuries of volleyball players in colleges, formulating countermeasures for preventive training of volleyball players. Methods The sports injuries of 38 volleyball players at a university were investigated, the physical training factors that caused injuries were analyzed, and the need to build an injury-prevention physical training system was discussed. Injury prevention physical training was presented to effectively prevent sports injuries. Results The common sports injuries of college volleyball athletes were mainly ligament injuries, knee joint injuries, patella cartilage injuries, and lumbar spine injuries. Conclusion Preventive physical training can effectively prevent sports injuries among college volleyball athletes, reduce the incidence of injury to a controlled extent, and at the same time extend the athletes' sports trajectory as far as possible beyond their efforts to improve their ultimate sports performance. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução O vôlei é um esporte muito apreciado pelos estudantes universitários chineses. Quase todas as faculdades e universidades esportivas profissionais criaram cursos superiores de voleibol. Para melhorar a aptidão física de base dos jogadores de voleibol, é necessário fortalecer seu treinamento físico. Objetivo Analisar as causas e os tipos de lesões esportivas dos jogadores de vôlei nas faculdades, formulando contramedidas para o treinamento preventivo dos jogadores de vôlei. Métodos Foram investigadas as lesões esportivas de 38 jogadores de vôlei de uma universidade, analisados os fatores do treinamento físico que causaram lesões, e discutida a necessidade de construir um sistema de treinamento físico de prevenção às lesões. O treinamento físico de prevenção de lesões foi apresentado para prevenir efetivamente as lesões esportivas. Resultados As lesões esportivas comuns dos atletas de vôlei universitários foram principalmente lesões ligamentares, lesões nas articulações dos joelhos, lesões na cartilagem da rótula e lesões na coluna lombar. Conclusão O treinamento físico preventivo pode efetivamente prevenir lesões esportivas entre os atletas de voleibol universitário, reduzir a incidência de lesões a uma extensão controlada e, ao mesmo tempo, estender ao máximo a trajetória esportiva dos atletas além dos esforços para melhorar seu desempenho esportivo final. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción El voleibol es un deporte popular entre los estudiantes universitarios chinos. Casi todas las facultades y universidades deportivas profesionales han creado cursos de especialización en voleibol. Para mejorar la forma física básica de los jugadores de voleibol, es necesario reforzar su entrenamiento físico. Objetivo Analizar las causas y los tipos de lesiones deportivas de los jugadores de voleibol en las universidades, formulando contramedidas para el entrenamiento preventivo de los jugadores de voleibol. Métodos Se investigaron las lesiones deportivas de 38 jugadores de voleibol de una universidad, se analizaron los factores del entrenamiento físico que causaban lesiones y se discutió la necesidad de crear un sistema de entrenamiento físico para la prevención de lesiones. Se presentó un entrenamiento físico de prevención de lesiones para prevenir eficazmente las lesiones deportivas. Resultados Las lesiones deportivas comunes de los atletas universitarios de voleibol fueron principalmente lesiones de ligamentos, lesiones de la articulación de la rodilla, lesiones del cartílago rotuliano y lesiones de la columna lumbar. Conclusión El entrenamiento físico preventivo puede evitar eficazmente las lesiones deportivas entre los atletas universitarios de voleibol, reducir de forma controlada la incidencia de lesiones y, al mismo tiempo, ampliar al máximo la trayectoria deportiva de los atletas más allá de los esfuerzos por mejorar su rendimiento deportivo final. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Functionalized Allopurinols Targeting Amyloid-Binding Alcohol Dehydrogenase Rescue Aß-Induced Mitochondrial Dysfunction.

Alzheimer's disease (AD) is the most common dementia affecting one in nine people over 65. Only a handful of small-molecule drugs and the anti-ß amyloid (Aß) antibody aducanumab are approved to treat AD. However, they only serve to reduce symptoms of advanced disease. Novel treatments administered early in disease progression before the accumulation of Aß and tau reaches the threshold where neuroinflammation is triggered and irreversible neuronal damage occurs are more likely to provide effective therapy. There is a growing body of evidence implying that mitochondrial dysfunction occurs at an early stage of AD pathology. The mitochondrial enzyme amyloid-binding alcohol dehydrogenase (ABAD) binds to Aß potentiating toxicity. Moreover, ABAD has been shown to be overexpressed in the same areas of the brain most affected by AD. Inhibiting the Aß-ABAD protein-protein interaction without adversely affecting normal enzyme turnover is hypothesized to be a potential treatment strategy for AD. Herein, we conduct structure-activity relationship studies across a series of functionalized allopurinol derivatives to determine their ability to inhibit Aß-mediated reduction of estradiol production from ABAD. The lead compound resulting from these studies possesses potent activity with no toxicity up to 100 µM, and demonstrates an ability to rescue defective mitochondrial metabolism in human SH-SY5Y cells and rescue both defective mitochondrial metabolism and morphology ex vivo in primary 5XFAD AD mouse model neurons.

Anticancer potential of indirubins in medicinal chemistry: Biological activity, structural modification, and structure-activity relationship.

Indirubin is the crucial ingredient of Danggui Longhui Wan and Qing-Dai, traditional Chinese medicine herbal formulas used for the therapy of chronic myelocytic leukemia in China for hundreds of years. Although the monomeric indirubin has been used in China for the treatment human chronic myelocytic leukemia. However, due to low water solubility, poor pharmacokinetic properties and low therapeutic effects are the major obstacle, and had significantly limited its clinical application. Consequently, the attractive anticancer profile of indirubin has enthused numerous researchers to discover novel indirubin derivatives with improved pharmacodynamic activity as well as good pharmacokinetic property. In this paper, we comprehensively review the recent progress of anticancer potential of indirubins, structural modification and structure-activity relationship, which may provide useful direction for the further development of novel indirubins with improved pharmacological profiles for the treatment of various types of cancer.

Synthesis and Antineoplastic Evaluation of Mitochondrial Complex†II (Succinate Dehydrogenase) Inhibitors Derived from Atpenin†A5.

Mitochondrial complex II (CII) is an emerging target for numerous human diseases. Sixteen analogues of the CII inhibitor natural product atpenin A5 were prepared to evaluate the structure-activity relationship of the C5 pyridine side chain. The side chain ketone moiety was determined to be pharmacophoric, engendering a bioactive conformation. One analogue, 1-(2,4-dihydroxy-5,6-dimethoxypyridin-3-yl)hexan-1-one (16 c), was found to have a CII IC50 value of 64 nm, to retain selectivity for CII over mitochondrial complex I (>156-fold), and to possess a ligand-lipophilicity efficiency (LLE) of 5.62, desirable metrics for a lead compound. This derivative and other highly potent CII inhibitors show potent and selective anti-proliferative activity in multiple human prostate cancer cell lines under both normoxia and hypoxia, acting to inhibit mitochondrial electron transport.

Efficacy of acetylsalicylic acid (aspirin) in skin B16-F0 melanoma tumor-bearing C57BL/6 mice.

Several epidemiological studies show that aspirin can act as a chemopreventive agent and decrease the incidences of various cancers including melanoma. In this work, we investigated the in vitro and in vivo efficacy of acetylsalicylic acid (ASA) as an antimelanoma agent in B16-F0 cells and skin B16-F0 melanoma tumor mouse model. Our findings indicate that the IC50 (48 h) for ASA in B16-F0 melanoma cells was 100 µM and that ASA caused a dose- and time-dependent GSH depletion and increase in reactive oxygen species (ROS) formation in B16-F0 melanoma cells. Male C57BL/6 mice were inoculated s.c. with 1 × 10(6) B16-F0 melanoma cells. ASA (80, 100, and 150 mg/kg) was initiated on day 1 or day 7, or day 9 after cell inoculation and continued daily for 13, 7, and 5 days, respectively. Animals were weighed daily and sacrificed on day 13. The tumors were excised and weighed. The animals receiving 13 days of ASA therapy at 80, 100, and 150 mg/kg demonstrated tumor growth inhibition by 1 ± 12%, 19 ± 22%, and 50 ± 29%, respectively. Animals receiving 7 days of therapy at 80, 100, and 150 mg/kg demonstrated tumor growth inhibition by 12 ± 14%, 27 ± 14%, and 40 ± 14%, respectively. No significant tumor growth inhibition was observed with 5 days of therapy. ASA at 100 and 150 mg/kg caused significant tumor growth inhibition in C57BL/6 mice when administered for 13 and 7 days, respectively. The results obtained in this study are consistent with the recent epidemiologically based report that aspirin is associated with lower melanoma risk in humans.

[Repair of severe blepharoptosis with a frontalis muscle complex suspension technique].

OBJECTIVE: To search an ideal method for treatment of severe blepharoptosis. METHODS: Fifty-four eyes of 47 patients with severe blepharoptosis were undergoing for the treatment with a frontalis muscle complex flap, included in the frontalis muscle, orbicularis oculi muscle and SMAS membranes, to suspend the dropped eyelids. RESULTS: The 54 eyes with severe blepharoptosis were successfully treated with the frontalis muscle complex suspension technique. Although the lagophthalmos in different degrees was shown in 3 months after the operation, it usually disappeared 6 months after the operation. The results were shown good appearance without recurrence. CONCLUSION: The above mentioned technique may be a good and effective method for treatment of the severe blepharoptosis, compared with the traditional technique.