Single organ metastatic sites in non-small cell lung cancer: Patient characteristics, treatment patterns and outcomes from a large retrospective Canadian cohort.

BACKGROUND: There is a paucity of information about the characteristics, treatment patterns, and outcomes of non-small cell lung cancer (NSCLC) patients with single organ metastasis (SOM). METHODS: This retrospective cohort study includes all patients with a diagnosis of stage IV NSCLC diagnosed from 2014 to 2016 and treated at Princess Margaret Cancer Centre. We compared baseline characteristics and patterns of metastatic sites between patients with SOM versus multiple (M)OM. Additionally, we identified treatment modalities and outcomes for patients with SOM. Cox multivariable models (MVA) were utilized to evaluate differences in overall survival (OS) between the SOM and MOM cohorts. RESULTS: Of 893 pts analyzed, 457 (51 %) had SOM, while 436 (49 %) had MOM at initial diagnosis. Demographics were comparable between the two groups. Brain was the most common site of metastasis for SOM patients. When compared to the MOM group, the SOM group had lower percentages of liver and adrenal metastases. Amongst SOM patients, 54 % received single modality treatment, and 20 % did not receive any treatment for their SOM. In MVA, patients with liver (HR 2.4), bone (HR 1.8), and pleural (HR 1.7) metastasis as their SOM site had the worst outcomes, with median OS of 6.8 months, 12.1 months, and 13.0 months respectively. Patients with SOM had a significantly improved median OS compared to those with MOM (15.9 months vs. 10.6 months; HR 0.56, 95 % CI 0.47-0.66, p < 0.001). CONCLUSION: In NSCLC patients who presented with SOM, survival correlated with the initial organ involved and was better overall compared to patients with MOM. SOM NSCLC may benefit from specific management strategies and SOM patients could be considered as a specific subgroup for survival analyses in observational and non-randomized interventional studies. In clinical trials, SOM can be considered as a stratification factor in the future.

Goldilocks effect in magnetic bistability: remote substituent modulation and lattice control of photoinduced valence tautomerism and light-induced thermal hysteresis.

The thermal-induced and photoinduced valence tautomerism of a series of Co(dioxolene)(2)(4-X-py)(2) complexes (dioxolene = 3,5-di-tert-butylcatecholate or 3,5-di-tert-butylsemiquinonate; 4-X-py = 4-(X)pyridine, X = H (1), OMe (2), Me (3), CN (4), Br (5), NO(2) (6)) is described. The thermal valence tautomerism (ls-Co(III)(SQ)(Cat)(4-X-py)(2) <--> hs-Co(II)(SQ)(SQ)(4-X-py)(2)) is only observed for complexes 4, 5, and 6 where each is accompanied by a hysteresis loop of ca. 5 K. When a crystalline sample of 4-6 is held at 10 K in a SQUID magnetometer and irradiated with white light (lambda = 400-850 nm), the hs-Co(II) tautomer is formed. When the light source is removed, and the sample is slowly heated, the hs-Co(II) tautomer persists until ca. 90 K, approximately 40 K higher than the thermal stability of previously reported complexes. Heating and cooling the sample while maintaining irradiation results in the appearance of a new light-induced thermal hysteresis loop below 90 K (DeltaT = ca. 25 K). Below 50 K, the hs-Co(II) tautomer displays temperature-independent relaxation to the ls-Co(III) form, and above 50 K, the relaxation is thermally activated with an activation energy E(a) > ca. 1500 cm(-1). The coordination geometry (trans-pyridines), pyridine substitution, and crystal packing forces conspire to create the comparatively thermally stable photogenerated hs-Co(II) tautomer, thus providing an excellent handle for molecular and crystal engineering studies.

BCL-2 cooperates with promyelocytic leukemia retinoic acid receptor alpha chimeric protein (PMLRARalpha) to block neutrophil differentiation and initiate acute leukemia.

The promyelocytic leukemia retinoic acid receptor alpha (PMLRARalpha) chimeric protein is associated with acute promyelocytic leukemia (APL). PMLRARalpha transgenic mice develop leukemia only after several months, suggesting that PMLRARalpha does not by itself confer a fully malignant phenotype. Suppression of apoptosis can have a central role in tumorigenesis; therefore, we assessed whether BCL-2 influenced the ability of PMLRARalpha to initiate leukemia. Evaluation of preleukemic animals showed that whereas PMLRARalpha alone modestly altered neutrophil maturation, the combination of PMLRARalpha and BCL-2 caused a marked accumulation of immature myeloid cells in bone marrow. Leukemias developed more rapidly in mice coexpressing PMLRARalpha and BCL-2 than in mice expressing PMLRARalpha alone, and all mice expressing both transgenes succumbed to leukemia by 7 mo. Although both preleukemic, doubly transgenic mice and leukemic animals had abundant promyelocytes in the bone marrow, only leukemic mice exhibited thrombocytopenia and dissemination of immature cells. Recurrent gain of chromosomes 7, 8, 10, and 15 and recurrent loss of chromosome 2 were identified in the leukemias. These chromosomal changes may be responsible for the suppression of normal hematopoiesis and dissemination characteristic of the acute leukemias. Our results indicate that genetic changes that inhibit apoptosis can cooperate with PMLRARalpha to initiate APL.

Focal Leptomeningeal Disease with Perivascular Invasion in EGFR-Mutant Non-Small-Cell Lung Cancer.

We report a previously undescribed pattern of brain metastases in patients with epidermal growth factor receptor-mutated non-small-cell lung cancer treated with tyrosine kinase inhibitors and radiation therapy. These highly distinct lesions appear to spread focally within the leptomeninges, with invasion along the perivascular spaces (FLIP). The survival of patients with FLIP was significantly better compared with patients with classic leptomeningeal disease (median survival, 21 versus 3 months; P = .003). It is unclear whether this pattern of growth is unique to epidermal growth factor receptor-mutated non-small-cell lung cancer.

A bis-bidentate dioxolene ligand induces thermal hysteresis in valence tautomerism interconversion processes.

The use of a bis-bidentate ligand in a solid cobalt dioxolene complex affords the necessary cooperative properties that lead to thermal hysteresis in a valence tautomeric interconversion equilibrium.

A technique for saliva collection in dogs.

A plastic two-chambered vacuum-collection device was developed to collect saliva produced by the parotid gland in dogs. Repeated application of the device on the parotid gland papilla was atraumatic. Dogs were restrained during the collection period with a continuous intravenous infusion of ketamine hydrochloride and diazepam in lactated Ringer's solution. The anesthetic regime did not interfere with salivation.

Synthesis and structure of a complex having a quartet ground state with three entirely different spin carriers: nitronyl nitroxide, o-semiquinone, and CuII.

A "spin diverse" S = 3/2 ground-state complex, NN-SQCuTpCum,Me, has been prepared. The three S = 1/2 spin carriers are nitronyl nitroxide (NN), o-semiquinone (o-SQ), and cupric ion. The solid-state structure of the ZnII derivative, NN-SQZnTpCum,Me (C56H69BN8O4Zn), was determined: monoclinic, P2(1)/c, a = 12.5781(12) A, b = 17.7408(17) A, c = 24.440(2) A, alpha = 90.00 degrees, beta = 98.240(2) degrees, gamma = 90.00 degrees, Z = 4. The results of X-ray structural characterization of the ZnII derivative suggest substantial interaction between the two spin carriers NN and o-SQ. Indeed, strong intramolecular exchange coupling has been determined by variable-temperature magnetic susceptibility studies. Intraligand ferromagnetic exchange is considerably greater than kT, such that only the triplet state is populated at 300 K, and CuII-ligand exchange is ferromagnetic, with J = +75 cm-1.

Molecular structures of carbonyl-linked bis(dioxolene) complexes: can a carbonyl group act as an effective ferromagnetic coupler?

Molecular structures of two bis(ZnIIdioxolene) complexes are described: (TpCum,MeZn)(2)1-H2 (C106H123.50B2N12O10Zn2), tetragonal, P4/ncc, a = 25.1810(2) A, b = 25.1810(2) A, c = 34.7744(2) A, alpha = 90 degrees, beta = 90 degrees, gamma = 90 degrees, Z = 8; (TpCum,MeZn)(2)1-H (C101H120B2N12O6Zn2), triclinic, P1, a = 13.6624(2) A, b = 13.80920(10) A, c = 26.62340(10) A, alpha = 96.6910(10) degrees, beta = 91.8560(10) degrees, gamma = 109.0190(10) degrees, Z = 2. One of the complexes, (TpCum,MeZn)(2)1-H2, has two protonated catecholate ligands, while the other complex, (TpCum,MeZn)(2)1-H, has one protonated catecholate and one semiquinone ligand. When reacted with PbO2, a labile S = 1, bis(ZnIIsemiquinone) complex is formed in which the two semiquinones are attached to a common carbonyl group.

Leukemia initiated by PMLRARalpha: the PML domain plays a critical role while retinoic acid-mediated transactivation is dispensable.

The most common chromosomal translocation in acute promyelocytic leukemia (APL), t15;17(q22;q21), creates PMLRARalpha and RARalphaPML fusion genes. We previously developed a mouse model of APL by expressing PMLRARalpha in murine myeloid cells. In order to examine the mechanisms by which PMLRARalpha can initiate leukemia, we have now generated transgenic mice expressing PMLRARalpham4 and RARalpham4, proteins that are unable to activate transcription in response to retinoic acid. PMLRARalpham4 transgenic mice developed myeloid leukemia, demonstrating that transcriptional activation by PMLRARalpha is not required for leukemic transformation. The characteristics of the leukemias arising in the PMLRARalpham4 transgenic mice varied from those previously observed in our PMLRARalpha transgenic mice, indicating that ligand responsiveness may influence the phenotype of the leukemic cells. The leukemias that arose in PMLRARalpham4 transgenic mice did not differentiate in response to retinoic acid therapy. This result supports the hypothesis that a major therapeutic effect of retinoic acid is mediated directly through the PMLRARalpha protein. However, a variable effect on survival suggested that this agent may be of some benefit in APL even when leukemic cells are resistant to its differentiative effects. Transgenic mice expressing high levels of RARalpham4 have not developed leukemia, providing evidence that the PML domain of PMLRARalpha plays a specific and critical role in the pathogenesis of APL. (Blood. 2000;95:1541-1550)

Charge distribution in bis-dioxolene radical metal complexes. synthesis and DFT characterization of dinuclear Co(III) and Cr(III) complexes with a mixed-valent, S = 1/2 semiquinone-catecholate ligand.

Bis-dioxolene bridged dinuclear metal complexes of general formula M2(CTH)2(diox-diox)(PF6)n (n = 2, 3; M = Co(III), Cr(III); CTH = tetraazamacrocycle) have been synthesized using the bis-bidentate ligand 5,5'-di-tert-butyl-3,3',4,4'-tetrahydroxybiphenyl. These complexes were characterized by means of ESR, UV-vis, temperature dependent magnetic susceptibility, and cyclic voltammetry. Our results unambiguously suggest that the tripositive dimetal cations can be described as containing a fully delocalized bis-dioxolene trinegative radical ligand (Cat-Sq) bridging two tripositive metal cations. In this frame the sextet electronic ground state characterizes the Cr2(CTH)2(Cat-SQ)3+ as a result of the antiferromagnetic coupling of the radical bridging ligand with the two equivalent paramagnetic metal centers. The electronic and geometrical structure and the magnetic properties of Cat-Sq and of its complexes have been studied with density functional theory.

Penetration and co-localization in MDCK cell mitochondria of IgA derived from patients with primary biliary cirrhosis.

Primary biliary cirrhosis (PBC) is a chronic autoimmune liver disease of unknown etiology characterized by high-titer anti-mitochondrial antibodies. The major autoantigen has been identified as the E2 subunit of the pyruvate dehydrogenase complex (PDC-E2). The fact that PDC-E2 is present in all nucleated cells, but autoimmune damage is confined to biliary epithelial cells, prompted us to investigate the possibility that mucosally-derived IgA may be pathogenic for biliary epithelial cells. Serum IgA was purified from six patients with PBC and its localization and ability to penetrate cells was studied using Madine-Darby canine kidney (MDCK) cells transfected with the human IgA receptor (MDCK-pIgR). The potential of IgA to be transported through the cells was studied by a combination of immunohistochemistry and dual color fluorescent microscopy. Interestingly, IgA from all PBC patients co-localized with PDC-E2 (the major autoantigen of PBC) inside the cells; this was demonstrated by dual staining with anti-human IgA and a mouse monoclonal antibody directed to PDC-E2. In contrast, no co-localization was observed for IgA controls. Furthermore, dual staining of liver sections from PBC patients demonstrated co-localization of IgA and PDC-E2, both cytoplasmically and at the apical surface. We postulate that there may be a direct effect of these autoantibodies on the mitochondrial function of biliary epithelial cells.