Maintenance durvalumab after first-line chemotherapy in patients with HER2-negative advanced oesophago-gastric adenocarcinoma: results from the randomised PLATFORM study.

BACKGROUND: PLAnning Treatment For Oesophago-gastric Cancer: a Randomised Maintenance Therapy Trial (PLATFORM) is an adaptive phase II study assessing the role of maintenance therapies in advanced oesophago-gastric (OG) adenocarcinoma. We evaluated the role of the anti-programmed death-ligand 1 (PD-L1) inhibitor durvalumab in these patients. PATIENTS AND METHODS: Patients with human epidermal growth factor receptor 2-negative locally advanced or metastatic OG adenocarcinoma with disease control or response to 18 weeks of platinum-based first-line chemotherapy were randomised to active surveillance or maintenance durvalumab. The primary endpoint was progression-free survival (PFS). Safety was assessed in all patients who had commenced surveillance visits or received at least one dose of durvalumab. Exploratory survival analyses according to PD-L1 Combined Positive Score (CPS) and immune (biomarker-positive) or angiogenesis dominant (biomarker-negative) tumour microenvironment (TME) phenotypes were conducted. RESULTS: Between March 2015 and April 2020, 205 patients were randomised to surveillance (n = 100) and durvalumab (n = 105). No significant differences were seen in PFS [hazard ratio (HR) 0.84, P = 0.13] and overall survival (OS; HR 0.98, P = 0.45) between surveillance and durvalumab. Five patients randomised to durvalumab demonstrated incremental radiological responses compared with none with surveillance. Treatment-related adverse events occurred in 77 (76.2%) durvalumab-assigned patients. A favourable effect in OS with durvalumab over surveillance in CPS ≥5 and immune biomarker-positive patients was observed compared with CPS <5 and biomarker-negative subgroups, respectively: CPS ≥5 versus <5: HR 0.63, 95% confidence interval (CI) 0.32-1.22 versus HR 0.93, 95% CI 0.44-1.96; biomarker-positive versus negative: HR 0.60, 95% CI 0.29-1.23 versus HR 0.84, 95% CI 0.42-1.65. CONCLUSION: Maintenance durvalumab does not improve PFS in patients with OG adenocarcinoma who respond to first-line chemotherapy but induced incremental radiological responses in a subset of patients. TME characterisation could refine patient selection for anti-PD-L1 therapy above PD-L1 CPS alone.

Exposure to the steroid hormone 20-hydroxyecdysone modulates agonistic interactions in male Homarus americanus.

In this study we present evidence that 20-hydroxyecdysone (20E) affects agonistic behavior in male American lobsters and that male and female animals differ in their response to the hormone. Thirty-minute staged fights were conducted between large males exposed either to artificial seawater (ASW) or 20E and small, anosmic opponents. The nephropores of both combatants were blocked. Fights were videotaped and quantitatively analyzed for aggressive, defensive and avoidance behaviors using an ethogram in which behaviors are ranked according to aggressiveness. Unlike female lobsters, exposing male lobsters to 20E did not increase their aggressive behavior; however, there was a marginally significant trend toward an increase in defensive behaviors with a lower aggressive content than in their ASW-exposed counterparts. The opponents of 20E-exposed animals performed significantly more aggressive behaviors than their counterparts. In fights with 20E-exposed animals, the overall aggressive intensity of the fight was increased and the animals performed a greater number of avoidance behaviors. Unlike the effects of 20E on females, where exposure to 20E caused an increase in overall agonistic arousal, males only exhibited a change in frequency of their behaviors. These findings suggest that while 20E affects both males and females in agonistic encounters, the nature of the effect is different for the two sexes.

Time in residence affects escape and agonistic behavior in adult male american lobsters.

Acquisition and retention of a shelter by a lobster are two of the variables that play a role in lobster agonistic interactions. Since shelter procurement and retention are important for lobster survival, behaviors related to this activity frequently outrank other daily behaviors (e.g., searching for food). Here, we examine the effects of time in residence on the parameters of the escape response of the American lobster, Homarus americanus. Adult male intermolt lobsters (Stage C4) were placed in an experimental tank for three different time periods (one hour, 24 hours, and 48 hours). The probability of eliciting an escape response was inversely related to the time spent in the tank. Eighty percent of the animals in residence for 1 h tailflipped in response to a threat, whereas only 14% of the animals in residence for 48 h tailflipped. There were also significant changes in some of the parameters of the escape response among animals in residence for 24 h compared to those in residence for 1 h. The number of tailflips and the distance traveled were reduced, although frequency, velocity, acceleration, force, and work factors were not significantly different. Furthermore, with increased time in residence, lobsters switched from an avoidance or escape-prone behavior to an aggressive-prone behavior. Most of the animals in residence for 48 h approached and attacked a threat-stimulus rather than fleeing from it. On an empirically defined "index of aggressiveness," in which various behaviors were numerically ranked from least aggressive (0) to most aggressive (6), animals residing in the tank for 1 h had an average index value of 0.1 compared to a value of 5.0 for animals in residence for 48 h. These findings are consonant with the suggestion that lobsters that have occupied a given space for an extended period of time take possession of the site and defend it instead of fleeing when threatened with a threat-inducing stimulus; it supports the idea that shelter retention increases aggressiveness and diminishes avoidance behaviors.

Molt-related and size-dependent differences in the escape response and post-threat behavior of the American lobster, Homarus americanus.

Videotaped recordings of adult lobsters of different molt stages were analyzed. The escape response of adults was compared with that of juveniles recorded in an earlier study. Juvenile lobsters always respond to a threat with escape behavior irrespective of their molt stage, but in adults the probability of eliciting a response was a function of molt stage: more hard-shelled (intermolt stage C) and (premolt stage D) animals tailflipped than did soft-shelled (postmolt stages A and B) animals. The number, frequency, and duration of tailflips, and the average distance swum by animals in each molt stage were measured for the entire escape response, for the initial power swim, and for the subsequent swims. These measurements were used to compute several parameters: velocity, acceleration, force, and work; average distance traveled in a tailflip for each kilogram of body weight (distance/kg/tailflip); and average distance traveled for each bodylength (distance/bodylength). Among adults, intermolt (stage C) lobsters traveled significantly farther and faster than postmolt animals (stages A and B). Among juveniles, late postmolt (stage B) animals traveled farther. Among adults, although the total number of tailflips and the duration of the response were not significantly different among molt stages, the number of tailflips/second (frequency) and distance traveled/kg/tailflip were greater for intermolt animals. In juvenile intermolts, however, frequency and distance/kg/tailflip were markedly lower than in the premolt stages. Although values were lower than intermolts and premolts, postmolt adults sustained their swimming frequency, distance/kg/tailflip, and distance/bodylength for the entire escape distance (as did postmolt juveniles). These parameters then dropped off sharply for both adult and juvenile intermolt and premolt animals in the second half of the escape distance. Post-threat behaviors reveal that stage D animals have the highest aggression index and often attack the presented stimulus, whereas stage A animals are the least likely to approach the stimulus and typically back away in a non-aggressive posture. Thus, although effects of the molt cycle on adult and juvenile escape behavior are similar in some ways, other physical characteristics of adults, such as weight, allometry, and physiology, seem to become important in determining the likelihood of escape behavior and the characteristics of the escape swim in each molt stage.

Multiple excitatory receptor types on individual olfactory neurons: implications for coding of mixtures in the spiny lobster.

The aim of our paper was to investigate whether single olfactory receptor neurons (ORNs) of the spiny lobster Panulirus argus functionally express more than one type of receptor, examine the consequences of this on coding of mixtures, and compare principles of odorant mixture coding by spiny lobsters with that by the channel catfish, which has been studied extensively using the same experimental and analytical procedures (Caprio et al. 1989; Kang and Caprio 1991). We examined responses of individual taurine-sensitive ORNs to binary mixtures of excitatory compounds, either competitive agonists (taurine, beta-alanine, hypotaurine) or non-competitive agonists (taurine, L-glutamate, ammonium chloride, adenosine-5'-monophosphate). Responses to mixtures were compared to two indices: mixture discrimination index (MDI) and independent component index (ICI). Binary mixtures of competitive agonists had MDI values close to 1.0, as expected for competitors. Mixtures of non-competitive agonists had ICI values averaging 0.83, indicating the effects of the components are not independent. We conclude that individual olfactory cells of spiny lobsters can express more than one type of receptor mediating excitation, one of which typically has a much higher density or affinity, and that spiny lobster and catfish olfactory cells encode mixtures of two excitatory agonists using similar rules.

Inhibitory receptor binding events among the components of complex mixtures contribute to mixture suppression in responses of olfactory receptor neurons of spiny lobsters.

Responses of olfactory receptor neurons of spiny lobsters Panulirus argus to two-component mixtures can be shaped by inhibitory events such as odor-activated hyperpolarizations and inhibition of odor-receptor binding (Daniel et al. 1996). In the current study, we extend this analysis to complex mixtures by examining responses of spiny lobster olfactory receptor neurons to mixtures containing up to seven odorants, consisting of adenosine-5'-monophosphate, ammonium, betaine, L-cysteine, L-glutamate, DL-succinate, and taurine. The response to a mixture was often less than the response to its most excitatory component. The effect of adding an excitatory odorant to a mixture depended on olfactory receptor neuron type, composition of the mixture, and which compound was added. In some cases the added excitatory compound had no effect or even decreased the mixture's response intensity, thus demonstrating nonlinear contributions of the components. Response intensities predicted by a noncompetitive model, which is most representative of these olfactory receptor neurons, were improved when the model included a term for empirical measurements of inhibitory binding interactions, suggesting that inhibitory binding interactions are one mechanism contributing to mixture suppression. This model's predictions were accurate for binary mixtures but not for larger mixtures, suggesting that additional inhibitory mechanisms are needed to account for mixture interactions in complex mixtures.

Depression of synaptic efficacy in high- and low-output Drosophila neuromuscular junctions by the molting hormone (20-HE).

The molt-related steroid hormone, 20-hydroxyecdysone (20-HE), was applied to muscles 6 and 7 of third instar larval of Drosophila melanogaster neuromuscular junction preparations to examine if rapid, nongenomic responses could be observed as was shown recently to occur in crustacean neuromuscular junctions. At a dose of 10 microM, the excitatory junction potentials were reduced in amplitude within minutes. To elucidate the site of action of the hormone, focal-macropatch recordings of synaptic currents were obtained over the neuromuscular junctions. The results showed that the high-output (Is) and the low-output (Ib) motor nerve terminals, which innervate muscles 6 and 7, released fewer synaptic vesicles for each stimulation while exposed to 20-HE. Because the size and shape of synaptic currents from spontaneous releases did not change, the effects of the 20-HE are presynaptic. The rapid effects of this hormone may account in part for the quiescent behavior associated with molts among insects and crustaceans.

Comparative Analysis of Escape Behavior in Male, and Gravid and Non-Gravid, Female Lobsters.

Few studies exist in which the parameters of a single behavior have been quantitatively compared for male and female lobsters. Here, we have examined the effects of sex and gravidity on the parameters of the escape behavior of the American lobster, Homarus americanus, elicited by a visual threat. Both non-gravid females and male lobsters readily tailflipped in response to the stimulus, but gravid females failed, with one exception, to initiate a swim, even when stimulus strength was increased. Although the total distance swum by males and non-gravid females was not statistically different, males covered more ground in the initial power swim and during the subsequent swims than did non-gravid females. Males swam for a longer time, performing more tailflips, than females. Relative to their length and weight, males swam a greater distance at each stroke during the initial power swim and the subsequent swims, although, females might have compensated by swimming at a higher frequency. There were no significant differences in swimming velocity or acceleration, nor in the calculated force or work performed by the two sex classes (male and non-gravid females). Therefore, apart from egg-bearing, which severely inhibits the escape response, it remains to be seen whether the subtle physiological and anatomical sexual dimorphism that produces longer and more swim strokes in males but higher frequency tailflips in females results in the same chances of survival for the sexes.

Autoinhibition of serotonin cells: an intrinsic regulatory mechanism sensitive to the pattern of usage of the cells.

After periods of high-frequency firing, the normal rhythmically active serotonin (5HT)-containing neurosecretory neurons of the lobster ventral nerve cord display a period of suppressed spike generation and reduced synaptic input that we refer to as "autoinhibition." The duration of this autoinhibition is directly related to the magnitude and duration of the current injection triggering the high-frequency firing. More interesting, however, is that the autoinhibition is inversely related to the initial firing frequency of these cells within their normal range of firing (0.5-3 Hz). This allows more active 5HT neurons to resume firing after shorter durations of inhibition than cells that initially fired at slower rates. Although superfused 5HT inhibits the spontaneous firing of these cells, the persistence of autoinhibition in saline with no added calcium, in cadmium-containing saline, and in lobsters depleted of serotonin suggests that intrinsic membrane properties account for the autoinhibition. A similar autoinhibition is seen in spontaneously active octopamine neurons but is absent from spontaneously active gamma-aminobutyric acid cells. Thus, this might be a characteristic feature of amine-containing neurosecretory neurons. The 5HT cells of vertebrate brain nuclei share similarities in firing frequencies, spike shapes, and inhibition by 5HT with the lobster cells that were the focus of this study. However, the mechanism suggested to underlie autoinhibition in vertebrate neurons is that 5HT released from activated or neighboring cells acts back on inhibitory autoreceptors that are found on the dendrites and cell bodies of these neurons.

Agonistic behavior in naïve juvenile lobsters depleted of serotonin 5,7-dihydroxytryptamine.

We have been exploring the role of serotonin in fighting behavior in lobsters using a specific model of agonistic behavior, the establishment of hierarchical relationships between pairs of socially naive juvenile lobsters. We selected this model because the behavior is easily evoked, readily quantifiable, and the effects of experience are eleminated by using socially naive animals. In these studies we injected a specific neurotoxin, 5,7-dihydroxytryptamine, into juvenile lobsters over a 4-week period and then measured the effects on fighting behavior. This treatment reduces the levels of serotonin in the nervous system and immunocytochemical studies show a dramatic reduction in neuropil staining for the amine. Control animals received vehicle injection alone. All injected animals were paired against larger or smaller non-injected opponents, and three successive 30-min fights were carried out and statistically analyzed. The results were surprising: As with elevations of serotonin, reduced levels of serotonin increased the amount of time animals engaged in fighting behavior. No significant effects were seen on who initiated encounters, who retreated first, or who the eventual winner would be. Thus, in this model, elevation or reduction of serotonergic function increases the tendency of animals to engage in agonistic encounters.