The impact of rare cancer and early-line treatments on the benefit of comprehensive genome profiling-based precision oncology.

BACKGROUND: Comprehensive genome profiling (CGP) serves as a guide for suitable genomically matched therapies for patients with cancer. However, little is known about the impact of the timing and types of cancer on the therapeutic benefit of CGP. MATERIALS AND METHODS: A single hospital-based pan-cancer prospective study (TOP-GEAR; UMIN000011141) was conducted to examine the benefit of CGP with respect to the timing and types of cancer. Patients with advanced solid tumors (>30 types) who either progressed with or without standard treatments were genotyped using a single CGP test. The subjects were followed up for a median duration of 590 days to examine therapeutic response, using progression-free survival (PFS), PFS ratio, and factors associated with therapeutic response. RESULTS: Among the 507 patients, 62 (12.2%) received matched therapies with an overall response rate (ORR) of 32.3%. The PFS ratios (≥1.3) were observed in 46.3% (19/41) of the evaluated patients. The proportion of subjects receiving such therapies in the rare cancer cohort was lower than that in the non-rare cancer cohort (9.6% and 17.4%, respectively; P = 0.010). However, ORR of the rare cancer patients was higher than that in the non-rare cancer cohort (43.8% and 20.0%, respectively; P = 0.046). Moreover, ORR of matched therapies in the first or second line after receiving the CGP test was higher than that in the third or later lines (62.5% and 21.7%, respectively; P = 0.003). Rare cancer and early-line treatment were significantly and independently associated with ORR of matched therapies in multivariable analysis (P = 0.017 and 0.004, respectively). CONCLUSION: Patients with rare cancer preferentially benefited from tumor mutation profiling by increasing the chances of therapeutic response to matched therapies. Early-line treatments after profiling increase the therapeutic benefit, irrespective of tumor types.

Transport of paraquat and mexiletine from the blood into the rat intestinal lumen and peritoneal cavity.

Transport of paraquat and mexiletine from the blood into the intestinal lumen and the peritoneal cavity was examined after their intravenous administration (paraquat: 20 mg kg-1, mexiletine: 10 mg kg-1) to rats. The average amounts of paraquat transferred into the intestinal lumen and the peritoneal cavity were 1.39 and 22.8% of the dose in 120 min, respectively. The average amounts of mexiletine transferred into the intestinal lumen and the peritoneal cavity were 6.1 and 2.5% of the dose in 120 min, respectively. The transfer rate of 3H2O into the peritoneal cavity after intravenous administration (1.85 MBq) was greater than that into the intestinal lumen. In view of the hydrophilic nature of paraquat cation, a solvent drag effect due to movement of water might contribute to transport of paraquat from the blood to the peritoneal cavity. Differences in transport behaviour across the two membranes could be due to differences in the geometrical factors such as the surface area and the distribution of blood vessels. Differences might also be due to differences in physicochemistry and pharmacological effects of both substances.

Determination of C-reactive protein in serum and plasma from healthy dogs and dogs with pneumonia by ELISA and slide reversed passive latex agglutination test.

The concentrations of C-reactive protein (CRP) in serum from dogs diagnosed as normal by clinical, haematological, and biochemical examination were determined by enzyme-linked immunosorbent assay (ELISA) and slide reversed passive latex agglutination (RPLA), using IgG antibody isolated from rabbit anti-canine CRP serum. The mean value of CRP in 66 normal dogs kept in private households was 8.4 +/- 4.9 micrograms/ml by ELISA and 8.5 +/- 6.3 micrograms/ml by RPLA. Thus, no significant difference was demonstrated between the values obtained by ELISA and RPLA. No significant age and sex-related differences were found in the CRP values. The mean concentration of CRP in 84 6-month-old Beagle dogs kept in kennels by breeders was 6.2 +/- 3.9 micrograms/ml by ELISA and 8.0 +/- 4.0 micrograms/ml by RPLA. Again no significant difference was found. The CRP values determined by ELISA and RPLA were closely correlated (r = 0.913). The serum and plasma concentrations of CRP measured by RPLA were also closely correlated (r = 0.994). This indicates that plasma can be used as well as serum to determine CRP concentrations by RPLA.

Canine C-reactive protein (CRP) does not share common antigenicity with human CRP.

Differences in antigenicity between human and canine C-reactive proteins were investigated by Western blotting analysis. It was confirmed that several commercial anti-human CRP sera reacted with canine CRP. However, 34 anti-canine CRP sera prepared by immunization of rabbits and goats with canine CRP all reacted with canine CRP but not with human CRP in either immunoelectrophoresis or Western blotting. Immunization with human CRP produced a cross-reacting antibody that reacted with canine CRP. Conversely, immunization with canine CRP did not produce a cross-reacting antibody that reacted with human CRP. These findings may be interpreted as showing that, while canine and human CRPs do not share common antigenicity, they do contain structurally similar antigenic determinants.

Changes in serum C-reactive protein levels in dogs with various disorders and surgical traumas.

The serum levels of C-reactive protein (CRP) produced as an inflammatory response in dogs with various disorders and surgical traumas were measured by enzyme-linked immunoabsorbent assay and slide reversed passive latex agglutination test (RPLA). The CRP levels were greatly increased 1-2 days after surgery in most of the dogs (n = 29) subjected to surgery. These levels had markedly decreased by the time the sutures were removed. In dogs with various disorders (n = 58), the serum CRP levels at first diagnosis were high in infectious diseases. In dogs from which paired serum samples were examined, the serum CRP usually showed a decrease with improvement in the condition (n = 11) or a terminal increase (n = 4) but, conversely, some showed an increase with improvement in the condition (n = 3).

Scanning and transmission electron microscopic study on a multilayered basement membrane in the pineal organ of the ayu Plecoglossus altivelis.

The pineal organ possesses highly fenestrated capillaries, and is devoid of the so-called blood-brain barrier. The present study indicated that the pineal epithelium of the teleost fish, ayu Plecoglossus altivelis, possesses an unusually thick and convoluted basement membrane (2.2-2.4 microm in width) which is visible even under the light microscope. This pineal basement membrane was observed by scanning and transmission electron microscopy and its detailed composition and relationships with the fenestrated capillaries and the perivascular space were investigated. As the basement membrane was composed of three to eight layers of basal laminae interspersed with laminae lucidae, we termed it the "multilayered basement membrane". In consideration of our previous demonstration that macromolecules such as HRP are trapped by the basement membrane, it is suggested that this multilayered basement membrane may prevent foreign substances from reaching the pineal epithelium.

Adsorption of mexiletine onto activated charcoal in macrogol-electrolyte solution.

Adsorption studies in vitro of mexiletine onto activated charcoal were performed in macrogol (polyethylene glycol)-electrolyte solution (PEG-ELS) and JP XII disintegration medium No. 2 (second medium). Mexiletine was adsorbed more extensively onto activated charcoal in PEG-ELS than that in JP XII second medium. The maximum adsorptive capacity of activated charcoal for the drug was 328 and 284 mg per gram of charcoal in PEG-ELS and JP XII second medium, respectively. In addition, the equilibrium constant of activated charcoal estimated according to the Langmuir equation was 0.079 and 0.034 l per gram of charcoal in PEG-ELS and JP XII second medium, respectively. Adsorption of mexiletine onto activated charcoal was decreased by omitting macrogol, sodium sulfate or sodium bicarbonate from a standard PEG-ELS formulation. Oral activated charcoal will be useful in combination with whole bowel irrigation with PEG-ELS in mexiletine overdose because of its excellent adsorbability in the solution.

Immunocytochemical localization of taurine in the pineal organ and retina of an anadromous fish, Plecoglossus altivelis.

Light and electron microscopic immunolocalization of taurine, a sulfur-containing free amino acid, was investigated in the photoneuroendocrine pineal organ and the retinal photoreceptor and pigment epithelial layer of the ayu Plecoglossus altivelis, an anadromous fish. Intense immunostaining was found in the outer segments of pineal photoreceptors and retinal cone-like cells. Moderate but definite immunostaining was found in the cytoplasmic processes of pineal supporting cells, the outer segments of retinal rod-like cells, and the apical processes of pigment epithelial cells. Although the electron microscopic immunogold labeling was not completely coincident with the results of light microscopic immunostaining, concentrated immunogold particles appeared in the inner segments of photoreceptor cells, the cytoplasmic processes of pineal supporting cells, and the apical processes of pigment epithelial cells. These light and electron microscopic findings in taurine immunolocalization were discussed in relation to the functions of taurine known mainly from retinal physiology. It was suggested that the abundant taurine localization may be involved at least in the protection of photoreceptor outer segments against harmful factors, and in the transportation of nutrients and metabolites. The immunostaining for taurine is useful for the discrimination of different types of photoreceptor cells in the pineal organ and retina of fish.

Atypical endocrine granules in atypical endocrine tumor (AET) of the lung. An immunoelectron microscopic study.

Highly dense granules are a hallmark for recognizing atypical endocrine tumor (AET) of the lung. We report a case of AET with many atypical neurosecretory-type granules: moderately dense granules (mean size 373.7 nm) and "target" granules with a central dense core (425.1 nm), both apparently larger than the highly dense granules (223.3 nm). Immunoelectron microscopical studies demonstrated that all three types of granule were positive for gastrin-releasing peptide (GRP), human chorionic gonadotropin alpha-subunit (hCG alpha), calcitonin or serotonin. Although the size profiles of positive granules were similar for calcitonin and hCG alpha, they were different from those of GRP or serotonin granules. The presence of atypical granules and the different size profiles of hormonal products in AET indicate that caution is required in ultrastructural evaluation of granules in lung carcinomas.

Human chorionic gonadotropin alpha-subunit in endocrine cells of fibrotic and neoplastic lung. Its mode of localization and the size profile of granules.

To investigate the nature of various endocrine cells immunoreactive for human chorionic gonadotropin (hCG alpha) in the lung, immunoelectron microscopic study was performed on fibrotic adult lungs and endocrine neoplasms of the lung. The mode of localization of hCG alpha and the size profile of hCG alpha granules were different among endocrine cells under various proliferative conditions. The population of hCG alpha granules in the grouped type of endocrine cells was more variable with a shift to smaller size (mean area: 1.395 x 10(-2) microns 2, mean maximum diameter: 149.8 nm), than that in solitary ones (1.493 x 10(-2) microns 2, 155.4 nm). Tumorlet endocrine cells had larger hCG alpha granules (1.800 x 10(-2) microns 2, 171.3 nm) without change of SD of size parameters. In carcinoid tumors, the size profile of hCG alpha granules was considerably different from that in the three types described above. Moreover, hCG alpha granules were significantly smaller in size in carcinoid tumors without lymph node metastasis (2.295 x 10(-2) microns 2, 189.8 nm) than those in malignant carcinoid tumors with metastasis (3.368 x 10(-2) microns 2, 230.5 nm). The population of hCG alpha granules in atypical endocrine tumor was the parallel shift to a larger scale (6.251 x 10(-2) microns 2, 307.5 nm) from that of malignant carcinoids and the distribution pattern was different from that in benign carcinoids. In small cell carcinoma of the lung, hCG alpha immunoreaction was preferentially present in perinuclear space and dilated rough endoplasmic reticulum. The mode of localization of hCG alpha and the size profile of hCG alpha granules, representing specific features of intracellular processing of hCG alpha, may be closely related with some qualitative changes in the neoplastic process of pulmonary endocrine cells.

Human airway submucosal glands augment eosinophil chemotaxis during rhinovirus infection.

BACKGROUND: Asthma exacerbations are frequently associated with rhinovirus (RV) infections. However, the contribution of airway submucosal gland (SMG) to exacerbations of asthma in RV respiratory infection has not been studied. OBJECTIVE: This study was undertaken to examine whether RV-infected human respiratory SMG cells produce pro-inflammatory cytokines and chemokines for eosinophils, and augment eosinophil transmigration across human airway epithelium. METHODS: We infected cultured human tracheal SMG cells with RV14, collected culture media at 1, 3, and 5 days after infection, and measured the chemotactic activity for eosinophils in the culture supernatant using a 48-well microchemotaxis chamber and a (51)Cr-labelled eosinophil transmigration assay. RESULTS: Exposing a confluent human tracheal SMG cell monolayer to RV14 consistently led to infection. Human SMG cells with RV infection secreted soluble factors activating human eosinophil chemotaxis into the culture supernatant in a time-dependent manner, and the culture supernatant significantly augmented the transmigration of (51)Cr-labelled eosinophils through human airway epithelial cell layers from the basal to mucosal side. These effects were completely abolished by a mixture of a monoclonal antibody regulated on activation, normal T cells expressed and secreted (RANTES) and an antibody to granulocyte macrophage-colony stimulating factor (GM-CSF). CONCLUSION: These results suggest that human respiratory SMG cells may augment eosinophil transmigration across the airway epithelium through the secretion of RANTES and GM-CSF after RV infection, and may contribute to exacerbations of asthma.