Long-term efficacy of neoadjuvant-adjuvant targeted therapy in borderline resectable stage IIIB-D and IV melanoma.

BACKGROUND: Neoadjuvant-adjuvant therapy for locally advanced or potentially resectable metastatic melanoma was expected to improve operability and clinical outcomes over upfront surgery and adjuvant treatment only. METHODS: Forty-seven consecutive patients were treated with neoadjuvant-adjuvant BRAF inhibitors (BRAFi)/MEK inhibitors (MEKi) and surgery. RESULTS: Twelve (26%) patients achieved a pathological complete response and 10 (21%) patients achieved a near-complete response. In the whole group, median recurrence-free survival was 19.4 months and median distant metastasis-free survival (mDMFS) was 21.9 months. In patients with a pathological complete response (pCR)/near-pCR median recurrence-free survival (RFS) and distant metastasis-free survival (DMFS) were significantly longer than in patients with minor pathological response with hazard ratio (HR) = 0.37 (p = .005) for RFS and HR = 0.33 (p = .002) for DMFS. After median follow-up of 52.5 months, median progression-free survival since BRAFi/MEKi therapy initiation was 25.1 months. The median time-to-treatment-failure since initiation of neoadjuvant therapy was 22.2 months and was significantly longer in patients with pCR/near-pCR (HR = 0.45; p = .022). Neoadjuvant therapy did not result in any new specific complications of surgery. After 48 months, RFS and overall survival were 36.3% and 64.8% or 20% and 37.4% in patients with pCR/near-pCR and pathological partial response/pathological nonresponse, respectively. CONCLUSIONS: The authors confirmed that BRAFi/MEKi combination is an effective and safe regimen in the perioperative treatment of stage III/IV melanoma. Major pathological response to neoadjuvant treatment is a surrogate marker of recurrence including DMFS in these patients. PLAIN LANGUAGE SUMMARY: Our study presents a large comprehensive analysis of neoadjuvant-adjuvant systemic therapy in patients diagnosed with marginally resectable stage III or IV melanoma. Neoadjuvant therapy effectively reduced the volume of the disease, which facilitated subsequent surgical resection. After median follow-up of 52.5 months, median progression-free survival since therapy initiation was 25.1 months. Twelve patients had complete pathological response and 10 patients had a near-complete pathological response-and together they had median recurrence-free survival and distant metastasis-free survival significantly longer than in patients with pathological partial response or nonresponse. Complete/near-complete pathological response to neoadjuvant treatment is a surrogate marker of recurrence-free, including distant metastasis-free, survival in these patients.

Preoperative-postoperative immunotherapy as treatment of borderline resectable and oligoprogressive stage III B-D and IV melanoma.

INTRODUCTION: Perioperative therapy has gained significant importance in patients with advanced melanoma. Currently, there is little data on the routine use of preoperative immunotherapy in metastatic melanoma outside clinical trials. This study aimed to evaluate the effectiveness of preoperative treatment in patients with borderline resectable stage III or IV melanoma as well as in oligoprogressing stage IV cases; the secondary aim is to describe the safety of surgery after immunotherapy. MATERIALS AND METHODS: Since 1/Jan/2016 seventeen patients were treated with curative intent neoadjuvant immunotherapy, surgery, and adjuvant immunotherapy, while nineteen patients were operated due to oligoprogression while treted with immunotherapy. Survival was analyzed using the Kaplan-Meier method and association between variables was tested using the chi-squared test. RESULTS: R0 resection was achieved in 76.5 % of cases after neoadjuvant immunotherapy. 24 % of patients achieved objective RECIST response and 35 % complete or major pathological response. At the median follow-up time of 51.4 months, 64.7 % of patients were free of PD after perioperative treatment, while 3-year RFS and OS rates were 68 % and 80.9 %, respectively. R0 resection was achieved in 73.7 % of oligo-progressing nodules. The median time to PD on immunotherapy after the first oligoprogression was 10.3 months. Immunotherapy did not result in any unexpected surgical complications. No patient died during preoperative treatment due to immunotherapy toxicity or disease progression. CONCLUSIONS: We confirmed treatment safety and long-term disease control after perioperative immunotherapy. Patients with borderline resectable melanoma should be referred to reference centers using neoadjuvant immunotherapy.

Establishing biomarkers for soft tissue sarcomas.

INTRODUCTION: Soft tissue sarcomas (STS) are a rare and diverse group of tumors. Curative options are limited to localized disease, with surgery being the mainstay. Advanced stages are associated with a poor prognosis. Currently, the prognosis of the patient is based on histological classification and clinical characteristics, with only a few biomarkers having entered clinical practice. AREAS COVERED: This article covers extensive recent research that has established novel potential biomarkers based on genomics, proteomics, and clinical characteristics. Validating and incorporating these biomarkers into clinical practice can improve prognosis, prediction of recurrence, and treatment response. Relevant literature was collected from PubMed, Scopus, and clinicaltrials.gov databases (November 2023). EXPERT OPINION: Currently, defining prognostic markers in soft tissue sarcomas remains challenging. More studies are required, especially to personalize treatment through advanced genetic profiling and analysis using individual tumor and patient characteristics.

Molecular and Clinicopathological Biomarkers in the Neoadjuvant Treatment of Patients with Advanced Resectable Melanoma.

Neoadjuvant systemic therapy is emerging as the best medical practice in patients with resectable stage III melanoma. As different regimens are expected to become available in this approach, the improved optimization of treatment strategies is required. Personalization of care in each individual patient-by precisely determining the disease-related risk and the most efficient therapeutic approach-is expected to minimize disease recurrence, but also the incidence of treatment-related adverse events and the extent of surgical intervention. This can be achieved through validation and clinical application of predictive and prognostic biomarkers. For immune checkpoint inhibitors, there are no validated predictive biomarkers until now. Promising predictive molecular biomarkers for neoadjuvant immunotherapy are tumor mutational burden and the interferon-gamma pathway expression signature. Pathological response to neoadjuvant treatment is a biomarker of a favorable prognosis and surrogate endpoint for recurrence-free survival in clinical trials. Despite the reliability of these biomarkers, risk stratification and response prediction in the neoadjuvant setting are still unsatisfactory and represent a critical knowledge gap, limiting the development of optimized personalized strategies in everyday practice.

Nitrogen doped graphene with diamond-like bonds achieves unprecedented energy density at high power in a symmetric sustainable supercapacitor.

Supercapacitors have attracted great interest because of their fast, reversible operation and sustainability. However, their energy densities remain lower than those of batteries. In the last decade, supercapacitors with an energy content of ∼110 W h L-1 at a power of ∼1 kW L-1 were developed by leveraging the open framework structure of graphene-related architectures. Here, we report that the reaction of fluorographene with azide anions enables the preparation of a material combining graphene-type sp2 layers with tetrahedral carbon-carbon bonds and nitrogen (pyridinic and pyrrolic) superdoping (16%). Theoretical investigations showed that the C-C bonds develop between carbon-centered radicals, which emerge in the vicinity of the nitrogen dopants. This material, with diamond-like bonds and an ultra-high mass density of 2.8 g cm-3, is an excellent host for the ions, delivering unprecedented energy densities of 200 W h L-1 at a power of 2.6 kW L-1 and 143 W h L-1 at 52 kW L-1. These findings open a route to materials whose properties may enable a transformative improvement in the performance of supercapacitor components.

OsPd bimetallic dimer pushes the limit of magnetic anisotropy in atom-sized magnets for data storage.

The growing gap between the volume of digital data being created and the extent of available storage capacities stimulates intensive research into surface-supported, well-ordered array of atom-sized magnets that represents the ultimate limit of magnetic data storage. Anchoring transition-metal heterodimers in vacancy defects in the graphene lattice has been identified as a vivid strategy to achieve large magnetic anisotropy energy (MAE) up to 80 meV with an easy axis aligned along the dimer bond. In this paper we have made a significant leap forward finding out MAE of 119 meV for an OsPt dimer and 170 meV for an OsPd dimer bound to a single nitrogen-decorated vacancy defect. The system with the highest MAE and with the theoretical storage density of ∼490 Tb·inch-2pushes the current limit of theoretical blocking temperature in graphene-supported transition-metal dimers from ∼20 to ∼44 K assuming the relaxation time of 10 years. The mechanism of the enhanced MAE is discussed.

OsPd bimetallic dimer pushes the limit of magnetic anisotropy in atom-sized magnets for data storage.

The growing gap between the volume of digital data being created and the extent of available storage capacities stimulates intensive research into surface-supported, well-ordered array of atom-sized magnets that represents the ultimate limit of magnetic data storage. Anchoring transition metal heterodimers in vacancy defects in the graphene lattice has been identified as a vivid strategy to achieve large magnetic anisotropy energy (MAE) up to 80 meV with an easy axis aligned along the dimer bond. In this paper we have made a significant leap forward finding out MAE of 119 meV for an OsPt dimer and 170 meV for an OsPd dimer bound to a single nitrogen-decorated vacancy defect. The system with the highest MAE and with the theoretical storage density of 490 Tb inch-2pushes the current limit of theoretical blocking temperature in graphene-supported transition-metal dimers from ~20 K to ~44 K assuming the relaxation time of 10 years. The mechanism of the enhanced MAE is discussed.

On-Surface Synthesis of One-Dimensional Coordination Polymers with Tailored Magnetic Anisotropy.

One-dimensional (1D) metalloporphyrin polymers can exhibit magnetism, depending on the central metal ion and the surrounding ligand field. The possibility of tailoring the magnetic signal in such nanostructures is highly desirable for potential spintronic devices. We present low-temperature (4.2 K) scanning tunneling microscopy and spectroscopy (LT-STM/STS) in combination with high-resolution atomic force microscopy (AFM) and a density functional theory (DFT) study of a two-step synthetic protocol to grow a robust Fe-porphyrin-based 1D polymer on-surface and to tune its magnetic properties. A thermally assisted Ullmann-like coupling reaction of Fe(III)diphenyl-bromine-porphyrin (2BrFeDPP-Cl) on Au(111) in ultra-high vacuum results in long (up to 50 nm) 1D metal-organic wires with regularly distributed magnetic and (electronically) independent porphyrins units, as confirmed by STM images. Thermally controlled C-H bond activation leads to conformational changes in the porphyrin units, which results in molecular planarization steered by 2D surface confinement, as confirmed by high-resolution AFM images. Spin-flip STS images in combination with DFT self-consistent spin-orbit coupling calculations of porphyrin units with different structural conformations reveal that the magnetic anisotropy of the triplet ground state of the central Fe ion units drops down substantially upon intramolecular rearrangements. These results point out to new opportunities for realizing and studying well-defined 1D organic magnets on surfaces and demonstrate the feasibility of tailoring their magnetic properties.

Large magnetic anisotropy in an OsIr dimer anchored in defective graphene.

Single-atom magnets represent the ultimate limit of magnetic data storage. The identification of substrates that anchor atom-sized magnets firmly and, thus, prevent their diffusion and large magnetic anisotropy has been at the centre of intense research efforts for a long time. Using density functional theory we show the binding of transition metal (TM) atoms in defect sites in the graphene lattice: single vacancy and double vacancy, both pristine and decorated by pyridinic nitrogen atoms, are energetically more favourable than away from the centre of defects, which could be used for engineering the position of TMs with atomic precision. Relativistic calculations revealed magnetic anisotropy energy (MAE) of ∼10 meV for Ir@NSV with an easy axis parallel to the graphene plane. MAE can be remarkably boosted to 50 meV for OsIr@NSV with the easy axis perpendicular to the graphene plane, which paves the way to the storage density of ∼490 Tb/inch2with the blocking temperature of 14 K assuming the relaxation time of 10 years. Magnetic anisotropy is discussed based on the relativistic electronic structures. The influence of an orbital-dependent on-site Coulomb repulsionUand a non-local correlation functional optB86b-vdW on MAE is also discussed.

Tailoring Electronic and Magnetic Properties of Graphene by Phosphorus Doping.

The electronic and magnetic properties of graphene can be modulated by doping it with other elements, especially those with a different number of valence electrons. In this article, we first provide a three-dimensional reconstruction of the atomic structure of a phosphorus substitution in graphene using aberration-corrected scanning transmission electron microscopy. Turning then to theoretical calculations based on the density functional theory (DFT), we show that doping phosphorus in various bonding configurations can induce magnetism in graphene. Our simulations reveal that the electronic and magnetic properties of P-doped (Gr-P) and/or phosphono-functionalized graphene (Gr-PO3H2) can be controlled by both the phosphorus concentration and configurations, ultimately leading to ferromagnetic (FM) and/or antiferromagnetic (AFM) features with the transition temperature up to room temperature. We also calculate core-level binding energies of variously bonded P to facilitate X-ray photoelectron spectroscopy-based identification of its chemical form present in P-doped graphene-based structures. These results may enable the design of graphene-based organic magnets with tailored properties for future magnetic or spintronic applications.

Thermally induced intra-molecular transformation and metalation of free-base porphyrin on Au(111) surface steered by surface confinement and ad-atoms.

We investigated chemical transformations of a fluorinated free-base porphyrin, 5,10,15,20-tetrakis(4-fluorophenyl)-21,23H-porphyrin (2H-4FTPP) under a Au(111) surface confinement and including gold adatoms by using an experiment and density functional theory based first-principles calculations. Annealing of 2H-4FTPP led to cyclodehydrogenation of the molecule to a π-extended fused aromatic planar compound, 2H-4FPP, and metallation of the porphyrin ring by Au atoms to Au-4FPP complex. Noticeable lowering of bond-dissociation energies of the pyrrole's C-H bonds of the Au(111) supported molecule with respect to their values in the gas phase explained the observed on-surface planarization. Our findings also indicate that Au adatoms may catalyze cleavage of C-H/F bonds in temperature-initiated processes on Au surfaces. BDEs and explicit inclusion of Au adatoms helps to rationalize thermally induced chemical reactions on the respective surface.

Thermally reduced fluorographenes as efficient electrode materials for supercapacitors.

There is an urgent need for a simple and up-scalable method for the preparation of supercapacitor electrode materials due to increasing global energy consumption worldwide. We have discovered that fluorographene exhibits great potential for the development of new kinds of supercapacitors aimed at practical applications. We have shown that time control of isothermal reduction of fluorographite at 450 °C under a hydrogen atmosphere led to the fine-tuning of fluorine content and electronic properties of the resulting fluorographene derivatives. Charge transfer resistances (Rct) of the thermally reduced fluorographenes (TRFGs) were decreased with respect to the pristine fluorographene; however, the Rctvs. time-of-reduction plot showed a v-shaped profile. The specific capacitance vs. time-of-reduction of TRFG followed the v-shaped trend, which could be the result of the decreasing content of sp3 carbons and increasing content of structural defects. An optimized material exhibited values of specific capacitance up to 539 F g-1 recorded at a current density of 0.25 A g-1 and excellent cycling durability with 100% specific capacitance retention after 1500 cycles in a three-electrode configuration and 96.7% of specific capacitance after 30 000 cycles in a two-electrode setup.

Microwave Energy Drives "On-Off-On" Spin-Switch Behavior in Nitrogen-Doped Graphene.

The established application of graphene in organic/inorganic spin-valve spintronic assemblies is as a spin-transport channel for spin-polarized electrons injected from ferromagnetic substrates. To generate and control spin injection without such substrates, the graphene backbone must be imprinted with spin-polarized states and itinerant-like spins. Computations suggest that such states should emerge in graphene derivatives incorporating pyridinic nitrogen. The synthesis and electronic properties of nitrogen-doped graphene (N content: 9.8%), featuring both localized spin centers and spin-containing sites with itinerant electron properties, are reported. This material exhibits spin-switch behavior (on-off-on) controlled by microwave irradiation at X-band frequency. This phenomenon may enable the creation of novel types of switches, filters, and spintronic devices using sp2 -only 2D systems.

Tuning the magnetic properties of graphene derivatives by functional group selection.

The recent discovery of hydroxofluorographene G(OH)F, a graphene derivative showing room temperature antiferromagnetic ordering, suggests that there may be other sp-materials based on sp3-functionalized graphene that exhibit magnetic ordering. Here, we report a detailed theoretical study of hydroxofluorographene analogs, G(X)F, where X = -F, -SH, -NH2, -CH3, -BH3, and -BH2, conducted to deeper understand the relation among their structural, electronic and magnetic properties and to identify an effect of the functional group on magnetic transition temperatures. Although the magnetism of all G(X)F materials stems from the presence of aromatic islands with diradicals coupled via functional groups that enable superexchange interactions, the materials exhibited widely varying magnetic transition temperatures. The trends in the studied materials' transition temperatures are discussed in relation to the widths of their spin-flip gaps and the materials' stability. Our findings indicate that the properties of graphene-based magnets can be tuned by changing their functionalization, which may enable the design of organic magnets with tailored properties.

Alkynylation of graphene via the Sonogashira C-C cross-coupling reaction on fluorographene.

We report successful grafting of alkynyl groups onto graphene via the Sonogashira reaction between fluorographene and terminal alkynes. Theoretical calculations revealed that fluorographene can efficiently bind and oxidize the palladium catalyst on electrophilic sites activated by fluorine atoms. This paves the way towards conductive and mechanically robust 3D covalent networks.

Zigzag sp2 Carbon Chains Passing through an sp3 Framework: A Driving Force toward Room-Temperature Ferromagnetic Graphene.

Stabilization of ferromagnetic ordering in graphene-based systems up to room temperature remains an important challenge owing to the huge scope for applications in electronics, spintronics, biomedicine, and separation technologies. To date, several strategies have been proposed, including edge engineering, introduction of defects and dopants, and covalent functionalization. However, these techniques are usually hampered by limited temperature sustainability of ferromagnetic ordering. Here, we describe a method for the well-controlled sp3 functionalization of graphene to synthesize zigzag conjugated sp2 carbon chains that can act as communication pathways among radical motifs. Zigzag sp2/sp3 patterns in the basal plane were clearly observed by high-resolution scanning transmission electron microscopy and provided a suitable matrix for stabilization of ferromagnetic ordering up to room temperature due to combined contributions of itinerant π-electrons and superexchange interactions. The results highlight the principal role of sp2/sp3 ratio and superorganization of radical motifs in graphene for generating room-temperature nonmetallic magnets.

Non-covalent control of spin-state in metal-organic complex by positioning on N-doped graphene.

Nitrogen doping of graphene significantly affects its chemical properties, which is particularly important in molecular sensing and electrocatalysis applications. However, detailed insight into interaction between N-dopant and molecules at the atomic scale is currently lacking. Here we demonstrate control over the spin state of a single iron(II) phthalocyanine molecule by its positioning on N-doped graphene. The spin transition was driven by weak intermixing between orbitals with z-component of N-dopant (pz of N-dopant) and molecule (dxz, dyz, dz2) with subsequent reordering of the Fe d-orbitals. The transition was accompanied by an electron density redistribution within the molecule, sensed by atomic force microscopy with CO-functionalized tip. This demonstrates the unique capability of the high-resolution imaging technique to discriminate between different spin states of single molecules. Moreover, we present a method for triggering spin state transitions and tuning the electronic properties of molecules through weak non-covalent interaction with suitably functionalized graphene.

Emerging chemical strategies for imprinting magnetism in graphene and related 2D materials for spintronic and biomedical applications.

Graphene, a single two-dimensional sheet of carbon atoms with an arrangement mimicking the honeycomb hexagonal architecture, has captured immense interest of the scientific community since its isolation in 2004. Besides its extraordinarily high electrical conductivity and surface area, graphene shows a long spin lifetime and limited hyperfine interactions, which favors its potential exploitation in spintronic and biomedical applications, provided it can be made magnetic. However, pristine graphene is diamagnetic in nature due to solely sp2 hybridization. Thus, various attempts have been proposed to imprint magnetic features into graphene. The present review focuses on a systematic classification and physicochemical description of approaches leading to equip graphene with magnetic properties. These include introduction of point and line defects into graphene lattices, spatial confinement and edge engineering, doping of graphene lattice with foreign atoms, and sp3 functionalization. Each magnetism-imprinting strategy is discussed in detail including identification of roles of various internal and external parameters in the induced magnetic regimes, with assessment of their robustness. Moreover, emergence of magnetism in graphene analogues and related 2D materials such as transition metal dichalcogenides, metal halides, metal dinitrides, MXenes, hexagonal boron nitride, and other organic compounds is also reviewed. Since the magnetic features of graphene can be readily masked by the presence of magnetic residues from synthesis itself or sample handling, the issue of magnetic impurities and correct data interpretations is also addressed. Finally, current problems and challenges in magnetism of graphene and related 2D materials and future potential applications are also highlighted.

Room temperature organic magnets derived from sp3 functionalized graphene.

Materials based on metallic elements that have d orbitals and exhibit room temperature magnetism have been known for centuries and applied in a huge range of technologies. Development of room temperature carbon magnets containing exclusively sp orbitals is viewed as great challenge in chemistry, physics, spintronics and materials science. Here we describe a series of room temperature organic magnets prepared by a simple and controllable route based on the substitution of fluorine atoms in fluorographene with hydroxyl groups. Depending on the chemical composition (an F/OH ratio) and sp3 coverage, these new graphene derivatives show room temperature antiferromagnetic ordering, which has never been observed for any sp-based materials. Such 2D magnets undergo a transition to a ferromagnetic state at low temperatures, showing an extraordinarily high magnetic moment. The developed theoretical model addresses the origin of the room temperature magnetism in terms of sp2-conjugated diradical motifs embedded in an sp3 matrix and superexchange interactions via -OH functionalization.

Cyanographene and Graphene Acid: Emerging Derivatives Enabling High-Yield and Selective Functionalization of Graphene.

Efficient and selective methods for covalent derivatization of graphene are needed because they enable tuning of graphene's surface and electronic properties, thus expanding its application potential. However, existing approaches based mainly on chemistry of graphene and graphene oxide achieve only limited level of functionalization due to chemical inertness of the surface and nonselective simultaneous attachment of different functional groups, respectively. Here we present a conceptually different route based on synthesis of cyanographene via the controllable substitution and defluorination of fluorographene. The highly conductive and hydrophilic cyanographene allows exploiting the complex chemistry of -CN groups toward a broad scale of graphene derivatives with very high functionalization degree. The consequent hydrolysis of cyanographene results in graphene acid, a 2D carboxylic acid with pKa of 5.2, showing excellent biocompatibility, conductivity and dispersibility in water and 3D supramolecular assemblies after drying. Further, the carboxyl groups enable simple, tailored and widely accessible 2D chemistry onto graphene, as demonstrated via the covalent conjugation with a diamine, an aminothiol and an aminoalcohol. The developed methodology represents the most controllable, universal and easy to use approach toward a broad set of 2D materials through consequent chemistries on cyanographene and on the prepared carboxy-, amino-, sulphydryl-, and hydroxy- graphenes.