Multicenter, Retrospective Study to Evaluate Necitumumab Plus Cisplatin and Gemcitabine After Immune Checkpoint Inhibitors in Advanced Squamous Cell Lung Cancer in Japan: The NINJA Study.

Introduction: Necitumumab plus gemcitabine and cisplatin (GCN) is a standard therapy for patients with advanced lung squamous cell carcinoma (LSqCC). However, the efficacy and tolerability of GCN in second-line or later treatment for patients previously treated with immune checkpoint inhibitors (ICIs) remain unknown. Methods: This multicenter, retrospective, cohort study assessed the efficacy and tolerability of GCN initiated between November 1, 2019 and March 31, 2022 as second-line to fourth-line treatment in patients with advanced LSqCC who had been pretreated with ICIs. The primary end point was progression-free survival (PFS). Results: A total of 93 patients from 35 institutions in Japan were enrolled. The median PFS, median overall survival (OS), and objective response rate were 4.4 months (95% confidence interval [CI]: 3.8-5.3), 13.3 months (95% CI: 9.6-16.5), and 27.3% (95% CI: 18.3-37.8), respectively. The median PFS, median OS, and objective response rate for second-line, third-line, and fourth-line treatment groups were 4.8 months, 3.8 months, and 4.3 months (p = 0.24); 15.7 months, 11.6 months, and 10.1 months (p = 0.06); and 31.0%, 13.6%, and 37.5% (p = 0.22), respectively. The severity of GCN-related skin disorders was associated with longer PFS (p < 0.05) and OS (p < 0.05). The frequencies of grade ≥3 skin disorders, hypomagnesemia, pneumonitis, and febrile neutropenia were 16.1%, 7.5%, 1.1%, and 4.3%, respectively. There were no treatment-related deaths. Conclusions: GCN for ICI-pretreated patients with LSqCC seems tolerable and offers promising efficacy regardless of treatment line, and ICI pretreatment might enhance GCN efficacy.

A Case of Recurrent Verruconis gallopava Infection at One Year after Excision of a Solitary Pulmonary Lesion.

We herein report a case of recurrent infection caused by Verruconis gallopava, which is known to cause fatal phaeohyphomycosis. A 71-year-old man presented with a fever, and computed tomography revealed right chest wall thickening. Eleven years earlier, he had undergone autologous peripheral blood stem cell transplantation for a hematological malignancy. One year earlier, he had undergone excision of a solitary pulmonary nodule, from which had been detected V. gallopava. On this occasion, right chest wall surgery was performed to investigate the cause of the fever, which led to the diagnosis of recurrent infection. Even if a localized lesion is excised, additional antifungal therapy should be performed.

Comprehensive circulating microRNA profile as a supersensitive biomarker for early-stage lung cancer screening.

PURPOSE:  Less-invasive early diagnosis of lung cancer is essential for improving patient survival rates. The purpose of this study is to demonstrate that serum comprehensive miRNA profile is high sensitive biomarker to early-stage lung cancer in direct comparison to the conventional blood biomarker using next-generation sequencing (NGS) technology combined with automated machine learning (AutoML). METHODS: We first evaluated the reproducibility of our measurement system using Pearson's correlation coefficients between samples derived from a single pooled RNA sample. To generate comprehensive miRNA profile, we performed NGS analysis of miRNAs in 262 serum samples. Among the discovery set (57 patients with lung cancer and 57 healthy controls), 1123 miRNA-based diagnostic models for lung cancer detection were constructed and screened using AutoML technology. The diagnostic faculty of the best performance model was evaluated by inspecting the validation samples (74 patients with lung cancer and 74 healthy controls). RESULTS: The Pearson's correlation coefficients between samples derived from the pooled RNA sample ≥ 0.98. In the validation analysis, the best model showed a high AUC score (0.98) and a high sensitivity for early stage lung cancer (85.7%, n = 28). Furthermore, in comparison to carcinoembryonic antigen (CEA), a conventional blood biomarker for adenocarcinoma, the miRNA-based model showed higher sensitivity for early-stage lung adenocarcinoma (CEA, 27.8%, n = 18; miRNA-based model, 77.8%, n = 18). CONCLUSION: The miRNA-based diagnostic model showed a high sensitivity for lung cancer, including early-stage disease. Our study provides the experimental evidence that serum comprehensive miRNA profile can be a highly sensitive blood biomarker for early-stage lung cancer.

Pt17 nanocluster electrocatalysts: preparation and origin of high oxygen reduction reaction activity.

We recently found that [Pt17(CO)12(PPh3)8]z (Pt = platinum; CO = carbon monoxide; PPh3 = triphenylphosphine; z = 1+ or 2+) is a Pt nanocluster (Pt NC) that can be synthesized with atomic precision in air. The present study demonstrates that it is possible to prepare a Pt17-supported carbon black (CB) catalyst (Pt17/CB) with 2.1 times higher oxygen reduction reaction (ORR) activity than commercial Pt nanoparticles/CB by the adsorption of [Pt17(CO)12(PPh3)8]z onto CB and subsequent calcination of the catalyst. Density functional theory calculation strongly suggests that the high ORR activity of Pt17/CB originates from the surface Pt atoms that have an electronic structure appropriate for the progress of ORR. These results are expected to provide design guidelines for the fabrication of highly active ORR catalysts using Pt NCs with a diameter of about 1 nm and thereby enabling the use of reduced amounts of Pt in polymer electrolyte fuel cells.

Metallic bonds and thermal vibration in brass.

Nature of the metallic bond and thermal vibration in brass alloy is investigated from the local structural and thermodynamical points of view by the temperature-dependent Cu and Zn K-edge extended X-ray absorption fine structure spectroscopy and the path-integral effective classical potential theoretical simulation. It is unexpectedly found that the thermal vibrational amplitude around Zn is a little but meaningfully smaller than that around Cu, although it is usually believed that Zn is a much softer metal than Cu in terms of various thermodynamical physical quantities of elemental metals. Moreover, it is found that the nearest neighbor distance around Zn is almost equivalent to that around Cu (only ∼0.01 Šdifference), although the metallic radius of Zn commonly used is considerably larger than that of Cu (∼0.06-0.09 Šdifference). These peculiar findings can be interpreted as a result of confinement of Zn atoms in a smaller space than usual and a significantly larger repulsive potential of Zn than Cu.

Clinical efficacy of osimertinib in EGFR-mutant non-small cell lung cancer with distant metastasis.

BACKGROUND: Osimertinib-the third-generation epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI)-has been widely used as a first-line treatment for patients with metastatic EGFR-mutant non-small cell lung cancer (NSCLC). Osimertinib demonstrated central nervous system activity in patients with brain metastasis; however, its efficacy against other distant metastatic organs, including bone and liver, remains unclear. Therefore, we retrospectively analyzed the clinical efficacy of osimertinib in these patients in comparison to other EGFR-TKIs. METHODS: Clinical data of patients with advanced NSCLC receiving gefitinib/erlotinib (n = 183), afatinib (n = 55), or osimertinib (n = 150) at five medical institutions were retrospectively assessed for progression-free survival (PFS), overall survival (OS), and best overall response rate (ORR). RESULTS: In univariate and multivariate analyses, most distant metastases, including the brain and bone, were unrelated to the therapeutic efficacy of osimertinib, although liver metastasis and L858R mutation were independently associated with shorter PFS. PFS and OS in patients with liver metastases were significantly shorter than those in patients without liver metastases (PFS: 7.4 vs. 19.7 months, OS: 12.1 months vs. not reached, respectively). Osimertinib provided significantly longer PFS in patients with brain or bone metastasis and exon 19 deletion than the other EGFR-TKIs. The PFS of patients with liver metastases was not significantly different among the three EGFR-TKI groups. Furthermore, the ORR of osimertinib in patients with liver metastases was significantly attenuated, and the effectiveness was similar to 1st- or 2nd -generation EGFR-TKIs. CONCLUSION: Osimertinib provided better clinical benefits than 1st- and 2nd-generation EGFR-TKIs for patients with EGFR-mutant NSCLC, particularly those with brain or bone metastases and exon 19 deletion; however, its efficacy against liver metastasis was remarkably attenuated. New therapeutic developments for patients with EGFR-mutant NSCLC with liver metastases are needed.

Femtosecond Charge Density Modulations in Photoexcited CuWO4.

Copper tungstate (CuWO4) is an important semiconductor with a sophisticated and debatable electronic structure that has a direct impact on its chemistry. Using the PAL-XFEL source, we study the electronic dynamics of photoexcited CuWO4. The Cu L3 X-ray absorption spectrum shifts to lower energy upon photoexcitation, which implies that the photoexcitation process from the oxygen valence band to the tungsten conduction band effectively increases the charge density on the Cu atoms. The decay time of this spectral change is 400 fs indicating that the increased charge density exists only for a very short time and relaxes electronically. The initial increased charge density gives rise to a structural change on a time scale longer than 200 ps.

Sulfur poisoning of Pt and PtCo anode and cathode catalysts in polymer electrolyte fuel cells studied by operando near ambient pressure hard X-ray photoelectron spectroscopy.

We have investigated the S adsorption behaviours on Pt (average particle diameter of ∼2.6 nm) and Pt3Co (∼3.0 nm) anode and cathode electrode catalysts in polymer electrolyte fuel cells (PEFCs) under working conditions for the fresh state just after the aging process and also the degraded state after accelerated degradation tests (ADT), by studying near ambient pressure hard X-ray photoelectron spectroscopy (HAXPES). S 1s HAXPES of both the anode and cathode electrodes shows not only the principal S species from the sulfonic acid group (-SO3H) in the Nafion electrolyte but also other characteristic S species such as zero-valent S (S0) adsorbed on the carbon support and anionic S (S2-) adsorbed on the Pt electrode. The S2- species on Pt should be ascribed to S contamination poisoning the Pt catalyst electrode. The S2- species on the cathode can be oxidatively removed by applying a high cathode-anode bias voltage (≥0.8 V) to form SO32-, while at the anode the S2- species cannot be eliminated because of reductive environment in hydrogen gas. The important finding is the difference in S adsorption behaviours between the Pt/C and Pt3Co/C electrodes after ADT. After ADT, the Pt/C anode electrode exhibits much larger S2- adsorption than the Pt3Co/C anode electrode. This indicates that the Pt3Co/C anode is more desirable than the Pt/C one from the viewpoint of S poisoning. The reason for more tolerance of the Pt3Co/C anode catalyst against S poisoning after ADT can be ascribed to the more negative charge of the surface Pt atoms in the Pt3Co/C catalyst than those in the Pt/C one, thus yielding a weaker interaction between the surface Pt and the anionic S species as S2-, SO32-, and SO42-. A similar behaviour was observed also in the cathode catalyst. The present findings will nevertheless provide important information to design novel Pt-based PEFC electrodes with higher performance and longer durability.

A Prospective, Randomized, Open-Label Trial of Early versus Late Favipiravir Therapy in Hospitalized Patients with COVID-19.

Favipiravir is an oral broad-spectrum inhibitor of viral RNA-dependent RNA polymerase that is approved for treatment of influenza in Japan. We conducted a prospective, randomized, open-label, multicenter trial of favipiravir for the treatment of COVID-19 at 25 hospitals across Japan. Eligible patients were adolescents and adults admitted with COVID-19 who were asymptomatic or mildly ill and had an Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1. Patients were randomly assigned at a 1:1 ratio to early or late favipiravir therapy (in the latter case, the same regimen starting on day 6 instead of day 1). The primary endpoint was viral clearance by day 6. The secondary endpoint was change in viral load by day 6. Exploratory endpoints included time to defervescence and resolution of symptoms. Eighty-nine patients were enrolled, of whom 69 were virologically evaluable. Viral clearance occurred within 6 days in 66.7% and 56.1% of the early and late treatment groups (adjusted hazard ratio [aHR], 1.42; 95% confidence interval [95% CI], 0.76 to 2.62). Of 30 patients who had a fever (≥37.5°C) on day 1, times to defervescence were 2.1 days and 3.2 days in the early and late treatment groups (aHR, 1.88; 95% CI, 0.81 to 4.35). During therapy, 84.1% developed transient hyperuricemia. Favipiravir did not significantly improve viral clearance as measured by reverse transcription-PCR (RT-PCR) by day 6 but was associated with numerical reduction in time to defervescence. Neither disease progression nor death occurred in any of the patients in either treatment group during the 28-day participation. (This study has been registered with the Japan Registry of Clinical Trials under number jRCTs041190120.).

Transforming Thermal Expansion from Positive to Negative: The Case of Cubic Magnetic Compounds of (Zr,Nb)Fe2.

Negative thermal expansion (NTE) is an intriguing property for not only fundamental studies but also technological applications. However, few NTE materials are available compared with the huge amount of positive thermal expansion materials. The discovery of new NTE materials remains challenging. Here we report a chemical modification strategy to transform thermal expansion from positive to negative in cubic magnetic compounds of (Zr,Nb)Fe2 by tuning the magnetic exchange interaction. Furthermore, an isotropic zero thermal expansion can be established in Zr0.8Nb0.2Fe2 (αl = 1.4 × 10-6 K-1, 3-470 K) over a broad temperature range that is even wider than that of the prototype Invar alloy of Fe0.64Ni0.36. The NTE of (Zr,Nb)Fe2 is originated from the weakened magnetic exchange interaction and the increased d electrons of Fe by the Nb chemical substitution, so that the magnetovolume effect overwhelms the contribution of anharmonic lattice vibration.

Photoinduced anisotropic distortion as the electron trapping site of tungsten trioxide by ultrafast W L1-edge X-ray absorption spectroscopy with full potential multiple scattering calculations.

Understanding the excited state of photocatalysts is significant to improve their activity for water splitting reaction. X-ray absorption fine structure (XAFS) spectroscopy in X-ray free electron lasers (XFEL) is a powerful method to address dynamic changes in electronic states and structures of photocatalysts in the excited state in ultrafast short time scales. The ultrafast atomic-scale local structural change in photoexcited WO3 was observed by W L1 edge XAFS spectroscopy using an XFEL. An anisotropic local distortion around the W atom could reproduce well the spectral features at a delay time of 100 ps after photoexcitation based on full potential multiple scattering calculations. The distortion involved the movement of W to shrink the shortest W-O bonds and elongate the longest one. The movement of the W atom could be explained by the filling of the dxy and dzx orbitals, which were originally located at the bottom of the conduction band with photoexcited electrons.

Reversible low-temperature redox activity and selective oxidation catalysis derived from the concerted activation of multiple metal species on Cr and Rh-incorporated ceria catalysts.

The ceria-based catalyst incorporated with Cr and a trace amount of Rh (Cr0.19Rh0.06CeOz) was prepared and the reversible redox performances and oxidation catalysis of CO and alcohol derivatives with O2 at low temperatures (<373 K) were investigated. In situ X-ray absorption fine structure (XAFS), ambient-pressure X-ray photoelectron spectroscopy (AP-XPS), high angle annular dark-field scanning transmission electron microscopy (HAADF-STEM)-EDS/EELS and temperature-programmed reduction/oxidation (TPR/TPO) revealed the structures and redox mechanisms of three metals in Cr0.19Rh0.06CeOz: dispersed Rh3+δ species (<1 nm) and Cr6-γO3-x nanoparticles (∼1 nm) supported on CeO2 in Cr0.19Rh0.06CeOz were transformed to Rh nanoclusters, Cr(OH)3 species and CeO2-x with two Ce3+-oxide layers at the surface in a concerted activation manner of the three metal species with H2.

Electronic and magnetic properties of the Fe2N monolayer film tuned by substrate symmetry.

The robust bonding between Fe and N atoms has the potential to fabricate a ferromagnetic Fe2N monolayer of a square lattice independently of the symmetry of the substrate. The electronic and magnetic properties tuned by the symmetry of the substrates are investigated by comparing the results of scanning tunnel microscopy and x-ray absorption spectroscopy/magnetic circular dichroism of the square Fe2N monolayer on the Cu(1 1 1) substrate with that on the Cu(0 0 1) substrate. A periodic electronic modulation of the Fe2N monolayer on the Cu(1 1 1) substrate is induced by the stripe superlattice due to the difference of the lattice symmetry between the Fe2N monolayer and the Cu(1 1 1) substrate. The electronic and magnetic properties of the monolayer are largely affected by the hybridization with the Cu substrate and the Fe magnetic moment is much reduced compared to the monolayer on the Cu(0 0 1) substrate.

SPring-8 BL36XU: Synchrotron Radiation X-Ray-Based Multi-Analytical Beamline for Polymer Electrolyte Fuel Cells under Operating Conditions.

We designed and constructed a beamline BL36XU at the 8 GeV synchrotron radiation facility SPring-8 to provide information required for the development of next-generation polymer electrolyte fuel cells (PEFCs) by clarifying the dynamic aspects of structures and electronic states of cathode catalysts under PEFC operating conditions and in the deterioration processes by accelerated durability test protcols. To investigate the mechanism and degradation process for the cathode electrocatalysis in practical PEFCs, we developed advanced time- and spatially-resolved in-situ/operando X-ray absorption fine structure measurement systems and complementary analytical systems (X-ray emission spectroscopy (XES), X-ray diffraction (XRD), X-ray computer tomography (CT) and hard X-ray photoelectron spectroscopy (HAXPES)) and combined them to develop multi-analytical systems at BL36XU. Multi-analytical systems are very powerful for observing spatial-temporal features of the transient processes occurring in complex systems such as PEFCs. This account describes the design, performance, and research results of the BL36XU and multi-analytical in-situ/operando systems.

Serum lactate levels are associated with serum alanine aminotransferase and total bilirubin levels in patients with type 2 diabetes mellitus: A cross-sectional study.

AIMS: It was recently reported that lactate acts as a metabolic mediator and rises in the diabetic state, but the physiological effects are as yet poorly understood. The objective of the current study was to evaluate the significance of serum lactate elevation in type 2 diabetes mellitus (T2DM) patients. METHODS: Fasting serum lactate levels, hematological and inflammatory serum markers and anthropometric parameters, obtained employing bioelectric impedance analysis, were measured in 103 patients with T2DM. RESULTS: Statistically significant correlations of serum lactate levels with C-reactive peptide, insulin, aspartate aminotransferase, alanine aminotransferase (ALT), serum lipids, total bilirubin, adiponectin, homeostasis model assessment-insulin resistance, body weight, body mass index and body fat (weight or percentage of subcutaneous fat, visceral fat or total body fat), but neither fasting plasma glucose nor HbA1c, were detected. Stepwise regression analysis showed ALT to be independently positively associated with total bilirubin, while being negatively associated with serum lactate levels. Furthermore, serum lactate levels were significantly higher in patients with ALT-predominant liver dysfunction. CONCLUSION: We found fasting serum lactate elevation in T2DM patients to be associated with the serum levels of ALT and total bilirubin independently of blood glucose control. TRIAL REGISTRATION: UMIN clinical trials registry (UMIN000029178).

Development of Surface Fluorescence X-Ray Absorption Fine Structure Spectroscopy Using a Laue-Type Monochromator.

Surface fluorescence X-ray absorption fine structure (XAFS) spectroscopy using a Laue-type monochromator has been developed to acquire structural information about metals with a very low concentrate on a flat highly oriented pyrolytic graphite (HOPG) surface in the presence of electrolytes. Generally, surface fluorescence XAFS spectroscopy is hindered by strong scattering from the bulk, which often chokes the pulse counting detector. In this work, we show that a bent crystal Laue analyzer (BCLA) can efficiently remove the scattered X-rays from the bulk even in the presence of solution. We applied the technique to submonolayer (∼1014  atoms cm-2 ) Pt on HOPG and successfully obtained high signal/noise in situ XAFS data in combination with back-illuminated fluorescence XAFS (BI-FXAFS) spectroscopy. This technique allows in situ XAFS measurements of flat electrode surfaces to be performed in the presence of electrolytes.

Nonlinear Spectroscopy with X-Ray Two-Photon Absorption in Metallic Copper.

X-ray two-photon absorption (TPA) spectrum of metallic copper is measured using a free-electron laser (XFEL). The spectrum differs from that measured by the conventional one-photon absorption (OPA), and characterized by a peak below the Fermi level, which is assigned to the transition to the 3d state. The impact of the XFEL pulse on the OPA spectrum is discussed by analyzing the pulse-energy dependence, which indicates that the intrinsic TPA spectrum is measured.

Ambient Pressure Hard X-ray Photoelectron Spectroscopy for Functional Material Systems as Fuel Cells under Working Conditions.

Heterogeneous interfaces play important roles in a variety of functional material systems and technologies, such as catalysis, batteries, and devices. A fundamental understanding of efficient functions at interfaces under realistic conditions is crucial for sophisticated designs of useful material systems and novel devices. X-ray photoelectron spectroscopy is one of the most promising and common methods to investigate such material systems. Although X-ray photoelectron spectroscopy is usually conducted under high vacuum because of the requirement of electron detection with the precise measurement of kinetic energies, extensive efforts have been devoted to the measurements in gaseous environments. Very recently, we have succeeded in measuring X-ray photoelectron spectra under real ambient atmosphere (105 Pa), using synchrotron radiation hard X-rays with the photon energy of 8 keV and the windowless electron spectrometer system. In this Account, the novel useful technique of real ambient pressure hard X-ray photoelectron spectroscopy is reviewed. As examples of (near) ambient pressure hard X-ray photoelectron spectroscopy, hydrogen storage of Pd nanoparticles is at first investigated by recording Pd 3d and valence band spectra under hydrogen atmosphere. The Pd 3d and valence band spectra are found to change rather abruptly depending on the hydrogen pressure, demonstrating a behavior like phase transformation. Subsequently, as a main topic in this Account, we describe investigations of the electronic states of platinum nanoparticles on the cathode electrocatalyst in a polymer electrolyte fuel cell (PEFC) under the voltage operating conditions using the near ambient pressure hard X-ray photoelectron spectroscopic system. The Pt 4f and 3d X-ray photoelectron spectra of the cathode Pt/C catalysts clearly show that the oxidized Pt species is at most divalent and the tetravalent Pt species does not exist on the Pt nanoparticles even at the positive cathode-anode voltage of ∼1.4 V. Although the water oxidation reaction may take place at the potential, such a reaction does not lead to a buildup of detectable tetravalent Pt in the PEFC. The voltage-dependent Pt 3d X-ray photoelectron spectra show a clear hysteresis between the voltage increase and decrease processes. The fraction of oxidized Pt species matched the ratio of surface to total Pt atoms in the nanoparticles, which suggests that Pt oxidation occurs as a reaction event at only the first Pt layer of the Pt nanoparticles and the inner Pt atoms do not participate in the reaction practically. The developed technique is a valuable in situ tool for the investigation of the electronic states of PEFCs and other interesting functional material systems and devices under realistic working conditions.

Non-contact electric potential measurements of electrode components in an operating polymer electrolyte fuel cell by near ambient pressure XPS.

Photoelectron spectroscopy has the advantage of providing electric potentials by non-contact measurements based on the kinetic energy shift in component potential. We performed operando hard X-ray photoelectron spectroscopy (HAXPES) measurements with an 8 keV excitation source to measure the shift in electron kinetic energies as a function of the voltages of all the components at the anode and cathode electrodes of a polymer electrolyte fuel cell (PEFC). At the cathode electrode, when we increase the voltage between the cathode and anode from 0.2 to 1.2 V, the O 1s and F 1s peaks shift to a lower binding energy and the magnitude of the energy shift is equal to the voltage. The Pt 3d and C 1s peaks do not shift with the voltage since platinum nanoparticles and carbon supports at the cathode electrode have ground contact. In contrast to the cathode electrode, the peak shifts of all the components at the anode electrode show the same amount of shift as the voltages. It is clear that the change in the potential difference occurs only in an electrical double layer at the interface between the cathode electrode (Pt/C) and the electrolyte (Nafion and water), and that the anode electrode is in equilibrium as a pseudo-hydrogen electrode. Moreover, the electric potential variation of the cathode electrode in a PEFC under a power generation condition was also directly detected by operando HAXPES.

Large-Gap Magnetic Topological Heterostructure Formed by Subsurface Incorporation of a Ferromagnetic Layer.

Inducing magnetism into topological insulators is intriguing for utilizing exotic phenomena such as the quantum anomalous Hall effect (QAHE) for technological applications. While most studies have focused on doping magnetic impurities to open a gap at the surface-state Dirac point, many undesirable effects have been reported to appear in some cases that makes it difficult to determine whether the gap opening is due to the time-reversal symmetry breaking or not. Furthermore, the realization of the QAHE has been limited to low temperatures. Here we have succeeded in generating a massive Dirac cone in a MnBi2Se4/Bi2Se3 heterostructure, which was fabricated by self-assembling a MnBi2Se4 layer on top of the Bi2Se3 surface as a result of the codeposition of Mn and Se. Our experimental results, supported by relativistic ab initio calculations, demonstrate that the fabricated MnBi2Se4/Bi2Se3 heterostructure shows ferromagnetism up to room temperature and a clear Dirac cone gap opening of ∼100 meV without any other significant changes in the rest of the band structure. It can be considered as a result of the direct interaction of the surface Dirac cone and the magnetic layer rather than a magnetic proximity effect. This spontaneously formed self-assembled heterostructure with a massive Dirac spectrum, characterized by a nontrivial Chern number C = -1, has a potential to realize the QAHE at significantly higher temperatures than reported up to now and can serve as a platform for developing future "topotronics" devices.