Prospective prediction of clinical drug response in high-grade gliomas using an ex vivo 3D cell culture assay.

BACKGROUND: Clinical outcomes in high-grade glioma (HGG) have remained relatively unchanged over the last 3 decades with only modest increases in overall survival. Despite the validation of biomarkers to classify treatment response, most newly diagnosed (ND) patients receive the same treatment regimen. This study aimed to determine whether a prospective functional assay that provides a direct, live tumor cell-based drug response prediction specific for each patient could accurately predict clinical drug response prior to treatment. METHODS: A modified 3D cell culture assay was validated to establish baseline parameters including drug concentrations, timing, and reproducibility. Live tumor tissue from HGG patients were tested in the assay to establish response parameters. Clinical correlation was determined between prospective ex vivo response and clinical response in ND HGG patients enrolled in 3D-PREDICT (ClinicalTrials.gov Identifier: NCT03561207). Clinical case studies were examined for relapsed HGG patients enrolled on 3D-PREDICT, prospectively assayed for ex vivo drug response, and monitored for follow-up. RESULTS: Absent biomarker stratification, the test accurately predicted clinical response/nonresponse to temozolomide in 17/20 (85%, P = .007) ND patients within 7 days of their surgery, prior to treatment initiation. Test-predicted responders had a median overall survival post-surgery of 11.6 months compared to 5.9 months for test-predicted nonresponders (P = .0376). Case studies provided examples of the clinical utility of the assay predictions and their impact upon treatment decisions resulting in positive clinical outcomes. CONCLUSION: This study both validates the developed assay analytically and clinically and provides case studies of its implementation in clinical practice.

Introduction of Stilbene Derivatives and Cinnamate Ester Derivatives at the ω-End Groups of Poly(Methyl Methacrylate) Prepared via RAFT Polymerization.

The capping of "living" poly(methyl methacrylate) (PMMA) and "living" polystyrene (PS), both prepared by the RAFT technique, with various olefins was screened using 19F-NMR spectroscopy. The capping of "living" PMMA with a labeled stilbene was as high as 63% and with certain cinnamate esters was essentially quantitative, but the capping of "living" polystyrene with all the olefins investigated was generally poor.

Synthesis of isopropyl-substituted anthraquinones via Friedel-Crafts acylations: migration of isopropyl groups.

Friedel-Crafts reactions of isopropyl-substituted benzenes with phthalic anhydride in the presence of aluminium trichloride, followed by cyclization of the products with strong sulfuric acid give, as expected, anthraquinones. The syntheses, however, often afford more than one anthraquinone. In some cases the isopropyl groups migrate cleanly to other ring positions; in other cases they are lost.

Polymer-supported syntheses of thiophene-containing compounds using a new type of traceless linker.

A new type of traceless linker is described for use in polymer-supported (PS) syntheses of thiophene-containing compounds. It is based on the cleavage of PS aryl 2-thienyl ketones by a mixture of potassium t-butoxide and water (typical mol ratio 10:3) in an ethereal solvent. Cleavage occurs to give the soluble thiophene-containing product. The method is used to prepare a range of eight thiophene-containing compounds including a terthiophene and a dialkylquaterthiophene. PS unsymmetrical diaryl ketones incorporating, for example, ortho-methoxyphenyl or pyrrole moieties could also serve as traceless linkers.

A unique approach to neurostimulation in patients with previous two-segment spine surgery and obstruction of epidural access for spinal cord stimulation: a case series.

INTRODUCTION: Patients with extensive surgery in the lumbar and thoracic spine are often not considered for neurostimulation due to the inability to perform a conventional spinal cord stimulation (SCS) trial. We are presenting six such patients in which spinal-peripheral neurostimulation (SPN) was used via a caudal approach. METHODS: Six patients with intractable low back and leg pain following extensive lumbar and thoracic surgeries, up to at least the T10 level, underwent a stimulation trial with one caudal lead and one subcutaneous lead in order to achieve SPN. RESULTS: In five cases, the trial was successful with coverage of the pain area and at least satisfactory pain relief. All six patients were implanted with a paddle lead(s) and a subcutaneous lead using SPN with good pain control. CONCLUSION: SPN with a caudal lead appears to be a viable option for SCS trial in patients with no possibilities for conventional trial lead placement.

Macrocyclic aromatic polysulfones and sulfide-sulfones: synthesis and structural characterisation of molecular pentagons and rectangles.

Cyclo-condensation of arylenedithiols with bis(4-chlorophenylenesulfone)s under pseudo-high-dilution conditions affords macrocyclic aromatic sulfide-sulfones which are readily oxidised to all-sulfone-linked macrocycles. The cyclic pentamer of poly(1,4-phenylenesulfone) and cyclic dimer of poly(1,4-phenylenesulfonyl-4,4'-biphenylenesulfone) have been isolated and characterised.

High throughput synthesis of polyesters using entropically driven ring-opening polymerizations.

Copolyesters were synthesized in a high throughput (HT) manner and in high yield on ca. a 90 mg scale using entropically driven ring-opening polymerizations (ED-ROPs). This synthetic approach is a valuable addition to the HT polymer synthesis arsenal in that it allows condensation-type polymers with relatively large repeat units, such as those in poly(ethylene terephthalate) and poly(butylene terephthalate), to be obtained easily. The synthetic procedure involved taking mixtures of the appropriate macrocyclic oligoesters and heating them together under neat conditions at 250-300 degrees C for 2 h in the presence of 0.1 mol % of di- n-butyltin oxide or tetra- n-butylammonium tetrafluoroborate. In most cases Mw values were >25,000 and, as expected for ED-ROPs, the polydispersity indices were close to 2.0. Higher molecular weights could be obtained by using longer reaction times, but this might lead to product decomposition. The method worked well for esters formally derived from aliphatic or aromatic acids and alcohols, but less well for esters derived from phenols. Attempts were also made to synthesize copolymers by mixing together the two homopolymers and heating with a catalyst. These reactions were successful in a few instances, but generally, they were not. This is probably because the homopolymers did not mix well. An aluminum reaction block with 36 wells lined with Teflon cups, that fitted snugly in a cylindrical Buchi oven, was the most successful method for carrying out syntheses in an HT manner.

Dithioacetalisation of PEEK: a general technique for the solubilisation and characterisation of semi-crystalline aromatic polyketones.

The family of semi-crystalline, aromatic, high-temperature thermoplastics known as poly(ether-ketone)s are insoluble in conventional organic solvents, but undergo completely general and quantitatively reversible reactions with alkanedithiols in strong acid media, to give soluble poly(dithioacetal)s, which are readily characterisable by GPC and light scattering techniques.

Michael reactions carried out using a bench-top flow system.

The Michael reaction between methyl 1-oxoindan-2-carboxylate and methyl vinyl ketone was achieved successfully by pumping solutions of the reactants in toluene through a fluid bed of Amberlyst A21 at 50 degrees C. The use of a fluid bed reactor is attractive as it allows gel-type beads, i.e. the type of bead used in most studies of polymer-supported (PS) organic reactions, to be used satisfactorily in a flow system. When polymer-supported cinchonidine was used in place of Amberlyst A21, the Michael product was obtained in high yield with an enantiomeric excess (ee) of 51%. This % ee is comparable to that achieved when the reaction was catalysed by cinchonidine itself.

Langmuir-Blodgett films of preformed polymers containing biphenyl groups.

Polymers containing liquid crystal groups have been studied previously as waveguides, and they have been deposited as spacer materials with various chromophores to form alternating films However, only a few members of this group of materials have been studied in any detail, and very little structural information has been obtained so far. Therefore, a more detailed examination of these materials as mono- and multilayers was undertaken. A new group of materials including the same mesogenic group, polymeric sulfones, was also studied. The polymers gave steep isotherms with high collapse pressures, indicating good packing of the monolayers, and could be deposited to form thick multilayers. X-ray diffraction showed that an ordered multilayer was formed, and the effects of the polymers chemical nature on the structure of the LB films are discussed. It appears that the dominant factor in monolayer structure is the nature of the polymer backbone rather than that of the liquid crystal side chains, which play a secondary role.

Biosynthesis of the allene (-)-marasin in Marasmius ramealis.

[1-14C]-E-dehydromatricaria methyl ester and dimethyl [1-14C]-deca-4,6,8-triyne-1,10-dioate are incorporated into the allene (-)-marasin in Marasmius ramealis without scrambling of the 14C label. This and the levels of the incorporations (0.8% and 4.9% respectively) strongly suggests that the above esters, or close relatives, can be converted directly into (-)-marasin in M. ramealis, and that the diyne-allene moiety in this latter compound arises by the rearrangement, under enzymic control, of an alkyltriyne moiety.

Towards more chemically robust polymer-supported chiral catalysts: alpha,alpha-diphenyl-L-prolinol based catalysts for the reduction of prochiral ketones with borane.

alpha,alpha-Diphenyl-L-prolinol derivatives with para-bromo substituents in either one or both of the phenyl rings are easily bound to crosslinked polystyrene beads containing phenylboronic acid residues by Suzuki couplings. By using extended reaction periods boronic acid residues that do not take part in the couplings are simply lost by hydrolysis. The polymer-supported (PS) alpha,alpha-diphenyl-L-prolinols were used to catalyse reductions of several prochiral ketones with borane in tetrahydrofuran at 22 degrees C. The expected secondary alcohols were obtained in high chemical yields and ees were generally in the range 79-97%. One PS catalyst was recycled 14 times without loss of stereochemical performance.

Organic synthesis using polymer-supported reagents, catalysts and scavengers in simple laboratory flow systems.

The use of appropriate combinations of polymer-supported reagents, catalysts and/or scavengers is a powerful approach, both for the synthesis of single organic compounds and for parallel syntheses. A further stage of development is the use of such reactants in flow systems. So far, it has been shown that a variety of flow formats afford excellent chemical yields and, where relevant, excellent enantiomeric excesses. The supports have a longer lifetime than in batch systems. 'Flow cascades' promise to be important in future.

Towards more chemically robust polymer-supported chiral catalysts for the reactions of aldehydes with dialkylzincs.

N-Methyl-alpha,alpha-diphenyl-L-prolinol derivatives with para-bromo substituents in one or both of the phenyl rings are easily bound to crosslinked polystyrene beads containing phenylboronic acid residues using Suzuki reactions. When the products were used as catalysts for the reactions of aldehydes with diethylzinc in toluene at 20 degrees C, the alcohols were produced in chemical yields >90% and with ees of upto 94%. The better of the two supported catalysts gave ees only 0-9% lower than those obtained with the corresponding soluble catalyst. One of the supported catalysts was recycled successfully nine times.