Changes in the treatment landscape of metastatic hormone-sensitive prostate cancer following approval of upfront androgen receptor signaling inhibitors: A multicenter study.

BACKGROUND: A multicenter database was utilized to examine the current treatment landscape and clinical outcomes among patients with metastatic hormone-sensitive prostate cancer (mHSPC) following approval of upfront androgen receptor signaling inhibitors (ARSIs). METHODS: We retrospectively analyzed patients with mHSPC who commenced treatment between February 2018 and June 2023. The Kaplan-Meier method was used to assess oncological outcomes, including time to castration-resistant prostate cancer (CRPC), progression-free survival 2 (PFS2, duration from initial treatment to tumor progression during second-line treatment), cancer-specific survival (CSS), and overall survival (OS). Cox regression analyses were performed to determine the impact of treatment choices on oncological outcomes. In addition, the incidence rate of adverse events was assessed. RESULTS: In total, 829 patients were analyzed; 42.5% received ARSIs with androgen deprivation therapy (ADT), 44.0% received combined androgen blockade (CAB), and 13.5% received ADT alone. Kaplan-Meier curves and multivariate Cox regression analyses indicated higher rates of CRPC and shorter PFS2 in patients treated with CAB versus ARSIs with ADT. By contrast, CSS and OS were not significantly different between the ARSI with ADT group and the CAB group. Grades 3-4 adverse events occurred in 1.9% of patients receiving CAB and 6.0% of those receiving ARSIs with ADT. CONCLUSIONS: Initial treatment with ARSIs in combination with ADT resulted in a longer time to CRPC and longer PFS2 compared to CAB. Although CAB and ADT alone were associated with fewer adverse events, ARSIs with ADT should be considered a first-line treatment option given its superior oncological outcomes.

Revealing Novel Aspects of Light-Matter Coupling by Terahertz Two-Dimensional Coherent Spectroscopy: The Case of the Amplitude Mode in Superconductors.

Recently developed terahertz (THz) two-dimensional coherent spectroscopy (2DCS) is a powerful technique to obtain materials information in a fashion qualitatively different from other spectroscopies. Here, we utilized THz 2DCS to investigate the THz nonlinear response of conventional superconductor NbN. Using broadband THz pulses as light sources, we observed a third-order nonlinear signal whose spectral components are peaked at twice the superconducting gap energy 2Δ. With narrow-band THz pulses, a THz nonlinear signal was identified at the driving frequency Ω and exhibited a resonant enhancement at temperature when Ω=2Δ. General theoretical considerations show that such a resonance can arise only from a disorder-activated paramagnetic coupling between the light and the electronic current. This proves that the nonlinear THz response can access processes distinct from the diamagnetic Raman-like density fluctuations, which are believed to dominate the nonlinear response at optical frequencies in metals. Our numerical simulations reveal that, even for a small amount of disorder, the Ω=2Δ resonance is dominated by the superconducting amplitude mode over the entire investigated disorder range. This is in contrast to other resonances, whose amplitude-mode contribution depends on disorder. Our findings demonstrate the unique ability of THz 2DCS to explore collective excitations inaccessible in other spectroscopies.

Real-world outcomes of adjuvant immunotherapy candidates with upper tract urothelial carcinoma: results of a multicenter cohort study.

BACKGROUND: Recent clinical trials have reported improved disease-free survival rates of patients with stage pT3-4/ypT2-4 or pN + upper tract urothelial carcinoma (UTUC) on adjuvant nivolumab therapy. However, the appropriateness of the patient selection criteria used in clinical practice remains uncertain. METHODS: We retrospectively analyzed 895 patients who underwent nephroureterectomy to treat UTUC. The patients were divided into two groups: grade pT3-4 and/or pN + without neoadjuvant chemotherapy (NAC) or grade ypT2-4 and/or ypN + on NAC (adjuvant immunotherapy candidates) and others (not candidates for adjuvant immunotherapy). Kaplan-Meier curves were drawn to assess the oncological outcomes, including recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). Cox proportional hazards models were used to identify significant prognostic factors for oncological outcomes. RESULTS: The Kaplan-Meier curves revealed notably inferior RFS, CSS, and OS of patients who were candidates for adjuvant immunotherapy. Multivariate analysis revealed that pathological T and N grade and lymphovascular invasion (LVI) status were independent risk factors for poor RFS, CSS, and OS. CONCLUSION: In total, 44.8% of patients were candidates for adjuvant immunotherapy. In addition to pathological T and N status, LVI was a significant predictor of survival, and may thus play a pivotal role in the selection of patients eligible for adjuvant immunotherapy.

Disentangling Lattice and Electronic Instabilities in the Excitonic Insulator Candidate Ta_{2}NiSe_{5} by Nonequilibrium Spectroscopy.

Ta_{2}NiSe_{5} is an excitonic insulator candidate showing the semiconductor or semimetal-to-insulator (SI) transition below T_{c}=326 K. However, since a structural transition accompanies the SI transition, deciphering the role of electronic and lattice degrees of freedom in driving the SI transition has remained controversial. Here, we investigate the photoexcited nonequilibrium state in Ta_{2}NiSe_{5} using pump-probe Raman and photoluminescence spectroscopies. The combined nonequilibrium spectroscopic measurements of the lattice and electronic states reveal the presence of a photoexcited metastable state where the insulating gap is suppressed, but the low-temperature structural distortion is preserved. We conclude that electron correlations play a vital role in the SI transition of Ta_{2}NiSe_{5}.

Nonreciprocal Terahertz Second-Harmonic Generation in Superconducting NbN under Supercurrent Injection.

Giant second-harmonic generation in the terahertz (THz) frequency range is observed in a thin film of an s-wave superconductor NbN, where the time-reversal (T) and space-inversion (P) symmetries are simultaneously broken by supercurrent injection. We demonstrate that the phase of the second-harmonic signal flips when the direction of supercurrent is inverted; i.e., the signal is ascribed to the nonreciprocal response that occurs under broken P and T symmetries. The temperature dependence of the SH signal exhibits a sharp resonance, which is accounted for by the vortex motion driven by the THz electric field in an anharmonic pinning potential. The maximum conversion ratio η_{SHG} reaches ≈10^{-2} in a thin film NbN with the thickness of 25 nm after the field cooling with a very small magnetic field of ≈1 Oe, for a relatively weak incident THz electric field of 2.8 kV/cm at 0.48 THz.

Phase-resolved Higgs response in superconducting cuprates.

In high-energy physics, the Higgs field couples to gauge bosons and fermions and gives mass to their elementary excitations. Experimentally, such couplings can be inferred from the decay product of the Higgs boson, i.e., the scalar (amplitude) excitation of the Higgs field. In superconductors, Cooper pairs bear a close analogy to the Higgs field. Interaction between the Cooper pairs and other degrees of freedom provides dissipation channels for the amplitude mode, which may reveal important information about the microscopic pairing mechanism. To this end, we investigate the Higgs (amplitude) mode of several cuprate thin films using phase-resolved terahertz third harmonic generation (THG). In addition to the heavily damped Higgs mode itself, we observe a universal jump in the phase of the driven Higgs oscillation as well as a non-vanishing THG above Tc. These findings indicate coupling of the Higgs mode to other collective modes and potentially a nonzero pairing amplitude above Tc.

Higgs Mode in the d-Wave Superconductor Bi_{2}Sr_{2}CaCu_{2}O_{8+x} Driven by an Intense Terahertz Pulse.

We investigate the terahertz (THz)-pulse-driven nonlinear response in the d-wave cuprate superconductor Bi_{2}Sr_{2}CaCu_{2}O_{8+x} (Bi2212) using a THz pump near-infrared probe scheme in the time domain. We observe an oscillatory behavior of the optical reflectivity that follows the THz electric field squared and is markedly enhanced below T_{c}. The corresponding third-order nonlinear effect exhibits both A_{1g} and B_{1g} symmetry components, which are decomposed from polarization-resolved measurements. A comparison with a BCS calculation of the nonlinear susceptibility indicates that the A_{1g} component is associated with the Higgs mode of the d-wave order parameter.