Association of Patient Characteristics and Tumor Genomics With Clinical Outcomes Among Patients With Non-Small Cell Lung Cancer Using a Clinicogenomic Database.

Importance: Data sets linking comprehensive genomic profiling (CGP) to clinical outcomes may accelerate precision medicine. Objective: To assess whether a database that combines EHR-derived clinical data with CGP can identify and extend associations in non-small cell lung cancer (NSCLC). Design, Setting, and Participants: Clinical data from EHRs were linked with CGP results for 28 998 patients from 275 US oncology practices. Among 4064 patients with NSCLC, exploratory associations between tumor genomics and patient characteristics with clinical outcomes were conducted, with data obtained between January 1, 2011, and January 1, 2018. Exposures: Tumor CGP, including presence of a driver alteration (a pathogenic or likely pathogenic alteration in a gene shown to drive tumor growth); tumor mutation burden (TMB), defined as the number of mutations per megabase; and clinical characteristics gathered from EHRs. Main Outcomes and Measures: Overall survival (OS), time receiving therapy, maximal therapy response (as documented by the treating physician in the EHR), and clinical benefit rate (fraction of patients with stable disease, partial response, or complete response) to therapy. Results: Among 4064 patients with NSCLC (median age, 66.0 years; 51.9% female), 3183 (78.3%) had a history of smoking, 3153 (77.6%) had nonsquamous cancer, and 871 (21.4%) had an alteration in EGFR, ALK, or ROS1 (701 [17.2%] with EGFR, 128 [3.1%] with ALK, and 42 [1.0%] with ROS1 alterations). There were 1946 deaths in 7 years. For patients with a driver alteration, improved OS was observed among those treated with (n = 575) vs not treated with (n = 560) targeted therapies (median, 18.6 months [95% CI, 15.2-21.7] vs 11.4 months [95% CI, 9.7-12.5] from advanced diagnosis; P < .001). TMB (in mutations/Mb) was significantly higher among smokers vs nonsmokers (8.7 [IQR, 4.4-14.8] vs 2.6 [IQR, 1.7-5.2]; P < .001) and significantly lower among patients with vs without an alteration in EGFR (3.5 [IQR, 1.76-6.1] vs 7.8 [IQR, 3.5-13.9]; P < .001), ALK (2.1 [IQR, 0.9-4.0] vs 7.0 [IQR, 3.5-13.0]; P < .001), RET (4.6 [IQR, 1.7-8.7] vs 7.0 [IQR, 2.6-13.0]; P = .004), or ROS1 (4.0 [IQR, 1.2-9.6] vs 7.0 [IQR, 2.6-13.0]; P = .03). In patients treated with anti-PD-1/PD-L1 therapies (n = 1290, 31.7%), TMB of 20 or more was significantly associated with improved OS from therapy initiation (16.8 months [95% CI, 11.6-24.9] vs 8.5 months [95% CI, 7.6-9.7]; P < .001), longer time receiving therapy (7.8 months [95% CI, 5.5-11.1] vs 3.3 months [95% CI, 2.8-3.7]; P < .001), and increased clinical benefit rate (80.7% vs 56.7%; P < .001) vs TMB less than 20. Conclusions and Relevance: Among patients with NSCLC included in a longitudinal database of clinical data linked to CGP results from routine care, exploratory analyses replicated previously described associations between clinical and genomic characteristics, between driver mutations and response to targeted therapy, and between TMB and response to immunotherapy. These findings demonstrate the feasibility of creating a clinicogenomic database derived from routine clinical experience and provide support for further research and discovery evaluating this approach in oncology.

Efficient sensing of explosives by using fluorescent nonporous films of oligophenyleneethynylene derivatives thanks to optimal structure orientation and exciton migration.

The fluorescence of thin films of a diimine-substituted phenyleneethynylene compound can be efficiently quenched by nitroaromatic vapors, which is not the case for the unsubstituted parent compound. Thin-film porosity is usually considered to be an essential factor for efficient quenching, but in the present case the origin of the quenching is completely different, as both films are nonporous and hermetic to 2,4-dinitrotoluene (DNT) molecules. The molecular organization in the two crystallized thin films offers a low level of π stacking for both compounds, but the orientation of the phenylenethynylene fluorophore differs markedly with respect to the surface of the films. For the substituted compound, the fluorophore is almost parallel to the surface, thus making it readily available to molecules of a nitroaromatic quencher. This rationale is also observed in the case of a related compound bearing methoxy side chains instead of the long octyloxy moieties. Fluorescence-lifetime experiments show that the efficient quenching process in the nonporous crystallized films of the substituted compound is due to a fast (<70 ps) diffusion of excitons from the bulk of the film toward the surface where they are quenched, thus providing evidence of antenna effects.

Ability of various materials to detect explosive vapors by fluorescent technologies: a comparative study.

For the development of fluorescent sensors, one of the key points is choosing the sensitive material. In this article, we aim at evaluating, under strictly identical experimental conditions, the performance of three materials for the detection of dinitrotoluene (a volatile marker of trinitrotoluene) through different parameters: response time, fluorescence intensity, sensitivity, reversibility, reaction after successive exposures and long-term stability. The results are discussed according to the nature of the sensitive materials. This first study rendered it possible to select a conjugated molecule as the best sensitive material for the development of a lab-made prototype. In a second part, the selectivity of this particular sensitive material was studied and its ability to detect TNT could be demonstrated.

Ultra trace detection of explosives in air: development of a portable fluorescent detector.

This paper describes a system for the detection of nitroaromatic explosives consisting of a portable detector based on a specific fluorescent material. The developed sensor was able to perform an ultra trace detection of explosives, such as trinitrotoluene (TNT) or its derivate 2,4-dinitrotoluene (DNT), in ambient air or on objects tainted with explosives. In the presence of nitroaromatic vapors, the fluorescence of the material was found to decrease due to the adsorption of nitroaromatic molecules on its specific adsorption sites. The sensor exhibited a large sensitivity to TNT or DNT at their vapor pressures (respectively 6 and 148 ppbv) and the detection threshold was evaluated on a laboratory test setup and was found to be 0.75 ppbv for TNT. Moreover, the detector demonstrated no loss of performance in the presence of humidity or interfering compounds. All the tests led to the conclusion that the sensor fulfills the main requirements for the identification of suspect luggage, forensic analyses or battlefields clearing.

Spectral assignments for 1H, 13C and 15N solution and solid-state NMR spectra of s-tetrazine and dihydro-s-tetrazine derivatives.

Tetrazine-based organic species are interesting intermediates for organic synthesis and represent a source of new materials bearing specific properties with potential applications in biology and material science. 1H, 13C, 15N NMR measurements carried out in solution and in the solid-state have been used to characterize a series of 3,6-disubstituted 1,2,4,5-tetrazine/dihydrotetrazine new derivatives. Experimental results presented here provide data for the assignment of 15N chemical shifts including new organic small molecules; two polymers having the tetrazine ring in the main chain and several previously published compounds. We report apparently for the first time 15N experimental chemical shift data for tetrazine systems in the solid state.