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Targeting HER2 with Trastuzumab Deruxtecan: A Dose-Expansion, Phase I Study in Multiple Advanced Solid Tumors [Research Articles]

HER2-targeted therapies are approved only for HER2-positive breast and gastric cancers. We assessed the safety/tolerability and activity of the novel HER2-targeted antibody–drug conjugate trastuzumab deruxtecan (T-DXd) in 60 patients with pretreated, HER2-expressing (IHC ≥ 1+), non-breast/non-gastric or HER2-mutant solid tumors from a phase I trial (NCT02564900). Most common (>50%) treatment-emergent adverse events (TEAE) were nausea, decreased appetite, and vomiting. Two drug-related TEAEs were associated with fatal outcomes. The confirmed objective response rate (ORR) was 28.3% (17/60). Median progression-free survival (PFS) was 7.2 [95% confidence interval (CI), 4.8–11.1] months. In HER2-mutant non–small cell lung cancer (NSCLC), ORR was 72.7% (8/11), and median PFS was 11.3 (95% CI, 8.1–14.3) months. Confirmed responses were observed in six tumor types, including HER2-expressing NSCLC, colorectal cancer, salivary gland cancer, biliary tract cancer, endometrial cancer, and HER2-mutant NSCLC and breast cancer. Results suggest T-DXd holds promise for HER2-expressing/mutant solid tumors.

Significance:

T-DXd demonstrated promising activity in a heterogeneous patient population with heavily pretreated HER2-expressing or HER2-mutant solid tumors, especially HER2-mutant NSCLC. The safety profile was generally acceptable. Interstitial lung disease can be severe and requires prompt monitoring and intervention. Further research of T-DXd is warranted to address these unmet medical needs.

See related commentary by Rolfo and Russo, p. 643.

This article is highlighted in the In This Issue feature, p. 627




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Radiomics Study of Thyroid Ultrasound for Predicting BRAF Mutation in Papillary Thyroid Carcinoma: Preliminary Results [FUNCTIONAL]

BACKGROUND AND PURPOSE:

It is not known how radiomics using ultrasound images contribute to the detection of BRAF mutation. This study aimed to evaluate whether a radiomics study of gray-scale ultrasound can predict the presence or absence of B-Raf proto-oncogene, serine/threonine kinase (BRAF) mutation in papillary thyroid cancer.

MATERIALS AND METHODS:

The study retrospectively included 96 thyroid nodules that were surgically confirmed papillary thyroid cancers between January 2012 and June 2013. BRAF mutation was positive in 48 nodules and negative in 48 nodules. For analysis, ROIs from the nodules were demarcated manually on both longitudinal and transverse sonographic images. We extracted a total of 86 radiomics features derived from histogram parameters, gray-level co-occurrence matrix, intensity size zone matrix, and shape features. These features were used to build 3 different classifier models, including logistic regression, support vector machine, and random forest using 5-fold cross-validation. The performance including accuracy, sensitivity, specificity, positive predictive value, negative predictive value, and area under the receiver operating characteristic curve, of the different models was evaluated.

RESULTS:

The incidence of high-suspicion nodules diagnosed on ultrasound was higher in the BRAF mutation–positive group than in the mutation–negative group (P = .004). The radiomics approach demonstrated that all classification models showed moderate performance for predicting the presence of BRAF mutation in papillary thyroid cancers with an area under the curve value of 0.651, accuracy of 64.3%, sensitivity of 66.8%, and specificity of 61.8%, on average, for the 3 models.

CONCLUSIONS:

Radiomics study using thyroid sonography is limited in predicting the BRAF mutation status of papillary thyroid carcinoma. Further studies will be needed to validate our results using various diagnostic methods.




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Save the Brain First: CTA and Mechanical Thrombectomy in Patients at Risk for Contrast-Induced Nephropathy [article-commentary]




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Contrast-Induced Acute Kidney Injury in Radiologic Management of Acute Ischemic Stroke in the Emergency Setting [INTERVENTIONAL]

BACKGROUND AND PURPOSE:

The use of invasive cerebral angiography with CTA for active treatment of patients with suspected ischemic strokes has been increasing recently. This study aimed to identify the incidence of postcontrast acute kidney injury using baseline renal function when CTA and cerebral angiography were performed sequentially.

MATERIALS AND METHODS:

This retrospective observational study evaluated adults (18 years of age or older) with ischemic stroke who underwent CTA and cerebral angiography sequentially between 2010 and 2018. The incidence of postcontrast acute kidney injury was determined using the baseline estimated glomerular filtration rate. The value of the baseline estimated glomerular filtration rate at which the occurrence of postcontrast acute kidney injury increased was also determined.

RESULTS:

Postcontrast acute kidney injury occurred in 57/601 (9.5%) patients. Those with a baseline estimated glomerular filtration rate of <30 mL/min/1.73 m2 showed a higher incidence of acute kidney injury. Age, chronic kidney disease, medication (nonsteroidal anti-inflammatory drugs, angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, β blockers, statins, and insulin) use following contrast media exposure, and serum albumin affected the incidence of postcontrast acute kidney injury. The incidence of postcontrast acute kidney injury increased when the baseline estimated glomerular filtration rate was <43 mL/min/1.73 m2.

CONCLUSIONS:

Patients with low baseline renal function had the highest incidence of postcontrast acute kidney injury after CTA and cerebral angiography, but no fatal adverse effects were documented. Thus, patients suspected of having a stroke should be actively managed with respect to neurovascular function.




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Discrimination between Glioblastoma and Solitary Brain Metastasis: Comparison of Inflow-Based Vascular-Space-Occupancy and Dynamic Susceptibility Contrast MR Imaging [FUNCTIONAL]

BACKGROUND AND PURPOSE:

Accurate differentiation between glioblastoma and solitary brain metastasis is of vital importance clinically. This study aimed to investigate the potential value of the inflow-based vascular-space-occupancy MR imaging technique, which has no need for an exogenous contrast agent, in differentiating glioblastoma and solitary brain metastasis and to compare it with DSC MR imaging.

MATERIALS AND METHODS:

Twenty patients with glioblastoma and 22 patients with solitary brain metastasis underwent inflow-based vascular-space-occupancy and DSC MR imaging with a 3T clinical scanner. Two neuroradiologists independently measured the maximum inflow-based vascular-space-occupancy–derived arteriolar CBV and DSC-derived CBV values in intratumoral regions and peritumoral T2-hyperintense regions, which were normalized to the contralateral white matter (relative arteriolar CBV and relative CBV, inflow-based vascular-space-occupancy relative arteriolar CBV, and DSC-relative CBV). The intraclass correlation coefficient, Student t test, or Mann-Whitney U test and receiver operating characteristic analysis were performed.

RESULTS:

All parameters of both regions had good or excellent interobserver reliability (0.74~0.89). In peritumoral T2-hyperintese regions, DSC-relative CBV (P < .001), inflow-based vascular-space-occupancy arteriolar CBV (P = .001), and relative arteriolar CBV (P = .005) were significantly higher in glioblastoma than in solitary brain metastasis, with areas under the curve of 0.94, 0.83, and 0.72 for discrimination, respectively. In the intratumoral region, both inflow-based vascular-space-occupancy arteriolar CBV and relative arteriolar CBV were significantly higher in glioblastoma than in solitary brain metastasis (both P < .001), with areas under the curve of 0.91 and 0.90, respectively. Intratumoral DSC-relative CBV showed no significant difference (P = .616) between the 2 groups.

CONCLUSIONS:

Inflow-based vascular-space-occupancy has the potential to discriminate glioblastoma from solitary brain metastasis, especially in the intratumoral region.




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Focused ultrasound opening brain to previously impossible treatments

Focused ultrasound, the researchers hope, could revolutionize treatment for conditions from Alzheimer's to epilepsy to brain tumors -- and even help repair the devastating damage caused by stroke.







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Russia, Belarus mark Victory Day in contrasting events

Russian President Vladimir Putin marked Victory Day, the anniversary of the defeat of Nazi Germany in World War II, in a ceremony shorn of its usual military parade and pomp by the coronavirus pandemic. In neighboring Belarus, however, the ceremonies went ahead in full, with tens of thousands of people in the sort of proximity that has been almost unseen in the world for months. Victory Day is Russia’s most important secular holiday and this year’s observance had been expected to be especially large because it is the 75th anniversary, but the Red Square military parade and a mass procession called The Immortal Regiment were postponed as part of measures to stifle the spread of the virus.






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Kim Petras's lockdown listening: 'My fans have truly kept me sane'

The cult pop star shares her self-isolation favourites, including Dua Lipa’s disco and Daft Punk’s dystopias

Isolation has definitely been a test, but I’m really lucky: I’m able to work on new music while quarantined with my best friends in Toluca Lake, Los Angeles. I’ve been super active on Twitter and Instagram, and playing Animal Crossing and Mario Kart with my fans after sharing my Nintendo Switch codes online – it’s really important for me to check in on my fans as I worry about them a lot. They have truly kept me sane, so I’m keeping an eye open for anybody that needs to talk.

Related: Belle and Sebastian's lockdown listening: 'I have a dance-off with my kids every night'

Continue reading...




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Ruby Wax on mindfulness, mantras and virtually connecting in lockdown

'Practising mindfulness is like going to a gym, you have to exercise the muscle and it works with anxiety'




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Amazon and Microsoft are trash talking each other over a DoD contract

The Department of Defense needs technology experts to migrate its roughly 500 disparate cloud environments into a unified system to help the military work better and faster. The Joint Enterprise Defense Infrastructure (JEDI) contract -- which has bee...




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Tom Brady, Tiger Woods, Peyton Manning, Phil Mickelson: Who is the best trash talker?

The zingers flew as Tom Brady, Tiger Woods, Peyton Manning and Phil Mickelson hyped their upcoming golf match. Which legend talked the best smack?




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Obama Trashes Trump Over Coronavirus Response as "Chaotic Disaster"

The gloves are officially off, because Barack Obama has made his feelings known about the way his predecessor has handled the coronavirus pandemic, and the former Prez did NOT mince words. Obama was speaking with members of the Obama Alumni Ass'n,…




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The force: How to improve ultrasonic plastic welding

Tom Hoover, senior medical business development manager – Americas, assembly technologies, at global technology and manufacturing company, Emerson, explains how ultrasonic plastic welding is improved through improved force control.




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JD(U) trashes Delhi govt's claim of bearing migrant labourers train fare

The ruling JD(U) on Saturday slammed AAP for claiming that it bore the cost of ferrying migrant workers from Delhi to their home in Bihar, saying the party was speaking "half-truth" as the Arvind Kejriwal government has sought reimbursement of the payment.




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Cyber Grand Challenge contrasts today’s cybersecurity risks

Cade Metz’s article for Wired titled “Hackers Don’t Have to Be Human Anymore. This Bot Battle Proves It” described a curious event that took place in Las Vegas on August 4, 2016. The first Defense Advanced Research Projects Agency (DARPA) Cyber Grand Challenge witnessed seven teams compete for cyber security supremacy. Unlike traditional hacking contests,…

       




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The weirdest trash found on beaches last year

This series of infographics reveals the bizarre discoveries made by volunteers during the 2017 International Coastal Cleanup.




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Plastic trash from Amsterdam’s canals turned into lovely furniture

In “fishing” for plastic to create new things, Plastic Whale Circular Furniture tackles a number of problems at once.




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Ultrasonic clothes dryers could shorten drying time to 20 minutes, and use 70% less energy

The next game-changing technology might not be in the form of an electric car with a longer range, or more efficient solar panels, but rather a better way to dry your clothes.




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Surprise! Americans send twice as much trash to landfills as we thought

A new study shows a major difference between EPA estimates and actual landfill numbers.




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The poor whales can't get away from all our plastic trash

The dead ones washing up on beaches are "just the tip of the iceberg."




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Floating Recycled Park modules are made out of reclaimed plastic trash (Video)

Plastic waste has been diverted from the city's shoreline to create a cost-effective, green space alternative.




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'Weed dating' & trash picking: The new tourist guide to Amsterdam

The city hopes to combat overtourism by getting visitors off the beaten track and doing more useful things.




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Canada agrees to take its trash back from the Philippines

A six-year dispute over mislabeled shipping containers has been settled, but the world can learn an important lesson from this.




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Philadelphia's solar-powered trash cans: Great green idea or flawed design?

Are solar-powered trash cans a fuel-saving, money-saving way to keep the streets clean? Or are they worse than regular trash cans?




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A sea of plastic trash hovers near Caribbean island

These photos reveal the horror of our disposable, consumerist culture and how it's ruining the most beautiful places on Earth.




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New documentary contrasts industrial ag with traditional Hawaiian model: ʻĀINA

This short film, while focused on the island of Kauai, highlights the challenges and crises we will all have to face on our island planet.




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Art Made from Mt. Everest Trash Exhibited in Nepal

Sixty-five porters and 75 yaks labored over two years to bring more than eight tons of trash down from the slopes of Mount Everest -- and into the hands of local artists.




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Expedition floats length of Mississippi River on raft made from trash

Recycled Mississippi is traveling the length of one of America's iconic rivers, which also happens to be one of the most polluted, and filming a documentary along the way.




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New York makes it illegal to put electronics in the trash

Starting in 2015, it will be illegal to leave computers and other electronic for curb-side pickup, as part of an effort to fight e-waste.




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TreeHugger Picks: Landfill Gas, From Trash to Alternative Energy

Landfill gas (LFG) isn't quite as sexy as some other alternative energy sources like wind or solar; still, TreeHugger thinks its an important part of our collective renewable energy portfolio. Plus, it's cool that landfills (and the stuff that fills




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"Pay-As-You-Throw" Trash Metering Cuts Landfill Waste by 50% in a Month

Some places have looked at paying people to recycle, but others think it makes more sense to charge people for their waste instead. When the UK talked about implementing a "pay-as-you-throw" scheme for trash, our readers were




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Bald eagles are littering Seattle backyards with landfill trash

Some 200 bald eagles are scavenging the goods at Cedar Hills Regional Landfill and dumping the leftovers in suburban backyards.




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These 100 popsicles are made with trash- and sewage-filled water

The Polluted Water Popsicles project is meant to shock viewers into realizing how serious water contamination is in Taiwan.




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Dreamy Danish holiday workshop village is entirely built from trash

Artist Thomas Dambo and his team of elves built this wonderful recycled village in Copenhagen where DIYers can make all of their gifts for free.




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Rampant death for hermit crabs who confuse plastic trash for shells

New research finds that on just two remote islands alone, nearly 600,000 crabs are killed every year by plastic debris.




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Australian high school gets rid of trash cans

Students will have to take home any waste that is not recyclable or compostable.




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Precious Waste: Elegant student jewelry made from upcycled trash

Handmade from discarded items, this collection of young designers' chic jewelry shows that 'waste' is merely a mentality, not a fact.




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Gyrecraft: creating luxurious objects from plastic ocean trash (Video)

Plastic pollution in our oceans is a big deal. These designers went out and collected some to create this surprising collection of items that look quite luxurious.




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Danish design students create sustainable waste bins to solve public trash problems

The award-winning DropBucket is a recycled cardboard trash can that can be reused and/or recycled.




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Trash talking: Cities finding smarter ways to collect our waste

How urban waste management is wising up.




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Plastic cutlery makes top 10 list of trash items found on beaches

This dismal finding shows that our eating culture needs a serious overhaul.




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Do women really need trash cans everywhere they go?

Surely there's a way to ditch our wasteful, disposable habits.




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The Trash Tycoon Facebook Game Launches Today!

Today, September 6th, Trash Tycoon officially launches! It's been a long, hard, fun road getting to this point, and we owe a special thanks to all the beta testers who have been playing and submitting bugs and comments on the forums.




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Waste Management CEO talks Q1 beat, trash collection during coronavirus

Waste Management CEO Jim Fish made an appearance on CNBC's "Mad Money" to discuss the trash collector company's three-month performance and what's ahead.




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Trashy Behavior that Belongs on Mount Garbage

If you're like anyone else, it's hard to escape garbage moments made possible by shortsighted people who aren't thinking with everyone's best interest in mind. There are crook landlords, people stealing crap, and some massive disrespect just floating around the world. This trashiness belongs on Garbage Island.




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Ciara FaceTimes hubby Russell Wilson during ultrasound

American singer Ciara, who is expecting her second child with National Football League (NFL) star hubby Russell Wilson, has some advice for pregnant women during the COVID-19 pandemic. Several hospitals and healthcare facilities in many countries have decided to ban partners from accompanying pregnant women for their doctor's appointments or entering the delivery room.

In a recent interview with Good Morning America, Ciara spoke about how pregnant women should make optimum use of technology to involve their partners during the maternity period.

Ciara revealed how she had to FaceTime Russell so that he could experience the ultrasound with her. "It was the first time we ever had that kind of experience and it was really a moment that marked the time we are living in... we made the best of it, but it was definitely surreal. I took tons and tons of videos, tons and tons of photos during the ultrasound and made the best of that. Also, what we do in our house is we sing to the belly," Ciara said.

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