Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): a randomised, double-blind, phase 3 trial

Few treatments with a distinct mechanism of action are available for patients with platinum-refractory advanced or metastatic urothelial carcinoma. We assessed the efficacy and safety of treatment with docetaxel plus either ramucirumab-a human IgG1 VEGFR-2 antagonist-or placebo in this patient population

Reactivities of copper-germanium alloys in the direct synthesis of dimethyldichlorogermane

The activities of the single phase alloys a (Ge in Cu), ζ (Cu5Ge), and ε{lunate} (Cu3Ge) in the reaction with methyl chloride to form methylchlorogermanes were measured at 426.7 °C. The alloys displayed essentially the same reactivity when compared on the basis of the same number of germanium atoms exposed to methyl chloride. Selectivity for (CH3)2GeCl2 approached 100% at 0% conversion of germanium, thus supporting the ionic mechanism of Voorhoeve. The extent of cracking of methyl chloride could be correlated with the fraction of the surface estimated to consist of copper atoms not involved in the synthesis of methylchlorogermanes. Removal of copper from thin surface layers, probably as CuCl, was confirmed by X-ray analysis in the case of the α phase. Mechanical mixtures of alloys and free germanium showed greatly enhanced reactivities which could be explained only by the creation of additional reaction sites on the surfaces of the free germanium particles. © 1973

Technology Roadmap for Flexible Sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity

Technology roadmap for flexible sensors

Humans rely increasingly on sensors to address grand challenges and to improve quality of life in the era of digitalization and big data. For ubiquitous sensing, flexible sensors are developed to overcome the limitations of conventional rigid counterparts. Despite rapid advancement in bench-side research over the last decade, the market adoption of flexible sensors remains limited. To ease and to expedite their deployment, here, we identify bottlenecks hindering the maturation of flexible sensors and propose promising solutions. We first analyze challenges in achieving satisfactory sensing performance for real-world applications and then summarize issues in compatible sensor-biology interfaces, followed by brief discussions on powering and connecting sensor networks. Issues en route to commercialization and for sustainable growth of the sector are also analyzed, highlighting environmental concerns and emphasizing nontechnical issues such as business, regulatory, and ethical considerations. Additionally, we look at future intelligent flexible sensors. In proposing a comprehensive roadmap, we hope to steer research efforts towards common goals and to guide coordinated development strategies from disparate communities. Through such collaborative efforts, scientific breakthroughs can be made sooner and capitalized for the betterment of humanity.Agency for Science, Technology and Research (A*STAR)National Research Foundation (NRF)Submitted/Accepted versionY.L., Z.L., M.Z., and X.C. acknowledge the National Research Foundation, Singapore (NRF) under NRF’s Medium Sized Centre: Singapore Hybrid-Integrated Next-Generation μElectronics (SHINE) Centre funding programme, and AME programming funding scheme of Cyber Physiochemical Interface (CPI) project (no. A18A1b0045). Y.L. acknowledges National Natural Science Foundation of China (62201243). C.J. acknowledges funding support from the National Key R&D Program of China (no. 2019YFA0706100), the National Natural Science Foundation of China (82151305), Lingang Laboratory (LG-QS-202202-09). T.Q.T. and N.E.L. acknowledge support by the Basic Science Research Program (no. 2020R1A2C3013480) through the National Research Foundation of Korea (NRF) funded by the Ministry of Science and ICT. A.F. acknowledges the AFOSR (grant FA9550-22-1-0423). Y.L. and Y.Z. would like to acknowledge the NSF (award no. 2134664) and NIH (award no. R01HD108473) for financial support. X.F. acknowledges the support from the National Natural Science Foundation of China (grant no. U20A6001). L.Y. would like to thank the A*STAR Central Research Fund (CRF) and the AME Programmatic A18A1b0045 (Cyber Physiochemical Interfaces) for funding support. C.F.G. acknowledges the National Natural Science Foundation of China (no. T2225017). T.Q.T. acknowledges the Brain Pool Program (No. 2020H1D3A2A02111068) through the National Research Foundation (NRF) funded by the Ministry of Science. Z.L. acknowledges the support from RIE2020 AME Programmatic Grant funded by A*STAR-SERC, Singapore (Grant No. A18A1b0045). X.G. acknowledges funding support through the Shanghai Science and Technology Commission (grant no. 19JC1412400), the National Science Fund for Excellent Young Scholars (grant no. 61922057). C.D. acknowledges National Science Foundation CAREER: Conformable Piezoelectrics for Soft Tissue Imaging (grant no. 2044688) and MIT Media Lab Consortium funding. D.K. and O.G.S. acknowledge Leibniz Association and the German Research Foundation DFG (Gottfried Wilhelm Leibniz Program SCHM 1298/22-1, KA5051/1-1 and KA 5051/3-1), as well as the Leibniz association (Leibniz Transfer Program T62/2019). C.W. acknowledges the National Key Research and Development Program of China (grant no. 2021YFA1202600), National Natural Science Foundation of China (grant no. 62174082). A.V.-Y.T., E.Z., Y.Z., X.Z., and J.P. acknowledge the National Research Foundation, Singapore (NRF) under NRF’s Medium Sized Centre: Singapore Hybrid-Integrated Next-Generation μElectronics (SHINE) Centre funding programme, and AME programming funding scheme of Cyber Physiochemical Interface (CPI) project (no. A18A1b0045). R.Z. acknowledges National Natural Science Foundation of China (grant no. 51735007) and Beijing Natural Science Foundation (grant no. 3191001). N.M. acknowledges the support by JST PRESTO Grant Number JPMJPR20B7 and JST Adaptable and Seamless Technology transfer Program through Target-driven R&D (ASTEP) grant number JPMJTM22BK. C.P. acknowledges the Korean government (Ministry of Science and ICT, MSIT) (2022R1A4A3032923). M.W. acknowledges the National Key R&D Program of China under Grant (2021YFB3601200). X.Z. acknowledges National Natural Science Foundation of China (no. 62074029). S.X. acknowledges the 3M nontenured faculty award. T.-W.L. and D.-G.S. acknowledge the Pioneer Research Center Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT & Future Planning (grant no. NRF-2022M3C1A3081211). C.T.L. would like to acknowledge support from the Institute for Health Innovation and Technology (iHealthtech), the MechanoBioEngineering Laboratory at the Department of Biomedical Engineering and the Institute for Functional Intelligent Materials (I-FIM) at the National University of Singapore (NUS). C.T.L. also acknowledges support from the National Research Foundation and A*STAR, under its RIE2020 Industry Alignment Fund − Industry Collaboration Projects (IAF-ICP) (grant no. I2001E0059) − SIA-NUS Digital Aviation Corp Lab and the NUS ARTIC Research (grant no. HFM-RP1). X.Y. acknowledges funding support by City University of Hong Kong (grant no. 9667221). T.X. and X.Z. acknowledge National Natural Science Foundation of China (22234006). B.C.K.T. acknowledges Cyber-Physiochemical Interfaces CPI, A*STAR A18A1b0045. H.G. acknowledges a research start-up grant (002479-00001) from Nanyang Technological University and the Agency for Science, Technology and Research (A*STAR) in Singapore. W.G. acknowledges National Science Foundation grant 2145802. D.J.L. acknowledges support from the US National Science Foundation grant number CBET-2223566. G.Y. acknowledges support from The Welch Foundation award F-1861, and Camille Dreyfus Teacher-Scholar Award. M.D.D. acknowledges funding support from NSF (grant no. EEC1160483). J.-H.A acknowledges the National Research Foundation of Korea (NRF-2015R1A3A2066337). J.C. acknowledges the Henry Samueli School of Engineering & Applied Science and the Department of Bioengineering at the University of California, Los Angeles for startup support and a Brain & Behavior Research Foundation Young Investigator Grant. K.T. acknowledges JST AIP Accelerated Program (no. JPMJCR21U1) and JSPS KAKENHI (grant no. JP22H00594). P.S.W. acknowledges the National Science Foundation (CMMI1636136) for support. A.M.A., M.C.H., and P.S.W. thank the National Institute on Drug Abuse (DA045550) for support. S.M. and X.C. appreciated the support from the Smart Grippers for Soft Robotics (SGSR) Programme under the National Research Foundation, Prime Minister’s Office, Singapore under its Campus of Research Excellence and Technological Enterprise (CREATE) programme

Ramucirumab plus docetaxel versus placebo plus docetaxel in patients with locally advanced or metastatic urothelial carcinoma after platinum-based therapy (RANGE): overall survival and updated results of a randomised, double-blind, phase 3 trial

Background: Ramucirumab—an IgG1 vascular endothelial growth factor receptor 2 antagonist—plus docetaxel was previously reported to improve progression-free survival in platinum-refractory, advanced urothelial carcinoma. Here, we report the secondary endpoint of overall survival results for the RANGE trial. Methods: We did a randomised, double-blind, phase 3 trial in patients with advanced or metastatic urothelial carcinoma who progressed during or after platinum-based chemotherapy. Patients were enrolled from 124 investigative sites (hospitals, clinics, and academic centres) in 23 countries. Previous treatment with one immune checkpoint inhibitor was permitted. Patients were randomly assigned (1:1) using an interactive web response system to receive intravenous ramucirumab 10 mg/kg or placebo 10 mg/kg volume equivalent followed by intravenous docetaxel 75 mg/m2 (60 mg/m2 in Korea, Taiwan, and Japan) on day 1 of a 21-day cycle. Treatment continued until disease progression, unacceptable toxicity, or other discontinuation criteria were met. Randomisation was stratified by geographical region, Eastern Cooperative Oncology Group performance status at baseline, and visceral metastasis. Progression-free survival (the primary endpoint) and overall survival (a key secondary endpoint) were assessed in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT02426125; patient enrolment is complete and the last patient on treatment is being followed up for safety issues. Findings: Between July 20, 2015, and April 4, 2017, 530 patients were randomly allocated to ramucirumab plus docetaxel (n=263) or placebo plus docetaxel (n=267) and comprised the intention-to-treat population. At database lock (March 21, 2018) for the final overall survival analysis, median follow-up was 7·4 months (IQR 3·5–13·9). In our sensitivity analysis of investigator-assessed progression-free survival at the overall survival database lock, median progression-free survival remained significantly improved with ramucirumab compared with placebo (4·1 months [95% CI 3·3–4·8] vs 2·8 months [2·6–2·9]; HR 0·696 [95% CI 0·573–0·845]; p=0·0002). Median overall survival was 9·4 months (95% CI 7·9–11·4) in the ramucirumab group versus 7·9 months (7·0–9·3) in the placebo group (stratified HR 0·887 [95% CI 0·724–1·086]; p=0·25). Grade 3 or worse treatment-related treatment-emergent adverse events in 5% or more of patients and with an incidence more than 2% higher with ramucirumab than with placebo were febrile neutropenia (24 [9%] of 258 patients in the ramucirumab group vs 16 [6%] of 265 patients in the placebo group) and neutropenia (17 [7%] of 258 vs six [2%] of 265). Serious adverse events were similar between groups (112 [43%] of 258 patients in the ramucirumab group vs 107 [40%] of 265 patients in the placebo group). Adverse events related to study treatment and leading to death occurred in eight (3%) patients in the ramucirumab group versus five (2%) patients in the placebo group. Interpretation: Additional follow-up supports that ramucirumab plus docetaxel significantly improves progression-free survival, without a significant improvement in overall survival, for patients with platinum-refractory advanced urothelial carcinoma. Clinically meaningful benefit might be restricted in an unselected population. Funding: Eli Lilly and Company