Adjuvant chemotherapy with or without bevacizumab in patients with resected non-small-cell lung cancer (E1505): an open-label, multicentre, randomised, phase 3 trial.

BackgroundAdjuvant chemotherapy for resected early-stage non-small-cell lung cancer (NSCLC) provides a modest survival benefit. Bevacizumab, a monoclonal antibody directed against VEGF, improves outcomes when added to platinum-based chemotherapy in advanced-stage non-squamous NSCLC. We aimed to evaluate the addition of bevacizumab to adjuvant chemotherapy in early-stage resected NSCLC.MethodsWe did an open-label, randomised, phase 3 trial of adult patients (aged ≥18 years) with an Eastern Cooperative Oncology Group performance status of 0 or 1 and who had completely resected stage IB (≥4 cm) to IIIA (defined by the American Joint Committee on Cancer 6th edition) NSCLC. We enrolled patients from across the US National Clinical Trials Network, including patients from the Eastern Cooperative Oncology Group-American College of Radiology Imaging Network (ECOG-ACRIN) affiliates in Europe and from the Canadian Cancer Trials Group, within 6-12 weeks of surgery. The chemotherapy regimen for each patient was selected before randomisation and administered intravenously; it consisted of four 21-day cycles of cisplatin (75 mg/m2 on day 1 in all regimens) in combination with investigator's choice of vinorelbine (30 mg/m2 on days 1 and 8), docetaxel (75 mg/m2 on day 1), gemcitabine (1200 mg/m2 on days 1 and 8), or pemetrexed (500 mg/m2 on day 1). Patients in the bevacizumab group received bevacizumab 15 mg/kg intravenously every 21 days starting with cycle 1 of chemotherapy and continuing for 1 year. We randomly allocated patients (1:1) to group A (chemotherapy alone) or group B (chemotherapy plus bevacizumab), centrally, using permuted blocks sizes and stratified by chemotherapy regimen, stage of disease, histology, and sex. No one was masked to treatment assignment, except the Data Safety and Monitoring Committee. The primary endpoint was overall survival, analysed by intention to treat. This trial is registered with ClinicalTrials.gov, number NCT00324805.FindingsBetween June 1, 2007, and Sept 20, 2013, 1501 patients were enrolled and randomly assigned to the two treatment groups: 749 to group A (chemotherapy alone) and 752 to group B (chemotherapy plus bevacizumab). 383 (26%) of 1458 patients (with complete staging information) had stage IB, 636 (44%) had stage II, and 439 (30%) had stage IIIA disease (stage of disease data were missing for 43 patients). Squamous cell histology was reported for 422 (28%) of 1501 patients. All four cisplatin-based chemotherapy regimens were used: 377 (25%) patients received vinorelbine, 343 (23%) received docetaxel, 283 (19%) received gemcitabine, and 497 (33%) received pemetrexed. At a median follow-up of 50·3 months (IQR 32·9-68·0), the estimated median overall survival in group A has not been reached, and in group B was 85·8 months (95% CI 74·9 to not reached); hazard ratio (group B vs group A) 0·99 (95% CI 0·82-1·19; p=0·90). Grade 3-5 toxicities of note (all attributions) that were reported more frequently in group B (the bevacizumab group) than in group A (chemotherapy alone) were overall worst grade (ie, all grade 3-5 toxicities; 496 [67%] of 738 in group A vs 610 [83%] of 735 in group B), hypertension (60 [8%] vs 219 [30%]), and neutropenia (241 [33%] vs 275 [37%]). The number of deaths on treatment did not differ between the groups (15 deaths in group A vs 19 in group B). Of these deaths, three in group A and ten in group B were considered at least possibly related to treatment.InterpretationAddition of bevacizumab to adjuvant chemotherapy did not improve overall survival for patients with surgically resected early-stage NSCLC. Bevacizumab does not have a role in this setting and should not be considered as an adjuvant therapy for patients with resected early-stage NSCLC.FundingNational Cancer Institute of the National Institutes of Health

Nipped in the Bud: COVID-19 Reveals the Malleability of STEM Student Self-Efficacy.

When a global pandemic hits during a longitudinal study of biology student success, researchers can unearth rich information about student resilience. By sharing case studies from two demographically different midsized 4-year institutions, this article illustrates the aspects of student self-efficacy beliefs that were undercut by the shift to emergency remote instruction (ERI) in introductory biology courses in Spring 2020: agency and belonging. By assessing student predictions of exam performance and analyzing themes from 276 student narrative surveys, we highlight the power of a careful balance between cognitive and social interventions to help students recover. Students in this study showed a 50% loss of efficacy beliefs after ERI (midsemester) but were able to improve to at least 75% above starting efficacy beliefs after instructor interventions. Thus, we also show how academic efficacy is highly malleable and is mediated in relationships. In turn, we demonstrate a new assessment model that uses student narrative writing to reveal "invisible" threats to students' perceptions of their capacity to succeed. Finally, we generalize from their findings to provide recommendations for effective strategies for supporting those students for whom every semester feels like a pandemic

Nipped in the Bud: COVID-19 Reveals the Malleability of STEM Student Self-Efficacy

When a global pandemic hits during a longitudinal study of biology student success, researchers can unearth rich information about student resilience. By sharing case studies from two demographically different midsized 4-year institutions, this article illustrates the aspects of student self-efficacy beliefs that were undercut by the shift to emergency remote instruction (ERI) in introductory biology courses in Spring 2020: agency and belonging. By assessing student predictions of exam performance and analyzing themes from 276 student narrative surveys, we highlight the power of a careful balance between cognitive and social interventions to help students recover. Students in this study showed a 50% loss of efficacy beliefs after ERI (midsemester) but were able to improve to at least 75% above starting efficacy beliefs after instructor interventions. Thus, we also show how academic efficacy is highly malleable and is mediated in relationships. In turn, we demonstrate a new assessment model that uses student narrative writing to reveal “invisible” threats to students’ perceptions of their capacity to succeed. Finally, we generalize from their findings to provide recommendations for effective strategies for supporting those students for whom every semester feels like a pandemic

Visual categorization shapes feature selectivity in the primate temporal cortex

The way that we perceive and interact with objects depends on our previous experience with them. For example, a bird expert is more likely to recognize a bird as a sparrow, a sandpiper or a cockatiel than a non-expert. Neurons in the inferior temporal cortex have been shown to be important in the representation of visual objects; however, it is unknown which object features are represented and how these representations are affected by categorization training. Here we show that feature selectivity in the macaque inferior temporal cortex is shaped by categorization of objects on the basis of their visual features. Specifically, we recorded from single neurons while monkeys performed a categorization task with two sets of parametric stimuli. Each stimulus set consisted of four varying features, but only two of the four were important for the categorization task (diagnostic features). We found enhanced neuronal representation of the diagnostic features relative to the non-diagnostic ones. These findings demonstrate that stimulus features important for categorization are instantiated in the activity of single units (neurons) in the primate inferior temporal corte