Efficacy of salvage therapies for advanced acral melanoma after anti-PD-1 monotherapy failure: a multicenter retrospective study of 108 Japanese patients

BackgroundAnti-programmed cell death protein 1 (PD-1) monotherapy is one of the standard systemic therapies for advanced melanoma; however, the efficacy of salvage systemic therapies after PD-1 monotherapy failure (PD-1 MF), particularly in acral melanoma (AM), the main clinical melanoma type in Japanese patients, is unclear. This study aimed to investigate the efficacy of salvage systemic therapies in Japanese patients with AM after PD-1 MF.Patients and methodsThe study included 108 patients with advanced AM (palm and sole, 72; nail apparatus, 36) who underwent salvage systemic therapy at 24 Japanese institutions. We mainly assessed the objective response rate (ORR), progression-free survival (PFS), and overall survival (OS).ResultsThirty-six (33%) patients received ipilimumab, 23 (21%) received nivolumab and ipilimumab (nivo/ipi), 10 (9%) received cytotoxic chemotherapy, 4 (4%) received BRAF and MEK inhibitors (BRAFi/MEKi), and the remaining 35 (32%) continued with PD-1 monotherapy after disease progression. The ORRs in the ipilimumab, nivo/ipi, cytotoxic chemotherapy, and BRAFi/MEKi groups were 8, 17, 0, and 100%, respectively. The nivo/ipi group showed the longest OS (median, 18.9 months); however, differences in ORR, PFS, and OS between the groups were insignificant. The OS in the nivo/ipi group was higher in the palm and sole groups than in the nail apparatus group (median: not reached vs. 8.7 months, p < 0.001). Cox multivariate analysis demonstrated that nail apparatus melanoma independently predicted unfavorable PFS and OS (p = 0.006 and 0.001). The total OS (from PD-1 monotherapy initiation to death/last follow-up) was insignificant between the groups.ConclusionNivo/ipi was not more effective than cytotoxic chemotherapy and ipilimumab after PD-1 MF in patients with advanced AM. The prognosis after PD-1 MF would be poorer for nail apparatus melanoma than for palm and sole melanoma

Clofibric Acid, a Peroxisome Proliferator-activated Receptor Alpha Ligand, Enhances a Suppressive Effect of Cis-diaminedichloroplatinum on Proliferation of Ovarian Carcinoma Cells

The purpose of this study was to elucidate the possible mechanism that clofibric acid (CA), a peroxisome proliferator-activated receptor α ligand, enhances a suppressive effect of cis-diaminedichloroplatinum (CDDP) on proliferation of the ovarian carcinoma line OVCAR-3. These cells was incubated with 0.5 μM/ml CDDP in the presence or absence of 50 μM CA or incubated with 50 μM CA alone for 72 hr. While treatment with CA alone did not affect proliferation of OVCAR-3 cells, simultaneous treatment with CDDP and CA significantly suppressed proliferation of the cells and significantly induced apoptosis compared to that with CDDP alone. Treatment with CDDP and CA significantly decreased the prostaglandin (PG) E 2 level in the medium of the cells compared with treatment with CDDP alone. These results suggest the ability of CA to enhance a suppressive effect of CDDP on proliferation of the ovarian carcinoma cells through reduction of PGE 2 level

A case of small cell carcinoma of the vagina

Primary small cell carcinoma of the vagina is quite rare, and a standard treatment has not been established yet. Herein, we report a case of an 81-year-old woman who was diagnosed with a vaginal tumor without continuity with the uterine cervix. Histopathological diagnosis indicated alveolar solid growth of nuclear chromatin-rich atypical cells with a high N/C ratio and a partially recognized rosette-like structure, suggesting a differentiated neuroendocrine system. Chromogranin A and synapto- physin were positive. Stage I vaginal small cell carcinoma localized to the vagina was diagnosed. The tumor disappeared by radiation monotherapy with external beam irradiation and endocavitary irradiation. The patient remains alive without any disease 1 year and 8 months after the treatment, suggesting the efficacy of radiotherapy in small cell carcinoma of the vagina.</p

Single Molecular Resistive Switch Obtained via Sliding Multiple Anchoring Points and Varying Effective Wire Length

A single molecular resistive (conductance) switch via control of anchoring positions was examined by using a molecule consisting of more than two same anchors. For this purpose, we adopted the covered quaterthiophene (QT)-based molecular wire junction. The QT-based wire consisted of two thiophene ring anchors on each side; thus, shift of anchors was potentially possible without a change in the binding modes and distortion of the intramolecular structure. We observed three distinct conductance states by using scanning tunneling microscope-based break junction technique. A detailed analysis of the experimental data and first-principles calculations revealed that the mechanism of the resistive switch could be explained by standard length dependence (exponential decay) of conductance. Here, the length is the distance between the anchoring points, i.e., length of the bridged π-conjugated backbone. Most importantly, this effective tunneling length was variable via only controlling the anchoring positions in the same molecule. Furthermore, we experimentally showed the possibility of a dynamic switch of anchoring positions by mechanical control. The results suggested a distinct strategy to design functional devices via contact engineering