Pembrolizumab monotherapy for previously treated metastatic triple-negative breast cancer: cohort A of the phase II KEYNOTE-086 study

Immunoterapia; Pembrolizumab; neoplàsies mamàries triple-negativesInmunoterapia; Pembrolizumab; neoplasias mamarias triple-negativasImmunotherapy; Pembrolizumab; triple-negative breast neoplasmsBackground: Treatment options for previously treated metastatic triple-negative breast cancer (mTNBC) are limited. In cohort A of the phase II KEYNOTE-086 study, we evaluated pembrolizumab as second or later line of treatment for patients with mTNBC. Patients and methods: Eligible patients had centrally confirmed mTNBC, ?1 systemic therapy for metastatic disease, prior treatment with anthracycline and taxane in any disease setting, and progression on or after the most recent therapy. Patients received pembrolizumab 200mg intravenously every 3 weeks for up to 2 years. Primary end points were objective response rate in the total and PD-L1–positive populations, and safety. Secondary end points included duration of response, disease control rate (percentage of patients with complete or partial response or stable disease for ?24 weeks), progression-free survival, and overall survival. Results: All enrolled patients (N¼170) were women, 61.8% had PD-L1–positive tumors, and 43.5% had received ?3 previous lines of therapy for metastatic disease. ORR (95% CI) was 5.3% (2.7–9.9) in the total and 5.7% (2.4–12.2) in the PD-L1–positive populations. Disease control rate (95% CI) was 7.6% (4.4–12.7) and 9.5% (5.1–16.8), respectively. Median duration of response was not reached in the total (range, 1.2þ–21.5þ) and in the PD-L1–positive (range, 6.3–21.5þ) populations. Median PFS was 2.0 months (95% CI, 1.9–2.0), and the 6-month rate was 14.9%. Median OS was 9.0 months (95% CI, 7.6–11.2), and the 6-month rate was 69.1%. Treatment-related adverse events occurred in 103 (60.6%) patients, including 22 (12.9%) with grade 3 or 4 AEs. There were no deaths due to AEs. Conclusions: Pembrolizumab monotherapy demonstrated durable antitumor activity in a subset of patients with previously treated mTNBC and had a manageable safety profile.This work was supported by Merck Sharp & Dohme Corp., a subsidiary of Merck & Co., Inc., Kenilworth, NJ, USA

ANALISIS YURIDIS SOSIOLOGIS PROSEDUR PENYELAMATAN KREDIT BERMASALAH BANK DANAMON BERDASARKAN PERATURAN BANK INDONESIA NOMOR 14/15/PBI/2012 TENTANG PENILAIAN KUALITAS ASET BANK UMUM (Studi Pada Kasus Konflik Bank Danamon Tanjung Balai Karimun Provinsi Kepualauan Riau Dengan Nasabah Bank Danamon)

Kasus mengenai penanganan kredit bermasalah di Bank Danamon sering mengalami permasalahan terutama dalam hal pelelangan. Kejadian tersebut dikarenakan bahwa Bank Danamon sering melakukan tindakan pelelangan tanpa pemberitahuan oleh nasabah serta tidak melakukan proses penyelamatan kredit bermasalah terlebih dahulu terhadap nasabah yang mengalami kredit bermasalah. Penelitian ini mengambil rumusan masalah Bagaimana prosedur penyelamatan kredit bermasalah yang dilakukan oleh PT.Bank Danamon dikaitkan dengan Peraturan Bank Indonesia Nomor 14/15/PBI/2012 Tentang Penilaian Kualitas Aset Bank Umum dan Apa faktor yang mendasari PT.Bank Danamon melakukan pelelangan terhadap jaminan nasabah. Penelitian ini menggunakan pendekatan Yuridis Sosiologis. Berdasarkan hasil penelitian tersebut ada beberapa peraturan dari Bank Danamon yang tidak mengikuti prosedur dari BI serta terjadi ketidaksesuain dengan peraturan yang dikeluarkan oleh Bank Danamon pusat dengan tindakan yang dilakukan oleh Bank Danamon Tanjung Balai Karimun. Proses penyelamatan kredit bermasalah yang dilakukan oleh bank adalah dengan mengeluarkan surat penggilan yang berisi mengenai pelunasan pembayaran, Bank Danamon tidak melakukan restrukturisasi sebelum nasabah sendiri yang membuat permohonan untuk dapat restrukturisasi. Mengenai pelelangan Bank Danmon kurang melengkapi salah satu persyaratan untuk melakukan lelng yaitu tidak adanya surat pemberitahuan lelang kepada debitur sehingga pelelangan yang dilakukan oleh bank danamon kurang sempurna. Kesimpulannya bahwa Bank Danamon Tanjung Balai Karimun kurang menerapkan peraturan yang telah dikeluarkan oleh Bank Danamon Pusat. Saran, Bank Danamon Tanjung Balai Karimun dapat memperbaiki kinerja bank dan melakukan perbuatan sesuai dengan perturan yang telah dikeluarkan

Dynamics of nanosecond laser pulse propagation and of associated instabilities in a magnetized underdense plasma

The propagation and energy coupling of intense laser beams in plasmas are critical issues in laser-driven inertial confinement fusion. Applying magnetic fields to such a setup has been evoked to enhance fuel confinement and heating, and mitigate laser energy losses. Here we report on experimental measurements demonstrating improved transmission and increased smoothing of a high-power laser beam propagating in an underdense magnetized plasma. We also measure enhanced backscattering, which our simulations show is due to hot electrons confinement, thus leading to reduced target preheating

Factors associated with return of spontaneous circulation after out-of-hospital cardiac arrest in Poland : a one-year retrospective study

Background: Out-of-hospital cardiac arrest (OHCA) is a common reason for calls for intervention by emergency medical teams (EMTs) in Poland. Regardless of the mechanism, OHCA is a state in which the chance of survival is dependent on rapid action from bystanders and responding health professionals in emergency medical services (EMS). We aimed to identify factors associated with return of spontaneous circulation (ROSC). Methods: The medical records of 2137 EMS responses to OHCA in the city of Wroclaw, Poland between July 2017 and June 2018 were analyzed. Results: The OHCA incidence rate for the year studied was 102 cases per 100,000 inhabitants. EMS were called to 2317 OHCA events of which 1167 (50.4%) did not have resuscitation attempted on EMS arrival. The difference between the number of successful and failed cardiopulmonary resuscitations (CPRs) was statistically significant (p < 0.001). Of 1150 patients in whom resuscitation was attempted, ROSC was achieved in 250 (27.8%). Rate of ROSC was significantly higher when CPR was initiated by bystanders (p < 0.001). Patients presenting with asystole or pulseless electrical activity (PEA) had a higher risk of CPR failure (86%) than those with ventricular fibrillation/ventricular tachycardia (VF/VT). Patients with VF/VT had a higher chance of ROSC (OR 2.68, 1.86–3.85) than those with asystole (p < 0.001). The chance of ROSC was 1.78 times higher when the event occurred in a public place (p < 0.001). Conclusions: The factors associated with ROSC were occurrence in a public place, CPR initiation by witnesses, and presence of a shockable rhythm. Gender, age, and the type of EMT did not influence ROSC. Low bystander CPR rates reinforce the need for further efforts to train the public in CPR

Elements in the Canine Distemper Virus M 3′ UTR Contribute to Control of Replication Efficiency and Virulence

Canine distemper virus (CDV) is a negative-sense, single-stranded RNA virus within the genus Morbillivirus and the family Paramyxoviridae. The Morbillivirus genome is composed of six transcriptional units that are separated by untranslated regions (UTRs), which are relatively uniform in length, with the exception of the UTR between the matrix (M) and fusion (F) genes. This UTR is at least three times longer and in the case of CDV also highly variable. Exchange of the M-F region between different CDV strains did not affect virulence or disease phenotype, demonstrating that this region is functionally interchangeable. Viruses carrying the deletions in the M 3′ UTR replicated more efficiently, which correlated with a reduction of virulence, suggesting that overall length as well as specific sequence motifs distributed throughout the region contribute to virulence

Evolution of microstructure and crystallographic texture during dissimilar friction stir welding of duplex stainless steel to low carbon-manganese structural steel

Electron backscattered diffraction (EBSD) was used to analyze the evolution of microstructure and crystallographic texture during friction stir welding of dissimilar type 2205 duplex stainless steel (DSS) to type S275 low carbon-manganese structural steel. The results of microstructural analyses show that the temperature in the center of stirred zone reached temperatures between Ac 1 and Ac 3 during welding, resulting in a minor ferrite-to-austenite phase transformation in the S275 steel, and no changes in the fractions of ferrite and austenite in the DSS. Temperatures in the thermomechanically affected and shoulder-affected zones of both materials, in particular toward the root of the weld, did not exceed the Ac 1 of S275 steel. The shear generated by the friction between the material and the rotating probe occurred in austenitic/ferritic phase field of the S275 and DSS. In the former, the transformed austenite regions of the microstructure were transformed to acicular ferrite, on cooling, while the dual-phase austenitic/ferritic structure of the latter was retained. Studying the development of crystallographic textures with regard to shear flow lines generated by the probe tool showed the dominance of simple shear components across the whole weld in both materials. The ferrite texture in S275 steel was dominated by D 1, D 2, E, E¯ , and F, where the fraction of acicular ferrite formed on cooling showed a negligible deviation from the texture for the ideal shear texture components of bcc metals. The ferrite texture in DSS was dominated by D 1, D 2, I, I¯ , and F, and that of austenite was dominated by the A, A¯ , B, and B¯ of the ideal shear texture components for bcc and fcc metals, respectively. While D 1, D 2, and F components of the ideal shear texture are common between the ferrite in S275 steel and that of dual-phase DSS, the preferential partitioning of strain into the ferrite phase of DSS led to the development of I and I¯ components in DSS, as opposed to E and E¯ in the S275 steel. The formations of fine and ultrafine equiaxed grains were observed in different regions of both materials that are believed to be due to strain-induced continuous dynamic recrystallization (CDRX) in ferrite of both DSS and S275 steel, and discontinuous dynamic recrystallization (DDRX) in austenite phase of DSS