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An optofluidic chip based on a multilayered photonic crystal structure is employed for an efficient beaming of the emitted radiation in a fluorescent microarray assay. Upon a near-field coupling of fluorescent emitters to surface modes sustained by the photonic crystal, a significant portion of radiated energy is diffracted out-of-plane towards the collection optics. The improvement in fluorescence collection is experimentally demonstrated in an antibody–antigene immunoassay. As a result, a decrease of the limit of detection for labelled antigenes by a factor of about 40 is demonstrated to occur in a robust and reproducible way, with little or no optical alignment issues. [ABSTRACT FROM AUTHOR]

A one-dimensional photonic crystal (1DPC) based on a planar stack of dielectric layers is used as an optical transducer for biosensing, upon the coupling of TE-polarized Bloch Surface Waves (BSW). The structure is tailored with a polymeric layer providing a chemical functionality facilitating the covalent binding of orienting proteins needed for a subsequent grafting of antibodies in an immunoassay detection scheme. The polymeric layer is impregnated with Cy3 dye, in such a way that the photonic structure can exhibit an emissive behavior. The BSW-coupled fluorescence shift is used as a means for detecting refractive index variations occurring at the 1DPC surface, according to a label-free concept. The proposed working principle is successfully demonstrated in real-time tracking of protein G covalent binding on the 1DPC surface within a fluidic cell. [ABSTRACT FROM AUTHOR]

Abstract: The rapid detection of enteropathogens with high sensitivity and selectivity continues to be a significant challenge, especially in order to transfer laboratory analyses to the Point-Of‐Care (POC) by developing simple and reliable diagnostic kits. Bacterial infections are already detected, in analytical labs, by means of high-density microarray biochips based both on RNA/DNA fragments and antibodies as probes and antigens receptors, respectively, immobilized on the chip surface. Many efforts to obtain a high efficiency of the surface chemical properties for a stable probes grafting in order to avoid unspecificity or non-selectivity of the bio-recognition are still under way. The aim of this work is to show the advantages of applying a low pressure plasma polymerized acrylic acid (exposing ps) thin coating to a low-density microarray biochip for the efficient grafting of suitable NH2 terminated probes able to match complementary DNA oligonucleotides of Listeria monocytogenes by means of a novel hybridization protocol and a commercial simple and low-cost colorimetric detection method compatible with POC applications. The chemical properties of the obtained polyacrylic acid thin films are characterized by means of ATR FT-IR spectroscopy, XPS and contact angle (OCA) measurements. The surface density of the carboxylic functionalities is quantified by colorimetric titration with Toluidine Blue O (TBO). The optimized functional thin film is shown to provide good advantages for DNA microarray diagnostics in terms of chemical stability, density of readily accessible ps and at the same time low hydrophilicity, crucial for reducing the dilution of spotted probes on the surface and thus resulting in higher and satisfying intensity of the detect signals in the microarray test. [Copyright &y& Elsevier]

Abstract: Physico-chemical and topographical cues allow to control the behavior of adherent cells. Towards this goal, commercially available cell culture carriers can be finished with a laterally microstructured biomolecular functionalization. As shown in a previous study [Biomacromolecules 4 (2003) 1072], the anhydride moiety facilitates a simple and versatile way to protein binding. The present work addresses the technical issue of anhydride surface functionalization of polystyrene, the most common material for cell culture ware. Different approaches based on low pressure plasma, electron beam and ultraviolet light techniques (i.e. maleic anhydride plasma reactions; plasma, electron beam and UV immobilization of functional polymer thin films; grafting of functional polymers to plasma activated surfaces) are introduced and briefly illustrated with examples. Results are characterized by Fourier transform infrared (FTIR) spectroscopy, X-ray photoelectron spectroscopy (XPS) and ellipsometry. The different routes are compared in terms of technical feasibility and achievable surface properties. [Copyright &y& Elsevier]

Lung cancer is the leading cause of cancer deaths worldwide. Novel targeted therapies based on specific molecular and biological characteristics of lung cancer have emerged as a new treatment paradigm. The current globally accepted standard of treatment for advanced non-small-cell lung cancer (NSCLC) is platinum-based combination therapy. Recently, several ongoing phase I and II trials with new drugs in NSCLC have been registered, such as sorafenib, sunitinib, mTOR inhibitors and ASA404. The optimal use of new agents is more likely in combination with standard cytotoxic or other targeted agents. Further investigations into adverse events with targeted therapy are urgently needed as these impact an increasing number of patients. Copyright © 2010 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Abstract: Pemetrexed, a new cytotoxic agent, is a potent inhibitor of thymidylate synthase and other folate-dependent enzymes. Firstly, pemetrexed was approved in combination with cisplatin for the treatment of malignant pleural mesothelioma. Successively, it has been studied, as single-agent, in phase II and III trials for second-line therapy of non-small cell lung cancer (NSCLC). Based on these results, pemetrexed has been registered for the treatment of recurrent NSCLC. The next step was to test pemetrexed plus cisplatin versus gemcitabine plus cisplatin, as first-line therapy in advanced NSCLC patients, in a phase III, non-inferiority, randomized trial. This trial reported the pemetrexed plus cisplatin regimen to be not inferior, in terms of activity and efficacy, to the control arm but statistically better tolerated. The role of pemetrexed as maintenance therapy after first-line therapy for advanced NSCLC is currently being evaluated into a phase III trial. The consistency of the results of these recent studies has identified a predictive effect of NSCLC non-squamous histology for pemetrexed. To date, pemetrexed is registered, at the dose of 500mg/m2 on day 1 of a 3-week schedule, in combination with cisplatin, for first-line therapy and, as single-agent, for second-line treatment of patients with non-squamous NSCLC.This review shows the latest and indicates the future developments of pemetrexed in the treatment of advanced NSCLC patients. [Copyright &y& Elsevier]

Cell–substrate interactions can modulate cellular behaviors in a variety of biological contexts, including development and disease. Light‐responsive materials have been recently proposed to engineer active substrates with programmable topographies directing cell adhesion, migration, and differentiation. However, current approaches are affected by either fabrication complexity, limitations in the extent of mechanical stimuli, lack of full spatio‐temporal control, or ease of use. Here, a platform exploiting light to plastically deform micropatterned polymeric substrates is presented. Topographic changes with remarkable relief depths in the micron range are induced in parallel, by illuminating the sample at once, without using raster scanners. In few tens of seconds, complex topographies are instructed on demand, with arbitrary spatial distributions over a wide range of spatial and temporal scales. Proof‐of‐concept data on breast cancer cells and normal kidney epithelial cells are presented. Both cell types adhere and proliferate on substrates without appreciable cell damage upon light‐induced substrate deformations. User‐provided mechanical stimulation aligns and guides cancer cells along the local deformation direction and constrains epithelial colony growth by biasing cell division orientation. This approach is easy to implement on general‐purpose optical microscopy systems and suitable for use in cell biology in a wide variety of applications. [ABSTRACT FROM AUTHOR]

Background. Severe skin rash is listed among important side effects of EGFR tyrosine kinase inhibitors. Polydatin (PD), a glycosylated polyphenol, is endowed with anti-inflammatory activity in human epidermal keratinocytes. Objective. This study evaluated the effect of topical application of a moisturizer containing PD to prevent skin rash in patients with mutated non-small cell lung cancer (NSCLC) treated with afatinib. Materials and Methods. Eligible NSCLC patients with metastatic disease were treated with first-line afatinib 40 mg/die. One day before starting systemic therapy, all patients received topical administration of a 1.5% PD-based cream b.i.d. every day until the end of afatinib treatment. Results. Out of 34 treated patients, the incidence of skin rash (all grades) was 41.2% and grade 2 rash was 20.6%, and grade 3 rash was not observed in any of the patients. None of the patients discontinued therapy for toxicity. The mean duration of treatment was 6.4 months, calculated from the time treatment was started to the date treatment was stopped. Conclusion. The results showed that a PD-based cream can reduce the incidence of grade ≥2 skin toxicities in patients treated with afatinib. Clinical study registration number: Prot. No. 130/CE Lazio 1 Italy. [ABSTRACT FROM AUTHOR]

A well-organized immobilization of bio-receptors is a crucial goal in biosensing, especially to achieve high reproducibility, sensitivity and specificity. These requirements are usually attained with a controlled chemical/biochemical functionalization that creates a stable layer on a sensor surface. In this work, a chemical modification protocol for silicon-based surfaces to be applied in biosensing devices is presented. An anhydrous silanization step through 3-aminopropylsilane (APTES), followed by a further derivatization with succinic anhydride (SA), is optimized to generate an ordered flat layer of carboxylic groups. The properties of APTES/SA modified surface were compared with a functionalization in which glutaraldehyde (GA) is used as crosslinker instead of SA, in order to have a comparison with an established and largely applied procedure. Moreover, a functionalization based on the controlled deposition of a plasma polymerized acrylic acid (PPAA) thin film was used as a reference for carboxylic reactivity. Advantages and drawbacks of the considered methods are highlighted, through physico-chemical characterizations (OCA, XPS, and AFM) and by means of a functional Protein G/Antibody immunoassay. These analyses reveal that the most homogeneous, reproducible and active surface is achieved by using the optimized APTES/SA coupling. [ABSTRACT FROM AUTHOR]

Highlights: [•] Plasma Polymerized Acrylic Acid exposes a large number of functional COOH groups. [•] Larger pores allow to a better conformal PolyAcrylic Acid coating. [•] PolyAcrylic Acid protects porous silicon from degradation in biological buffers. [•] Protein can be bound to PolyAcrylic Acid onto porous silicon. [•] Plasma functionalized porous silicon may be a suitable platform for biosensing. [Copyright &y& Elsevier]

Nivolumab was the first immune checkpoint inhibitor approved for previously treated advanced non–small cell lung cancer (NSCLC). Before its introduction in the market, nivolumab was made available to NSCLC patients through an expanded access program (EAP). Here we present the Italian cohort of patients with non-squamous NSCLC enrolled in a worldwide nivolumab EAP, with subgroup analyses involving elderly patients, patients with central nervous system (CNS) metastases and patients receiving nivolumab beyond progression. Pretreated patients with advanced non-squamous NSCLC received nivolumab at 3 mg/kg every 2 weeks up to 24 months. Efficacy data (investigator-assessed tumour response, progression date and survival) and safety data were collected. 1588 patients were treated across 153 Italian centres. Overall response rate and disease control rate were 18% and 44%, respectively; median overall survival (OS) was 11.3 months (95% CI: 10.2–12.4). Elderly patients (≥70 n = 522; ≥75 n = 232) achieved outcomes similar to the global study population; patients with CNS metastases (n = 409) had an OS of 8.6 months (95% CI: 6.4–10.8), and a 1-year OS rate of 43%. Nivolumab was administered beyond progression to 276 patients (26%), 57 of whom achieved subsequent disease control; the median OS of patients receiving nivolumab beyond progression was 16.2 months (95% CI: 14.0–18.4), while 1-year OS rate was 62%. To date, this is the largest clinical experience with nivolumab in a real-world setting. Our data support its use in clinical practice for pretreated non-squamous NSCLC, including patients with older age or CNS metastases. • The Italian expanded access program (EAP) made nivolumab available to a wide population of non–small cell lung cancer (NSCLC) patients. • The outcomes of non-squamous NSCLC patients were consistent with the pivotal trial. • Nivolumab was effective and safe in subgroups poorly represented in clinical trials. • Postprogression benefit was observed with continued administration of nivolumab. • The Italian EAP is the largest real-life clinical experience with nivolumab to date. [ABSTRACT FROM AUTHOR]

• SENECA didn't show differences between weekly and q3wks docetaxel plus nintedanib. • No differences were noticed between relapse timing cohorts from end of chemotherapy. • Higher toxicities for q3wks docetaxel arm have been found. • Quality-of-life was stable during study in both treatment groups and cohorts. Despite the scant docetaxel's tolerability, second-line association with nintedanib still represents a standard-of-care for non-squamous non-small cell lung cancer (nsNSCLC), giving to rapidly-progressing patients the greatest survival advantage. The SENECA trial is a phase IIb, open-label, study evaluating whether nintedanib/docetaxel can be equally effective and safe regardless docetaxel schedule. Recurrent nsNSCLC patients were stratified into cohort 1 and 2, according to relapse-time (within or over 3 months) from end of first-line chemotherapy. They were treated with docetaxel (T1: 33 mg/mq on days 1 and 8 in a 21-days cycle; T2: 75 mg/mq q3wks) plus nintedanib, allowing maintenance in case of disease-control. Primary endpoint was progression-free survival (PFS) by investigator's assessment; secondary endpoints: overall survival (OS), safety and quality-of-life. Between January 2016-April 2018, 212 patients were evaluated: 30 resulted screening-failures, 12 were excluded for lack of compliance. According to investigator's choice, 85 patients received T1 docetaxel and 85 T2; 138 (81.2%) were stratified in C1, 32 (18.8%) in C2, with a median relapse-time of 0.54 and 9.29 months, respectively. Baseline characteristics were balanced between groups. After 35.5 months follow-up, no survival differences appear between cohorts and treatments; toxicity seems to be slightly higher in T2, especially for chemotherapy-related events. Perception of quality-of-life remains stable and docetaxel schedule doesn't modify patients' load. The SENECA trial confirms efficacy of second-line nintedanib/docetaxel for nsNSCLC, regardless time of recurrence and docetaxel schedule; higher toxicities for q3wks docetaxel, without alterations in quality-of-life, have been described, underling the possibility, adopting the weekly schedule, to maintain efficacy with better tolerability. [ABSTRACT FROM AUTHOR]

In order to confer adhesive properties to commercial polypropylene (PP) meshes, a surface plasma-induced deposition of poly-(acrylic acid) (PPAA) is performed. Once biomaterials were functionalized, different post-deposition treatments (i.e. water washing and/or thermal treatments) were investigated with the aim of monitoring the coating degradation (and therefore the loss of adhesion) after 3 months of aging in both humid/oxidant (air) and inert (nitrogen) atmospheres. A wide physicochemical characterization was carried out in order to evaluate the functionalization effectiveness and the adhesive coating homogeneity by means of static water drop shape analysis and several spectroscopies (namely, FTIR, UV–Visible and X-ray Photoemission Spectroscopy). The modification of the adhesion properties after post-deposition treatments as well as aging under different storage atmospheres were investigated by means of Atomic Force Microscopy (AFM) used in Force/Distance (F/D) mode. This technique confirms itself as a powerful tool for unveiling the surface adhesion capacity as well as the homogeneity of the functional coatings along the fibers. Results obtained evidenced that post-deposition treatments are mandatory in order to remove all oligomers produced during the plasma-treatment, whereas aging tests evidenced that these devices can be simply stored in presence of air for at least three months without a meaningful degradation of the original properties. [ABSTRACT FROM AUTHOR]

In label-free biosensing, a continuous improvement of the limit of detection is necessary to resolve the small change of the surface refractive index produced by interacting biomolecules at a very small concentration. In the present work, optical sensors based on one-dimensional photonic crystals supporting Bloch surface waves are proposed and adopted for label-free optical biosensing. We describe the implementation of an angularly resolved ellipsometric optical sensing scheme based on Bloch surface waves sustained by tantala/silica multilayers. The angular operation is obtained using a focused beam at fixed wavelength and detection of the angular reflectance spectrum by means of an array detector. The results show that the experimental limit of detection for a particular photonic crystal design is 6.5×10−7 refractive index units (RIU)/Hz1/2 and further decrease could be obtained. For the first time, we report on the practical application of this technique to a cancer biomarker protocol that aims at the detection of a specific glycoprotein (angiopoietin 2) involved in angiogenesis and inflammation processes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: AIOT (Italian Association of Thoracic Oncology) produces up-to-date, clinical practice guidelines for the management of lung cancer in Italy. Guidelines were developed by answering clinical relevant questions. Here we report only major clinical issues concerning the management of advanced non-small-cell lung cancer (NSCLC). Methods: A PubMed search was performed to identify published data until December 2009. Abstracts presented at the main International meetings between 2004 and 2009 were also searched. The writing committee developed and graded recommendations, which were subsequently revised by experts. The search has been subsequently updated for this manuscript in December 2010. Results: In patients with epidermal growth factor receptor (EGFR) mutation positive tumour, gefitinib is recommended as first-line treatment. In presence of EGFR mutation negative or unknown status, patients with advanced squamous NSCLC, with good performance status (PS) and without major co-morbidities, chemotherapy with third-generation regimens containing cisplatin is the recommended treatment. In non-squamous NSCLC patients, also cisplatin plus pemetrexed and platinum-based chemotherapy plus bevacizumab should be considered. Carboplatin is a valid option for patients unsuitable for cisplatin. Maintenance therapy with pemetrexed or erlotinib is a reasonable choice if allowed by reimbursement procedures and discussed with patients. Elderly patients, defined as≥70 years old, should receive third-generation single-agent chemotherapy, but in elderly patients with good PS, without major co-morbidities and with adequate organ function, platinum-based doublets with attenuated doses can be a valid option. In PS 2 patients, single-agent third-generation drug is a reasonable choice. Combination chemotherapy with carboplatin or low doses of cisplatin is a suitable alternative. For second-line treatment, two cytotoxic drugs (docetaxel and pemetrexed, the latter only in non-squamous tumours), and erlotinib, an EGFR inhibitor, are available. There are no strong data to help the choice between chemotherapy and erlotinib. Conclusions: Many developments have been made in advanced NSCLC treatment, and the appropriate use of available therapeutic approaches and the improved understanding of lung cancer molecular abnormalities continue to enhance the outcomes on the basis of well-designed clinical trials which address critical issues in this population. [Copyright &y& Elsevier]