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The need for new options in lung cancer treatment inevitably leads back to basic research. The tumor itself and the tumor environment especially the interaction with the immune system need to be better understood to develop targeted therapies. In the context of lung cancer glucocorticoids (GC) are mainly known as a combination drug to attenuate side-effects of chemotherapies. However, endogenous extra-adrenal GC have been shown to substantially regulate local immune responses within various tissues, including the lung. In this study we investigated whether primary lung tumors have maintained the capacity to synthesize GC and may thereby regulate anti-tumor immune responses. We show that several non-small cell lung carcinoma (NSCLC) and small cell lung carcinoma (SCLC) cell lines express key steroidogenic enzymes and synthesize bioactive GC under steady state conditions. We also show that tumor-derived GC can inhibit splenic T cell activation, thus demonstrating their immunoregulatory potential. Moreover, steroidogenic enzymes were detected by quantitative RT-PCR and immunohistochemistry in tissue sections of different human lung tumors, further strengthening the idea that human lung carcinomas regulate their microenvironment by releasing immunoregulatory GC, which potentially contributes to immune evasion and treatment resistance.

Metastases from primary prostate cancers to rare locations, such as the brain, are becoming more common due to longer life expectancy resulting from improved treatments. Epigenetic dysregulation is a feature of primary prostate cancer, and distinct DNA methylation profiles have been shown to be associated with the mutually exclusive SPOP-mutant or TMPRSS2-ERG fusion genetic backgrounds. Using a cohort of prostate cancer brain metastases (PCBM) from 42 patients, with matched primary tumors for 17 patients, we carried out a DNA methylation analysis to examine the epigenetic distinction between primary prostate cancer and PCBM, the association between epigenetic alterations and mutational background, and particular epigenetic alterations that may be associated with PCBM. Multiregion sampling of PCBM revealed epigenetic stability within metastases. Aberrant methylation in PCBM was associated with mutational background and PRC2 complex activity, an effect that is particularly pronounced in SPOP-mutant PCBM. While PCBM displayed a CpG island hypermethylator phenotype, hypomethylation at the promoters of genes involved in neuroactive ligand–receptor interaction and cell adhesion molecules such as GABRB3, CLDN8, and CLDN4 was also observed, suggesting that cells from primary tumors may require specific reprogramming to form brain metastasis. This study revealed the DNA methylation landscapes of PCBM and the potential mechanisms and effects of PCBM-associated aberrant DNA methylation.Significance:DNA methylation analysis reveals the molecular characteristics of PCBM and may serve as a starting point for efforts to identify and target susceptibilities of these rare metastases.

Supplementary Figures

Metastases from primary prostate cancers to rare locations, such as the brain, are becoming more common due to longer life expectancy resulting from improved treatments. Epigenetic dysregulation is a feature of primary prostate cancer, and distinct DNA methylation profiles have been shown to be associated with the mutually exclusive SPOP-mutant or TMPRSS2-ERG fusion genetic backgrounds. Using a cohort of prostate cancer brain metastases (PCBM) from 42 patients, with matched primary tumors for 17 patients, we carried out a DNA methylation analysis to examine the epigenetic distinction between primary prostate cancer and PCBM, the association between epigenetic alterations and mutational background, and particular epigenetic alterations that may be associated with PCBM. Multiregion sampling of PCBM revealed epigenetic stability within metastases. Aberrant methylation in PCBM was associated with mutational background and PRC2 complex activity, an effect that is particularly pronounced in SPOP-mutant PCBM. While PCBM displayed a CpG island hypermethylator phenotype, hypomethylation at the promoters of genes involved in neuroactive ligand–receptor interaction and cell adhesion molecules such as GABRB3, CLDN8, and CLDN4 was also observed, suggesting that cells from primary tumors may require specific reprogramming to form brain metastasis. This study revealed the DNA methylation landscapes of PCBM and the potential mechanisms and effects of PCBM-associated aberrant DNA methylation. Significance: DNA methylation analysis reveals the molecular characteristics of PCBM and may serve as a starting point for efforts to identify and target susceptibilities of these rare metastases.

In recent years, current-sensing dc-SQUIDs have enabled the application of noise thermometry at ultralow temperatures. A major advantage of noise thermometry is the fact that no driving current is needed to operate the device and thus the heat dissipation within the thermometer can be reduced to a minimum. Such devices can be used either in primary or relative primary mode and cover typically several orders of magnitude in temperature extending into the low microkelvin regime. Here we will review recent advances of noise thermometry for ultralow temperatures.

Lethal prostate cancer commonly metastasizes to bone, lymph nodes, and visceral organs but with more effective therapies, there is an increased frequency of metastases to the brain. Little is known about the genomic drivers of prostate cancer brain metastases (PCBM). To address this, we conducted a comprehensive multi-regional, genomic, and targeted transcriptomic analysis of PCBM from 28 patients. We compared whole-exome and targeted RNA sequencing with matched primary tumors when available (n = 10) and with publicly available genomic data from non-brain prostate cancer metastases (n = 416). In addition to common alterations inTP53,AR,RB1, andPTEN, we identified highly significant enrichment of mutations inNF1(25% cases (6/28),q= 0.049, 95% CI = 2.38 – 26.52, OR = 8.37) andRICTOR(17.9% cases (5/28),q= 0.01, 95% CI = 6.74 – 480.15, OR = 43.7) in PCBM compared to non-brain prostate cancer metastases, suggesting possible activation of the druggable pathways RAS/RAF/MEK/ERK and PI3K/AKT/mTOR, respectively. Compared to non-brain prostate cancer metastases, PCBM were almost three times as likely to harbor DNA homologous repair (HR) alterations (42.9% cases (12/28), p =0.016, 95% CI = 1.17 – 6.64, OR = 2.8). When considering the combination of somatic mutations, copy number alteration, and Large-scale State Transitions, 64.3% of patients (18/28) were affected. HR alterations may be critical drivers of brain metastasis that potentially provide cancer cells a survival advantage during re-establishment in a special microenvironment. We demonstrate that PCBM have genomic dependencies that may be exploitable through clinical interventions including PARP inhibition.

Purpose Classical type of lobular neoplasia (LN) spans a spectrum of disease, including atypical lobular hyperplasia (ALH) and lobular carcinoma in situ (LCIS), classical lobular neoplasia (LN), and the three-tiered classification of lobular intraepithelial neoplasia (LIN-1, -2, -3). This study addressed inter-observer variability of classical lobular neoplasias (LN) (B3 lesions) in preoperative breast biopsies among breast and gynecopathologists Methods A retrospective, observational, cross-sectional study was conducted. 40 preoperative digital images of breast core/vacuum biopsies were analyzed by eight experienced breast- and gynecopathologists. Evaluation criteria were ALH, LCIS, LN classic, LIN-1, LIN-2, LIN-3, focal B3 (one focus), extensive B3 (> one focus). Kappa-index and Chi-square tests were used for statistics. Digital scanned slides were provided to each participant. Agreement between the categories was defined as at least six of eight (cut-off 75%) concordant diagnoses. Results The highest agreement between eight pathologists was reached using the category lobular neoplasia (LN, classical), 26/40 (65%) cases were diagnosed as such. Agreements in other categories was low or poor: 12/40 (30%) (ALH), 9/40 (22%) (LCIS), 8/40 (20%) (LIN-1), 8/40 (20%) (focal B3), 3/40 (7.5%) (LIN-2), and 2/40 (5%) (extensive B3). Chi-square-test (classical LN versus the other nomenclatures) was significant (p = 0.001137). Conclusion Our data suggest that among Swiss breast pathologists, the most reproducible diagnosis for B3 lobular lesions is the category of classical LN. These data further support lack of consistent data in retrospective studies using different terminologies. Validation of reproducible nomenclature is warranted in further studies. This information is useful especially in view of retro- and prospective data analysis with different diagnostic categories.

The European physical journal / C Particles and fields C 79(12), 1026 (2019). doi:10.1140/epjc/s10052-019-7513-x, Published by Springer, Heidelberg

Precise nuclear data from radioactive decays are important for the accurate non-destructive assay of fissile materials in nuclear safeguards. We are developing high energy resolution gamma detectors based on metallic magnetic calorimeters (MMCs) to accurately measure gamma-ray energies and branching ratios of uranium isotopes. Our MMC gamma detectors exhibit good linearity, reproducibility and a consistent response function for low energy gamma-rays. We illustrate the capabilities of MMCs to improve literature values of nuclear data with an analysis of gamma spectra of U-233. In this context, we also improve the value of the energy for the single gamma-ray of the U-233 daughter Ra-225 by over an order of magnitude from 40.09 ± 0.05 to 40.0932 ± 0.0007 keV.

The goal of the Advanced Mo-based Rare process Experiment (AMoRE) is to search for the neutrinoless double beta decay of $$^{100}$$ Mo using low-temperature detectors consisting of Mo-based scintillating crystals read out via metallic magnetic calorimeters. Heat and light signals are measured simultaneously at millikelvin temperatures, which are reached using a cryogen-free dilution refrigerator. The AMoRE-Pilot experiment, using six $$^{100}$$ Mo-enriched, $$^{48}$$ Ca-depleted calcium molybdate crystals with a total mass of about 1.9 kg, has been running in the 700-m-deep Yangyang underground laboratory as the pilot phase of the AMoRE project. Several setup improvements through different runs allowed us to achieve a high energy resolution and an efficient particle discrimination. This article briefly presents the status of the AMoRE-Pilot experiment, as well as the plans for the next, larger-scale, experimental stages.

Metallic magnetic calorimeters (MMCs) are calorimetric low-temperature particle detectors that are currently strongly advancing the state of the art in energy-dispersive single particle detection. They are typically operated at temperatures below $$100\,\mathrm {mK}$$ and make use of a metallic, paramagnetic temperature sensor to transduce the temperature rise of the detector upon the absorption of an energetic particle into a change of magnetic flux which is sensed by a superconducting quantum interference device. This outstanding interplay between a high-sensitivity thermometer and a near quantum-limited amplifier results in a very fast signal rise time, an excellent energy resolution, a large dynamic range, a quantum efficiency close to 100% as well as an almost ideal linear detector response. For this reason, a growing number of groups located all over the world is developing MMC arrays of various sizes which are routinely used in a variety of applications. Within this paper, we briefly review the state of the art of metallic magnetic calorimeters. This includes a discussion of the detection principle, sensor materials and detector geometries, readout concepts, the structure of modern detectors as well as the state-of-the-art detector performance.

With the approval of pembrolizumab for first- and second-line treatment of PD-L1+ non-small cell lung cancer (NSCLC), PD-L1 testing by immunohistochemistry (IHC) has become a necessity. However, the DAKO autostainer ASL48 for the FDA approved DAKO 22C3 pharmDx assay is not broadly available in Switzerland and other parts of Europe. The primary goal of this study was to cross-validate the 22C3 anti-PD-L1 antibody on Benchmark Ultra (VBMU) and Leica Bond (LBO) immunostainers. IHC protocols were developed for 22C3 on both platforms with the 22C3phDx using ASL48 as reference. A tissue microarray (TMA) was constructed from 23 NSCLC specimens with a range of PD-L1 staining results. Empty TMA sections and the 22C3 antibody were distributed to 16 participants for staining on VBMU (8 centers) and/or LBO (12 centers) using the centrally developed protocols. Additionally the performance of the Ventana SP263 assay was tested in five centers. IHC scoring was performed centrally. Categorical PD-L1 staining (0-49% vs. 50-100%) did not significantly differ between centers using VBMU, whereas data from LBO were highly variable (p

We present the design of MOCCA, a large-area particle detector that is developed for the position- and energy-resolving detection of neutral molecule fragments produced in electron–ion interactions at the Cryogenic Storage Ring at the Max Planck Institute for Nuclear Physics in Heidelberg. The detector is based on metallic magnetic calorimeters and consists of 4096 particle absorbers covering a total detection area of $$44.8\,\mathrm {mm} \times 44.8\,\mathrm {mm}$$ . Groups of four absorbers are thermally coupled to a common paramagnetic temperature sensor where the strength of the thermal link is different for each absorber. This allows attributing a detector event within this group to the corresponding absorber by discriminating the signal rise times. A novel readout scheme further allows reading out all 1024 temperature sensors that are arranged in a $$32 \times 32$$ square array using only $$16+16$$ current-sensing superconducting quantum interference devices. Numerical calculations taking into account a simplified detector model predict an energy resolution of $$\Delta E_\mathrm {FWHM} \le 80\,\mathrm {eV}$$ for all pixels of this detector.

Summary Background We previously reported the 5-year results of the phase 3 IBCSG 23-01 trial comparing disease-free survival in patients with breast cancer with one or more micrometastatic (≤2 mm) sentinel nodes randomly assigned to either axillary dissection or no axillary dissection. The results showed no difference in disease-free survival between the groups and showed non-inferiority of no axillary dissection relative to axillary dissection. The current analysis presents the results of the study after a median follow-up of 9·7 years (IQR 7·8–12·7). Methods In this multicentre, randomised, controlled, open-label, non-inferiority, phase 3 trial, participants were recruited from 27 hospitals and cancer centres in nine countries. Eligible women could be of any age with clinical, mammographic, ultrasonographic, or pathological diagnosis of breast cancer with largest lesion diameter of 5 cm or smaller, and one or more metastatic sentinel nodes, all of which were 2 mm or smaller and with no extracapsular extension. Patients were randomly assigned (1:1) before surgery (mastectomy or breast-conserving surgery) to no axillary dissection or axillary dissection using permuted blocks generated by a web-based congruence algorithm, with stratification by centre and menopausal status. The protocol-specified primary endpoint was disease-free survival, analysed in the intention-to-treat population (as randomly assigned). Safety was assessed in all randomly assigned patients who received their allocated treatment (as treated). We did a one-sided test for non-inferiority of no axillary dissection by comparing the observed hazard ratios (HRs) for disease-free survival with a margin of 1·25. This 10-year follow-up analysis was not prespecified in the trial's protocol and thus was not adjusted for multiple, sequential testing. This trial is registered with ClinicalTrials.gov, number NCT00072293. Findings Between April 1, 2001, and Feb 8, 2010, 6681 patients were screened and 934 randomly assigned to no axillary dissection (n=469) or axillary dissection (n=465). Three patients were ineligible and were excluded from the trial after randomisation. Disease-free survival at 10 years was 76·8% (95% CI 72·5–81·0) in the no axillary dissection group, compared with 74·9% (70·5–79·3) in the axillary dissection group (HR 0·85, 95% CI 0·65–1·11; log-rank p=0·24; p=0·0024 for non-inferiority). Long-term surgical complications included lymphoedema of any grade in 16 (4%) of 453 patients in the no axillary dissection group and 60 (13%) of 447 in the axillary dissection group, sensory neuropathy of any grade in 57 (13%) in the no axillary dissection group versus 85 (19%) in the axillary dissection group, and motor neuropathy of any grade (14 [3%] in the no axillary dissection group vs 40 [9%] in the axillary dissection group). One serious adverse event (postoperative infection and inflamed axilla requiring hospital admission) was attributed to axillary dissection; the event resolved without sequelae. Interpretation The findings of the IBCSG 23-01 trial after a median follow-up of 9·7 years (IQR 7·8–12·7) corroborate those obtained at 5 years and are consistent with those of the 10-year follow-up analysis of the Z0011 trial. Together, these findings support the current practice of not doing an axillary dissection when the tumour burden in the sentinel nodes is minimal or moderate in patients with early breast cancer. Funding International Breast Cancer Study Group.

Cryogenic high-resolution $$\gamma $$ -ray detectors can improve the accuracy of non-destructive assay (NDA) of nuclear materials in cases where conventional high-purity germanium detectors are limited by line overlap or by the Compton background. We have improved the performance of gamma detectors based on metallic magnetic calorimeters (MMCs) by separating the 0.5 $$\times $$ 2 $$\times $$ 0.25 mm $$^{3}$$ Au absorber from the Au:Er sensor with sixteen 30- $$\upmu $$ m-diameter Au posts. This ensures that the entire $$\gamma $$ -ray energy thermalizes in the absorber before heating the Au:Er sensor, and improves the energy resolution at 35 mK to as low as 90 eV FWHM at 60 keV. This energy resolution enables the direct detection of $$\gamma $$ -rays from Pu-242, an isotope that cannot be measured by traditional NDA and whose concentration is therefore inferred through correlations with other Pu isotopes. The Pu-242 concentration of 11.11 $$\pm $$ 0.42 % measured by NDA with MMCs agrees with mass spectrometry results and exceeds the accuracy of correlation measurements.

Metallic magnetic calorimeters (MMCs) are low-temperature particle detectors that are typically read out by using superconducting quantum interference devices (SQUIDs). But since MMCs are sensitive to the input circuitry and the noise performance of the SQUID, the energy resolution of MMCs have not yet reached their fundamental limit. A possible solution to overcome present limits is to maximize the flux coupling by minimizing parasitic inductance in the input circuit. To show the suitability of this approach, we realized a 64 pixel MMC detector array with integrated dc-SQUID readout, i.e., detector and SQUID are on the same chip. We observed an influence of the power dissipation of the SQUID on the detector temperature. We achieved a baseline energy resolution of $$\Delta E_\mathrm {FWHM} = 25\,\mathrm {eV}$$ and $$\Delta E_\mathrm {FWHM} = 30\,\mathrm {eV}$$ for X-rays with energies up to $$6\,\mathrm {keV}$$ .

Several (pre-) clinical trials are currently investigating the benefit of HER2-targeted therapy in urothelial bladder cancer (UBC). Patients with HER2 amplified UBC could potentially profit from these therapies. However, little is known about histomorphology, HER2 protein expression patterns and occurrence of alterations in the HER2 gene in their tumors. Among 150 metastasizing primary UBC, 13 HER2 amplified tumors were identified. Their histopathological features were compared with 13 matched, non-amplified UBC. HER2 protein expression was determined by immunohistochemistry. The 26 tumors were screened for mutations in exons 19 and 20 of the HER2 gene. UBC with HER2 amplification presented with a broad variety of histological variants (median 2 vs. 1), frequently featured micropapillary tumor components (77 % vs. 8 %) and demonstrated a high amount of tumor associated inflammation. Immunohistochemically, 10 of 13 (77 %) HER2 amplified tumors were strongly HER2 protein positive. Three tumors (23 %) were scored as HER2 negative. One of the HER2 amplified tumors harbored a D769N mutation in exon 19 of the HER2 gene; all other tested tumors were wild type. In conclusion, HER2 amplified UBC feature specific morphological characteristics. They frequently express the HER2 protein diffusely and are, therefore, promising candidates for HER2 targeted therapies. The detection of mutations at the HER2 locus might add new aspects to molecular testing of UBC.

The isotope ^{163}Ho is in many ways the best candidate to perform experiments to investigate the value of the electron neutrino mass. It undergoes an electron capture process to ^{163}Dy with an energy available to the decay, Q_{EC}, of about 2.8 keV. According to the present knowledge, this is the lowest Q_{EC} value for such transitions. Here we discuss a newly obtained spectrum of ^{163}Ho, taken by cryogenic metallic magnetic calorimeters with ^{163}Ho implanted in the absorbers and operated in anticoincident mode for background reduction. For the first time, the atomic deexcitation of the ^{163}Dy daughter atom following the capture of electrons from the 5s shell in ^{163}Ho, the OI line, was observed with a calorimetric measurement. The peak energy is determined to be 48 eV. In addition, a precise determination of the energy available for the decay Q_{EC}=(2.858±0.010_{stat}±0.05_{syst}) keV was obtained by analyzing the intensities of the lines in the spectrum. This value is in good agreement with the measurement of the mass difference between ^{163}Ho and ^{163}Dy obtained by Penning-trap mass spectrometry, demonstrating the reliability of the calorimetric technique.

Neuroendocrine serum markers released from prostate cancers have been proposed for monitoring disease and predicting survival. However, neuroendocrine differentiation (NED) in various tissue compartments of metastatic prostate cancer is poorly described and its correlation with specific tumor features is unclear. NED was determined by Chromogranin A expression on immunostains from a tissue microarray of 119 nodal positive, hormone treatment-naïve prostate cancer patients who underwent radical prostatectomy and extended lymphadenectomy. NED in the primary cancer and in the metastases was correlated with tumor features and survival. The mean percentage of NED cells increased significantly (p < 0.001) from normal prostate glands (0.4%), to primary prostate cancer (1.0%) and nodal metastases (2.6%). In primary tumors and nodal metastases, tumor areas with higher Gleason patterns tended to display a higher NED, although no significance was reached. The same was observed in patients with a larger primary tumor volume and higher total size and number of metastases. NED neither in the primary tumors nor in the metastases predicted outcome significantly. Our data suggest that (a) increasing levels of neuroendocrine serum markers in the course of prostate cancer might primarily derive from a poorly differentiated metastatic tumor component; and (b) NED in conventional hormone-naïve prostate cancers is not significantly linked to adverse tumor features.

The extranodal extension (ENE) of nodal metastasis involves the extension of neoplastic cells through the lymph node capsule into the perinodal adipose tissue. This morphological feature has recently been indicated as an important prognostic factor in various cancer types, but its role in prostate cancer is still unclear. We aimed to clarify it, performing the first meta-analysis on this issue, comparing prognostic parameters in surgically treated, node-positive prostate cancer patients with (ENE+) vs. without (ENE−) ENE. Data were summarized using risk ratios (RRs) for number of deaths/recurrences and hazard ratios (HRs), with 95% confidence intervals (CI), for the time-dependent risk related to ENE positivity. Six studies followed-up 1,113 patients with N1 prostate cancer (658 ENE+ vs. 455 ENE−) for a median of 83 months. The presence of ENE was associated with a significantly higher risk of biochemical recurrence (RR = 1.15; 95%CI: 1.03–1.28; I2 = 0%; HR = 1.40, 95%CI: 1.12–1.74; I2 = 0%) and “global” (biochemical recurrence and distant metastasis) recurrence (RR = 1.15; 95%CI: 1.04–1.28; I2 = 0%; HR = 1.41, 95%CI: 1.14–1.74; I2 = 0%). ENE emerged as a potential prognostic moderator, earmarking a subgroup of patients at higher risk of recurrence. It may be considered for the prognostic stratification of metastatic patients. New possible therapeutic approaches may explore more in depth this prognostic parameter.

Although the introduction of novel targeted agents has improved patient outcomes in several human cancers, no such advance has been achieved in muscle-invasive bladder cancer (MIBC). However, recent sequencing efforts have begun to dissect the complex genomic landscape of MIBC, revealing distinct molecular subtypes and offering hope for implementation of targeted therapies. Her2 (ERBB2) is one of the most established therapeutic targets in breast and gastric cancer but agents targeting Her2 have not yet demonstrated anti-tumor activity in MIBC. Through an integrated analysis of 127 patients from three centers, we identified alterations of Her2 at the DNA, RNA and protein level, and demonstrate that Her2 relevance as a tumor driver likely may vary even within ERBB2 amplified cases. Importantly, tumors with a luminal molecular subtype have a significantly higher rate of Her2 alterations than those of the basal subtype, suggesting that Her2 activity is also associated with subtype status. Although some of our findings present rare events in bladder cancer, our study suggests that comprehensively assessing Her2 status in the context of tumor molecular subtype may help select MIBC patients most likely to respond to Her2 targeted therapy.

BACKGROUND TMPRSS2-ERG gene fusion is the most frequent genetic alteration in prostate cancer. However, information about its distribution in lymph node positive prostate cancers and the prognostic significance in these advanced tumors is unknown. METHODS Gene fusion status was determined by fluorescence in situ hybridization on a tissue-microarray constructed from 119 hormone-naive nodal positive, surgically treated prostate cancers containing samples from the primary tumors and corresponding lymph node metastases. Data were correlated with various tumor features (Gleason score, stage, cancer volume, nodal tumor burden) and biochemical recurrence-free, disease-specific, and overall survival. RESULTS TMPRSS2-ERG fusion was detected in 43.5% of the primary tumors. Conversely, only 29.9% of the metastasizing components showed the fusion. Concordance in TMPRSS2-ERG status between primary tumors and metastases was 70.9% (Kappa 0.39); 20.9% and 8.1% of the patients showed the mutation solely in their primary tumors and metastases, respectively. TMPRSS2-ERG fusion was not correlated with specific histopathological tumor features but predicted favorable biochemical recurrence-free, disease-specific and overall survival independently when present in the primary tumor (P

The determination of the absolute scale of the neutrino masses is one of the most challenging present questions in particle physics. The most stringent limit, $$m(\bar{\nu }_{\mathrm {e}})< 2$$ eV, was achieved for the electron anti-neutrino mass. Different approaches are followed to reach a sensitivity on neutrino masses in the sub-eV range. Among them, experiments exploring the beta decay or electron capture of suitable nuclides can provide information on the electron neutrino mass value. We present the electron capture $$^{163}$$ Ho experiment ECHo, which aims to investigate the electron neutrino mass in the sub-eV range by means of the analysis of the calorimetrically measured energy spectrum following electron capture in $$^{163}$$ Ho. A high precision and high statistics spectrum will be measured with arrays of metallic magnetic calorimeters. We discuss some of the essential aspects of ECHo to reach the proposed sensitivity: detector optimization and performance, multiplexed readout, $$^{163}$$ Ho source production and purification, as well as a precise theoretical and experimental parameterization of the calorimetric EC spectrum including in particular the value of $$Q_{\mathrm {EC}}$$ . We present preliminary results obtained with a first prototype of single channel detectors as well as a first 64-pixel chip with integrated micro-wave SQUID multiplexer, which will already allow to investigate $$m(\nu _{\mathrm {e}})$$ in the eV range.

We have realized a frequency-domain multiplexing technique for the readout of large metallic magnetic calorimeter detector arrays. It is based on non-hysteretic single-junction SQUIDs and allows for a simultaneous readout of hundreds or thousands of detectors by using a single cryogenic high electron mobility transistor amplifier and two coaxial cables that are routed from room-temperature to the detector array. We discuss the working principle of the multiplexer and present details about our prototype multiplexer design. We show that fabricated devices are fully operational and that characteristic SQUID parameters such as the input sensitivity of the SQUID or the resonance frequency of the readout circuit can be predicted with confidence. Our best device so far has shown a magnetic flux white noise level of 1.4 m $${\Phi _0}/\sqrt{Hz}$$ which can in future be reduced by an optimization of the fabrication processes as well as an improved microwave readout system.

PURPOSE FGFR3 is considered a good therapeutic target for bladder cancer. However to our knowledge it is unknown whether the FGFR3 status of primary tumors is a surrogate for related metastases which must be targeted by FGFR targeted systemic therapies. We assessed FGFR3 protein expression in primary bladder tumors and matched nodal metastases. MATERIALS AND METHODS We examined matched primary tumor and nodal metastases from 150 patients with bladder cancer clinically staged as N0M0. Four samples per patient were incorporated into a tissue microarray and FGFR3 expression was assessed by immunohistochemistry. FGFR3 expression was tested for an association with categorical clinical data using the Fisher exact test and with overall and recurrence free survival by Kaplan Meier analysis. RESULTS Duplicate spots from primary tumors and lymph node metastases were highly concordant (OR 8.6 and 16.7 respectively each p

Histopathologic tumor regression grades (TRGs) after neoadjuvant chemotherapy predict survival in different cancers. In bladder cancer, corresponding studies have not been conducted. Fifty-six patients with advanced invasive urothelial bladder cancer received neoadjuvant chemotherapy before cystectomy and lymphadenectomy. TRGs were defined as follows: TRG1: complete tumor regression; TRG2: >50% tumor regression; TRG3: 50% or less tumor regression. Separate TRGs were assigned for primary tumors and corresponding lymph nodes. The prognostic impact of these 2 TRGs, the highest (dominant) TRG per patient, and competing tumor features reflecting tumor regression (ypT/ypN stage, maximum diameter of the residual tumor) were determined. Tumor characteristics in initial transurethral resection of the bladder specimens were tested for response prediction. The frequency of TRGs 1, 2, and 3 in the primary tumors were n=16, n=19, and n=21; corresponding data from the lymph nodes were n=31, n=9, and n=16. Interobserver agreement in determination of the TRG was strong (κ=0.8). Univariately, all evaluated parameters were significantly (P ≤ 0.001) related to overall survival; however, the segregation of the Kaplan-Meier curves was best for the dominant TRG. In multivariate analysis, only dominant TRG predicted overall survival independently (P=0.035). In transurethral resection specimens of the chemotherapy-naive bladder cancer, the only tumor feature with significant (P

A scintillating crystal that contains a candidate isotope for DBD provides a promising technique for the high detection-efficiency and good energy resolution. The AMoRE (Advanced Molybdenum based Rare process Experiment) collaboration is studying the potential of CaMoO4 scintillation crystals for searches for looMo 0v DBD.

Gastrin releasing peptide (GRP) is a regulatory peptide that acts through its receptor (GRPR) to regulate physiological functions in various organs. GRPR is overexpressed in neoplastic cells of most prostate cancers and some renal cell cancers and in the tumoral vessels of urinary tract cancers. Thus, targeting these tumours with specifically designed GRP analogues has potential clinical application. Potent and specific radioactive, cytotoxic or nonradioactive GRP analogues have been designed and tested in various animal tumour models with the aim of receptor targeting for tumour diagnosis or therapy. All three categories of compound were found suitable for tumour targeting in animal models. The cytotoxic and nonradioactive GRP analogues have not yet shown convincing tumour-reducing effects in human trials; however, the first clinical studies of radioactive GRP analogues--both agonists and antagonists--suggest promising opportunities for both diagnostic tumour imaging and radiotherapy of prostate and other GRPR-expressing cancers.

Aim: Lymph node metastases influence prognosis and outcome in patients with bladder and prostate cancer. Cross sectional imaging criteria are limited in detecting metastases in normal sized lymph nodes. This prospective study assessed the diagnostic accuracy of ultrasmall superparamagnetic particles of iron oxide (USPIO) enhanced magnetic resonance imaging (MRI) for the detection of metastases in normal sized lymph nodes using extended pelvic lymph node dissection (ePLND) and histopathology as the reference standard. Methods: Seventy five patients (bladder cancer n = 19 prostate cancer n = 48 both n = 8) were examined using 3T MR before and after USPIO administration. A preoperative reading with two readers in consensus and a second postoperative reading with three independent blinded readers were performed. Results were correlated with histopathology and diagnostic accuracies were calculated for all readings. Results: A total of 2993 lymph nodes were examined histopathologically. Fifty four metastatic nodes were found in 20/75 patients (26.7). The first reading had a sensitivity of 55.0 specificity of 85.5 positive predictive value (PPV) of 57.9 negative predictive value (NPV) of 83.9 and diagnostic accuracy (DA) of 77.3 on a per patient level. The second reading had a mean sensitivity of 58.3 specificity of 83.0 PPV of 58.0 NPV of 84.4 and DA of 76.4 on a per patient level. The majority of missed metastases were smaller than 5 mm in short axis diameter. Conclusions: USPIO enhanced MRI in bladder and prostate cancer patients allows detection of metastases in normal sized lymph nodes and might guide the surgeon to remove suspicious lymph nodes not included in standard PLND. © 2012 Elsevier Ltd. All rights reserved.

The exploration of the unique properties of stored and cooled beams of highly-charged ions as provided by heavy-ion storage rings has opened novel and fascinating research opportunities in the realm of atomic and nuclear physics research. Since the late 1980s, pioneering work has been performed at the CRYRING at Stockholm (Abrahamsson et al. 1993) and at the Test Storage Ring (TSR) at Heidelberg (Baumann et al. 1988). For the heaviest ions in the highest charge-states, a real quantum jump was achieved in the early 1990s by the commissioning of the Experimental Storage Ring (ESR) at GSI Helmholtzzentrum fur Schwerionenforschung (GSI) in Darmstadt (Franzke 1987) where challenging experiments on the electron dynamics in the strong field regime as well as nuclear physics studies on exotic nuclei and at the borderline to atomic physics were performed. Meanwhile also at Lanzhou a heavy-ion storage ring has been taken in operation, exploiting the unique research opportunities in particular for medium-heavy ions and exotic nuclei (Xia et al. 2002).

Anterior gradient 2 (AGR2) is a cancer-associated secreted protein found predominantly in adenocarcinomas. Given its ubiquity in solid tumors, cancer-secreted AGR2 could be a useful biomarker in urine or blood for early detection. However, normal organs express and might also secrete AGR2, which would impact its utility as a cancer biomarker. Uniform AGR2 expression is found in the normal bladder urothelium. Little AGR2 is secreted by the urothelial cells as no measurable amounts could be detected in urine. The urinary proteomes of healthy people contain no listing for AGR2. Likewise, the blood proteomes of healthy people also contain no significant peptide counts for AGR2 suggesting little urothelial secretion into capillaries of the lamina propria. Expression of AGR2 is lost in urothelial carcinoma, with only 25% of primary tumors observed to retain AGR2 expression in a cohort of lymph node-positive cases. AGR2 is secreted by the urothelial carcinoma cells as urinary AGR2 was measured in the voided urine of 25% of the cases analyzed in a cohort of cancer vs. non-cancer patients. The fraction of AGR2-positive urine samples was consistent with the fraction of urothelial carcinoma that stained positive for AGR2. Since cancer cells secrete AGR2 while normal cells do not, its measurement in body fluids could be used to indicate tumor presence. Furthermore, AGR2 has also been found on the cell surface of cancer cells. Taken together, secretion and cell surface localization of AGR2 are characteristic of cancer, while expression of AGR2 by itself is not.

Ultrasmall superparamagnetic iron oxide (USPIO) particles are promising contrast media, especially for molecular and cellular imaging besides lymph node staging owing to their superior NMR efficacy, macrophage uptake and lymphotropic properties. The goal of the present prospective clinical work was to validate quantification of signal decrease on high-resolution T(2)-weighted MR sequences before and 24-36 h after USPIO administration for accurate differentiation between benign and malignant normal-sized pelvic lymph nodes. Fifty-eight patients with bladder or prostate cancer were examined on a 3 T MR unit and their respective lymph node signal intensities (SI), signal-to-noise (SNR) and contrast-to-noise (CNR) were determined on pre- and post-contrast 3D T(2)-weighted turbo spin echo (TSE) images. Based on histology and/or localization, USPIO-uptake-related SI/SNR decrease of benign vs malignant and pelvic vs inguinal lymph nodes was compared. Out of 2182 resected lymph nodes 366 were selected for MRI post-processing. Benign pelvic lymph nodes showed a significantly higher SI/SNR decrease compared with malignant nodes (p < 0.0001). Inguinal lymph nodes in comparison to pelvic lymph nodes presented a reduced SI/SNR decrease (p < 0.0001). CNR did not differ significantly between benign and malignant lymph nodes. The receiver operating curve analysis yielded an area under the curve of 0.96, and the point with optimal accuracy was found at a threshold value of 13.5% SNR decrease. Overlap of SI and SNR changes between benign and malignant lymph nodes were attributed to partial voluming, lipomatosis, histiocytosis or focal lymphoreticular hyperplasia. USPIO-enhanced MRI improves the diagnostic ability of lymph node staging in normal-sized lymph nodes, although some overlap of SI/SNR-changes remained. Quantification of USPIO-dependent SNR decrease will enable the validation of this promising technique with the final goal of improving and individualizing patient care.

The measurement of calorimetric spectra following atomic weak decays, beta (b) and electron capture (EC), of nuclides having a very low Q-value, can provide an impressively high sensitivity to a non-vanishing neutrino mass. The achievable sensitivity in this kind of experiments is directly connected to the performance of the used detectors. In particular an energy resolution of a few eV and a pulse formation time well below 1 microsecond are required. Low temperature Metallic Magnetic Calorimeters (MMCs) for soft X-rays have already shown an energy resolution of 2.0 eV FWHM and a pulse rise-time of about 90 ns for fully micro-fabricated detectors. We present the use of MMCs for high precision measurements of calorimetric spectra following the beta-decay of Re-187 and the EC of Ho-163. We show results obtained with detectors optimized for Re-187 and for Ho-163 experiments respectively. While the detectors equipped with superconducting Re absorbers have not yet reached the aimed performance, a first detector prototype with a Au absorber having implanted Ho-163 ions already shows excellent results. An energy resolution of 12 eV FWHM and a rise time of 90 ns were measured.

Highly-charged heavy ions like U91+ provide unique conditions for the investigation of relativistic and quantum electrodynamical effects in strong electromagnetic fields. We present two X-ray detectors developed for high-resolution spectroscopy on highly-charged heavy ions. Both detectors consist of metallic magnetic calorimeters (MMCs) forming linear eight-pixel arrays. The first detector, maXs-20, is developed for the detection of X-rays up to 20 keV with an energy resolution below 3 eV. The second device, maXs-200, is designed for X-ray energies up to 200 keV with an energy resolution of 40 eV. The results of characterization measurements of single detectors of both arrays will be shown and discussed. In both cases, the performance of the detectors agrees well with their design values. Furthermore, we present a prototype MMC for soft X-rays with improved magnetic flux coupling. In first characterization measurements the energy resolution of this device was 2.0 eV (FWHM) for X-rays up to 6 keV.

Ultrasmall superparamagnetic iron oxide (USPIO) particles are promising contrast media especially for molecular and cellular imaging besides lymph node staging owing to their superior NMR efficacy macrophage uptake and lymphotropic properties. The goal of the present prospective clinical work was to validate quantification of signal decrease on high resolution T2 weighted MR sequences before and 24 36h after USPIO administration for accurate differentiation between benign and malignant normal sized pelvic lymph nodes. Fifty eight patients with bladder or prostate cancer were examined on a 3 T MR unit and their respective lymph node signal intensities (SI) signal to noise (SNR) and contrast to noise (CNR) were determined on pre and post contrast 3D T2 weighted turbo spin echo (TSE) images. Based on histology and/or localization USPIO uptake related SI/SNR decrease of benign vs malignant and pelvic vs inguinal lymph nodes was compared. Out of 2182 resected lymph nodes 366 were selected for MRI post processing. Benign pelvic lymph nodes showed a significantly higher SI/SNR decrease compared with malignant nodes (p

Overexpression of anti-apoptotic Bcl-2 plays a role in prostate cancer progression, particularly in transformation to androgen-independent disease. Androgen-independent prostate cancers have been shown to harbor Bcl-2 gene copy number gains frequently suggesting that this genetic alteration might play a role in Bcl-2 overexpression. The relation of Bcl-2 overexpression and copy number gains or translocation of the BCL-2 gene in prostate cancer under hormone-naive conditions is unknown.

Gastrin-releasing peptide (GRP) and GRP receptors (GRPR) play a role in tumor angiogenesis. Recently, GRPR were found to be frequently expressed in the vasculature of a large variety of human cancers. Here, we characterize these GRPR by comparing the vascular GRPR expression and localization in a selection of human cancers with that of an established biological marker of neoangiogenesis, the vascular endothelial growth factor (VEGF) receptor. In vitro quantitative receptor autoradiography was performed in parallel for GRPR and VEGF receptors (VEGFR) in 32 human tumors of various origins, using ¹²⁵I-Tyr-bombesin and ¹²⁵I-VEGF₁₆₅ as radioligands, respectively. Moreover, VEGFR-2 was evaluated immunohistochemically. All tumors expressed GRPR and VEGFR in their vascular system. VEGFR were expressed in the endothelium in the majority of the vessels. GRPR were expressed in a subpopulation of vessels, preferably in their muscular coat. The vessels expressing GRPR were all VEGFR-positive whereas the VEGFR-expressing vessels were not all GRPR-positive. GRPR expressing vessels were found immunohistochemically to co-express VEGFR-2. Remarkably, the density of vascular GRPR was much higher than that of VEGFR. The concomitant expression of GRPR with VEGFR appears to be a frequent phenomenon in many human cancers. The GRPR, localized and expressed in extremely high density in a subgroup of vessels, may function as target for antiangiogenic tumor therapy or angiodestructive targeted radiotherapy with radiolabeled bombesin analogs alone, or preferably together with VEGFR targeted therapy.

BackgroundMatrix metalloproteinases (MMP), particularly MMP-2 and MMP-9, participate in tumour progression and metastasis in various cancers. Their significance in urothelial cancer of the bladder (UCB) is unclear. Expression analysis of MMP-2 and MMP-9 in tissue microarrays (TMA) constructed of corresponding samples from histopathological normal urothelium, tumour centre and invasion front of primary tumours and lymph-node (LN) metastases might help to elucidate their relevance in UCB.MethodMMP-2 and MMP-9 expression was evaluated in TMA of 150 surgically treated LN-positive UCB patients. Biomarker expression was correlated with tumour characteristics (primary tumour and LN stage, number, total diameter and extracapsular extension of LN metastases) and overall survival.ResultsWhile there was a significant increase in MMP-9 expression from normal urothelium over primary tumours to metastases (median scores: 20, 50, 65; pConclusionIn LN-positive UCB, MMP-2 and MMP-9 expression was not increased at the invasion front, suggesting an infiltration strategy independent of MMP-2 and MMP-9 activity. Larger series are needed to detect a potential significant trend for favourable outcome in cancers with high MMP-2 expression.

Patients with nodal positive prostate cancers are an important cohort with poorly defined risk factors. CD10 is a cell surface metallopeptidase that has been suggested to play a role in prostate cancer progression. CD10 expression was evaluated in 119 nodal positive prostate cancer patients using tissue microarrays constructed from primary tumors and lymph node metastases. All patients underwent radical prostatectomy and standardized extended lymphadenectomy. They had no neoadjuvant therapy and received deferred androgen deprivation. In the primary tumor, high CD10 expression was significantly associated with earlier death from disease when compared with low CD10 expression (5-year survival 73.7% vs. 91.8%; p = 0.043). In the metastases, a high CD10 expression was significantly associated with larger total size of metastases (median 11.4 vs. 6.5 mm; p = 0.015), earlier death of disease (5-year survival 71.5% vs. 87.3%; p = 0.017), and death of any cause (5-year survival 70.0% vs. 87.2%; p = 0.001) when compared with low CD10 expression. CD10 expression in the metastases added independent prognostic information for overall survival (p = 0.029) after adjustment for Gleason score of the primary tumor, nodal tumor burden, and resection margins. In conclusion, a high CD10 expression in prostate cancer predicts early death. This information is inherent in the primary tumors and in the lymph node metastases and might help to personalize patient management.

Fleischmann A, Rocha C, Saxer-Sekulic N, Zlobec I, Sauter G & Thalmann G N (2011) Histopathology58, 781–789 High-level cytoplasmic cyclin D1 expression in lymph node metastases from prostate cancer independently predicts early biochemical failure and death in surgically treated patients Aims: To test the prognostic significance of cyclin D1 in nodal-positive prostate cancer. Methods and results: Nuclear and cytoplasmic cyclin D1 expression was evaluated in 119 nodal-positive prostate cancer patients undergoing radical prostatectomy and extended lymphadenectomy. Cyclin D1 was correlated with various tumour features and biochemical recurrence-free survival (bRFS), disease-specific survival (DSS) and overall survival (OS). In the metastases, high-level cytoplasmic cyclin D1 expression independently predicted poor outcome (5-year bRFS, 12.5% versus 26.4%, P = 0.006; 5-year DSS, 56.3% versus 80.7%, P = 0.007; 5-year OS, 56.3% versus 78.7%, P = 0.011). These patients had a 2.62-fold elevated risk of dying from prostate cancer as compared with patients with low-level cytoplasmic cyclin D1 expression (P = 0.024). All other subcellular compartments of cyclin D1 expression in primary tumours and metastases were prognostically non-significant. Conclusions: The subcellular location of cyclin D1 expression in prostate cancer is linked to specific clinical courses. Survival stratification according to biomarker expression in metastases indicates an important role for tumour sampling from these tissues.