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International audience; Aberrant activation of RET is a critical driver of growth and proliferation in diverse solid tumours. Multikinase inhibitors (MKIs) showing anti-RET activities have been tested in RET-altered tumours with variable results. The low target specificity with consequent increase in side-effects and off-target toxicities resulting in dose reduction and drug discontinuation are some of the major issues with MKIs. To overcome these issues, new selective RET inhibitors such as pralsetinib (BLU-667) and selpercatinib (LOXO-292) have been developed in clinical trials, with selpercatinib recently approved by the Food and Drug Administration (FDA). The results of these trials showed marked and durable antitumour activity and manageable toxicity profiles in patients with RET-altered tumours. The European Society for Medical Oncology (ESMO) Translational Research and Precision Medicine Working Group (TR and PM WG) launched a collaborative project to review the available methods for the detection of RET gene alterations, their potential applications and strategies for the implementation of a rational approach for the detection of RET fusion genes and mutations in human malignancies. We present here recommendations for the routine clinical detection of targetable RET rearrangements and mutations.

Studies of targeted therapy resistance in lung cancer have primarily focused on single-gene alterations. Based on prior work implicating apolipoprotein b mRNA-editing enzyme, catalytic polypeptide-like (APOBEC) mutagenesis in histological transformation of epidermal growth factor receptor (EGFR)-mutant lung cancers, we hypothesized that mutational signature analysis may help elucidate acquired resistance to targeted therapies.APOBEC mutational signatures derived from an Food and Drug Administration-cleared multigene panel [Memorial Sloan Kettering Cancer Center Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT)] using the Signature Multivariate Analysis (SigMA) algorithm were validated against the gold standard of mutational signatures derived from whole-exome sequencing. Mutational signatures were decomposed in 3276 unique lung adenocarcinomas (LUADs), including 93 paired osimertinib-naïve and -resistant EGFR-mutant tumors. Associations between APOBEC and mechanisms of resistance to osimertinib were investigated. Whole-genome sequencing was carried out on available EGFR-mutant lung cancer samples (10 paired, 17 unpaired) to investigate large-scale genomic alterations potentially contributing to osimertinib resistance.APOBEC mutational signatures were more frequent in receptor tyrosine kinase (RTK)-driven lung cancers (EGFR, ALK, RET, and ROS1; 25%) compared to LUADs at large (20%, P0.001); across all subtypes, APOBEC mutational signatures were enriched in subclonal mutations (P0.001). In EGFR-mutant lung cancers, osimertinib-resistant samples more frequently displayed an APOBEC-dominant mutational signature compared to osimertinib-naïve samples (28% versus 14%, P = 0.03). Specifically, mutations detected in osimertinib-resistant tumors but not in pre-treatment samples significantly more frequently displayed an APOBEC-dominant mutational signature (44% versus 23%, P0.001). EGFR-mutant samples with APOBEC-dominant signatures had enrichment of large-scale genomic rearrangements (P = 0.01) and kataegis (P = 0.03) in areas of APOBEC mutagenesis.APOBEC mutational signatures are frequent in RTK-driven LUADs and increase under the selective pressure of osimertinib in EGFR-mutant lung cancer. APOBEC mutational signature enrichment in subclonal mutations, private mutations acquired after osimertinib treatment, and areas of large-scale genomic rearrangements highlights a potentially fundamental role for APOBEC mutagenesis in the development of resistance to targeted therapies, which may be potentially exploited to overcome such resistance.

Tumor-only sequencing, implemented for the identification of somatic variants, is oftentimes used for the detection of actionable germline variants. We sought to determine whether tumor-only sequencing assays are suitable for detection of actionable germline variants, given their importance for the delivery of targeted therapies and risk-reducing measures.The detection of germline variants affecting moderate- and high-penetrance cancer susceptibility genes (CSGs) by tumor-only sequencing was compared to clinical germline testing in 21 333 cancer patients who underwent tumor and germline testing using the Food and Drug Administration (FDA)-authorized Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Targets (MSK-IMPACT) assay. Seven homologous recombination deficiency (HRD), two DNA damage response (DDR) and four mismatch repair (MMR) genes, as well as NF1, RB1 and TP53 were included in the analysis. FDA-authorized and New York State Department of Health-approved sequencing methods for germline, tumor/normal and tumor-only sequencing assays and analytical pipelines were employed.In patients who underwent tumor and germline sequencing, as compared to clinical genetic testing, tumor-only sequencing failed to detect 10.5% of clinically actionable pathogenic germline variants in CSGs, including 18.8%, 12.8% and 7.3% of germline variants in MMR, DDR and HRD genes, respectively. The sensitivity for detection of pathogenic germline variants by tumor-only sequencing was 89.5%. Whilst the vast majority of pathogenic germline exonic single-nucleotide variants (SNVs) and small indels were detected by tumor-only sequencing, large percentages of germline copy number variants, intronic variants and repetitive element insertions were not detected.Tumor-only sequencing is adequate for the detection of clinically actionable germline variants, particularly for SNVs and small indels; however, a small subset of alterations affecting HRD, DDR and MMR genes may not be detected optimally. Therefore, for high-risk patients with negative tumor-only sequencing results, clinical genetic testing could be considered given the impact of these variants on therapy and genetic counseling.

Background Although EGFR mutant tumors exhibit low response rates to immune checkpoint blockade overall, some EGFR mutant tumors do respond to these therapies; however, there is a lack of understanding of the characteristics of EGFR mutant lung tumors responsive to immune checkpoint blockade. Patients and methods We retrospectively analyzed de-identified clinical and molecular data on 171 cases of EGFR mutant lung tumors treated with immune checkpoint inhibitors from the Yale Cancer Center, Memorial Sloan Kettering Cancer Center, University of California Los Angeles, and Dana Farber Cancer Institute. A separate cohort of 383 EGFR mutant lung cancer cases with sequencing data available from the Yale Cancer Center, Memorial Sloan Kettering Cancer Center, and The Cancer Genome Atlas was compiled to assess the relationship between tumor mutation burden and specific EGFR alterations. Results Compared with 212 EGFR wild-type lung cancers, outcomes with programmed cell death 1 or programmed death-ligand 1 (PD-(L)1) blockade were worse in patients with lung tumors harboring alterations in exon 19 of EGFR (EGFRΔ19) but similar for EGFRL858R lung tumors. EGFRT790M status and PD-L1 expression did not impact response or survival outcomes to immune checkpoint blockade. PD-L1 expression was similar across EGFR alleles. Lung tumors with EGFRΔ19 alterations harbored a lower tumor mutation burden compared with EGFRL858R lung tumors despite similar smoking history. Conclusions EGFR mutant tumors have generally low response to immune checkpoint inhibitors, but outcomes vary by allele. Understanding the heterogeneity of EGFR mutant tumors may be informative for establishing the benefits and uses of PD-(L)1 therapies for patients with this disease.

Background Noninvasive genotyping using plasma cell-free DNA (cfDNA) has the potential to obviate the need for some invasive biopsies in cancer patients while also elucidating disease heterogeneity. We sought to develop an ultra-deep plasma next-generation sequencing (NGS) assay for patients with non-small-cell lung cancers (NSCLC) that could detect targetable oncogenic drivers and resistance mutations in patients where tissue biopsy failed to identify an actionable alteration. Patients and methods Plasma was prospectively collected from patients with advanced, progressive NSCLC. We carried out ultra-deep NGS using cfDNA extracted from plasma and matched white blood cells using a hybrid capture panel covering 37 lung cancer-related genes sequenced to 50 000× raw target coverage filtering somatic mutations attributable to clonal hematopoiesis. Clinical sensitivity and specificity for plasma detection of known oncogenic drivers were calculated and compared with tissue genotyping results. Orthogonal ddPCR validation was carried out in a subset of cases. Results In 127 assessable patients, plasma NGS detected driver mutations with variant allele fractions ranging from 0.14% to 52%. Plasma ddPCR for EGFR or KRAS mutations revealed findings nearly identical to those of plasma NGS in 21 of 22 patients, with high concordance of variant allele fraction (r = 0.98). Blinded to tissue genotype, plasma NGS sensitivity for de novo plasma detection of known oncogenic drivers was 75% (68/91). Specificity of plasma NGS in those who were driver-negative by tissue NGS was 100% (19/19). In 17 patients with tumor tissue deemed insufficient for genotyping, plasma NGS identified four KRAS mutations. In 23 EGFR mutant cases with acquired resistance to targeted therapy, plasma NGS detected potential resistance mechanisms, including EGFR T790M and C797S mutations and ERBB2 amplification. Conclusions Ultra-deep plasma NGS with clonal hematopoiesis filtering resulted in de novo detection of targetable oncogenic drivers and resistance mechanisms in patients with NSCLC, including when tissue biopsy was inadequate for genotyping.

Due to the efficacy of tropomyosin receptor kinase (TRK) inhibitor therapy and the recent Food and Drug Administration approval of larotrectinib, it is now clinically important to accurately and efficiently identify patients with neurotrophic TRK (NTRK) fusion-driven cancer. These oncogenic fusions occur when the kinase domain of NTRK1, NTRK2 or NTRK3 fuse with any of a number of N-terminal partners. NTRK fusions are characteristic of a few rare types of cancer, such as secretory carcinoma of the breast or salivary gland and infantile fibrosarcoma, but they are also infrequently seen in some common cancers, such as melanoma, glioma and carcinomas of the thyroid, lung and colon. There are multiple methods for identifying NTRK fusions, including pan-TRK immunohistochemistry, fluorescence in situ hybridisation and sequencing methods, and the advantages and drawbacks of each are reviewed here. While testing algorithms will obviously depend on availability of various testing modalities and economic considerations for each individual laboratory, we propose triaging specimens based on histology and other molecular findings to most efficiently identify tumours harbouring these treatable oncogenic fusions.

Background Kinase fusions are rare and poorly characterized in breast cancer (BC). We aimed to characterize kinase fusions within a large cohort of advanced BC. Patients and methods A total of 4854 patients with BC were analyzed by Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets (MSK-IMPACT) targeted DNAseq and MSK-Fusion targeted RNAseq during the study time period. Results Twenty-seven of 4854 (0.6%) patients harbored fusions: 11 FGFR (five FGFR2, three FGFR3, three FGFR1), five BRAF, four NTRK1, two RET, two ROS1, one ALK, one ERBB2, and one MET. A history of endocrine therapy was present in 15 (56%) of fusion-positive BC; eight of the 15 cases had available pre-treatment samples, of which six were fusion-negative. None of the fusion-positive BC samples harbored ESR1 hotspot mutations. Two patients with acquired LMNA-NTRK1 fusions and metastatic disease received larotrectinib and demonstrated clinical benefit. Conclusion Kinase fusions in BC are extremely rare, and appear to be enriched in hormone-resistant, metastatic carcinomas and mutually exclusive with ESR1 mutations. The present study expands the spectrum of genetic alterations activating mitogen-activated protein kinase (MAPK) signaling that can substitute for ESR1 mutations in this setting. Molecular testing at progression after endocrine therapy should include fusion testing, particularly in the absence of ESR1 hotspot alterations, in an effort to identify additional therapeutic options which may provide substantial clinical benefit.

Background On the basis of historical data, patients with cancer of unknown primary (CUP) are generally assumed to have a dismal prognosis with overall survival of less than 1 year. Treatment is typically cytotoxic chemotherapy guided by histologic features and the pattern of metastatic spread. The purpose of this study was to provide a clinical and pathologic description of patients with CUP in the modern era, to define the frequency of clinically actionable molecular alterations in this population, to determine how molecular testing can alter therapeutic decisions, and to investigate novel uses of next-generation sequencing in the evaluation and treatment of patients with CUP. Patients and methods Under Institutional Review Board approval, we identified all CUP patients evaluated at our institution over a recent 2-year period. We documented demographic information, clinical outcomes, pathologic evaluations, next-generation sequencing of available tumor tissue, use of targeted therapies, and clinical trial enrollment. Results We identified 333 patients with a diagnosis of CUP evaluated at our institution from 1 January 2014 through 30 June 2016. Of these patients, 150 had targeted next-generation sequencing carried out on available tissue. Median overall survival in this cohort was 13 months. Forty-five of 150 (30%) patients had potentially targetable genomic alterations identified by tumor molecular profiling, and 15 of 150 (10%) received targeted therapies. Dominant mutation signatures were identified in 21 of 150 (14%), largely implicating exogenous mutagen exposures such as ultraviolet radiation and tobacco. Conclusions Patients with CUP represent a heterogeneous population, harboring a variety of potentially targetable alterations. Next-generation sequencing may provide an opportunity for CUP patients to benefit from novel personalized therapies.

Background: Mutations in VHL, PBRM1, SETD2, BAP1, and KDM5C are common in clear cell renal cell carcinoma (ccRCC), and presence of certain mutations has been associated with outcomes in patients with non-metastatic disease. Limited information is available regarding the correlation between genomic alterations and outcomes in patients with metastatic disease, including response to VEGF-targeted therapy. Objective: To explore correlations between mutational profiles and cancer-specific outcomes, including response to standard VEGF-targeted agents, in patients with metastatic cc RCC. Methods: A retrospective review of 105 patients with metastatic ccRCC who had received systemic therapy and had targeted next-generation sequencing of tumors was conducted. Genomic alterations were correlated to outcomes, including overall survival and time to treatment failure to VEGF-targeted therapy. Results: The most frequent mutations were detected in VHL (83%), PBRM1 (51%), SETD2 (35%), BAP1 (24%), KDM5C (16%), and TERT (14%). Time to treatment failure with VEGF-targeted therapy differed significantly by PBRM1 mutation status (p = 0.01, median 12.0 months for MT versus 6.9 months for WT) and BAP1 mutation status (p = 0.01, median 6.4 months for MT versus 11.0 months for WT). Shorter overall survival was associated with TERT mutations (p = 0.03, median 29.6 months for MT versus 52.6 months for WT) or BAP1 mutations (p = 0.02, median 28.7 months for MT versus not reached for WT). Conclusions: Genomic alterations in ccRCC tumors have prognostic implications in patients with metastatic disease. BAP1 and TERT promoter mutations may be present in higher frequency than previously thought, and based on this data, deserve further study for their association with poor prognosis.

It is increasingly common in oncology practice to perform tumour sequencing using large cancer panels. For pathogenic sequence variants in cancer susceptibility genes identified on tumour-only sequencing, it is often unclear whether they are of somatic or constitutional (germline) origin. There is wide-spread disparity regarding both the extent to which systematic ‘germline-focussed analysis’ is carried out upon tumour sequencing data and for which variants follow-up analysis of a germline sample is carried out. Here we present analyses of paired sequencing data from 17 152 cancer samples, in which 1494 pathogenic sequence variants were identified across 65 cancer susceptibility genes. From these analyses, the European Society of Medical Oncology Precision Medicine Working Group Germline Subgroup has generated (i) recommendations regarding germline-focussed analyses of tumour-only sequencing data, (ii) indications for germline follow-up testing and (iii) guidance on patient information-giving and consent.

BACKGROUND RET rearrangements are targetable, oncogenic lung cancer drivers. While previous series have shown durable clinical benefit with pemetrexed-based therapies in ALK- and ROS1-rearranged lung cancers, the benefits of pemetrexed-based treatments in patients with RET-rearranged lung cancers relative to other genomic subsets have not previously been explored. PATIENTS AND METHODS A retrospective review of patients with pathologically confirmed stage IIIB/IV lung adenocarcinomas and evidence of a RET, ROS1, or ALK rearrangement, or a KRAS mutation was conducted. Patients were eligible if they received treatment with pemetrexed alone or in combination. The primary outcome of progression-free survival (PFS), and secondary outcomes of overall response rate (ORR, RECIST v1.1), time to progression (TTP), and time to treatment discontinuation were compared between RET-rearranged and groups of ROS1-rearranged, ALK-rearranged, and KRAS-mutant lung cancers. RESULTS We evaluated 104 patients. Patients with RET-rearranged lung cancers (n = 18) had a median PFS of 19 months [95% confidence interval (CI) 12-not reached (NR)] that was comparable with patients with ROS1- (23 months, 95% CI 14-NR, n = 10) and ALK-rearranged (19 months, 95% CI 15-36, n = 36) lung cancers, and significantly improved compared with patients with KRAS-mutant lung cancers (6 months, 95% CI 5-9, P < 0.001, n = 40). ORR (45%), median TTP (20 months, 95% CI 17-NR), and median time to treatment discontinuation (21 months, 95% CI 6-NR) in patients with RET-rearranged lung cancers were not significantly different compared with patients with ALK- and ROS1-rearranged lung cancers, and improved compared with patients with KRAS-mutant lung cancers. CONCLUSION Durable benefits with pemetrexed-based therapies in RET-rearranged lung cancers are comparable with ALK- and ROS1-rearranged lung cancers. When selecting therapies for patients with RET-rearranged lung cancers, pemetrexed-containing regimens should be considered.

Experimental studies of solvation dynamics in liquids invariably ask how changing a solute from its electronic ground state to an electronically excited state affects a solution's dynamics. With traditional time-dependent-fluorescence experiments, that means looking for the dynamical consequences of the concomitant change in solute-solvent potential energy. But if one follows the shift in the dynamics through its effects on the macroscopic polarizability, as recent solute-pump/solvent-probe spectra do, there is another effect of the electronic excitation that should be considered: the jump in the solute's own polarizability. We examine the spectroscopic consequences of this solute polarizability change in the classic example of the solvation dye coumarin 153 dissolved in acetonitrile. After demonstrating that standard quantum chemical methods can be used to construct accurate multisite models for the polarizabilities of ground- and excited-state solvation dyes, we show via simulation that this polarizability change acts as a contrast agent, significantly enhancing the observable differences in optical-Kerr spectra between ground- and excited-state solutions. A comparison of our results with experimental solute-pump/solvent-probe spectra supports our interpretation and modeling of this spectroscopy. We predict, in particular, that solute-pump/solvent-probe spectra should be sensitive to changes in both the solvent dynamics near the solute and the electronic-state-dependence of the solute's own rotational dynamics.

BACKGROUND The advent of effective targeted therapy for BRAFV600E-mutant lung adenocarcinomas necessitates further exploration of the unique clinical features and behavior of advanced-stage BRAF-mutant lung adenocarcinomas. METHODS Data were reviewed for patients with advanced lung adenocarcinomas enrolled in the Lung Cancer Mutation Consortium whose tumors underwent testing for mutations in epidermal growth factor receptor (EGFR), Kirsten rat sarcoma viral oncogene homolog (KRAS), human epidermal growth factor receptor 2 (HER2), AKT1, BRAF, dual-specificity mitogen-activated protein kinase kinase 1 (MEK1), neuroblastoma RAS viral (v-ras) oncogene homolog (NRAS), and phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit α (PIK3CA); for anaplastic lymphoma kinase (ALK) translocations; and for MET amplification. RESULTS Twenty-one BRAF mutations were identified in 951 patients with adenocarcinomas (2.2%; 95% confidence interval [CI], 1.4%-3.4%): 17 (81%; 95% CI, 60%-92%) were BRAFV600E mutations, and 4 were non-BRAFV600E mutations. Among the 733 cases tested for all 10 genes, BRAF mutations were more likely to occur than most other genotypic abnormalities in current or former smokers (BRAF vs sensitizing EGFR, 82% vs 36%, mid-P .20). CONCLUSIONS BRAF mutations occurred in 2.2% of advanced-stage lung adenocarcinomas, were most commonly V600E, and were associated with distinct clinicopathologic features in comparison with other genomic subtypes and with a high mutation rate in more than 1 gene. These findings underscore the importance of comprehensive genomic profiling in assessing patients with advanced lung adenocarcinomas. Cancer 2015;121:448–456. © 2014 American Cancer Society.

EGFR T790M is the most common mutation associated with acquired resistance to EGFR tyrosine kinase inhibitors (TKIs). Baseline EGFR T790M mutations in EGFR TKI-naïve patients have been reported, but the frequency and their association with response to EGFR TKIs remain unclear.The frequency of baseline EGFR T790M as detected by routine molecular genotyping was determined by reviewing clinical results obtained at our institution from 2009 to 2013. We also collected outcome data for treatment with EGFR TKIs.To define the incidence of EGFR T790M, we reviewed 2774 sequentially tested patients with lung cancer who underwent molecular testing using a mass spectrometry-based assay, and 11 (0.5%) had baseline EGFR T790M. Compiling results from several molecular techniques, we observed EGFR T790M in tumors from 20 patients who had not previously been treated with an EGFR TKI. In all cases, EGFR T790M occurred concurrently with another EGFR mutation, L858R (80%, 16/20), or exon 19 deletion (20%, 4/20). Two percent of all pre-treatment EGFR-mutant lung cancers harbored an EGFR T790M mutation. Thirteen patients received erlotinib monotherapy as treatment for metastatic disease. The response rate was 8% (1/13, 95% confidence interval 0%-35%). For the patients who received erlotinib, the median progression-free survival was 2 months and the median overall survival was 16 months.De novo EGFR T790M mutations are rare (1%) when identified by standard sensitivity methods. TKI therapy for patients with baseline EGFR T790M detected by standard molecular analysis has limited benefit.

We present the results of a molecular simulation study of polarizability anisotropy relaxation of liquid acetonitrile confined in approximately cylindrical silica pores of diameters in the range of 20-40 Å. Grand Canonical Monte Carlo simulation is used to determine the density of acetonitrile in pores in equilibrium with the bulk liquid, and canonical-ensemble molecular dynamics is then used to calculate the trajectories of the filled pores prepared in this way. We find that the pores are wetting, partially due to hydrogen bonding between acetonitrile nitrogen and pore silanol groups and that acetonitrile molecules have preferential orientations relative to the interface. The mobility of molecules in interfacial regions is considerably reduced and dependent mainly on their proximity to the interface. We include the contributions of molecular and interaction-induced polarizabilities to the collective polarizability anisotropy relaxation. We find that this relaxation includes a slowly relaxing component absent from the corresponding process in bulk acetonitrile and that the amplitude of this component increases as the pore diameter decreases. These results are in agreement with optical Kerr effect experiments on acetonitrile in silica pores in a similar diameter range. Further analysis of our data indicates that collective reorientation and predominantly translational "collision-induced" polarizability dynamics both contribute to the slowly relaxing portion of polarizability anisotropy decay. We further find that pore anisotropy plays a role, giving rise to different relaxation rates of polarizability anisotropy components with a different mix of axial and radial character and that collective reorientation contributing to polarizability anisotropy relaxation is somewhat faster at long times than single-molecule orientational relaxation.

Recent developments in the computer simulation studies of the effects of counterions on the properties of ionic surfactant systems in contact with aqueous solution phase are discussed. The article deals with three types of systems: normal micelles, monolayers at the air/aqueous solution interface, and reverse micelles, i.e., water-in-oil microemulsions.

The density dependence of the local structure and of collective dynamics of a polar fluid fluoroform along an isotherm at a temperature of 1.03 T(c), in the near-critical (NC) region, were studied by classical molecular dynamics (MD) simulations. In the case of local structure we focus on local density inhomogeneities and on orientational pair correlations that are relevant to dielectric properties and light scattering intensities. Our results show that the density dependence of the frequency shifts of fluoroform ν(2) and ν(3) modes correlates well with that of intermolecular dipole-dipole interactions. Our study of collective dynamics deals with dipole and polarizability anisotropy relaxation, experimentally accessible through far-infrared absorption, depolarized light scattering, and optical Kerr effect. Our MD simulations were performed using an all-atom nonpolarizable potential model of fluoroform. Contributions of induced dipoles to dielectric properties were included using first-order perturbation theory, and this approach was also used to include interaction-induced contributions to polarizability anisotropy relaxation. For interactions involving induced dipoles, we calculated and compared the results of a distributed polarizability model to a model with a single polarizable site located at the center-of-mass. Using a projection scheme that allows us to identify the contributions from different relaxation mechanisms, we found that dipole relaxation is dominated by collective reorientation, while in the case of polarizability anisotropy, relaxation processes related to translational dynamics make a major contribution over most of the fluid density range. The dielectric properties of fluoroform in the NC region were calculated and compared to the corresponding measurements. We found the dielectric constant and the far-infrared absorption spectrum to be in good agreement with experiments.

Molecular dynamics simulations are performed for the reverse micelles (RMs) formed by the surfactant Aerosol-OT (AOT, sodium bis(2-ethylhexyl)sulfosuccinate) in isooctane. The appropriate simulation methodology is identified and applied to the study of the effect of RM size, as quantified by w0 = [H2O]/[AOT], on the structure of the reverse micelle. The radial and intrinsic density profiles, pair densities and pair orientations in the first solvation shell, and water-water hydrogen bonding profiles were constructed. On the basis of these various structural characteristics, we find that the organization of sodium ions, sulfonate headgroup, and water oxygen atoms at the surfactant interface is consistent with a pseudolattice structure for w0 = 2. An increase in the RM size leads to the disruption of this lattice, with more sodium ions dissociating from the sulfonate headgroup and an increase in the aqueous solvation of these two species. The water molecules exist primarily in the interior of the RM and exhibit bulklike properties only for w0 approximately 7.5. Some water molecules and sodium ions exist in the intersulfonate headgroup region and interact with the AOT carbonyl group.

The dynamics of hydrogen bond formation and breakage for water in the vicinity of water/hydrocarbon liquid interfaces is studied using molecular dynamics simulations. Several liquid alkanes are considered as the hydrocarbon phase in order to determine the effects of their chain length and extent of branching on the properties of the adjacent water phase. In addition to defining the interface location in terms of the laboratory-frame density profiles, the effects of interfacial fluctuations are considered by locating the interface in terms of the proximity of the molecules of the other phase. We find that the hydrogen bond dynamics of interfacial water is weakly influenced by the identity of the hydrocarbon phase and by capillary waves. In addition to calculating hydrogen bond time correlations, we examine how the hydrogen bond dynamics depend on local coordination and determine the extent of cooperativity in the population relaxation of the hydrogen bonds that a given molecule participates in. The contributions of translational diffusion and reorientation of molecular O-H bonds to the mechanism of hydrogen bond breakage and reformation are investigated. In previous work, we have shown that rotation of the principal axes of water is anisotropic at the interface and depends on the initial orientation of the molecule relative to the interface. Here, we extend this analysis to the reorientation of the O-H vector and to hydrogen bond time correlation. We find that hydrogen bond dynamics are also sensitive to the initial orientation of the molecules participating in the hydrogen bond.

Water/hydrocarbon interfaces are studied using molecular dynamics simulations in order to understand the effect of hydrocarbon branching on the dynamics of the system at and away from the interface. A recently proposed procedure for studying the intrinsic structure of the interface in such systems is utilized, and dynamics are probed in the usual laboratory frame as well as the intrinsic frame. The use of these two frames of reference leads to insight into the effect of capillary waves at the interface on dynamics. The systems were partitioned into zones with a width of 5 A, and a number of quantities of dynamical relevance, namely, the residence times, mean squared displacements, the velocity auto correlation functions, and orientational time correlations for molecules of both phases, were calculated in the laboratory and intrinsic frames at and away from the interface. For the aqueous phase, translational motion is found to be (a) diffusive at long times and not anomalous as in proteins or micelles, (b) faster at the interface than in the bulk, and (c) faster upon reduction of the effect of capillary waves. The rotational motion of water is (a) more anisotropic at the interface than in the bulk and (b) dependent on the orientation of the covalent O-H bond with respect to the plane of the interface. The effect of hydrocarbon branching on aqueous dynamics was found to be small, a result similar to the effect on the interfacial water structure. The hydrocarbon phase shows a larger variation for all dynamical probes, a trend consistent with their interfacial structure.

Here, we describe the dramatic response of a patient with an ETV6-NTRK3-driven mammary analogue secretory carcinoma to treatment with a pan-Trk inhibitor, and the development of acquired resistance linked to a novel NTRK3 mutation that interferes with drug binding. This case emphasizes how molecular profiling can identify therapies for rare diseases and dissect mechanisms of drug resistance., Background Mammary analogue secretory carcinoma (MASC) is a recently described pathologic entity. We report the case of a patient with an initial diagnosis of salivary acinic cell carcinoma later reclassified as MASC after next-generation sequencing revealed an ETV6-NTRK3 fusion. Patients and methods This alteration was targeted with the pan-Trk inhibitor entrectinib (Ignyta), which possesses potent in vitro activity against cell lines containing various NTRK1/2/3 fusions. Results A dramatic and durable response was achieved with entrectinib in this patient, followed by acquired resistance that correlated with the appearance of a novel NTRK3 G623R mutation. Structural modeling predicts that this alteration sterically interferes with drug binding, correlating to decreased sensitivity to drug inhibition observed in cell-based assays. Conclusions This first report of clinical activity with TrkC inhibition and the development of acquired resistance in an NTRK3-rearranged cancer emphasize the utility of comprehensive molecular profiling and targeted therapy for rare malignancies (NCT02097810).

Epidermal growth factor receptor (EGFR) exon 20 insertions (exon20ins) represent approximately 10% of EGFR-mutant lung adenocarcinomas, and are associated with resistance to EGFR tyrosine kinase inhibitors (TKIs). Clinical outcomes in comparison with patients with sensitizing EGFR mutations are not well established.Patients with stage IV lung adenocarcinomas with EGFR exon20ins were identified through routine molecular testing. Clinicopathologic data were collected. Overall survival (OS) was measured from the diagnosis of stage IV disease, and in patients treated with EGFR TKIs, the time to progression (TTP) on erlotinib was measured.One thousand eight hundred and eighty-two patients with stage IV lung adenocarcinomas were identified: 46 patients had EGFR exon20ins (2%), and 258 patients had an EGFR exon 19 deletion (exon19del)/L858R point mutation (14%). Among 11 patients with lung adenocarcinomas with EGFR exon20ins who received erlotinib, 3 patients (27%) had a partial response (FQEA, 1; ASV, 1; and unknown variant, 1). TTP for patients with EGFR exon20ins and patients with EGFR exon19del/L858R on erlotinib were 3 and 12 months, respectively (P .01). Responses to chemotherapy were similar for patients with lung adenocarcinomas with EGFR exon20ins and patients with lung adenocarcinomas with EGFR exon19del/L858R. Median OS from the diagnosis of stage IV disease for patients with EGFR exon20ins and patients with EGFR exon19del/L858R was 26 months (95% confidence interval, 19 months-not reached n = 46) and 31 months (95% confidence interval, 28-33 months; n = 258), respectively (P = .53).The majority of patients with advanced lung adenocarcinomas harboring EGFR exon20ins do not respond to EGFR TKI therapy. Standard chemotherapy should be used as first-line therapy. These patients have an OS similar to that of patients with sensitizing EGFR mutations. Individuals with certain variants such as FQEA and ASV may respond to erlotinib.

We have investigated the photodissociation dynamics of NaI(H(2)O)(n) [n = 1-4] clusters using the molecular dynamics with quantum transitions method and a quantum mechanics/molecular mechanics description of NaI(H(2)O)(n), which involves a semiempirical valence-bond approach to describe the NaI electronic structure and classical solvent-solvent and solute-solvent interaction potentials. Our simulation results show that the NaI(H(2)O)(n) excited-state population decay upon reaching the NaI curve-crossing region increases with cluster size due to the stabilization of the ionic branch of the NaI excited state by the surrounding water molecules, and the resulting increase in nonadiabatic transition probability. After reaching the curve-crossing region for the first time, however, the excited-state population decay resembles that of bare NaI because of rapid evaporation of 99% and 95% of the water molecules for NaI(H(2)O) and NaI(H(2)O)(n) [n = 2-4], respectively. This extensive evaporation is due to the reversed NaI polarity in the Franck-Condon region of the NaI first excited state, which causes strong repulsive NaI-H(2)O forces and induces rapid nonstatistical water evaporation, where product water molecules are formed more rotationally than translationally hot. A few water molecules (5% or less) remain transiently or permanently bound to NaI, forming long-lived clusters, when NaI remains predominantly ionic, i.e., remains in the excited state, after reaching the curve-crossing region. To connect simulation results with experiment, we have simulated femtosecond probe signals resulting from two-photon and one-photon excitation to the X and I NaI(+) probe states. In agreement with experimental findings, the probe signals resulting from the two-photon probe scheme, where excitation occurs from the covalent branch of the excited state, decay exponentially over the NaI first excited-state vibrational period, with very little evidence of long-time dynamics. The one-photon probe scheme (not used for experimental cluster studies) is shown to be less sensitive to solvation, in that excitation energies will remain similar over a range of cluster sizes, as the ionic branch of the excited state and the NaI(+) probe states are stabilized to the same extent by the presence of water molecules. The resulting probe signals are also more revealing of the NaI(H(2)O)(n) photodissociation dynamics than the two-photon probe signals, as they may allow monitoring of solvation effects on the NaI nonadiabatic dynamics and of successive evaporation of water molecules. Time-resolved photoelectron spectra provide limited additional information regarding the NaI(H(2)O)(n) photodissociation dynamics. A key consequence of the rapid water evaporation demonstrated here is that experimentally observed signals may arise from the photodissociation of much larger NaI(H(2)O)(n) parent clusters.

We report the results of a molecular dynamics (MD) simulation study of solvation dynamics associated with electronic excitation of the coumarin 343 (C343) dye at the interface of water and zirconia (ZrO2). We use an all-atom representation of the species present in this system. The ZrO2 partial charges and C343 geometries and charge distributions in the ground and excited electronic states have been obtained from electronic structure calculations. Our work is inspired by recent time-resolved fluorescence experiments involving C343 adsorbed at the surface of zirconia nanoparticles dissolved in H2O and D2O (Pant, D.; Levinger, N. E. J. Phys. Chem. B 1999, 103, 7846). In addition to simulation of solvation dynamics, we investigate the structure and dynamics of the dye and water in the presence of a planar ZrO2 interface. We also address several issues relevant to the interpretation of experiments, including the solvent isotope effects and the ionization state of the carboxylate group of C343 on solvation dyn...

We present the results of a molecular dynamics simulation study of the effects of counterion type on the properties of the interior region of aqueous reverse micelles. The model systems, which treat only the interior region at the atomistic level, are designed to represent water-in-oil microemulsions formed by the aerosol-OT surfactant, either with its usual counterion, Na+, or with the K+ counterion. Our study covers the water content, w0 = [H2O]/[surfactant], range of 1−7.5, where the reverse micelles are approximately spherical and contain tens to hundreds of water molecules in their interior pool. We find that several key structural and dynamical features of the reverse micelle water pool are strongly affected by counterion type. These effects can be ascribed to the differences in headgroup−counterion coordination and to the stronger affinity for water that the smaller Na+ ion exhibits. At low water content, K+ ions are able to coordinate four headgroups, while Na+ coordinates a maximum of three. As w...

When the relevant frequencies get high enough, vibrational energy relaxation in liquids should, in principle, be governed by instantaneous-pair theory. The basic idea is that in any significantly contributing liquid configuration there is a single critical solvent molecule and that solute relaxation rates are determined by the time evolution of that molecule’s distance from the solute. The theory posits, moreover, that dynamics can always be modeled as a simple one-dimensional, two-body, scattering process with the liquid playing a role only in determining the initial conditions for the scattering. In this article we reformulate this theory so that it can address both polyatomic solutes and molecular solvents and we show that fundamental assumptions and basic approach remain valid even with multiple solute and solvent sites and with long-ranged intermolecular forces. We further show that while the corrections are often not large, it is possible to make systematic improvements by allowing for the multidimensionality of the solute–solvent scattering. We then turn to the instantaneous-normal-mode (INM) interpretation and implementation of the theory. At the lowest level, INM analysis enables us to define the “high frequencies” relevant to the theory as being outside the INM band of the liquid’s intermolecular vibrations and to think of the liquid as generating these frequencies from the overtones of a single INM mode. This kind of analysis predicts a temperature dependence to high-frequency vibrational relaxation remarkably similar to that of solid-state multiphonon models. However, by systematically improving this INM formulation we find that we can also explore the steps a liquid has to take to handle the relaxation of frequencies within its natural band. As the frequency decreases, a liquid evidently needs to invoke more and more of its band to drive the important solvent dynamics. Nonetheless, we continue to find that none of this important dynamics ever seems to involve anything more than the solute’s first solvation shell.

We present here the results of molecular dynamics simulation of solvation dynamics (SD) in benzene, acetonitrile, and their mixtures corresponding to three sets of acetonitrile mole fractions, xac = 0.20, 0.50, and 0.75, at temperature and densities appropriate for ambient conditions. The change in solute−solvent interactions triggered by solute electronic S0 → S1 excitation is represented as dipole creation in a benzene-like solute. We find that both solvent components are active participants in the SD event, with electrostatic interactions of the dipolar solute with quadrupolar benzene molecules making an important contribution to the solvation mechanism and the steady-state Stokes shift in the fluorescence spectrum. Our model solute is preferentially solvated by acetonitrile in its S1 state and the enhancement in the local acetonitrile concentration contributes significantly to the solvation time scale, especially in the benzene-rich mixture, where this process becomes considerably slower than the solv...