Immune Checkpoint Blockade in Advanced Cutaneous Squamous Cell Carcinoma: What Do We Currently Know in 2020?

Cutaneous squamous cell carcinoma (cSCC) is the second most common skin cancer that predominantly arises in chronically sun-damaged skin. Immunosuppression, genetic disorders such as xeroderma pigmentosum (XP), exposure to certain drugs and environmental noxae have been identified as major risk factors. Surgical removal of cSCC is the therapy of choice and mostly curative in early stages. However, a minority of patients develop locally advanced tumors or distant metastases that are still challenging to treat. Immune checkpoint blockade (ICB) targeting CTLA-4, PD-L1 and PD-1 has tremendously changed the field of oncological therapy and especially the treatment of skin cancers as tumors with a high mutational burden. In this review, we focus on the differences between cSCC and cutaneous melanoma (CM) and their implications on therapy, summarize the current evidence on ICB for the treatment of advanced cSCC and discuss the chances and pitfalls of this therapy option for this cancer entity. Furthermore, we focus on special subgroups of interest such as organ transplant recipients, patients with hematologic malignancies, XP and field cancerization.     

用户指导的多层混合检查点技术及性能优化*

检查点机制是一种典型有效的软件容错技术。在对现有检查点实现技术综合研究的基础上,设计了一个用户指导的多层混合检查点模型uHybcr,并在IA64 Linux系统中予以实现。最后,通过对比测试对引入用户指导机制所带来的性能优化进行了验证。     

设置进程检查点的嵌入式容错系统设计

针对嵌入式Linux系统的特点,通过设置检查点(checkpoint)实现ARM平台进程级容错。在检查点工作时,通过/proc文件系统与内核进行交互,实时地获取与进程有关的PID、CPU状态以及内存信息,并保存在存储介质中。当进程出现故障后,将上述与进程有关的状态信息进行恢复,从而实现进程级容错。实验表明,该进程级容错系统有较好的容错能力,极大地缩短了进程恢复的时间。     

TMB in NSCLC: A Broken Dream?

Although immune checkpoint inhibitors have changed the treatment paradigm of a variety of cancers, including non-small-cell lung cancer, not all patients respond to immunotherapy in the same way. Predictive biomarkers for patient selection are thus needed. Tumor mutation burden (TMB), defined as the total number of somatic/acquired mutations per coding area of a tumor genome (Mut/Mb), has emerged as a potential predictive biomarker of response to immune checkpoint inhibitors. We found that the limited use of TMB in clinical practice is due to the difficulty in its detection and compounded by several different biological, methodological and economic issues. The incorporation of both TMB and PD-L1 expression or other biomarkers into multivariable predictive models could result in greater predictive power.     

免疫检查点抑制剂相关甲状腺毒症

免疫检查点抑制剂(immune checkpoint inhibitors, ICIs)是近年来恶性肿瘤治疗领域的一项重大突破。其通过针对T细胞的调节作用,增强抗肿瘤免疫反应,改善恶性肿瘤患者的预后,延长患者生存期,现已获批用于治疗多种肿瘤,但ICIs在应用过程中产生的甲状腺毒症是不容忽视的临床问题。本文对ICIs相关甲状腺毒症的发生机制、临床表现、处理对策等进行综述。     

Neurological Immunotoxicity from Cancer Treatment

The emergence of immune-based treatments for cancer has led to a growing field dedicated to understanding and managing iatrogenic immunotoxicities that arise from these agents. Immune-related adverse events (irAEs) can develop as isolated events or as toxicities affecting multiple body systems. In particular, this review details the neurological irAEs from immune checkpoint inhibitors (ICI) and chimeric antigen receptor (CAR) T cell immunotherapies. The recognition and treatment of neurological irAEs has variable success, depending on the severity and nature of the neurological involvement. Understanding the involved mechanisms, predicting those at higher risk for irAEs, and establishing safety parameters for resuming cancer immunotherapies after irAEs are all important fields of ongoing research.     

Immune Aging and Immunotherapy in Cancer

Immune functions decline as we age, while the incidence of cancer rises. The advent of immune checkpoint blockade (ICB) has not only revolutionized cancer therapy, but also spawned great interest in identifying predictive biomarkers, since only one third of patients show treatment response. The aging process extensively affects the adaptive immune system and thus T cells, which are the main target of ICB. In this review, we address age-related changes regarding the adaptive immune system with a focus on T cells and their implication on carcinogenesis and ICB. Differences between senescence, exhaustion, and anergy are defined and current knowledge, treatment strategies, and studies exploring T cell aging as a biomarker for ICB are discussed. Finally, novel approaches to improve immunotherapies and to identify biomarkers of response to ICB are presented and their potential is assessed in a comparative analysis.     

Docking onto chromatin via the Saccharomyces cerevisiae Rad9 Tudor domain

An integrated cellular response to DNA damage is essential for the maintenance of genome integrity. Recently, post-translational modifications to histone proteins have been implicated in DNA damage responses involving the Rad9 family of checkpoint proteins. In budding yeast, methylation of histone H3 on lysine 79 (H3-K79me) has been shown to be required for efficient checkpoint signalling and Rad9 localization on chromatin. Here, we have used a rad9 Tudor mutant allele and cells mutated for Dot1, the H3-K79 methylase, to analyse the epistatic relationship between RAD9 and DOT1 genes regarding the DNA damage resistance and checkpoint activation pathways. Our results show that RAD9 is epistatic to DOT1 and suggest that it acts downstream of the Dot1 methylase in the damage resistance and checkpoint response. We have also found that the Tudor domain of Rad9 is necessary for in vitro binding to H3-K79me as well as Rad9 focal accumulation in response to DNA damage in vivo. In summary, our study demonstrates that the interaction between Rad9, via its Tudor domain, and methylated H3-K79 is required at two different steps of the DNA damage response, an early step corresponding to checkpoint activation, and a late step corresponding to DNA repair. The study further shows that the function of this interaction is cell cycle-regulated; the role in checkpoint activation is restricted to the G(1) phase and its role in DNA repair is restricted to G(2).     

Unified model for assessing checkpointing protocols at extreme‐scale

In this paper, we present a unified model for several well‐known checkpoint/restart protocols. The proposed model is generic enough to encompass both extremes of the checkpoint/restart space, from coordinated approaches to a variety of uncoordinated checkpoint strategies (with message logging). We identify a set of crucial parameters, instantiate them, and compare the expected efficiency of the fault tolerant protocols, for a given application/platform pair. We then propose a detailed analysis of several scenarios, including some of the most powerful currently available high performance computing platforms, as well as anticipated Exascale designs. The results of this analytical comparison are corroborated by a comprehensive set of simulations. Altogether, they outline comparative behaviors of checkpoint strategies at very large scale, thereby providing insight that is hardly accessible to direct experimentation. Copyright © 2013 John Wiley & Sons, Ltd.     

Multiple fault detection in two-level multi-output circuits

It is often stated that in irredundant two-level logic circuits, a test set for all single stuck faults will also detect all multiple stuck faults. We show by a simple example that this result does not hold for multi-output circuits even when each output function is prime and irredundant. Using a result from the programmable logic array technology, we give an output ordering constraint that, if satisfied during test generation, will make a single stuck fault test set a valid multiple stuck fault test set for irredundant two-level multi-output circuits.