Immune-checkpoint inhibitors (ICIs) are approved in the first-line and third-line settings for patients with extensive-stage or relapsed small-cell lung cancer (SCLC), respectively. In the firstline setting, the addition of the anti-programmed cell death 1 ligand 1 (PD-L1) antibody atezolizumab to chemotherapy improves overall survival (OS). In patients with relapsed disease, data from nonrandomized trials have revealed promising responses, although a significant improvement in OS over that obtained with conventional chemotherapy was not achieved in a randomized trial in this setting. Substantial research interest exists in identifying predictive biomarkers that could guide the use of ICIs in patients with SCLC. PD-L1 expression is typically low or absent in SCLC, which has precluded its use as a predictive biomarker. Tumour mutational burden might have some predictive value, although blood-based measures of tumour mutational burden did not have predictive value in patients receiving atezolizumab plus chemotherapy in the first-line setting. After three decades, ICIs have finally enabled an improvement in OS for patients with SCLC; however, a substantial amount of research remains to be done, including identifying the optimal therapeutic strategy and predictive biomarkers. In this Review, we describe the available data on clinical efficacy, the emerging evidence regarding biomarkers and ongoing clinical trials using ICIs and other immunotherapies in patients with SCLC. Small-cell lung cancer (SCLC) accounts for ~15% of all lung cancers and ~30,000 deaths in the USA annually 1. Owing to the elusive pathophysiology of the disease, the poor prognosis of patients and minimal improvement in the effectiveness of therapies over the past decades, SCLC is a US National Cancer Institute-designated recalcitrant malignancy 2. With the FDA approval of carboplatin, etoposide and the anti-programmed cell death 1 ligand 1 (PD-L1) antibody atezolizumab as a first-line therapy, and the anti-programmed cell death protein 1 (PD-1) antibodies nivolumab and pembrolizumab as monotherapies in the third-line setting, immune-checkpoint inhibitors (ICIs) have entered the treatment

Cytochrome P450 1B1 contributes to the development of angiotensin II-induced hypertension and associated cardiovascular pathophysiology. In view of the critical role of angiotensin II in the kidney, as well as in salt and water homeostasis, and blood pressure regulation, we determined the contribution of cytochrome P450 1B1 to renal dysfunction and injury associated with angiotensin II-induced hypertension in male Cyp1b1+/+ and Cyp1b1−/− mice. Angiotensin II infusion (700 ng/kg/min) given by miniosmotic pumps for 13 and 28 days increased systolic blood pressure in Cyp1b1+/+ mice; this increase was significantly reduced in Cyp1b1−/− mice. Angiotensin II increased renal Cyp1b1 activity, vascular resistance and reactivity to vasoconstrictor agents, and caused endothelial dysfunction in Cyp1b1+/+ but not Cyp1b1−/− mice. Angiotensin II increased water consumption and urine output, decreased urine osmolality, increased urinary Na+ and K+ excretion, and caused proteinuria and albuminuria in Cyp1b1+/+ mice that was diminished in Cyp1b1−/− mice. Infusion of angiotensin II for 28, but not 13 days, caused renal fibrosis, tubular damage and inflammation in Cyp1b1+/+ mice, which was minimized in Cyp1b1−/− mice. Angiotensin II increased levels of 12- and 20-hydroxyeicosatetraenoic acids; reactive oxygen species; and activity of NADPH oxidase, ERK1/2, p38 MAPK, and c-Src in the kidneys of Cyp1b1+/+ but not Cyp1b1−/− mice. These data suggest that increased thirst, renal dysfunction, and injury and inflammation associated with angiotensin II-induced hypertension in mice depend on cytochrome P450 1B1 activity thus indicating that cytochrome P450 1B1 could serve as a novel target for treating renal disease and hypertension.

BackgroundPrimary central nervous system (CNS) tumors and brain metastases (BMs) are major causes of morbidity and mortality, accompanied by low survival rates. Efforts to early discovery of CNS malignancies are critical. However, to date, there are no biomarkers approved for detection of cancer activity in the brain. Blood levels of neurofilament light (NfL) and tau, as well as glial fibrillary acidic protein (GFAp), show promise as biomarkers for brain injury in previous studies. Therefore, we performed a cross-sectional study to investigate correlations of those biomarkers with CNS activity of gliomas and BMs.MethodsSerum samples of 36 participants of a single centered institution were tested for NfL, GFAp and tau with Simoa immunoassay, and correlated with clinical and radiological data.ResultsNfL and GFAp levels were significantly associated with the state of intracranial disease (analysis of variance (ANOVA), PsNfL = 0.03; ANOVA, PGFAp = 0.03). Although statistically significant (P = 0.04), differences in concentrations were not clinically meaningful for tau levels. Serum NfL (sNfL) and GFAp concentrations were higher in the group of patients with CNS tumors with disease in progression versus CNS with stable disease (P = 0.03 and P = 0.01, respectively). In addition, sNfL were higher in patients with metastatic solid tumors with known BMs than in those with metastatic tumors with no BM (P = 0.0004).ConclusionsNfL and GFAp both apparently vary closely with presence and activity of gliomas and BMs. Further studies in larger populations are needed to expand these findings.