Background Metformin has been shown to have anti-neoplastic activity in non-small cell lung cancer (NSCLC) in both preclinical and observational studies, however this has never been prospectively evaluated. This single-arm phase II trial, while not fully accrued, is the first known prospective study evaluating the use of metformin with chemotherapy in advanced NSCLC. Methods Patients received carboplatin AUC 5 + pemetrexed 500 mg/m2 IV every 21 days for 4 cycles. For patients who achieved at least stable disease, maintenance pemetrexed was administered until progression or toxicity. Metformin was initiated at 1000 mg/day for week 1, 1500 mg/day for week 2, then 2000 mg/day thereafter, in divided doses. The primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS), objective response rate (ORR), disease control rate (DCR), duration of response (DOR), and adverse events (AE). Tumor tissue was tested for LKB1/STK11 mutations, and non-fasting serum insulin levels were longitudinally assessed. Results Of a planned 50 patients, 14 were enrolled. ORR was 23% and median PFS was 3.9 months. Median OS was 11.7 months. No LKB1/STK11 mutations were identified. The most common AE were fatigue (42.9%), anemia, and nausea (28.6% each). The most common grade III AE was nausea (14.3%). No grade IV AE occurred. Mean duration of metformin treatment was 5.6 months. Conclusion Adding metformin to chemotherapy for advanced NSCLC was safe but did not significantly improve clinical outcomes compared to historical phase III controls. These results are limited by the small sample size; larger trials are needed.

Pharmaceuticals, Inivata, MD Serono, and Novartis; fees for speakers bureau from AstraZeneca, Merck Sharp & Dohme, and Roche; and nonfinancial support from Guardant Health through a research collaboration. Dr. Russo reports receiving personal fees for attending advisory board meetings from AstraZeneca, Merck Sharp & Dohme, and Novartis. The Icahn School of Medicine at Mount Sinai has filed patent applications relating to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) serologic assays and NDV-based SARS-CoV-2 vaccines which list Dr. Krammer as coinventor. Mount Sinai has spun out a company, Kantaro, to market serologic tests for SARS-CoV-2. Dr. Krammer has consulted for Merck and Pfizer (before 2020

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Public safety networks are wireless communication networks used for public protection and disaster relief. Mobile broadband access to cloud‐based computing power improves the flexibility of these networks. Modern public safety networks must support endpoints such as wireless laptops, handheld computers, and mobile video cameras, as well as facilitate communication, collaboration, and operation with central command posts, coworkers, and other agencies in order to provide situational awareness and optimized operations. Unattended video surveillance and sensor systems also use public service networks to transport control information and data. This combination of interconnectivity and interoperability of endpoints, communications, coworkers, agencies, video surveillance, and sensor systems results in a complex automated information system and introduces new security risks into public safety networks. First responders and public safety personnel are familiar with controls such as encryption, redundancy, and physical security used to protect traditional public safety networks; however, they may be unfamiliar with the controls needed to secure next‐generation networks. This letter identifies some of the security factors that make public safety network design challenging. © 2012 Alcatel‐Lucent.

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