| 2. |
- Bonfiglio, Silvia, et al.
(författare)
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BTK and PLCG2 remain unmutated in one-third of patients with CLL relapsing on ibrutinib
- 2023
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Ingår i: Blood Advances. - : American Society of Hematology. - 2473-9529 .- 2473-9537. ; 7:12, s. 2794-2806
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Tidskriftsartikel (refereegranskat)abstract
- Patients with chronic lymphocytic leukemia (CLL) progressing on ibrutinib constitute an unmet need. Though Bruton tyrosine kinase (BTK) and PLCG2 mutations are associated with ibrutinib resistance, their frequency and relevance to progression are not fully understood. In this multicenter retrospective observational study, we analyzed 98 patients with CLL on ibrutinib (49 relapsing after an initial response and 49 still responding after ≥1 year of continuous treatment) using a next-generation sequencing (NGS) panel (1% sensitivity) comprising 13 CLL-relevant genes including BTK and PLCG2. BTK hotspot mutations were validated by droplet digital polymerase chain reaction (ddPCR) (0.1% sensitivity). By integrating NGS and ddPCR results, 32 of 49 relapsing cases (65%) carried at least 1 hotspot BTK and/or PLCG2 mutation(s); in 6 of 32, BTK mutations were only detected by ddPCR (variant allele frequency [VAF] 0.1% to 1.2%). BTK/PLCG2 mutations were also identified in 6 of 49 responding patients (12%; 5/6 VAF <10%), of whom 2 progressed later. Among the relapsing patients, the BTK-mutated (BTKmut) group was enriched for EGR2 mutations, whereas BTK-wildtype (BTKwt) cases more frequently displayed BIRC3 and NFKBIE mutations. Using an extended capture-based panel, only BRAF and IKZF3 mutations showed a predominance in relapsing cases, who were enriched for del(8p) (n = 11; 3 BTKwt). Finally, no difference in TP53 mutation burden was observed between BTKmut and BTKwt relapsing cases, and ibrutinib treatment did not favor selection of TP53-aberrant clones. In conclusion, we show that BTK/PLCG2 mutations were absent in a substantial fraction (35%) of a real-world cohort failing ibrutinib, and propose additional mechanisms contributing to resistance.
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| 3. |
- Martin, P., et al.
(författare)
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Overview of RFX-mod results
- 2009
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Ingår i: Nuclear Fusion. - : IOP Publishing. - 0029-5515 .- 1741-4326. ; 49:10, s. 104019-
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Tidskriftsartikel (refereegranskat)abstract
- With the exploration of the MA plasma current regime in up to 0.5 s long discharges, RFX-mod has opened new and very promising perspectives for the reversed field pinch (RFP) magnetic configuration, and has made significant progress in understanding and improving confinement and in controlling plasma stability. A big leap with respect to previous knowledge and expectations on RFP physics and performance has been made by RFX-mod since the last 2006 IAEA Fusion Energy Conference. A new self-organized helical equilibrium has been experimentally achieved ( the Single Helical Axis-SHAx-state), which is the preferred state at high current. Strong core electron transport barriers characterize this regime, with electron temperature gradients comparable to those achieved in tokamaks, and by a factor of 4 improvement in confinement time with respect to the standard RFP. RFX-mod is also providing leading edge results on real-time feedback control of MHD instabilities, of general interest for the fusion community.
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