Kagawa University

Hepatocellular carcinoma (HCC) is usually diagnosed in patients at the age of > 45 years. We aimed to determine the prognosis of patients with HCC at the age of 30-44 years compared with that of patients at a more senior age.

Based on the Sun Yat-sen University Cancer Center database, a total of 1745 patients with HCC were retrospectively enrolled and were assigned to three age groups (30-44, 45-59, and 60-70 years). The primary endpoint was overall survival. Among baseline characteristics, five variables including sex, serum albumin level, total bilirubin level, the maximum tumor diameter, and the number of tumor nodules were adjusted using propensity score matching.

Patients aged 30-44 years presented a worse overall survival, a greater number of HCC nodules, a greater maximum tumor diameter, and higher serum alpha-fetoprotein (AFP) concentration than those aged 45-59 years in a crude analysis (p < 0.05). Using propensity score matching, the difference in overall survival between the two cohorts was canceled (p > 0.05).

The prognosis of patients with HCC at age 30-44 years was equal to that of patients aged 45-59 years.

FOLFOXIRI plus bevacizumab (BEV) is an option for first-line treatment of metastatic colorectal cancer (mCRC). However, there is no consensus on the optimal treatment strategy when disease progresses. The EFFORT open-label, multicenter, single-arm phase II study investigated whether FOLFIRI plus aflibercept retains activity after progression of FOLFOXIRI plus BEV treatment.

The patients with unresectable mCRC who failed first-line FOLFOXIRI plus BEV received FOLFIRI plus aflibercept. The primary endpoint was progression-free survival (PFS) in the full analysis set (FAS). Angiogenic biomarkers were measured before treatment initiation.

From April 2019 to May 2021, 35 patients were enrolled and 34 were analysed in the FAS population (men, 18; median age, 63 years [range: 32-78]). The primary tumor was left-sided in most cases (23/34), 23 patients were RAS mutant, 3 patients had BRAF V600E mutation and 27 patients had liver metastases. The primary end-point was met with a median PFS of 4.3 months [80% confidence interval [CI] 3.7-5.1]. Median overall survival was 15.2 months [95% CI 8.9-22.7]. Per RECIST, there were 1 complete response, 4 partial responses, 21 stable diseases and 8 disease progressions. Overall response rate was 14.7% [95% CI 5.0-31.1], and disease control rate was 76.5% [95% CI 58.8-89.3]. Responses were more common in patients with high VEGF-C, low VEGF-D and low PlGF levels before treatment.

FOLFIRI plus aflibercept, administered after failure of FOLFOXIRI plus BEV, is effective and has a manageable safety profile. This regimen may be a useful second-line treatment option for these patients.

The primary factors that determine the efficiency and selectivity of multi-electron photoreduction of CO₂ include the chemical properties of the active sites, as well as the kinetics of charge separation and transfer. Herein, a novel two-dimensional QDs-Co-CuS_1-x/Ti₃C₂/TiO₂ heterojunction is developed, with Co-CuS_1-x quantum dots serving as cocatalysts and Ti₃C₂ MXene as an effective electron transfer channel. The anchoring effect of Ti₃C₂ facilitates the formation of robust TiS bonds with Co-CuS_1-x, thereby promoting efficient separation and transfer of photoelectrons to the Co-Cu bimetallic active sites. This process enhances the local electron density at these sites and accelerates the kinetics of electron transfer to absorbed CO₂. The recyclability of the Co-Cu sites is also significantly enhanced by continuous photoelectron injection. Importantly, DFT calculations indicate that the synergistic dual sites involving highly exposed Co-Cu and S vacancies promote rate-determining step from COO* to COOH*, which may account for the highly selective photoreduction of CO₂-to-CO. Benefitting from the synergic effects of the active sites and efficient separation of carriers, the optimized Co-CuS_1-x/Ti₃C₂/TiO₂ exhibits a satisfactory CO photoreduction rate of 30.8 µmol∙g^-1∙h^-1, with an excellent selectivity of 87.9 % and apparent quantum yield of 0.61 % in the absence of any sacrificial reagents, which is 6.5 times higher than Co-CuS_1-x, 54.0 times than Ti₃C₂T_x/TiO₂.