BACKGROUND The emergence of secondary drug resistance when treating epidermal growth factor receptor(EGFR)mutated non-small cell lung cancer(NSCLC)using EGFRtyrosine kinase inhibitors(EGFR-TKIs),seriously affects the ...BACKGROUND The emergence of secondary drug resistance when treating epidermal growth factor receptor(EGFR)mutated non-small cell lung cancer(NSCLC)using EGFRtyrosine kinase inhibitors(EGFR-TKIs),seriously affects the therapeutic efficacy and survival of patients.Here,we report a case of advanced NSCLC focusing on the application of multiple biopsy modalities to reveal the development of multiple resistance mechanisms during targeted therapies.CASE SUMMARY A 54-year-old male patient presented with EGFR 19Del-mutated advanced lung adenocarcinoma,and exhibited the development of a T790M mutation during initial TKI treatment.Following 3 mo of Osimertinib treatment,a mixed response was observed.Tissue biopsy of the progressive lesion showed transformation to small cell lung cancer(SCLC)harboring RB1 and TP53 mutations,with loss of the original T790M mutation.A standard chemotherapy regimen with Anlotinib for SCLC was administered.Repeat biopsy revealed adenocarcinoma combined with SCLC after tumor progression.The patient’s overall survival was 24 mo.CONCLUSION Multiple biopsy modalities can reveal the development of multiple resistance mechanisms which help with treatment decision-making.Comprehensive treatment regimens according to the drug resistance mechanism significantly improved the prognosis of such patients.展开更多
The wave transformation over slope topography is widely studied,but most of studies are for common coastal slopes.This paper presents an experimental study of 2-D regular and irregular wave transformations on a simpli...The wave transformation over slope topography is widely studied,but most of studies are for common coastal slopes.This paper presents an experimental study of 2-D regular and irregular wave transformations on a simplified coral reef with a steep slope of 1:5 and a horizontal reef flat,focusing on the characteristics of the waves that break on the reef flat.The analyzed results show that the estimates of the wave breaking made by using the well-known previous formulae do not agree completely with the experimental results.When the waves break on a reef flat,the relative breaking wave height(H/d)b is related to the incident deep-water wave steepness and the relative water depth db/L0.Hence,a new criterion for breaking waves on a reef flat is proposed.Furthermore,in view of the fact that the local Ursell number is commonly used to parameterize the wave nonlinearity,the relationships among the skewness,the asymmetry,and the local Ursell number are also presented.Experimental data confirm that when the Ursell number is greater than 30,the absolute values of the skewness and the asymmetry on a reef flat are greater than those on a steep slope.展开更多
文摘BACKGROUND The emergence of secondary drug resistance when treating epidermal growth factor receptor(EGFR)mutated non-small cell lung cancer(NSCLC)using EGFRtyrosine kinase inhibitors(EGFR-TKIs),seriously affects the therapeutic efficacy and survival of patients.Here,we report a case of advanced NSCLC focusing on the application of multiple biopsy modalities to reveal the development of multiple resistance mechanisms during targeted therapies.CASE SUMMARY A 54-year-old male patient presented with EGFR 19Del-mutated advanced lung adenocarcinoma,and exhibited the development of a T790M mutation during initial TKI treatment.Following 3 mo of Osimertinib treatment,a mixed response was observed.Tissue biopsy of the progressive lesion showed transformation to small cell lung cancer(SCLC)harboring RB1 and TP53 mutations,with loss of the original T790M mutation.A standard chemotherapy regimen with Anlotinib for SCLC was administered.Repeat biopsy revealed adenocarcinoma combined with SCLC after tumor progression.The patient’s overall survival was 24 mo.CONCLUSION Multiple biopsy modalities can reveal the development of multiple resistance mechanisms which help with treatment decision-making.Comprehensive treatment regimens according to the drug resistance mechanism significantly improved the prognosis of such patients.
基金Project supported by the National Basic Research Program of China(Grant No.2013CB036101)the National Natural Science Foundation of China(Grant Nos.51879037,51739010).
文摘The wave transformation over slope topography is widely studied,but most of studies are for common coastal slopes.This paper presents an experimental study of 2-D regular and irregular wave transformations on a simplified coral reef with a steep slope of 1:5 and a horizontal reef flat,focusing on the characteristics of the waves that break on the reef flat.The analyzed results show that the estimates of the wave breaking made by using the well-known previous formulae do not agree completely with the experimental results.When the waves break on a reef flat,the relative breaking wave height(H/d)b is related to the incident deep-water wave steepness and the relative water depth db/L0.Hence,a new criterion for breaking waves on a reef flat is proposed.Furthermore,in view of the fact that the local Ursell number is commonly used to parameterize the wave nonlinearity,the relationships among the skewness,the asymmetry,and the local Ursell number are also presented.Experimental data confirm that when the Ursell number is greater than 30,the absolute values of the skewness and the asymmetry on a reef flat are greater than those on a steep slope.
