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Matching adjusted indirect comparison (MAIC) of ¹⁷⁷ Lu-DOTATATE vs. sunitinib as first-line (1L) treatment for advanced grade 2 (G2) pancreatic neuroendocrine tumors (pNETs).

664 Background: The phase 3 NETTER-2 trial recently demonstrated a statistically significant improvement in progression-free survival (PFS) with [ 177 Lu]Lu-DOTA-TATE ( 177 Lu-DOTATATE) plus long-acting octreotide (Oct LAR) vs. high-dose Oct LAR in patients with G2/G3 gastroenteropancreatic neuroendocrine tumors in the 1L setting, across tumor grades and origins (including pNETs). However, no head-to-head comparison of 177 Lu-DOTATATE to other treatment options was conducted. Sunitinib is a currently recommended 1L treatment for patients with advanced G2 pNETs. The Raymond 2018 study is the only study that assessed sunitinib in advanced pNETs and provided sub-group data for the 1L setting (80% of the patients had G2 tumors). We aimed to determine the relative efficacy (PFS) of 177 Lu-DOTATATE + Oct LAR vs. sunitinib as 1L treatment for advanced G2 pNETs using MAIC. Methods: An unanchored MAIC (due to absence of a common comparator) of PFS in patients with advanced G2 pNETs treated in 1L with 177 Lu-DOTATATE + Oct LAR vs. sunitinib was conducted using individual patient data from NETTER-2 and aggregated data published in the Raymond 2018 study. Baseline characteristics and PFS data for the sunitinib arm were available for the treatment-naïve subgroup and were considered for the analysis. Baseline characteristics considered in the MAIC included age, sex, race, prior somatostatin analogue use, and number as well as location of involved disease sites. Multiple scenarios with various combinations of covariates were considered with multivariate Cox-regression of NETTER-2 used to identify covariates predictive of PFS. Finally, the combination of covariates with a reasonable effective sample size (ESS) was selected. Results: The final ESS was estimated to be 22 for 177 Lu-DOTATATE + Oct LAR, representing 43% of the original sample size (n=50), whereas sample size for sunitinib arm was 61 patients. After matching and weighting, patient characteristics were well balanced. MAIC analysis showed a statistically significant PFS benefit with 1L 177 Lu-DOTATATE + Oct LAR vs. sunitinib in G2 pNET (PFS hazard ratio: 0.23 [95% CI: 0.12–0.45]). Unadjusted comparison showed similar results (PFS hazard ratio: 0.34 [95% CI: 0.19–0.61]). Results were consistent across various scenarios assessed. Conclusions: Using MAIC to adjust for cross trial differences, PFS comparison favored 177 Lu-DOTATATE + Oct LAR over sunitinib as 1L treatment of patients with G2 pNET.

High‐Throughput Single‐Cell Analysis of Local Nascent Protein Deposition in 3D Microenvironments via Extracellular Protein Identification Cytometry (EPIC) (Adv. Mater. 6/2025)

Constructing the Dirac Electronic Behavior Database of Under‐Stress Transition Metal Dichalcogenides for Broad Applications

AbstractDiscovering and utilizing the unique optoelectronic properties of transition metal dichalcogenides (TMDCs) is of great significance for developing next‐generation electronic devices. In particular, research on Dirac state modulations of TMDCs under external strains is lacking. To fill this research gap, it has established a comprehensive database of 90 types of TMDCs and their response behaviors under external strains have been systematically investigated regarding the presence of Dirac cones and electronic structure evolutions. Among all the conditions, 27.3% of the TMDCs are Dirac materials with three distinct types of Dirac cones, which are mainly attributed to the electron localizations induced by external strains. TMDCs based on tellurides with 1H phase favor the formation of Dirac cones under stresses, leading to metallic‐like properties and ultra‐fast charge transportation. Correlations among Dirac cones, energy, electronic properties, and lattice structures have been revealed, offering critical references for modulating the properties of well‐known TMDCs. More importantly, it has confirmed that the phase transition points are not sufficient for the appearance of Dirac cones. This work provides critical guidance to facilitate the development of TMDCs‐based superconducting and optoelectronic devices for broad applications.

Optimal duration of neoadjuvant chemotherapy prior to CRS±HIPEC for colorectal cancer: An assessment of survival and postoperative outcomes.

188 Background: Cytoreductive surgery (CRS) with or without heated intraperitoneal chemotherapy (HIPEC) represents a viable treatment option for select patients with colorectal cancer peritoneal metastases. Given high recurrence rates after surgery, it is common practice to administer neoadjuvant chemotherapy (NAC). The optimal duration, however, when considering oncologic value and postoperative outcomes, is not known. Methods: A single institution database (2009-2024) of colorectal cancer patients that underwent CRS±HIPEC was reviewed. Patients with colorectal cancer undergoing CRS±HIPEC for curative intent (completeness of cytoreduction 0 or 1) with known NAC duration were included. Analysis was stratified by NAC duration of 0-3 months or greater than 3 months. Co-primary outcomes were recurrence free survival (RFS) and overall survival (OS). Secondary outcomes included clinically significant complications, defined as Grade 3 or greater adverse events based on Common Terminology Criteria for Adverse Events Version 5.0. Results: From 2009-2024, 108 patients underwent CRS±HIPEC for colorectal cancer. Final analysis included 84 patients that underwent curative intent surgery and had a known duration of NAC ( > 3 months NAC: 55 patients, 0-3 months NAC: 29 patients). Median peritoneal cancer index (PCI) score was similar between the two cohorts ( > 3 months: median PCI 11 versus (vs) 0-3 months: median PCI 12; p = 0.42). Recurrence-free survival was 9 months for the entire cohort and not significantly different based on duration of NAC ( > 3 months: 8 months vs 0-3 months: 15 months, p = 0.14). Overall survival was also similar between both cohorts ( > 3 months: 26 months vs 0-3 months: 37 months; p = 0.11). On univariate analysis, > 3 months of NAC was associated with an increased rate of complications of any severity ( > 3 months: 83.6% vs 0-3 months: 55.2%; p = 0.01), clinically significant complications ( > 3 months: 54.5% vs 0-3 months: 31.0%; p = 0.07), and increased median length of stay ( > 3 months: 10 days vs 0-3 months: 8 days; p = 0.01). When controlling for other perioperative variables on multivariable analysis, > 3 months of NAC trended towards an increased risk of clinically significant complications (HR 1.76, 95% CI 0.59-5.30; p = 0.32). Conclusions: Even with a similar disease burden, as measured by PCI, an extended duration of neoadjuvant chemotherapy prior to CRS±HIPEC does not appear to be associated with any improved recurrence-free or overall survival. Conversely, postoperative outcomes are worse with higher complication rates and increased length of stay. Thus, despite high recurrence rates after CRS±HIPEC for this disease, it still appears that in well selected patients, an extended duration of neoadjuvant chemotherapy may not be the best treatment strategy.

Role of cfDNA and DNA integrity index (DII) in colon cancer in response to surgery.

236 Background: Colorectal cancer diagnosis requires new biomarkers for improved detection and monitoring. cfDNA has shown potential in detecting minimal residual disease, evaluating treatment response, and providing prognostic information. Recent studies highlight cfDNA as a promising molecular marker for early disease detection and progression monitoring. This study aims to evaluate the role of cfDNA and DII in assessing surgical response in CRC patients. The primary objective is to assess cfDNA levels pre- and post-curative resection. Secondary objectives include identifying factors influencing baseline cfDNA levels, evaluating factors affecting DII, and comparing cfDNA and CEA levels in response to surgery. Statistical analyses included descriptive statistics, ROC curve, Student T tests and Fisher's exact test. Methods: The study was designed as a prospective investigation conducted over a period from September 2022 to April 2024 at the Regional Cancer Centre. Forty pathologically proven non metastatic colonic carcinoma planned for primary surgery were included and patients with sepsis and chronic diseases were excluded from the study. Blood samples (10 ml) were collected pre-surgery and at four weeks post-surgery. Plasma cfDNA was extracted, quantified, and analyzed via quantitative real-time PCR using human β-actin as a reference. The DII was calculated as the ratio of 394 bp to 99 bp amplicons of β-actin. Results: The mean age was 62.15 years (range 39-85), with 55% over 60 years. High-risk features included poor differentiation (4.2%), preoperative CEA >5 ng/ml (17.5%), LVI (20.8%), and PNI (6.3%). Surgical approaches included 10 laparoscopic, 29 open, and 1 converted from laparoscopic to open due to excessive bleeding. Overall stage grouping showed 18 patients in Stage III, and 11 each in Stage I and II. Median pre- and postoperative cfDNA levels were 24.2 ng/μl and 29.6 ng/μl (p=0.83), and median DNA integrity index levels were 1.1 and 1.0 (p=0.95). Preoperative cfDNA levels averaged 24.2 ng/μl and postoperative levels 29.6 ng/μl (p = 0.83); DII levels were 1.1 preoperatively and 1.0 postoperatively (p = 0.95). Postoperative cfDNA levels decreased in 21 patients and increased in 19, while DII decreased in 20 and increased in 20. Significant associations were noted for cfDNA changes with surgery type and high-risk features. ROC analysis revealed cfDNA cut-off at 275 ng/μl, DII at 1.5, and CEA at 4 µg/L. Sensitivities for cfDNA and DII were 66.67% and 100%, respectively, with combined sensitivity reaching 100%. Conclusions: Persistent high cfDNA levels post-surgery suggest potential minimal residual disease despite radical resection. The residual disease is a harbinger of systemic failure. Monitoring cfDNA and DII can identify patients at risk for recurrence, guiding intensified adjuvant therapy. Further studies with extended follow-up are recommended to validate these findings. Clinical trial information: CTRI/2023/10/058468 .

Surgical treatment results for oligo-recurrence of gastric cancer.

462 Background: Despite advancements in diverse treatments, approximately 40-50% of advance gastric cancer patients experience recurrence even after curative resection surgery. The condition where there is a limited recurrence after the control of the primary tumor site is referred to as oligo-recurrence. However, there is scarce reporting on oligo-recurrence after gastric cancer surgery. This study compiled cases of patients who underwent surgery for recurrent gastric cancer after R0 surgery. Since there are no specific treatment guidelines for recurrence after gastric cancer surgery, this research could be beneficial in providing insights and assistance. Methods: This retrospective study includes data from 25 patients who underwent surgery for suspected oligo-recurrence of gastric cancer among those who had undergone surgery from June 2008 to May 2018. If a solitary mass suspected of recurrence is identified during surveillance, a PET-CT is performed. Patients with suspicion of peritoneal dissemination, carefully excluded through a multidisciplinary approach, are selectively omitted. All patients undergo excision surgery for both treatment and tissue examination purposes. Results: Out of 25 cases, there were 6 cases of paraaortic lymph node enlargement, 9 cases liver nodules, 8 case lung nodules, and 1 case tumor bed mass. In the postoperative tissue analysis, 4 cases of paraaortic lymph node enlargement, 5 cases of the liver nodules, and 1case tumor bed mass were confirmed to be recurrences of gastric cancer. All of lung nodule were diagnosed with lung cancer. All 10 cases underwent chemotherapy after metastatectomy. Among them, 3 cases experienced recurrence and died an average of 12.3 months after surgery. Seven cases did not experience recurrence and have survived with an average survival time of 102 months to date. Conclusions: The metastatectomy is safe and effective for patients with oligo-recurrence from GC and can improve their prognosis. For an accurate diagnosis, oligometastectomy is essential. However, our results need to be confirmed by more randomized controlled clinical studies. Treatment result after metastatectomy. Case Diagnosis Chemotherapy aftermetastatectomy Recurence after metastatectomy DFS after metastatectomy OS after metastatectomy OS after gastrectomy Status 1 LN metastasis 1/1 15cycles FOLFOX 147 147 156.4 ALIVE 2 LN metastasis 1/1 37cycles TAS-118 liver metastasis 22 40.6 74.9 DEATH 3 LN metastasis 1/3 12cycles FOLFOX 98.1 98.1 125.5 ALIVE 4 LN metastasis 1/1 35cycles FOLFOX 50.9 50.9 71.3 ALIVE 5 Liver metastasis ONO tiral Liver, bone mets. 3.73 27.9 64.6 DEATH 6 Liver metastasis 12cycles FOLFOX 68.3 68.3 122.2 ALIVE 7 Liver metastasis 12cycles FOLFOX 96 96 105.8 ALIVE 8 Liver metastasis 82cycles FOLFOX 55 55 77.4 ALIVE 9 Liver metastasis 12cycles FOLFOX 94.4 94.4 103.9 ALIVE 10 Tumor bed 12cycles FOLFOX 　 9 25.5 24.4 DEATH

Printed High‐Entropy Prussian Blue Analogs for Advanced Non‐Volatile Memristive Devices (Adv. Mater. 8/2025)

Transformation‐Invariant Laplacian Metadevices Robust to Environmental Variation

Abstract As one of the typical applications of metamaterials, the invisibility cloak has raised vast research interests. After many years’ research efforts, the invisibility cloak has extended its applicability from optics and acoustics to electrostatics and thermal diffusion. One scientific challenge that has significantly restricted the practical application of the invisibility cloak is the strong background dependence, that is, all passive cloaking devices realized thus far are unable to resist variation in the background refractive index. To tackle such a challenge, the concept of transformation‐invariant metamaterials (TIMs) is applied to static‐field systems and shows that, for any physical fields governed by Laplace equation, judiciously designed TIMs can be used to realize invisibility cloaks robust to the environment variation. As an experimental proof, an ideal direct current (DC) cloak‐is implemented based on TIMs and near‐field measurement results demonstrate that such a cloak can successfully conceal a large‐scale object when the background conductivity varies from 22 to 859 kS m −1 . Moreover, the background‐immune cloaking effect is observed under arbitrary electric sources. The approach proposed in this work can be also applied to static magnetics, thermal diffusion, and beyond, enabling robust isolation of the target from the external field in versatile application scenarios.

Provider perspectives on non-medical barriers to GI cancer care at a regional cancer center.

807 Background: Disparities in care for patients with gastrointestinal (GI) cancers are well-documented, but solutions remain elusive. Understanding the barriers faced by healthcare providers is essential to improving care equity. This study explored the perceptions of healthcare providers at a regional academic health system regarding barriers to care for GI cancer patients. Methods: A cross-sectional survey was conducted among healthcare providers, including physicians, advanced care providers (APPs), nurses, dietitians, social workers, care coordinators, and physical/occupational therapists who directly care for patients with GI malignancies. Survey items assessed specific barriers encountered in clinical practice and suggestions for improving care. Descriptive statistical analysis evaluated the quantitative data from the closed-ended questions across professional roles. A thematic analysis was performed on open-response items and assessed to further identify key barriers to care based on respondents' clinical roles and experiences. Results: Seventy-nine healthcare providers responded to the survey. Initial treatment planning was consistently identified as the phase with the most significant barriers across all disciplines. Health literacy was cited as the most critical barrier to diagnosis, while insurance coverage, financial constraints, geographic location, lack of transportation, and social support were the primary obstacles to treatment. The importance of these barriers varied by profession: physicians noted geographic and transportation limitations, while nurses and social workers emphasized gaps in health literacy, insurance, and social support. Systemic issues such as limited access to specialized care and healthcare personnel shortages were also noted. Notably, 55% of physicians spent 10-30% of their time addressing non-medical barriers to treatment, while 38% of nurses spent 30-50%. Care coordination across disciplines was commonly cited as a challenge, with many calling for improved communication and establishing multidisciplinary clinics. Food insecurity, housing stability, and language/cultural barriers were less prominent concerns at this institution. Conclusions: Oncology providers at a large regional cancer center spend significant time addressing non-medical barriers to treatment for GI cancer patients, particularly during initial treatment planning. The most common challenges reported were insurance, transportation, health literacy, and social support. We will use these findings to guide in-depth provider and patient interviews and develop a team-based, equity-focused intervention. These efforts aim to improve care delivery at our institution and serve as a model enhancing GI cancer care in broader healthcare settings.

Adjuvant chemotherapy or chemo-radiation in gallbladder cancer: A phase III randomized controlled study (ACCELERATE trial).

519 Background: Role of adjuvant therapy in gallbladder cancer is still evolving and no prospective trial has compared chemotherapy (ChT) alone to combination of chemotherapy and chemo-radiation (CRT). We designed this trial to answer whether adding CRT to ChT improves relapse free survival. Methods: In this open-label, multicentric, phase 3, non-inferiority academic trial, operated gallbladder cancers (R0 or R1) patients were randomized to physicians choice of ChT alone (either 6 cycles of mGemOx- Gemcitabine 900 mg/m2 and oxaliplatin 80 mg/m2 IVI days 1 and 8 every 3 weeks or GemCis- Gemcitabine 1000 mg/m2 and cisplatin 25 mg/m2 1 and 8 every 3 weeks) or 3 cycles of physicians choice of ChT (as above) followed by CRT (radiation 45Gyin 25 fractions in 5 weeks with concurrent oral capecitabine in the dose of 825 mg/m2 twice a day on days of radiation and further 2-3 cycles of mGemOx or GemCis. The primary endpoint was the relapse free survival. Planned sample size was 100 subjects in each arm. Results: Between April 2018 and January 2021, 137 patients were screened, and 94 eligible patients were randomized, 49 (52.1%) in chemotherapy alone arm (standard-arm1) and 45 (47.9%) in chemotherapy plus chemo-radiation arm (experimental-arm 2). Slow accrual led to premature closure of trial. COVID pandemic might have contributed to that. Baseline characteristics were well balanced (like, sex, presenting symptoms, ECOG PS, duration of symptoms, comorbidities, location of tumour in GB, presence of gallstone disease, and tumour markers were well balance in both groups) except that a greater number of patients had deranged baseline LFTs in arm1 and there was a trend towards higher numbers of stage IIA in arm 1. The median age was 55 years (range 27-73 years). Females constituted 32 in each group. 43 and 45 patients had ECOG PS of 0-1 in arm 1 and arm 2 respectively. One patient in arm 1 was ineligible. All had R0 resection. Incidences of dose reductions and dose delays were similar. A greater number of patients in arm 1 experienced diarrheal episodes (p=0.021) and peripheral neuropathy (0.001). 42 (85.7%) patients in arm 1 and 28 (62.2%) patients in arm completed 5-6 cycles. 18 (36.73%) and 23 (51.11%) died till last follow up. 14 (28.57%) and 20(44.44%) died because of disease progression. One patient in each arm died of toxicity. The primary end point of study, relapse free survival was not estimable in arm 1 and was 34.39 months in arm 2 (p=0.202). Median overall survival was not estimable in arm 1 and was 34.56 months in arm 2 (p=0.123). Mean RFS was 51.96 Vs 43.99 months in arm 1 and arm 2 respectively. Conclusions: This trial suggests that addition of CRT to ChT doesn’t improve outcome in resected gallbladder cancer compared to ChT alone. A larger trial is needed to address this issue. Clinical trial information: CTRI/2018/04/013218.

Characterization of the real-world first line (1L) use of single dose tremelimumab regular interval durvalumab (STRIDE), for treatment of unresectable hepatocellular carcinoma (uHCC), using two electronic medical record (EMR) databases.

534 Background: In October 2022, the US FDA approved the STRIDE (Single Dose Tremelimumab Regular Interval Durvalumab) regimen, comprising tremelimumab 300 mg for 1 dose plus durvalumab 1500 mg every 4 weeks, for the 1L treatment of uHCC in adults aged ≥18 years. Thus far there is limited data characterizing STRIDE's 1L use in the real world. This observational study aims to describe patient characteristics, and clinical profiles of a 1L STRIDE cohort. Methods: A retrospective cohort study was conducted using EMR data from two community oncology practice networks, Florida Cancer Specialists and American Oncology Network, from January 1, 2018, to March 31, 2024. Adults with HCC who received ≥1 administration of the STRIDE regimen as 1L treatment following diagnosis were included. Patients with evidence of other cancers or systemic therapies pre-index date were excluded, to establish a cancer-naïve cohort at index. Index date was first administration of STRIDE. The analysis described the patient characteristics and clinical profile at index date. Patient demographics, severity indicators (cancer stage, albumin-bilirubin index (ALBI), alpha fetoprotein (AFP), Eastern Cooperative Oncology Group (ECOG)) and lab data were assessed on or closest to index date. Results: 79 patients initiated the 1L STRIDE regimen. The median (P25, P75) age at index was 70 (63.2-76.4) years. 72.2% were males, 64.6% were white, and 69.6% were overweight or obese patients. 95% had their first HCC diagnosis between 2022-2024 and the mean time from diagnosis to index date was 3.8 months (SD: 10.2). Among patients with reported cancer stage (n=57), most (82.5%, n=47) were diagnosed with stages IIIA to IVB. 18% had ECOG scores ≥2. 86% had ALBI grades between 2-3; 42.1% had AFP level ≥400 ng/ml; 30.4% had cirrhosis (among those that reported comorbidities) and 24.1% received any loco-regional therapy. Conclusions: Our study provides a real-world profile of patients on 1L STRIDE. Compared to the HIMALAYA trial, these findings suggest that patients in this real-world study tend to be older, diagnosed at late-stage, have a poor liver profile, and potentially worse prognosis over time. Further research is required to explore treatment pathways after index date, over a long follow-up, which may provide more insight into the continuity and effectiveness of IL STRIDE in the real-world.

cfDNA screening for fetal aneuploidy facilitates maternal cancer detection

Ultra‐Fast, Unidirectional Water Absorption on Wood Ear (Adv. Mater. 7/2025)

Fe/Mo‐Based Lipid Peroxidation Nanoamplifier Combined with Adenosine Immunometabolism Regulation to Augment Anti‐Breast Cancer Immunity

Abstract Immunogenic cell death (ICD)‐mediated immunization strategies have great potential against breast cancer. However, traditional strategies neglect the increase in the immunosuppressive metabolite, adenosine (ADO), during ICD, leading to insufficient therapeutic outcomes. In this study, it is found that the adenosine A2A receptor (A2AR) is significantly expressed in breast cancer and positively associated with regulatory T (Treg) cells. Herein, a strategy combining Fe/Mo‐based lipid peroxidation (LPO) nanoamplifiers and A2AR blockade is reported to maximize ICD‐mediated anti‐tumor immunity. This LPO nanoamplifier causes LPO explosion by the Fe (II)‐mediated Fenton reaction and Mo(V)‐mediated Russell mechanism. Subsequently, it elicits the ICD magnification of tumor cells by inducing multiple regulated cell death patterns of ferroptosis, apoptosis, and necroptosis. Additionally, the A2AR antagonist (SCH58261), an immunometabolic checkpoint blocker, is found to relieve ADO‐related immunosuppression, amplify anti‐tumor immunological effects, and elicit immune memory responses. This robust anti‐tumor immunity is observed in primary, distant, pulmonary metastatic, and recurrent tumors. This study provides a novel strategy for optimizing ICD‐mediated immunotherapy and highlights the benefits of combining LPO explosion with A2AR blockade to enhance breast cancer immunotherapy.

Impact of unplanned readmission to the same facility within 30 days following robot-assisted and laparoscopic hemicolectomy for early-onset non-metastatic colon cancer.

111 Background: Colon cancer in younger populations has risen in recent years, prompting changes in screening guidelines. Hemicolectomy remains integral for standard treatment for non-metastatic early-onset colon cancer, and many institutions have adopted robot-assisted approaches for this procedure. However, high costs associated with this technology along with mixed data regarding survival benefits and post-surgical complications warrant further investigations on the specific advantages of robot-assisted surgery. This study aims to examine the impact of unplanned readmission to the same facility within 30 days following surgery for patients receiving robot-assisted and laparoscopic hemicolectomy on long-term survival for early-onset non-metastatic colon cancer to see how current paradigms of colon cancer treatment extend to early-onset patients. Methods: The National Cancer Database was used to identify patients under the age of 50 receiving a minimally invasive hemicolectomy for primary non-metastatic colon cancer diagnosed between 2016-2020. Patients were stratified based on surgical approach and whether they underwent an unplanned readmission to the same facility within 30 days following surgery, and survival differences were calculated log-rank test and Cox regression analysis that included co-variates related to tumor characteristics, patient demographics, and facility characteristics. Results: 5,076 patients were identified, with 577 receiving a robot-assisted approach and 4,499 receiving a laparoscopic approach. Multivariate analysis found no significant difference in long-term survival between patients receiving a laparoscopic versus robot-assisted approach (HR: 0.893, 95% CI: 0.687-1.161, p=0.398). Additionally, multivariate analysis found that unplanned readmission within 30 days did not have a significant impact on long-term survival outcomes for patients receiving a robot-assisted approach (HR: 0.856, 95% CI: 0.257-2.848, p=0.800), but it did find worsened survival outcomes for the laparoscopic approach (HR: 1.535, 95% CI: 1.070-2.203, p=0.020). Conclusions: Patients receiving laparoscopic hemicolectomy for early-onset non-metastatic colon cancer appear to have worsened overall long-term survival outcomes when undergoing an unplanned readmission to the same facility within 30 days of surgery when compared to patients receiving a robot-assisted surgical approach. However, it also appears that overall, both surgical approaches have similar overall long-term survival. Further research on how robot-assisted surgery impacts survival and post-surgical complications in patients with early-onset non-metastatic colon cancer is warranted to examine how this advancing technology could improve cancer care.

Clinical outcomes of adjuvant chemoradiotherapy in pancreatic adenocarcinoma with R1 resection.

731 Background: The benefit of chemoradiotherapy (CRT) following adjuvant chemotherapy in pancreatic cancer is unclear, though recent findings suggest some disease-free survival benefit over chemotherapy alone. We aimed to assess overall (OS) and progression-free survival (PFS) and patterns of disease recurrence following adjuvant chemoradiotherapy (CRT) in pancreatic adenocarcinoma patients with R1 resection (defined as <1mm). Methods: We retrospectively collected data of patients with pancreatic adenocarcinoma who underwent adjuvant CRT (50.4-54Gy) following surgery with R1 resection between 2007-2023 in a single centre in the UK. Clinical data was collected from electronic medical records and information on radiotherapy was collected from treatment planning systems (TPS). Toxicity during and after CRT was graded with Common Terminology Criteria for Adverse Events (CTCAE). OS and PFS were measured with Kaplan-Meier curves from the time of surgery to death or disease progression or last follow up. In-field and locoregional recurrence were determined from restaging scans compared against radiotherapy field in TPS. Results: Among 33 patients included, 27 (81.8%) died within median follow-up 39 (14.8-111.4) months. All patients received adjuvant chemotherapy prior to CRT. Median OS was 42 (21.6-52.7) months and median PFS was 18.2 (15.5-28.4) months. In all but one patient, the R1 involved the posterior resection margin. Most patients (84.8%) had documented disease progression. In the majority the site of first progression was distant metastatic disease (51.5%), whilst six (18.2%) had local recurrence within the radiotherapy field. Four (12.1%) relapsed locoregionally. No statistically significance difference in OS or PFS was seen with presence of perineural or lymphovascular invasion, though analysis was limited by low number of patients. The majority of patients (72%) were node positive on pathology. Two (6.1%) patients had grade 3-4 toxicity during CRT (neutropenic and non-neutropenic sepsis). Conclusions: Our study supported acceptable safety following CRT as an adjuvant treatment in pancreatic cancer patients with R1 resection on surgery. Despite R1 resection, we observed survival outcomes with adjuvant chemotherapy and CRT somewhat above previously reported data. However the benefit of CRT after adjuvant chemotherapy remains unclear. Further evaluation is warranted to clarify which subgroups of patients benefit.

Safety and efficacy of conversion therapy for metastatic esophageal cancer: Exploratory analysis of JCOG1314.

401 Background: Patients with esophageal cancer (EC) with distant metastasis were treated with systemic chemotherapy. Recent advances in multimodal treatments have made conversion therapy (CT) a viable option for patients with metastatic EC. JCOG1314 was a randomized phase III trial to confirm the survival benefit of docetaxel plus cisplatin plus 5-fluorouracil (DCF) versus cisplatin plus 5-fluorouracil (CF) as initial treatment for unresectable or recurrent esophageal cancer. The purpose of this study was to evaluate the safety and survival impact of CT in patients enrolled in JCOG1314. Methods: CT was defined as surgery or chemoradiotherapy (CRT) aiming at cure after initial treatment for tumors that were initially unresectable due to distant metastasis. Clinicopathologic factors, surgical outcomes, toxicities during CRT, and survival were compared between CT and non-CT groups. CTCAE v4.0-JCOG was used to evaluate postoperative complications and adverse events during CRT. Results: Between September 2014 and April 2021, 240 patients were randomized to CF or DCF. Excluding patients with recurrent disease, 154 patients with initially unresectable esophageal cancer due to distant metastasis were selected for this study. Among them, 21 patients received CT which included conversion surgery (n=5) and conversion CRT (n=16). There was no significant difference in the number of metastatic organs, depth of invasion of the primary tumor, lymph node metastasis, and chemotherapy regiment between CT and non-CT groups. The most common M1 factor in CT group was the thoracic lymph node, followed by abdominal lymph node and cervical node. In conversion surgery group, there was no incidence of Grade 3 or higher pneumonia/leakage. Regarding the Grade 3 or higher non-hematological toxicities during conversion CRT, the incidence of appetite loss/ oral mucositis/pneumonia was 2 (13%)/2 (13%)/1 (6%), respectively. The 3-year overall survival (OS) of CT and non-CT groups was 52.4% and 14.3%, respectively. On multivariable analysis, patients with CT showed significantly better OS compared with the non-CT group (HR 0.36, 95% CI 0.19-0.67, p<0.01). In patients who underwent CT, there was no significant difference in OS between conversion surgery and CRT groups. Conclusions: This study demonstrated that CT was safely performed with favorable prognosis. A prospective study is warranted to investigate whether CT would improve survival in metastatic esophageal cancer.

Novel Selectivity: Target of Gas Sensing Defined by Behavior (Adv. Mater. 7/2025)

Elastocaloric Thermal Battery: Ultrahigh Heat‐Storage Capacity Based on Generative Learning‐Designed Phase‐Change Alloys

Abstract An elastocaloric thermal battery based on generative learning‐designed phase‐change alloys is developed to facilitate the efficient recycling of low‐temperature waste heat. This battery stores thermal energy as latent heat in a phase‐change alloy and releases it on demand through applied stress at ambient temperature. Alloy compositions and corresponding processing parameters, tailored to desired transformation characteristics, are efficiently discovered through a generative learning‐enabled inverse design framework, which converts the hand‐drawn target heat flow curve into tangible compositional and processing designs. The designed battery achieves an ultrahigh figure of merit for heat storage capacity, surpassing existing thermal batteries, and boasts a work‐to‐heat efficiency exceeding 9. This opens up exciting possibilities for manipulating thermal energy in diverse applications such as low‐temperature waste heat recycling, solar thermal collection, and heat management in electric vehicles and data center facilities. The inverse design framework promises to expedite the development of various materials with tailored property curves.

Aflibercept (AFL) vs. ramucirumab (RAM) -based therapy in patients with advanced colorectal cancer: Efficacy comparison using real-world data evidence from TriNetX platform.

71 Background: FOLFIRI in combination with Aflibercept (AFL) or Ramucirumab (RAM) prolongs overall survival compared with FOLFIRI alone in patients with advanced colorectal cancer (aCCR) as second-line therapy, however, there are no comparative studies between them. Methods: Utilizing the TriNetX Global Collaborative Network, a platform that operates globally based on anonymized and aggregated clinical data, a sample of aCCR patients from 128 healthcare organizations (HCOs) who met the initial criteria was selected. 5-year overall survival (OS) was analyzed between these cohorts using a Kaplan-Meier analysis. Hazard Ratio (HR) and its 95% confidence interval (95%CI) were calculated to evaluate the difference between cohorts. Propensity Score Matching (PSM) was used to balance the cohorts based on age, gender, and race mitigating possible cofounding variables. All statistical analyses were conducted utilizing the TriNetX Analytics function in the online research platform. Results: A total of 1046 patients met the study criteria and were included in our study. 523 received AFL and 523r received RAM-based therapy. Patients treated with AFL showed a significant better OS compared to patients treated with RAM, both previous to PSM and before PSM (post-PMS median OS 430 days vs 317 days, HR 0.797, 95%CI 0.683-0.930). Conclusions: In this study, based on Real World data, Aflibercept showed superior results to Ramucirumab in advanced colorectal cancer patients treatment. To date this is the largest study comparison between this two therapeutic options.