👤 A S Paulson

Encephalocraniocutaneous lipomatosis (ECCL) is a rare genetic condition with well-described skin, ocular, and central nervous system findings. Several case reports have been documented demonstrating the presence of low-grade gliomas in patients with ECCL and the association with certain FGFR1 mutations. We report on a case of diffuse low-grade glioma, mitogen activated protein kinase pathway altered in a patient with ECCL, who was found to have a distinct FGFR1 mutation. Show less

Fibroblast growth factor receptor 2 (FGFR2) fusions and rearrangements are clinically actionable genomic alterations in cholangiocarcinoma (CCA). Pemigatinib is a selective, potent, oral inhibitor of FGFR1-3 and demonstrated efficacy in patients with previously treated, advanced/metastatic CCA with FGFR2 alterations in FIGHT-202 (NCT02924376). We report final outcomes from the extended follow-up period. The multicenter, open-label, single-arm, phase II FIGHT-202 study enrolled patients ≥18 years old with previously treated advanced/metastatic CCA with FGFR2 fusions or rearrangements (cohort A), other FGF/FGFR alterations (cohort B), or no FGF/FGFR alterations (cohort C). Patients received once-daily oral pemigatinib 13.5 mg in 21-day cycles (2 weeks on, 1 week off) until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) in cohort A assessed as per RECIST v1.1 by an independent review committee; secondary endpoints included duration of response (DOR), progression-free survival (PFS), overall survival (OS), and safety. FIGHT-202 enrolled 147 patients (cohort A, 108; cohort B, 20; cohort C, 17; unconfirmed FGF/FGFR alterations, 2). By final analysis, 145 (98.6%) had discontinued treatment due to progressive disease (71.4%), withdrawal by patient (8.2%), or adverse events (AEs; 6.8%). Median follow-up was 45.4 months. The ORR in cohort A was 37.0% (95% confidence interval 27.9% to 46.9%); complete and partial responses were observed in 3 and 37 patients, respectively. Median DOR was 9.1 (6.0-14.5) months; median PFS and OS were 7.0 (6.1-10.5) months and 17.5 (14.4-22.9) months, respectively. The most common treatment-emergent AEs (TEAEs) were hyperphosphatemia (58.5%), alopecia (49.7%), and diarrhea (47.6%). Overall, 15 (10.2%) patients experienced TEAEs leading to pemigatinib discontinuation; intestinal obstruction and acute kidney injury (n = 2 each) occurred most frequently. Pemigatinib demonstrated durable response and prolonged OS with manageable AEs in patients with previously treated, advanced/metastatic CCA with FGFR2 alterations in the extended follow-up period of FIGHT-202. Show less

A morphometric analysis of coated and uncoated structures found in the apical portion of principal cells from both the proximal and distal caput epididymidis has been carried out. Almost all endocytic, coated vesicles are found within 1 micron of the luminal surface of principal cells and the volume fraction of these and of uncoated vesicles is much greater in the proximal caput epididymidis. A serial section analysis indicated that many coated "vesicles" are tangentially sectioned coated pits and that a complex network of interconnected vesicular and tubular structures exists in the apical cytoplasm. Efferent duct ligation has no effect on the number of size of large coated and uncoated vesicles in either the proximal or distal caput epididymidis, indicating that substances delivered to principal cells from the lumen are not required to maintain the endocytic machinery. However, this treatment does result in a considerable increase in the number of large coated vesicles associated with the basal surface of principal cells from the proximal but not the distal caput epididymidis. The volume fraction of small, presumably exocytic, coated vesicles is significantly greater in the apical cytoplasm of cells from the distal caput epididymidis in control animals. Efferent duct ligation results in a significant increase in the volume fraction of these vesicles in the proximal but not distal caput epididymidis. These results show that there are marked differences in structure among principal cells from these two regions of the epididymis and that this may reflect differences in control and function. Show less

The immunocytochemical localization of the milk protein alpha-lactalbumin in the male reproductive tract is described. Using a primary antiserum raised against highly purified rat milk alpha-lactalbumin, specific staining was consistently shown in the supranuclear Golgi region of the principal cells of the proximal caput epididymidis but only occasionally in epithelial cells from other regions of the duct. Staining was also found in the epididymal lumen and associated with spermatozoa. This luminal staining persisted throughout the distal caput, corpus and cauda epididymidis. Staining was rarely associated with spermatozoa in the efferent ducts and initial segment. Alpha-lactalbumin immunoreactivity was also detected in the seminiferous epithelium. Staining was confined to the Golgi-acrosome region of spermatids. These results indicate that an alpha-lactalbumin-like molecule, or molecules, is present in the male reproductive tract and that it is localized specifically in principal cells from the proximal caput epididymidis and germ cells from the seminiferous epithelium. Show less