5/27/2023 0 Comments Phoneview mac□ Tip: For macOS versions 10-12, please follow the instructions on this screen. Click the button to display instructions for iMazing to access macOS backups.Enable Full Disk Access for iMazing by finding this button at the bottom of iMazing's left sidebar:.Launch iMazing (enter your license code or continue in Trial mode).would like iMazing to read from that same default macOS backup location.have previously used PhoneView with a device backup (or Finder or iTunes) and.How to access PhoneView backups with iMazing IMazing can access this same backup data.Įxample of an iPad backed up with Finder under macOS 13: PhoneView can access data from a previous backup initiated by Finder or iTunes iMazing cannot access or import this archived data (.db or.These files are stored at: ~/Library/Application Support/PhoneView.PhoneView then parses some of this data from the backup and archives it in a custom database. iMazing can access this same backup data.This backup is stored at the default macOS backup location: ~/Library/Application Support/MobileSync/Backup.PhoneView describes this as Downloading data from but it is in fact triggering an iOS backup of the device. PhoneView can access data from a device connected via USB PhoneView, like iMazing, relies on backups of your iPhone, iPad, or iPod touch in order to access the data on the device. If you are not sure about your company’s license or subscription, contact your IT department.This guide is intended to assist PhoneView users migrating to iMazing, including some key differences and considerations between the two apps. Commercial and business features of this app require a Microsoft 365 E3, E5, Microsoft Defender for Endpoint P1, P2, Microsoft 365 Defender for Business license, or a Microsoft 365 Business Premium subscription. Put time back in the hands of defenders to prioritize risks and elevate your security posture.Īdvance beyond endpoint silos and mature your security based on a foundation for XDR and Zero Trust.ĢIf you are a member of a business or organization, you need to login with your company email when you install Microsoft Defender on your devices. Gain the upper hand against sophisticated threats like ransomware, fileless attacks, and nation state threats. Microsoft Defender uses accessibility services to automatically block malicious web pages that may be accessed via links from SMS, messaging apps, browsers, and email. Our comprehensive solution helps to rapidly stop attacks, scale your security resources, and evolve your defenses. Microsoft Defender for Endpoint is an industry-leading, cloud-powered endpoint security solution that helps to secure against ransomware, file-less malware, and other sophisticated attacks across platforms. Microsoft Defender for individuals requires a Microsoft 365 Family or Personal subscription. View alerts and cross-device activity history from the past 30 days.ġIf you are an individual, please login with your personal Microsoft account.Take recommended actions to help keep your personal data and devices secure.Get real-time alerts to stay up to date about changes to your security status and your family members’ statuses.Expert guidance is available to help you recover and restore your stolen identity.Alerts you if personal information is compromised or at risk.Monitors the web for threats to your identity and personal information.Protect your personal data and identity(Available in US) Continuously scans your device to protect against malware, spyware, and ransomware threats.Malware protection for you and your family’s devices against new and existing threats.Easily add or remove your favorite devices and personal data for you and your family.See your and your family’s cross-device protections in one place.A centralized dashboard to check your security status and everyone in your family.Microsoft Defender for individuals requires a Microsoft 365 Personal or Family subscription. 1 You and your family can easily manage your online security in one app with notifications, expert recommendations, and security tips designed to help you stay safer online. Seamlessly protect your data and devices with Microsoft Defender. Sign-in with your work 2 account to access features for Microsoft Defender for Endpoint. Sign-in with your personal account 1 to access features for Microsoft Defender for individuals. For work, Microsoft Defender for Endpoint helps organizations around the world stay more secure. Use Microsoft Defender for individuals 1 at home and on the go. Microsoft Defender is a unified online security app for your work and personal life.
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Released approximately five years after the commercially successful Metallica, Load saw the band embrace a collective sound and identity closer to traditional heavy metal and different from their thrash metal roots. Only "Thorn Within" and "Cure" had occasional jam sessions throughout 1997, but were stopped thereafter. " The House Jack Built", " Cure", " Ronnie", and " Thorn Within" have never been played live. The minute you stop exploring, then just sit down and fucking die." - Lars Ulrich " This album and what we're doing with it – that, to me, is what Metallica are all about: exploring different things. The album garnered backlash from a portion of the band's fan base because of a shift in tone from the group's previous efforts ( Load features a bluesier sound than the band's previous outings). Four singles were released in part of the marketing campaign of the album: " Until It Sleeps", " Hero of the Day", " Mama Said", and " King Nothing". The album has sold over five million copies in United States and is certified 5x platinum by the RIAA. Load debuted (and spent four consecutive weeks) at #1 on Billboard 200. Load was released on Jthrough Elektra Records, it sold 680,000 units in its first week (making it the biggest opening week for Metallica) and the biggest debut of 1996. Hard Rock, Alternative Metal, Post Grunge May 1995 – February 1996 at The Plant Studios in Sausalito, The United States 5/27/2023 0 Comments Interstellar qwikiOr maybe it’s just for selling Valentine’s Day cards. It’s love, Nolan would like us to believe, that saves the universe, and perhaps love that exists as a quantifiable higher dimension, better understood by future civilisations. It is love which drove him to give Murph a watch as a parting gift, and love that gives him faith she will return to her childhood bedroom to find it. But later in the film, he changes his mind, telling TARS that “ is quantifiable”. Maybe we should trust that, even if we can't understand it.Ĭoop is skeptical. Love is the one thing that we're capable of perceiving that transcends dimensions of time and space. I'm drawn across the universe to someone I haven't seen in a decade who I know is probably dead. Maybe it's some evidence, some artefact of a higher dimension that we can't consciously perceive. Brand (Anne Hathaway) when they debate which planet to visit first:īrand: Maybe means something more - something we can't yet understand. It’s discussed in a key scene between Coop and Dr. Whichever camp you fall in, Christopher Nolan would like you to accept it as an important part of the film’s architecture. Spacetime is warped around Earth, for example (as proved by a 2004 satellite) for a black hole with a circumference of a billion kilometres, as Gargantua is, spacetime is warped considerably more.Īs Romilly says: ”That’s relativity, folks.” What’s love got to do with it? His revolutionary 1915 theory proposed that the larger the object, the more spacetime is warped and twisted. Compared to Earth, space-time on Miller’s planet has been warped, hence why the crew say they must “think of time as a resource, just like food or oxygen”.Įinstein’s theory of relativity is key to all this. Gargantua warps space-time its gravitational strength bends Miller’s planet (which, according to Kip Thorne, is as near to Gargantua as it can get without falling in), stretching and squeezing it toward and away from the black hole. After a massive tidal wave hits the spacecraft and delays their exit, they find that 23 years have passed on Earth. Due to Gargantua’s massive gravitational pull, “every hour on that planet is seven years on Earth”. It’s orbiting Gargantua, the massive glowing black hole that exists in the foreign galaxy. After passing through the wormhole, Coop’s team decide to land on Dr. The idea that gravity can be harnessed in this way, or can travel across dimensions, is speculative science-fiction, but it’s rooted in theoretical astrophysics. But as a character later notes, “the equation couldn’t reconcile relativity with quantum mechanics. The gravity equation seeks to manipulate gravity, using the anomalies, in order to “get a viable amount of fuel and life off the planet”.īrand has been attempting to “solve gravity” for 40 years, to no avail he’s even built his entire facility as a space station in preparation. If the Earth is dying, a mass evacuation of humanity is nearly impossible with current rocket propulsion technology. The gravitational anomalies observed by Coop, Murph and Professor Brand lead to a complete reevaluation of the scientific understanding of gravity. So I started working on the theory.Įssentially, the gravity equation is Professor Brand’s attempt to control gravity. Suddenly we knew that harnessing gravity was real. 5/27/2023 0 Comments Osrs left click pickpocketYou can get the cloaks from Two Pints, in East Ardougne's Flying Horse Inn. Keep in mind, you don’t have to equip the cloaks for the bonuses to come into effect. The third-tier stacks with the previous diaries after completing the hard diaries and provides you with a 10 percent higher chance of succeeding when pickpocketing around Gielinor. The second-tier stacks with the easy diary after completing the medium diaries and offers an additional 10 percent higher chance of pickpocketing in Ardougne. Upon completing the Ardougne easy diaries, the first stage, the Ardougne Cloak 1, gives you a 10 percent greater chance of thieving successfully from Ardougne stalls. Upon completing every Ardougne diary you can get these exclusive Cloaks. If you'd like to skip the questing process, consider using our OSRS Questing Service.įor you to use in your Thieving journey to 99, we recommend you use these following items, as they can make your journey a lot more profitable, faster, or both! If you need some gold to afford these items, consider checking out our OSRS Buy Gold Page. Here's a rundown of all the OSRS quests offering thieving experience. The early thieving grind can be very repetitive and involves intense clicking, so we recommend completing a couple of quests that give a reasonable amount of thieving experience to zoom through early levels. Prior to the actual thieving guide, we want to discuss the importance of questing. Feel free to rotate, in particular towards the later levels, through the methods in this OSRS Thieving Guide by Ezrsgold. You never know, you may even make some real life money while training thieving. Get ready for thieving, as in this guide, we’ll go through not just the shortest path to 99 thieving, but also go over a few money makers. Released in May of 2002, Thieving has become a very common skill for Old School RuneScape players, and a fairly quick 99 to achieve. 5/27/2023 0 Comments Wii sports cheats and tipsThe other way is much faster, but also more difficult. Each time they are knocked down, the chance they will get up again decreases, and if they do get up, their maximum health will be two units lower than before. The most common way is by repeatedly knocking down your opponent. There are basically two ways to score a KO against your opponent. An improperly aimed counter will either miss completely or bounce harmlessly off your opponent's glove. A properly aimed counter cannot be dodged, making it invaluable against skilled opponents. You will know if you made a counter-punch by the loud slamming sound coming from the wiimote speaker. If you throw the correct kind of punch during that window, it will deal extra damage. This is the indicator that you can throw a counter-punch. If you dodge a punch you will often notice that the game slows down briefly and makes a "whoosh" sound effect.This can also be done by simply moving the Wii Remote and nunchuk together in these directions if you are not feeling very energetic. Lean your body left, right or back to dodge punches.
This is much like what was said above for Finale or Sibelius and the free trial. I only spent one night with it, but plan to get back to it and try some different tricks. GPP seemed to give me what I got from SS, but then I got it to also give me tabs as well, but there was a lot of jumble to be fixed. xml file that was not exactly accurate but workable I thought. enf (or the other way around) then from that to. Using a copied PDF from my laptop I was able to convert the pdf to first a. The download is provided as is, with no modifications or changes made on our side. Each download we provide is subject to periodical scanning, but we strongly recommend you to check the package for viruses on your side before running the installation. Seeing this app got my attention as I played with SmartScore enough to remember the files that were able to export. You are downloading PDFtoMusic Pro, version 1.7.5. They will, however go the other way and let you buy the full laptop edition for something like half price if you buy PDF-to-XML or Musict-to-XML, I forget the exact name. I have been wrestling with purchasing Music to XML put out by the same Musitek and they won't even give you some type of discount to purchase the $100 USD app (App Store). Nothing was simple as they would lead you to believe and nothing came out right. However, learning curve was too steep for me and had not touched it since almost my purchase date. I have to say that Misitek did give me a bit of a brake, but I paid a lot to this point. That so much was so little that if you want a program that will actually do justice to what was advertised I had to upgrade to the SongBook Edition and quite a bit more money, but I was already caught with one edition and no return. I purchased SmartScore 3 years ago because it had a specific edition for Guitar, Yey! I pay for that app and it is not easy at all and worse you quickly realize, even as a beginner, that it will only do so much. Many thanks in advance for any suggestions! Is there a way to convert my PDF file into MIDI format (a type of musical OCR, I suppose), while also maintaining the different channels (one channel for the left hand staff, and another channel for the right hand), or would I just have to get the original music file that the sheet music was rendered from? I just bought the score of this song from there, and because the score was rendered with the Scorch format, I assumed that I'd be able to also download the music file (in Scorch/Sibelius/MIDI format), however all I got was the PDF, which is of no use to me right now, since what I wanted to do was to transfer the MIDI file to my Yamaha keyboard and to learn how to play this piece using the keyboard's Waiting/Learning Mode. Both have downsides.I long wanted to learn the piano part for Coldplay's "Fix You" (acoustic arrangement for piano+voice), however I only found a single version of it on the Internet, on a paid site (). Measures were correct.Įven so, depending on the situation, I would choose PDF import over manual entry. Three separate times a single measure took up an entire page. MuseScore import lacked any dynamics and hairpins, and staff text of any kind. I did a test just now with an export from Audiverius. The main problem is that MuseScore's mxl import has problems. The PDF needs to be as perfect as possible. Both for the rare occasion I need one of them. Before the evaluation mode expires, you must assign to your hosts a license that supports all the features in use. The evaluation mode provides the set of features equal to a vSphere Enterprise Plus license. I don't have much use for a pdf converter. You can use evaluation mode to explore the entire set of features for ESXi hosts. Even though it is faster than a standard mouse, I am in the group than inputs slowly. The standard reply that it's just quicker to input manually may, indeed, be true for some. That kind of expertise takes months or years to develop, but just a couple of days is more than enough time to get good at the basics of entering notes. It's highly unlikely two weeks would be enough time to learn the program so well that you'd be able to successfully find and fix the errors caused by attempts to import PDF files quickly enough. So if you only have two weeks, spending the first couple of days just getting good at entering notes should allow you to enter the rest of the charts quickly. It's much easier to get good at entering music into MuseScore than it is to get good at identifying and fixing the errors caused by PDF import attempts. An expert might be able to identify and fix the errors faster, but then, they'd also be able to enter the music faster. Realistically, fixing the many nasty errors caused by the AI programs that attempt to turn pictures of music into actual music is way harder than simply entering the music yourself, especially if you are not an expert at using MuseScore. You can then switch back to Timeline View, and use the filter icons in the entity panel to view only events associated with a single character. Repeat until you have associated characters with all of your events. Click on an intersection between an event and a character to set a relationship between the items: you might mark a character as a Participant in or Witness to an event. Then, switch into Relationship View, which shows visually how those characters relate to events in your story. Click on the person icon in the Sidebar to open the Characters panel, and use the Add button to create a few characters. Once you have your basic ideas laid out, it is a good time to introduce some characters. Step 4: Meet your charactersĮvents on a timeline don't mean much until you build a richer picture of everything involved: the characters and settings that drive your scenes, and the story arcs that guide your narrative. Once you add dates and durations, you will start to see a more graphical sense of time emerge from your story. You can add dates by typing them into the Spreadsheet or the Item Inspector, or by splitting your workspace and dragging events into the timeline.Īlternatively, if you want to think about the relative duration and spacing of events without locking yourself into real-world dates, switch to a relative Weekly or Daily calendar in Timeline Settings, and you can work with dates like "Tuesday Week 3" or "1:00pm Day 1" instead. You can move on to later steps and come back when you are ready. But if you are not ready to think about dates yet, that is fine. We are a timeline app after all, and so people will be expecting to see a timeline sooner or later. The tutorial introduces dates at this point. As with everything, only do this if you feel it will help your planning. We will arrange them into a narrative order in a later step.Īs your story grows, you can use nested events to organise events into groups, or break larger events down into smaller items. It is safe to include items that may only become back story, or events that you might wish to tell in a different order when you write the story. Although they don't have dates yet, Spreadsheet View still keeps events in a "chronological order" of your choosing, so you can drag events around to sort them into the rough order in which they should occur.Īt this point, you ae introducing events that occur in your story world. From there, you can begin to fill some of the gaps in between. The best place to start is Spreadsheet View, which is designed to help you get your ideas down fast, and allows you to create events without thinking about dates yet.Ĭreate a few events to represent those key story points you already know. Unless you are writing historical fiction centered around a key moment in history, the last thing you want to be thinking about right now is dates. Step 2: Get down the basicsĪt this stage, you may only have a few loose ideas for what your story is about: a few characters, a couple of key events, and nothing much in between. You will get best results if you take your time with each step, enter real data and plan your actual project as you work. The tutorial will teach you how to use parts of the interface, but it is also designed to help you complete actual work. The path suggested in this article also happens to be the same path as is suggested in our in-built tutorial system, so the easiest way to get going is to start the tutorial and work through the steps. If you are writing Science Fiction or Fantasy and require a different calendar system, now is the time to set that up.įor everyone else, the default settings should be fine. To get started, click on the Create New button and choose from one of our Fiction templates. Create your project and follow the bouncing ball.This guide suggests one such path, assuming you are starting a brand new project, but there are several alternative starting points listed at the end of the article that may suit your workflow better. Only move on to a new step when you have achieved all you want to achieve in an earlier step. The key is to decide where you want to start based on your own workflow, and then focus on one task (and often one feature!) at a time. Aeon Timeline offers a lot of flexibility, which can be great when you are knee-deep in a project and keen to untangle your latest plot hole, but not so useful when you are just starting out and a little lost about where to begin. 5/27/2023 0 Comments Focus groupsCan uncover unsuspected problems and solutions.Relatively inexpensive to conduct and can generate a great deal of customer information.Provide fast turnaround time for acquiring knowledge.Excellent for gathering information regarding customer attitudes and opinions and learning exactly how internal and external customers use your work, products and services.Insights that go beyond a list of demographics, attitudes, and behavior.Although focus groups may only represent a statistically small sample size of a population they offer these additional benefits: The weakness of conducting focus groups is that they use a statistically small sample size population and the attitudes and opinions expressed by a single or a few focus groups may not be representative of the population as a whole. The Benefitsįocus group research methods are an excellent method for gathering in-depth information about customer attitudes and opinions regarding the use of a company’s product or service. The new picture of the consumer is a possibility to consider and to explore further through quantitative studies with larger samples and structured questionnaires. We have to be open and receptive while observing respondents: What stands out about these people? What is the dominant feeling and impression they leave behind? The answer is to consider what comes out of qualitative research as hypothesis, not absolute fact. In addition, what is important and relevant in one category (how people dress or their energy level, for instance) may be meaningless in another. Qualitative research allows us to see in consumers what they themselves may not be aware of and, therefore, what they cannot report in straightforward questioning. These observations often cannot easily be formalized and packaged into quantitative studies. Without answers, client companies don't know how to communicate with their markets or how to design products for them. The company may not even know why its customers buy the product or service, or why non-customers are avoiding it. What clients are missing is their customers' mindsets, what they feel, what motivates them, how they see themselves. This information is both crucial and incomplete - it's not alive or dynamic. In other cases, they already have a demographic profile of their customers, for instance, information about age, income, geographic area, occupation, and children in the home. In some cases, there is a total information vacuum, and qualitative research is the first step in learning about the customers. When companies start to ask these questions, they have varying degrees of knowledge. What kinds of people are your customers? How do they talk? How do they think? How do they see themselves? How do they live? How do they feel about your product? How should you talk to them? What do they want and need? Finding the answers to questions like these is the primary reason why focus groups and in-depth interviews are used. A trained moderator asks a group to focus on a particular topic and facilitates an open-ended, free-flowing discussion regarding an existing or proposed service offering. Focus groups are informal loosely- structured customer interviews with groups of roughly 8 to 12 participants. Lisa Boughton What is a focus group research method?įocus groups are one of the most effective and most frequently used research methods for collecting qualitative data about customer attitudes and perceptions. 5/26/2023 0 Comments Nomacs plugins x86 or x64This program fills the requirement of showing the description text and Labels it “notes” the notes panel does not open fully so you can’t read the info at once and it is fixed in the one place and cant be moved. I was planning to view a collection in a slide show through a television. I was looking for a light fast viewer for scanned images the only thing I wanted was to be able to view the description (IPTC metadata) in a neat and tidy way. I thought I had finally found a perfect photo viewer but there are problems. Aún no lo e probado en GNU/Linux, así que no puedo decir mucho al respecto. Uso Windows 10 Mayo, pero también me gustan Ubuntu y Manjaro, ambos en KDE o Gnome. Lo malo es que, cuando uno ya tiene una imagen abierta, y da clic en otra imagen, en la carpeta en la que nos encontremos, tela abre en una nueva ventana, si lo hiciera en la misma para no estar dando escape, al estilo de Piccasa, agilizaría aún más la tarea. Se que es una tontería, pero es un recurso que aprecio, pues a mi entender agiliza el trabajo, y si necesitamos la barra de herramientas para algo, la hacemos aparecer y ya, pero para ver las imágenes solo necesitamos eso, verlas sin más. Además, de poder ocultar tanto la barra de herramientas como la de miniaturas, dejando una vista limpia, lo justo y necesario en un visor a mi parecer, solo la imagen y todo lo demás atrás y punto. Me gusta por el uso del fondo transparente al mejor estilo de Piccasa, ya que permite ver las imágenes detrás en el directorio en el que estemos, a modo de poder cazarlas como un halcón volando al asecho, sin la necesidad de saltar a una u otra en la barra de miniaturas de abajo. No menciono los errores porque muchos ya se los han dicho. DownloadĮs una pena que tengan muchos bugs aún, y no han actualizado más la aplicación en meses. GIT Repository (containing the source code of nomacs and all dependencies).If there is no package available for your favorite distribution, you can download the sources and compile nomacs according to the compile instructions.update your FreeBSD repository and change directory to /usr/ports/graphics/nomacs (if your repository directory is the default, otherwise change to the particular directory). repositories (Tumbleweed, Factory, 12.1, 11.4).nomacs is officially available on Arch Linux, simply install it with:.nomacs is included in the official repositories.Install the heif plugin to load heif images.translations can be added with sudo apt-get install nomacs-l10n.Just install it using your favorite package manager. nomacs is available in the “universe” repository of Ubuntu.We recommend installing nomacs from there if you want to have the latest version. © Markus Diem, Stefan Fiel, and Florian Kleber, 2011 – 2020 Windows (7/8/10) Nomacs – Image Lounge is licensed under the GNU General Public License v3 5/26/2023 0 Comments Her2 postie received zalota“Importantly, patients were enrolled based on histology as opposed to tumor location. The primary end points of the trial for nivolumab plus chemotherapy versus chemotherapy were OS and PFS by blinded independent central review in patients whose tumors expressed PD-L1 with a CPS of 5 or greater. Participants were randomized to receive nivolumab at 360 mg every 3 weeks or 240 mg every 2 weeks plus chemotherapy comprised of XELOX every 3 weeks or FOLFOX every 2 weeks, nivolumab plus ipilimumab (Yervoy), or chemotherapy. Those with HER2 positivity were excluded from the trial. Patients with previously treated, unresectable advanced, or metastatic gastric cancer, GEJ cancer, or esophageal adenocarcinoma were enrolled to the trial, irrespective of PD-L1 expression. The phase 3 CheckMate-649 trial (NCT02872116) was a larger study than KEYNOTE-062. There was no benefit for pembrolizumab compared with chemotherapy or pembrolizumab with chemotherapy.”ĬheckMate-649 Introduces New Standard First-Line Treatment Option “Nonetheless, the study was heartbreaking to everyone because it did not change practice. Statistically, it was underpowered and had too many complicated alphas and questions to answer,” said Janjigian. “This was an eagerly awaited study, but relatively poorly designed with a small sample size. 05) or a CPS of 10 or greater, at a median of 6.9 months versus 6.4 months, respectively (HR, 0.84 95% CI, 0.70-1.02 P =.04). Moreover, pembrolizumab plus chemotherapy was not superior to chemotherapy for OS in patients with a CPS of 1 or greater, at a median of 12.5 months versus 11.1 months, respectively (HR, 0.85 95% CI, 0.70-1.03 P =. The PD-1 inhibitor prolonged OS versus chemotherapy in patients with a CRPS of 10 or greater, at a median of 17.4 months versus 10.8 months, respectively (HR, 0.69 95% CI, 0.49-0.97). Single-agent pembrolizumab was not superior to chemotherapy alone in patients with a CPS of 1 or greater. Results showed that pembrolizumab was noninferior to chemotherapy in terms of OS in patients with a CPS of 1 or greater, at a median OS of 10.6 months versus 11.1 months, respectively (HR, 0.91 99.2% CI, 0.69-1.18). The primary end points of the trial were overall survival (OS) and progression-free survival (PFS) in patients with PD-L1 CPS of 1 or greater or 10 or greater. 2Ī total of 763 patients were randomized 1:1:1 to receive pembrolizumab at 200 mg (n = 256) pembrolizumab plus chemotherapy which was comprised of cisplatin at 80 mg/m2 on day 1 plus fluorouracil (5-FU) at 800 mg/m2 on days 1 to 5 or capecitabine 1000 mg/m2 twice daily (n = 257) or chemotherapy plus placebo (n = 250) every 3 weeks. The randomized, controlled, partially blinded phase 3 KEYNOTE-062 trial (NCT02494583) enrolled patients with untreated, locally advanced, unresectable, or metastatic gastric/gastroesophageal junction (GEJ) cancer with a PD-L1 CPS of 1 or greater. However, 2020 was a groundbreaking year.” When their tumors are PD-L1 negative, they feel like you’re withholding some therapy from them, but really doesn’t benefit them. That’s part of the frustration that experience. “Disappointingly, with anti–PD-1 therapy alone, CPS-low expressors benefit very little. “TMB has been approved for pembrolizumab as well, although it’s important to know that for gastric cancer, pretty much all patients who have TMB-high tumors are also MSI high that’s really our niche,” said Janjigian. Additionally, pembrolizumab (Keytruda) was approved by the FDA for use in the third-line setting in patients with a PD-L1 combined positive score (CPS) of 1 or higher, tumor mutational burden (TMB) of 10 or higher, or those with microsatellite instability–high tumors. In Asia, the PD-1 agent nivolumab (Opdivo) was approved for use as third-line treatment in patients with adenocarcinoma, regardless of PD-L1 expression status. Checkpoint inhibitors are typically given after disease progression on standard chemotherapy, usually in the third-line setting, said Janjigian. Immunotherapy is an approach that is utilized in later lines of treatment in gastric cancer. “We’re going to examine what’s to come in 20 for anti–PD-1 combination strategies and review some of the molecular features that will allow us to understand how to time treatments and allow our patients to achieve maximum benefits with maximum options to maximize cures,” said Janjigian, associate attending physician and associate professor of Weill Cornell Medical College, and chief of Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center, in a virtual presentation during the 2020 Ruesch Center Symposium. Janjigian, MD, who added that certain molecular features will affect response and inform treatment selection and timing. Future research efforts are focused on examining anti–PD-1 combination strategies, particularly with HER2-directed therapies, according to Yelena Y. |