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Riedel R, Fassunke J, Scheel AH, Scheffler M, Heydt C, Nogova L, Michels S, Fischer RN, Eisert A, Scharpenseel H, John F, Ruge L, Schaufler D, Siemanowski J, Ihle MA, Wagener-Ryczek S, Pappesch R, Rehker J, Bunck A, Kobe C, Keil F, Merkelbach-Bruse S, Büttner R, Wolf J. MET Fusions in NSCLC: Clinicopathologic Features and Response to MET Inhibition. J Thorac Oncol 2024; 19:160-165. [PMID: 37429463 DOI: 10.1016/j.jtho.2023.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 06/28/2023] [Accepted: 06/30/2023] [Indexed: 07/12/2023]
Abstract
INTRODUCTION MET fusions have been described only rarely in NSCLC. Thus, data on patient characteristics and treatment response are limited. We here report histopathologic data, patient demographics, and treatment outcome including response to MET tyrosine kinase inhibitor (TKI) therapy in MET fusion-positive NSCLC. METHODS Patients with NSCLC and MET fusions were identified mostly by RNA sequencing within the routine molecular screening program of the national Network Genomic Medicine, Germany. RESULTS We describe a cohort of nine patients harboring MET fusions. Among these nine patients, two patients had been reported earlier. The overall frequency was 0.29% (95% confidence interval: 0.15-0.55). The tumors were exclusively adenocarcinoma. The cohort was heterogeneous in terms of age, sex, or smoking status. We saw five different fusion partner genes (KIF5B, TRIM4, ST7, PRKAR2B, and CAPZA2) and several different breakpoints. Four patients were treated with a MET TKI leading to two partial responses, one stable disease, and one progressive disease. One patient had a BRAF V600E mutation as acquired resistance mechanism. CONCLUSIONS MET fusions are very rare oncogenic driver events in NSCLC and predominantly seem in adenocarcinomas. They are heterogeneous in terms of fusion partners and breakpoints. Patients with MET fusion can benefit from MET TKI therapy.
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Affiliation(s)
- Richard Riedel
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Jana Fassunke
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Andreas H Scheel
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Matthias Scheffler
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Carina Heydt
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Lucia Nogova
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Sebastian Michels
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Rieke N Fischer
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Anna Eisert
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Heather Scharpenseel
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Felix John
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Lea Ruge
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Diana Schaufler
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany
| | - Janna Siemanowski
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Michaela A Ihle
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Svenja Wagener-Ryczek
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Roberto Pappesch
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Jan Rehker
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Anne Bunck
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Radiology, University of Cologne, Cologne, Germany
| | - Carsten Kobe
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Nuclear Medicine, University of Cologne, Cologne, Germany
| | - Felix Keil
- Institute of Pathology, University of Regensburg, Regensburg, Germany
| | - Sabine Merkelbach-Bruse
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Reinhard Büttner
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Institute of Pathology, University of Cologne, Cologne, Germany
| | - Jürgen Wolf
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, University of Cologne, Cologne, Germany; Lung Cancer Group Cologne, Cologne, Germany.
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2
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Riedel R, Fassunke J, Tumbrink HL, Scheel AH, Heydt C, Hieggelke L, Scheffler M, Heimsoeth A, Nogova L, Michels S, Weber JP, Fischer RN, Eisert A, Westphal T, Schaufler D, Siemanowski J, Ihle MA, Wagener-Ryczek S, Castiglione R, Pappesch R, Rehker J, Jürgens J, Stoelben E, Bunck A, Kobe C, Merkelbach-Bruse S, Sos ML, Büttner R, Wolf J. Resistance to MET inhibition in MET-dependent NSCLC and therapeutic activity after switching from type I to type II MET inhibitors. Eur J Cancer 2023; 179:124-135. [PMID: 36521334 DOI: 10.1016/j.ejca.2022.11.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 10/30/2022] [Accepted: 11/09/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Resistance to MET inhibition occurs inevitably in MET-dependent non-small cell lung cancer and the underlying mechanisms are insufficiently understood. We describe resistance mechanisms in patients with MET exon 14 skipping mutation (METΔex14), MET amplification, and MET fusion and report treatment outcomes after switching therapy from type I to type II MET inhibitors. MATERIALS AND METHODS Pre- and post-treatment biopsies were analysed by NGS (next generation sequencing), digital droplet PCR (polymerase chain reaction), and FISH (fluorescense in situ hybridization). A patient-derived xenograft model was generated in one case. RESULTS Of 26 patients with MET tyrosine kinase inhibitor treatment, eight had paired pre- and post-treatment biopsies (Three with MET amplification, three with METΔex14, two with MET fusions (KIF5B-MET and PRKAR2B-MET).) In six patients, mechanisms of resistance were detected, whereas in two cases, the cause of resistance remained unclear. We found off-target resistance mechanisms in four cases with KRAS mutations and HER2 amplifications appearing. Two patients exhibited second-site MET mutations (p.D1246N and p. Y1248H). Three patients received type I and type II MET tyrosine kinase inhibitors sequentially. In two cases, further progressive disease was seen hereafter. The patient with KIF5B-MET fusion received three different MET inhibitors and showed long-lasting stable disease and a repeated response after switching therapy, respectively. CONCLUSION Resistance to MET inhibition is heterogeneous with on- and off-target mechanisms occurring regardless of the initial MET aberration. Switching therapy between different types of kinase inhibitors can lead to repeated responses in cases with second-site mutations. Controlled clinical trials in this setting with larger patient numbers are needed, as evidence to date is limited to preclinical data and case series.
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Affiliation(s)
- Richard Riedel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Jana Fassunke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Hannah L Tumbrink
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Translational Genomics, Germany
| | - Andreas H Scheel
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Carina Heydt
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Lena Hieggelke
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Matthias Scheffler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Alena Heimsoeth
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Translational Genomics, Germany
| | - Lucia Nogova
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Sebastian Michels
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Jan-Phillip Weber
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Rieke N Fischer
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Anna Eisert
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Theresa Westphal
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Diana Schaufler
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany
| | - Janna Siemanowski
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Michaela A Ihle
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Svenja Wagener-Ryczek
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | | | - Roberto Pappesch
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Jan Rehker
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Jessica Jürgens
- Lung Clinic Merheim, Hospital of the City of Cologne, University of Witten-Herdecke, Germany
| | - Erich Stoelben
- Lung Clinic Merheim, Hospital of the City of Cologne, University of Witten-Herdecke, Germany
| | - Anne Bunck
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Radiology, Germany
| | - Carsten Kobe
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Nuclear Medicine, Germany
| | - Sabine Merkelbach-Bruse
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany
| | - Martin L Sos
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Translational Genomics, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne, Germany
| | - Reinhard Büttner
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department of Pathology, Molecular Pathology, Germany; University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne, Germany
| | - Jürgen Wolf
- University of Cologne, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology, Department I of Internal Medicine, Germany; Lung Cancer Group, Cologne, Germany.
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3
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Thomas MN, Dieplinger G, Datta RR, Kleinert R, Fuchs HF, Bunck A, Peterhans M, Bruns CJ, Stippel D, Wahba R. Navigated laparoscopic microwave ablation of tumour mimics in pig livers: a randomized ex-vivo experimental trial. Surg Endosc 2021; 35:6763-6769. [PMID: 33289054 PMCID: PMC8599321 DOI: 10.1007/s00464-020-08180-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/15/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND In order to efficiently perform laparoscopic microwave ablation of liver tumours precise positioning of the ablation probe is mandatory. This study evaluates the precision and ablation accuracy using the innovative laparoscopic stereotactic navigation system CAS-One-SPOT in comparison to 2d ultrasound guided laparoscopic ablation procedures. METHODS In a pig liver ablation model four surgeons, experienced (n = 2) and inexperienced (n = 2) in laparoscopic ablation procedures, were randomized for 2d ultrasound guided laparoscopic or stereotactic navigated laparoscopic ablation procedures. Each surgeon performed a total of 20 ablations. Total attempts of needle placements, time from tumor localization till beginning of ablation and ablation accuracy were analyzed. RESULTS The use of the laparoscopic stereotactic navigation system led to a significant reduction in total attempts of needle placement. The experienced group of surgeons reduced the mean number of attempts from 2.75 ± 2.291 in the 2d ultrasound guided ablation group to 1.45 ± 1.191 (p = 0.0302) attempts in the stereotactic navigation group. Comparable results could be observed in the inexperienced group with a reduction of 2.5 ± 1.50 to 1.15 ± 0.489 (p = 0.0005). This was accompanied by a significant time saving from 101.3 ± 112.1 s to 48.75 ± 27.76 s (p = 0.0491) in the experienced and 165.5 ± 98.9 s to 66.75 ± 21.96 s (p < 0.0001) in the inexperienced surgeon group. The accuracy of the ablation process was hereby not impaired as postinterventional sectioning of the ablation zone revealed. CONCLUSION The use of a stereotactic navigation system for laparoscopic microwave ablation procedures of liver tumors significantly reduces the attempts and time of predicted correct needle placement for novices and experienced surgeons without impairing the accuracy of the ablation procedure.
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Affiliation(s)
- M N Thomas
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany.
| | - G Dieplinger
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R R Datta
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R Kleinert
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - H F Fuchs
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - A Bunck
- Department of Diagnostic and Interventional Radiology, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | | | - C J Bruns
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - D Stippel
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R Wahba
- Department of General, Visceral, Cancer and Transplant Surgery, University of Cologne, Faculty of Medicine and University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
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4
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Trommer M, Yeo SY, Persigehl T, Bunck A, Grüll H, Schlaak M, Theurich S, von Bergwelt-Baildon M, Morgenthaler J, Herter JM, Celik E, Marnitz S, Baues C. Corrigendum: Abscopal Effects in Radio-Immunotherapy-Response Analysis of Metastatic Cancer Patients With Progressive Disease Under Anti-PD-1 Immune Checkpoint Inhibition. Front Pharmacol 2020; 10:1615. [PMID: 32082149 PMCID: PMC7006368 DOI: 10.3389/fphar.2019.01615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 12/10/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Maike Trommer
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Sin Yuin Yeo
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Anne Bunck
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Holger Grüll
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Max Schlaak
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sebastian Theurich
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Gene Center, Cancer- and Immunometabolism Research Group, Ludwig-Maximilians University Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Janis Morgenthaler
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Jan M Herter
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Eren Celik
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Simone Marnitz
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Christian Baues
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
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5
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Riedel R, Michels S, Heydt C, Siemanowski J, Kobe C, Bunck A, Schäfer S, Fischer RN, Scheffler M, Abdulla DS, Nogová L, Koleczko S, Merkelbach-Bruse S, Büttner R, Wolf J. Acquired KRAS mutation and loss of low-level MET amplification after durable response to crizotinib in a patient with lung adenocarcinoma. Lung Cancer 2019; 133:20-22. [DOI: 10.1016/j.lungcan.2019.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Revised: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 11/28/2022]
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6
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Stippel DL, Wahba R, Bruns CJ, Bunck A, Baues C, Persigehl T. [Image-guided, minimally invasive surgery and other local therapeutic procedures for primary liver tumors]. Chirurg 2019; 89:872-879. [PMID: 30030546 DOI: 10.1007/s00104-018-0688-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The incidence of primary liver tumors is rising. Modern minimally invasive, image-guided procedures offer a potentially curative therapy option. OBJECTIVE The aim of this study was to evaluate the multitude of image-guided minimally invasive procedures concerning their evidence-based effect on local tumor control and overall survival. MATERIAL AND METHODS A systematic search of MEDLINE focused on hepatocellular cancer, minimally invasive treatment, local ablative therapy, therapeutic stratification and comparative studies was performed. RESULTS The level of evidence varied greatly depending on the procedure used. The highest quality evidence including prospective randomized studies was found for radiofrequency ablation (RFA) of hepatocellular cancer. The RFA is superior with respect to local tumor control and overall survival in comparison to other ablative procedures. Prospective randomized studies comparing surgery and RFA showed diverging and contradictory results. Microwave ablation and robotic stereotactic irradiation showed sufficient potential in retrospective studies in comparison to RFA and surgery in order to confirm the techniques in randomized studies. There is only anecdotal evidence concerning high intensity focused ultrasound (HIFU) and irreversible electroporation. Percutaneous ethanol injection (PEI), cryoablation and laser-induced thermal therapy (LITT) were inferior techniques to RFA in most studies. CONCLUSION Minimally invasive resection and local ablative therapies based on structured imaging and image reporting can improve the prognosis of patients with hepatocellular cancer even in patients that exceed the BCLC 0/A stage.
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Affiliation(s)
- D L Stippel
- Klinik für Allgemein‑, Viszeral- und Tumorchirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland.
| | - R Wahba
- Klinik für Allgemein‑, Viszeral- und Tumorchirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - C J Bruns
- Klinik für Allgemein‑, Viszeral- und Tumorchirurgie, Uniklinik Köln (AöR), Kerpener Str. 62, 50937, Köln, Deutschland
| | - A Bunck
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Deutschland
| | - C Baues
- Klinik und Poliklinik für Radioonkologie, Cyberknife- und Strahlentherapie, Uniklinik Köln, Köln, Deutschland
| | - T Persigehl
- Institut für Diagnostische und Interventionelle Radiologie, Uniklinik Köln, Köln, Deutschland
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7
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Trommer M, Yeo SY, Persigehl T, Bunck A, Grüll H, Schlaak M, Theurich S, von Bergwelt-Baildon M, Morgenthaler J, Herter JM, Celik E, Marnitz S, Baues C. Abscopal Effects in Radio-Immunotherapy-Response Analysis of Metastatic Cancer Patients With Progressive Disease Under Anti-PD-1 Immune Checkpoint Inhibition. Front Pharmacol 2019; 10:511. [PMID: 31156434 PMCID: PMC6530339 DOI: 10.3389/fphar.2019.00511] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2019] [Accepted: 04/24/2019] [Indexed: 12/31/2022] Open
Abstract
Immune checkpoint inhibition (ICI) targeting the programmed death receptor 1 (PD-1) has shown promising results in the fight against cancer. Systemic anti-tumor reactions due to radiation therapy (RT) can lead to regression of non-irradiated lesions (NiLs), termed “abscopal effect” (AbE). Combination of both treatments can enhance this effect. The aim of this study was to evaluate AbEs during anti-PD-1 therapy and irradiation. We screened 168 patients receiving pembrolizumab or nivolumab at our center. Inclusion criteria were start of RT within 1 month after the first or last application of pembrolizumab (2 mg/kg every 3 weeks) or nivolumab (3 mg/kg every 2 weeks) and at least one metastasis outside the irradiation field. We estimated the total dose during ICI for each patient using the linear quadratic (LQ) model expressed as 2 Gy equivalent dose (EQD2) using α/β of 10 Gy. Radiological images were required showing progression or no change in NiLs before and regression after completion of RT(s). Images must have been acquired at least 4 weeks after the onset of ICI or RT. The surface areas of the longest diameters of the short- and long-axes of NiLs were measured. One hundred twenty-six out of 168 (75%) patients received ICI and RT. Fifty-three percent (67/126) were treated simultaneously, and 24 of these (36%) were eligible for lesion analysis. AbE was observed in 29% (7/24). One to six lesions (mean = 3 ± 2) in each AbE patient were analyzed. Patients were diagnosed with malignant melanoma (MM) (n = 3), non-small cell lung cancer (NSCLC) (n = 3), and renal cell carcinoma (RCC) (n = 1). They were irradiated once (n = 1), twice (n = 2), or three times (n = 4) with an average total EQD2 of 120.0 ± 37.7 Gy. Eighty-two percent of RTs of AbE patients were applied with high single doses. MM patients received pembrolizumab, NSCLC, and RCC patients received nivolumab for an average duration of 45 ± 35 weeks. We demonstrate that 29% of the analyzed patients showed AbE. Strict inclusion criteria were applied to distinguish the effects of AbE from the systemic effect of ICI. Our data suggest the clinical existence of systemic effects of irradiation under ICI and could contribute to the development of a broader range of cancer treatments.
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Affiliation(s)
- Maike Trommer
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Sin Yuin Yeo
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Thorsten Persigehl
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Anne Bunck
- Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Holger Grüll
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Department of Diagnostic and Interventional Radiology, University of Cologne, Cologne, Germany
| | - Max Schlaak
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Dermatology and Allergology, Ludwig-Maximilians University Munich, Munich, Germany
| | - Sebastian Theurich
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany.,Gene Center, Cancer- and Immunometabolism Research Group, Ludwig-Maximilians University Munich, Munich, Germany
| | - Michael von Bergwelt-Baildon
- Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Department of Medicine III, University Hospital, Ludwig-Maximilians University Munich, Munich, Germany
| | - Janis Morgenthaler
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Jan M Herter
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Molecular Medicine Cologne, University of Cologne, Cologne, Germany
| | - Eren Celik
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Simone Marnitz
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
| | - Christian Baues
- Faculty of Medicine and University Hospital Cologne, Department of Radiation Oncology and Cyberknife Center, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Radio Immune-Oncology Consortium, University of Cologne, Cologne, Germany.,Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology (CIO Köln Bonn), University of Cologne, Cologne, Germany
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8
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Trommer M, Yeo S, Persigehl T, Bunck A, Schlaak M, Grüll H, Theurich S, Von Bergwelt M, Herter J, Celik E, Marnitz S, Baues C. PO-0890 Abscopal effects in metastasized cancer patients treated with PD-1 inhibition and radiation therapy. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31310-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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9
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Quaas A, Heydt C, Waldschmidt D, Alakus H, Zander T, Goeser T, Kasper P, Bruns C, Brunn A, Roth W, Hartmann N, Bunck A, Schmidt M, Buettner R, Merkelbach-Bruse S. Alterations in ERBB2 and BRCA and microsatellite instability as new personalized treatment options in small bowel carcinoma. BMC Gastroenterol 2019; 19:21. [PMID: 30717682 PMCID: PMC6360678 DOI: 10.1186/s12876-019-0942-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Accepted: 01/25/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Carcinomas of the small bowel are rare tumors usually with dismal prognosis. Most recently, some potentially treatable molecular alterations were described. We emphasize the growing evidence of individualized treatment options in small bowel carcinoma. METHODS We performed a DNA- based multi-gene panel using ultra-deep sequencing analysis (including 14 genes with up to 452 amplicons in total; KRAS, NRAS, HRAS, BRAF, DDR2, ERBB2, KEAP1, NFE2L2, PIK3CA, PTEN, RHOA, BRCA1, BRCA2 and TP53) as well as an RNA-based gene fusion panel including ALK, BRAF, FGFR1, FGFR2, FGFR3, MET, NRG1, NTRK1, NTRK2, NTRK3, RET and ROS1 on eleven formalin fixed and paraffin embedded small bowel carcinomas. Additionally, mismatch-repair-deficiency was analyzed by checking the microsatellite status using the five different mononucleotide markers BAT25, BAT26, NR-21, NR-22 and NR-27 and loss of mismatch repair proteins using four different markers (MLH1, MSH6, MSH2, PMS2). RESULTS In five out of eleven small bowel carcinomas we found potentially treatable genetic alterations. Three patients demonstrated pathogenic (class 5) BRCA1 or BRCA2 mutations - one germline-related in a mixed neuroendocrine-non neuroendocrine neoplasm (MiNEN). Two additional patients revealed an activating ERBB2 mutation or PIK3CA mutation. Furthermore two tumors were highly microsatellite-instable (MSI-high), in one case associated to Lynch-syndrome. We did not find any gene fusions. CONCLUSION Our results underscore, in particular, the relevance of potentially treatable molecular alterations (like ERBB2, BRCA and MSI) in small bowel carcinomas. Further studies are needed to proof the efficacy of these targeted therapies in small bowel carcinomas.
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Affiliation(s)
- Alexander Quaas
- Institute of Pathology, University of Cologne, Cologne, Germany.
| | - Carina Heydt
- Institute of Pathology, University of Cologne, Cologne, Germany
| | - Dirk Waldschmidt
- Department of Hepato- and Gastroenterology, University of Cologne, Cologne, Germany
| | - Hakan Alakus
- Department of Visceral Surgery, University of Cologne, Cologne, Germany
| | - Thomas Zander
- Department of Oncology and Hematology, University of Cologne, Cologne, Germany
| | - Tobias Goeser
- Department of Hepato- and Gastroenterology, University of Cologne, Cologne, Germany
| | - Philipp Kasper
- Department of Hepato- and Gastroenterology, University of Cologne, Cologne, Germany
| | - Christiane Bruns
- Department of Visceral Surgery, University of Cologne, Cologne, Germany
| | - Anna Brunn
- Institute of Neuropathology, University of Cologne, Cologne, Germany
| | - Wilfried Roth
- Institute of Pathology, University of Mainz, Mainz, Germany
| | - Nils Hartmann
- Institute of Pathology, University of Mainz, Mainz, Germany
| | - Anne Bunck
- Department of Radiology, University of Cologne, Cologne, Germany
| | - Matthias Schmidt
- Department of Nuclear Medicine, University of Cologne, Cologne, Germany
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10
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Michels S, Scheffler M, Wagener S, Plenker D, Scheel A, Nogová L, Schultheis A, Fischer RN, Abdulla DS, Riedel R, Bunck A, Kobe C, Baus W, Merkelbach-Bruse S, Sos ML, Büttner R, Wolf J. Loss of G2032R Resistance Mutation Upon Chemotherapy Treatment Enables Successful Crizotinib Rechallenge in a Patient With ROS1-Rearranged NSCLC. JCO Precis Oncol 2018; 2:1-6. [DOI: 10.1200/po.18.00121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Sebastian Michels
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Matthias Scheffler
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Svenja Wagener
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Dennis Plenker
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Andreas Scheel
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Lucia Nogová
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Anne Schultheis
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Rieke N. Fischer
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Diana S.Y. Abdulla
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Richard Riedel
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Anne Bunck
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Carsten Kobe
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Wolfgang Baus
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Sabine Merkelbach-Bruse
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Martin L. Sos
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Reinhard Büttner
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
| | - Jürgen Wolf
- All authors: University Hospital of Cologne; Martin L. Sos, University of Cologne, Cologne, Germany
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11
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Quaas A, Waldschmidt D, Alakus H, Zander T, Heydt C, Goeser T, Daheim M, Kasper P, Plum P, Bruns C, Brunn A, Roth W, Hartmann N, Bunck A, Schmidt M, Göbel H, Tharun L, Buettner R, Merkelbach-Bruse S. Therapy susceptible germline-related BRCA 1-mutation in a case of metastasized mixed adeno-neuroendocrine carcinoma (MANEC) of the small bowel. BMC Gastroenterol 2018; 18:75. [PMID: 29855275 PMCID: PMC5984468 DOI: 10.1186/s12876-018-0803-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 05/23/2018] [Indexed: 01/04/2023] Open
Abstract
Background Adenocarcinomas or combined adeno-neuroendocrine carcinomas (MANEC) of small bowel usually have a dismal prognosis with limited systemic therapy options. This is the first description of a patient showing a germline-related BRCA1 mutated MANEC of his ileum. The tumor presented a susceptibility to a combined chemotherapy and the PARP1-inhibitor olaparib. Case presentation A 74-year old male patient presented with a metastasized MANEC of his ileum. Due to clinical symptoms his ileum-tumor and the single brain metastasis were removed. We verified the same pathogenic (class 5) BRCA1 mutation in different tumor locations. There was no known personal history of a previous malignant tumor. Nevertheless we identified his BRCA1 mutation as germline-related. A systemic treatment was started including Gemcitabine followed by selective internal radiotherapy (SIRT) to treat liver metastases and in the further course Capecitabine but this treatment finally failed after 9 months and all liver metastases showed progression. The treatment failure was the reason to induce an individualized therapeutic approach using combined chemotherapy of carboplatin, paclitaxel and the Poly (ADP-ribose) polymerase- (PARP)-inhibitor olaparib analogous to the treatment protocol of Oza et al. All liver metastases demonstrated with significant tumor regression after 3 months and could be removed. In his most current follow up from December 2017 (25 months after his primary diagnosis) the patient is in a very good general condition without evidence for further metastases. Conclusion We present first evidence of a therapy susceptible germline-related BRCA1 mutation in small bowel adeno-neuroendocrine carcinoma (MANEC). Our findings offer a personalized treatment option. The germline background was unexpected in a 74-year old man with no previously known tumor burden. We should be aware of the familiar background in tumors of older patients as well.
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Affiliation(s)
- A Quaas
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany. .,Gastrointestinal Cancer Group Cologne, Cologne, Germany.
| | - D Waldschmidt
- Department of Hepato- and Gastroenterology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - H Alakus
- Department of Visceral Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.,Gastrointestinal Cancer Group Cologne, Cologne, Germany
| | - T Zander
- Department of Oncology and Hematology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.,Gastrointestinal Cancer Group Cologne, Cologne, Germany
| | - C Heydt
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - T Goeser
- Department of Hepato- and Gastroenterology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - M Daheim
- Department of Hepato- and Gastroenterology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - P Kasper
- Department of Hepato- and Gastroenterology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - P Plum
- Department of Visceral Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - C Bruns
- Department of Visceral Surgery, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - A Brunn
- Institute of Neuropathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - W Roth
- Institute of Pathology, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - N Hartmann
- Institute of Pathology, University of Mainz, Langenbeckstraße 1, 55131, Mainz, Germany
| | - A Bunck
- Department of Radiology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - M Schmidt
- Department of Nuclear-Medicine, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - H Göbel
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - L Tharun
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - R Buettner
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - S Merkelbach-Bruse
- Institute of Pathology, University of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
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12
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Bunck AC, Dos Santos DP, Chang DH, Reiser M, Pfister D, Bunck A, Drzezga A, Maintz D, Schmidt M. Successful Yttrium-90 Microsphere Radioembolization for Hepatic Metastases of Prostate Cancer. Case Rep Oncol 2017; 10:627-633. [PMID: 28868022 PMCID: PMC5566710 DOI: 10.1159/000478004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 12/22/2022] Open
Abstract
Prostate cancer is the most common solid tumor malignancy worldwide with an estimated 180,000 new cases of prostate cancer and 26,000 deaths in the USA in 2016. Although significant advances in the treatment of prostate cancer have recently been made, the treatment of metastatic disease remains a challenge. With visceral metastases marking more advanced tumor stages, liver involvement is associated with the worst prognosis. So far, no locoregional treatment regimens for the management of liver metastases of prostatic cancer exist. Herein, we report for the first time a successful treatment of hepatic metastases of prostatic cancer using radioembolization with selective intra-arterial administration of Yttrium-90 resin microspheres.
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Affiliation(s)
- Alexander C Bunck
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | | | - De-Hua Chang
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Marcel Reiser
- Practice for Oncology and Hematology, Cologne, Germany
| | - David Pfister
- Department of Urology, University Hospital of Cologne, Cologne, Germany
| | - Anne Bunck
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Alexander Drzezga
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
| | - David Maintz
- Department of Radiology, University Hospital of Cologne, Cologne, Germany
| | - Matthias Schmidt
- Department of Nuclear Medicine, University Hospital of Cologne, Cologne, Germany
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13
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Hickethier T, Baeßler B, Kroeger J, Doerner J, Pahn G, Maintz D, Michels G, Bunck A. Nutzen monoenergetischer Rekonstruktionen eines neuen Spectral-Detector-CTs für die Bildgebung von Koronarstents: erste in-vitro Ergebnisse. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- T Hickethier
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - B Baeßler
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - J Kroeger
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - J Doerner
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - G Pahn
- Philips Deutschland GmbH, Clinical Science CT, Hamburg
| | - D Maintz
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
| | - G Michels
- Uniklinik Köln, Klinik III für Innere Medizin, Köln
| | - A Bunck
- Uniklinik Köln, Institut für Diagnostische und Interventionelle Radiologie, Köln
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14
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Kröger J, Hickethier T, Pahn G, Maintz D, Bunck A. Evaluation eines CAD-Tools und des Einflusses der Spectral Detector CT bei der automatischen Detektion von pulmonalarteriellen Thromben. ROFO-FORTSCHR RONTG 2017. [DOI: 10.1055/s-0037-1600177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- J Kröger
- Uniklinik Köln, Institut für Diagnostische und interventionelle Radiologie, Köln
| | - T Hickethier
- Uniklinik Köln, Institut für Diagnostische und interventionelle Radiologie, Köln
| | | | - D Maintz
- Uniklinik Köln, Institut für Diagnostische und interventionelle Radiologie, Köln
| | - A Bunck
- Uniklinik Köln, Institut für Diagnostische und interventionelle Radiologie, Köln
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15
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Baeßler B, Schmidt M, Lücke C, Blazek S, Ou P, Maintz D, Bunck A. Modern Imaging of Myocarditis: Possibilities and Challenges. ROFO-FORTSCHR RONTG 2016; 188:915-25. [DOI: 10.1055/s-0042-108342] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- B. Baeßler
- Department of Radiology, University Hospital of Cologne, Germany
| | - M. Schmidt
- Department of Nuclear Medicine, University Hospital of Cologne, Germany
| | - C. Lücke
- Diagnostic and Interventional Radiology, Herzzentrum Leipzig GmbH – University Clinic, Leipzig, Germany
| | - S. Blazek
- Department of Internal Medicine/Cardiology, Herzzentrum Leipzig GmbH Universitatsklinik, Leipzig, Germany
| | - P. Ou
- Department of Cardiovascular Imaging, Universite Paris Diderot, Paris, France
| | - D. Maintz
- Department of Radiology, University Hospital of Cologne, Germany
| | - A. Bunck
- Department of Radiology, University Hospital of Cologne, Germany
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Hickethier T, Spiczak JV, Baeßler B, Müller D, Michels G, Maintz D, Bunck A. Nutzen verschiedener modell-basierter iterativer Rekonstruktionsfilter auf die CT-Bildgebung von Koronarstents: eine Phantomstudie. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Baeßler B, Schaarschmidt F, Schnackenburg B, Stehning C, Dick A, Maintz D, Bunck A. Ein neuer multiparametrischer Ansatz in der MRT-basierten Diagnostik der Myokarditis: Kombination von T2-Mapping mit Feature Tracking basierter Strain-Analyse. ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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18
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Bunck A. MRT: wo stehen wir, wo wollen wir hin? ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Baeßler B, Michels G, Hellmich M, Kröger J, Maintz D, Bunck A. MRT-basierte Strain-Analyse mittels Feature Tracking bei Myokarditis. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1550966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Michels G, Pfister R, Witthus M, Hiss S, Bunck A. 26-jähriger Mann mit Thoraxschmerzen und unspezifischen Arthralgien. Dtsch Med Wochenschr 2014; 139:1521-2. [DOI: 10.1055/s-0034-1370213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G. Michels
- Klinik III für Innere Medizin, Universität zu Köln
| | - R. Pfister
- Klinik III für Innere Medizin, Universität zu Köln
| | - M. Witthus
- Klinik II für Innere Medizin, Universität zu Köln
| | - S. Hiss
- Institut und Poliklinik für Radiologische Diagnostik, Universität zu Köln
| | - A. Bunck
- Institut und Poliklinik für Radiologische Diagnostik, Universität zu Köln
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Michels G, Bunck A, Pfister R. 82-jähriger Mann mit akutem Koronarsyndrom und unklarer Arthropathie. Dtsch Med Wochenschr 2014; 139:1121-2. [DOI: 10.1055/s-0034-1369956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- G. Michels
- Klinik III für Innere Medizin, Universität zu Köln
| | - A. Bunck
- Institut und Poliklinik für Radiologische Diagnostik, Universität zu Köln
| | - R. Pfister
- Klinik III für Innere Medizin, Universität zu Köln
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Stahlhut L, Bunck A, Tan Y, Franke M, Höink A, Guo X, Maintz D, Schwartz L, Zhao B, Persigehl T. Evaluierung der Inter-/Intrareader Reproduzierbarkeit unterschiedlich erfahrener Untersucher beim Therapiemonitoring von Pleuramesotheliomen mittels mRECIST, RECIST 1.0, RECIST 1.1 und WHO Kriterien. ROFO-FORTSCHR RONTG 2013. [DOI: 10.1055/s-0033-1346330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Brägelmann A, Bunck A, Donas K, Kasprzak B, Maintz D, Heindel W, Seifarth H. [Dual-Energy CT in the follow-up after endovascular abdominal aortic aneurysm repair]. ROFO-FORTSCHR RONTG 2013; 185:351-7. [PMID: 23426909 DOI: 10.1055/s-0032-1330447] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE This study investigates the dual-energy procedure for postoperative CT follow-up scans after endovascularly treated abdominal aortic aneurysms. The procedure is analyzed with respect to its sensitivity and specificity as well as the associated radiation exposure. MATERIALS AND METHODS 51 examinations were carried out on 47 patients between February 2009 and March 2010. For each patient, a non-enhanced, an arterial and a venous scan were conducted, the latter two using the dual-energy technology. Virtual images for the non-enhanced phase were reconstructed from the data taken in the venous phase. Protocol A, the reference standard, consisted of non-enhanced images and images of the arterial and venous phase. In protocol B, standard non-enhanced images were replaced by the reconstructed virtual non-enhanced images. Protocol C consisted only of virtual non-enhanced and 80 kV images taken during the venous phase. All data was anonymized and evaluated by two independent radiologists. For protocol C, sensitivity, specificity, negative and positive predictive values were computed. The effective radiation dosage was determined for each scan. RESULTS All endoleaks identified in protocol A were found using protocols B and C. For protocol C, the sensitivity and negative predictive value were 100 %, the specificity was 94.1 %, and the positive predictive value was 89.5 %. Compared to protocol A, protocol C reduces the radiation exposure by 62.45 %. CONCLUSION A scan protocol consisting of virtual non-enhanced images as well as 80 kV images taken during the venous phase was found to be a reliable alternative method for diagnosing endoleaks, while reducing the radiation exposure by 62.45 %.
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Affiliation(s)
- A Brägelmann
- Institut für Klinische Radiologie, Universitätsklinikum Münster, Germany
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Bunck A, Özgün M, Kirchhof P, Heindel W, Maintz D. Detektion von Katheterablationsnarben im rechten Atrium mittels 2D- and 3D-Late Enhancement MRT. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0029-1247970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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