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Hohneck A, Meissner R, Reyser C, Heinemann L, Christians K, Merx K, Weingärtner S, Mavratzas A, Schulte N, Burkholder I, Hofmann WK, Hofheinz RD. Effects of a Sound Intervention on Physical and Emotional Well-Being in Patients with Cancer: A Prospective Randomized Trial. Oncol Res Treat 2023; 46:1-10. [PMID: 36657417 PMCID: PMC10015753 DOI: 10.1159/000528187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 11/06/2022] [Indexed: 01/20/2023]
Abstract
AIM Cancer remains a disease with a significant impact on morbidity and mortality but also on quality of life. This prospective randomized pilot study investigated the effects of a sound intervention on physical and emotional well-being in outpatients with cancer. METHODS Two self-applied sound interventions were used for this purpose, either active "music playing" with a body monochord or passive sound intervention with headphones to listen to a given music compilation. Interventions were carried out over a period of 4 weeks for at least 15 min in the evening before bedtime. The following self-assessment questionnaires were completed both at baseline and after 4 weeks to evaluate the response: the Pittsburgh Sleep Quality Index (PSQI), the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30), Visual Analogue Scale (VAS) for pain and fatigue, and the Fear of Progression (FoP) questionnaire. Primary endpoint of this exploratory trial was to describe the rate of patients with improvement in at least one dimension without worsening of any other. RESULTS 73 patients (29 male, 44 female) were included in the study and randomized to either active (n = 34, 47%) or passive sound intervention (n = 39, 53%). Median age was 52.0 years (range 21-79). Fourteen patients (19%) stated that they were musically active. The sound intervention was carried out on a median of 26 days (range 5-28). A higher percentage of patients in the passive group reached the primary endpoint: n = 15 (39%) versus n = 9 (27%). Response differences in favour of the passive group were seen with the VAS fatigue and with QLQ-30 questionnaires. Overall, an improvement in QLQ-30 questionnaire was seen in 12 patients (31%) in the passive group versus 3 patients (9%). Moreover, sound intervention significantly improved social functioning and shortness of breath in the passive group according to QLQ-C30. Significant improvements were also noticed in the passive group in terms of affective reactions as a domain of the FoP questionnaire. No effects on pain or sleep quality could be observed. CONCLUSION A 4-week self-administered sound intervention was feasible in outpatients suffering from cancer. Using a panel of 5 questionnaires, passive sound interventions appeared to be more likely to positively influence patient-reported outcomes. In particular, a positive impact was documented in social functioning and fatigue.
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Affiliation(s)
- Anna Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Rosa Meissner
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Christina Reyser
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Lara Heinemann
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Kirsten Merx
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingärtner
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Athanasios Mavratzas
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Nadine Schulte
- Department of Gastroenterology, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Burkholder
- Department of Nursing and Health, University of Applied Sciences of the Saarland, Saarbruecken, Saarbrücken, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
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Rosenkaimer SL, Winter L, Sieburg T, Maier S, Mavratzas A, Hofmann WK, Akin I, Duerschmied D, Hofheinz RD, Hohneck A. Diagnostic value of sST2, VCAM-1 and adiponectin in patients with breast cancer to predict anti-tumor treatment-related cardiac events: A pilot study. Oncol Res Treat 2022; 45:598-607. [PMID: 35764064 DOI: 10.1159/000525683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Accepted: 06/09/2022] [Indexed: 11/19/2022]
Abstract
Aim The present exploratory study investigated the diagnostic value of inflammatory markers in patients with breast cancer to predict anti-tumour treatment-related cardiac events. Methods Twenty-one patients with breast cancer were enrolled in this prospective observational study and followed over 6 months. Transthoracic echocardiography and measurement of cardiac (N terminal prohormone of brain natriuretic peptide (NT proBNP), Troponin I (TnI)) and inflammatory biomarkers (vascular adhesion molecule 1 (VCAM-1), soluble suppression of tumorigenesis-2 (sST2), adiponectin) was performed at 3-month intervals (baseline, follow-up, final visit). Cardiac events were defined as decrease in left ventricular ejection fraction (LVEF, decrease by 10 % or < 50 %) or increase in global longitudinal strain (GLS, increase by 15 % or > 16 %), as a more sensitive marker of LV function. Results Cardiac deterioration was observed in nine out of 21 patients (event group). While LVEF did not differ significantly between the two groups (event vs no event) at any visit, GLS was significantly higher during follow-up (follow-up: event -16 ± 3.3 % vs no event -18 ± 1.6 %, p = 0.04, final visit: event -16 ± 2.1 % vs no event -19 ± 1.9 %, p = 0.003). NT-proBNP was numerically higher in patients with a cardiac event during all visits, with NT-proBNP negatively correlated with LVEF and MAPSE (both r = -0.33, p = 0.02), whereas GLS (r = 0.40, p = 0.006), TnI (r = 0.44, p = 0.001), and VCAM-1 (r = 0.48, p = 0.003) showed a positive association with NT-proBNP. In comparison, higher VCAM 1 and sST2 concentrations were detected in the event group at both baseline and the final visit, with a significant difference for baseline (VCAM-1: p = 0.02; sST2: p = 0.03). Adiponectin was also lower in patients with a treatment-related event. Thresholds for VCAM 1 > 762 ng/ml and sST2 > 18.7 ng/ml, as detected by ROC analysis, correlated best with the primary endpoint. Conclusion Cardiac events during anti-tumour treatment in patients with breast cancer are relatively common. Inflammatory markers such as VCAM-1 or sST2 were associated with an increased likelihood for occurrence of a treatment-related event, which may therefore hold the promise to better identify patients at high risk.
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Affiliation(s)
- Stephanie Luise Rosenkaimer
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Laura Winter
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Tina Sieburg
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Sandra Maier
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
| | - Athanasios Mavratzas
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Ibrahim Akin
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Duerschmied
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Anna Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany
- European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) Partner Site Heidelberg/Mannheim, Mannheim, Germany
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3
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Rosenkaimer S, Sieburg T, Winter L, Mavratzas A, Hofmann WK, Hofheinz RD, Akin I, Duerschmied D, Hohneck A. Adverse Cardiovascular Effects of Anti-tumor Therapies in Patients With Breast Cancer: A Single-center Cross-sectional Analysis. Anticancer Res 2022; 42:3075-3084. [PMID: 35641278 DOI: 10.21873/anticanres.15795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND/AIM Cardiotoxicity due to antitumor therapy is a dreaded complication and could thus impact the prognosis of patients with breast cancer. This study sought to analyze the occurrence of adverse cardiovascular events and to identify potential risk factors. PATIENTS AND METHODS A total of 136 patients with breast cancer were divided into two groups based on the occurrence of treatment-related cardiovascular toxicity [event 47 (35%) vs. no event 89 (65%)]. Patients were followed over a median of 45 months (range=37-83 months). RESULTS Most common events were thromboembolic complications (26%), followed by heart failure (15%) and acute toxic cardiomyopathy (5%), with a reduced left ventricular ejection fraction [LVEF (%), no event 59±5.0 vs. event 55±11, p=0.01 ]. Patients with leftsided breast cancer and an advanced stage disease had a higher risk of developing adverse cardiovascular events. The highest risk was found for patients with a high number of cardiovascular risk factors. In addition to LVEF, mitral annular plane systolic excursion was also significantly reduced in the event group, while there was a trend for higher global longitudinal strain. During follow-up, 26 patients (19.1%) deceased, whereof 12 had a treatment-related cardiovascular event, but without statistical difference. CONCLUSION Treatment-related cardiovascular events are relatively common in about one third of patients with breast cancer. Women with a cardiovascular risk profile or an advanced stage disease had a higher risk for adverse events. Despite the treatment-related cardiac deterioration, no difference in mortality was observed during follow up.
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Affiliation(s)
- Stephanie Rosenkaimer
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Tina Sieburg
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Laura Winter
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Athanasios Mavratzas
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Wolf-Karsten Hofmann
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Ralf-Dieter Hofheinz
- Department of Hematology and Oncology, University Medical Centre Mannheim, Heidelberg University, Mannheim, Germany
| | - Ibrahim Akin
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Daniel Duerschmied
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
| | - Anna Hohneck
- Department of Cardiology, Angiology, Haemostaseology and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany; .,European Center for AngioScience (ECAS) and German Center for Cardiovascular Research (DZHK) partner site Heidelberg/Mannheim, Mannheim, Germany
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4
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Hajda J, Leuchs B, Angelova AL, Frehtman V, Rommelaere J, Mertens M, Pilz M, Kieser M, Krebs O, Dahm M, Huber B, Engeland CE, Mavratzas A, Hohmann N, Schreiber J, Jäger D, Halama N, Sedlaczek O, Gaida MM, Daniel V, Springfeld C, Ungerechts G. Phase 2 Trial of Oncolytic H-1 Parvovirus Therapy Shows Safety and Signs of Immune System Activation in Patients With Metastatic Pancreatic Ductal Adenocarcinoma. Clin Cancer Res 2021; 27:5546-5556. [PMID: 34426438 DOI: 10.1158/1078-0432.ccr-21-1020] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 07/02/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the safety, clinical efficacy, virus pharmacokinetics, shedding, and immune response after administration of an oncolytic parvovirus (H-1PV, ParvOryx) to patients with metastatic pancreatic ductal adenocarcinoma (PDAC) refractory to first-line therapy. PATIENTS AND METHODS This is a noncontrolled, single-arm, open-label, dose-escalating, single-center clinical trial. Seven patients with PDAC and at least one liver metastasis were included. ParvOryx was administered intravenously on 4 consecutive days and as an intralesional injection, 6 to 13 days thereafter. Altogether, three escalating dose levels were investigated. In addition, gemcitabine treatment was initiated on day 28. RESULTS ParvOryx showed excellent tolerability with no dose-limiting toxicities. One patient had a confirmed partial response and one patient revealed an unconfirmed partial response according to RECIST criteria. Both patients showed remarkably long surivial of 326 and 555 days, respectively. Investigation of pharmacokinetics and virus shedding revealed dose dependency with no excretion of active virus particles in saliva or urine and very limited excretion in feces. H-1PV nucleic acids were detected in tumor samples of four patients. All patients showed T-cell responses to viral proteins. An interesting immunologic pattern developed in tumor tissues and in blood of both patients with partial response suggesting immune activation after administration of ParvOryx. CONCLUSIONS The trial met all primary objectives, revealed no environmental risks, and indicated favorable immune modulation after administration of ParvOryx. It can be considered a good basis for further systematic clinical development alone or in combination with immunomodulatory compounds.
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Affiliation(s)
- Jacek Hajda
- Coordination Centre for Clinical Trials, University Hospital, Marsilius-Arkaden, Tower West, Heidelberg, Germany.
| | - Barbara Leuchs
- Virus Production & Development Unit (VP&DU), Division of Tumor Virology (F010), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Assia L Angelova
- Clinical Cooperation Unit Virotherapy (F230), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Veronika Frehtman
- Virus Production & Development Unit (VP&DU), Division of Tumor Virology (F010), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Jean Rommelaere
- Clinical Cooperation Unit Virotherapy (F230), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | - Maximilian Pilz
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Marsilius-Arkaden, Tower West, Heidelberg, Germany
| | - Meinhard Kieser
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Marsilius-Arkaden, Tower West, Heidelberg, Germany
| | | | | | | | - Christine E Engeland
- Clinical Cooperation Unit Virotherapy (F230), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Faculty of Health/School of Medicine, Institute of Virology and Microbiology, Center for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Germany
| | - Athanasios Mavratzas
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Nicolas Hohmann
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Jutta Schreiber
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Niels Halama
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Tissue Imaging & Analysis Center (TIGA), BioQuant, University Heidelberg, Heidelberg, Germany
| | - Oliver Sedlaczek
- Department of Radiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Matthias M Gaida
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany.,Institute of Pathology, University Medical Center, University Mainz, Mainz, Germany
| | - Volker Daniel
- Department of Transplantation-Immunology, Institute of Immunology, University Heidelberg, Heidelberg, Germany
| | - Christoph Springfeld
- Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Guy Ungerechts
- Clinical Cooperation Unit Virotherapy (F230), German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Department of Medical Oncology, University Hospital Heidelberg and National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
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5
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Walle T, Erdal E, Mühlsteffen L, Singh HM, Gnutzmann E, Grün B, Hofmann H, Ivanova A, Köhler BC, Korell F, Mavratzas A, Mock A, Pixberg C, Schult D, Starke H, Steinebrunner N, Woydack L, Schneeweiss A, Dietrich M, Jäger D, Krisam J, Kather JN, Winkler EC. Completion rate and impact on physician-patient relationship of video consultations in medical oncology: a randomised controlled open-label trial. ESMO Open 2021; 5:e000912. [PMID: 33203685 PMCID: PMC7674103 DOI: 10.1136/esmoopen-2020-000912] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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: 07/14/2020] [Revised: 09/13/2020] [Accepted: 10/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background Mobile phone video call applications generally did not undergo testing in randomised controlled clinical trials prior to their implementation in patient care regarding the rate of successful patient visits and impact on the physician–patient relationship. Methods The National Center for Tumour Diseases (NCT) MOBILE trial was a monocentric open-label randomised controlled clinical trial of patients with solid tumours undergoing systemic cancer therapy with need of a follow-up visit with their consulting physician at outpatient clinics. 66 patients were 1:1 randomised to receive either a standard in-person follow-up visit at outpatient clinics or a video call via a mobile phone application. The primary outcome was feasibility defined as the proportion of patients successfully completing the first follow-up visit. Secondary outcomes included success rate of further video calls, time spent by patient and physician, patient satisfaction and quality of physician–patient relationship. Findings Success rate of the first follow-up visit in the intention-to-treat cohort was 87.9% (29 of 33) for in-person visits and 78.8% (26 of 33) for video calls (relative risk: RR 0.90, 95% CI 0.70 to 1.13, p=0.51). The most common reasons for failure were software incompatibility in the video call and no-show in the in-person visit arm. The success rate for further video visits was 91.7% (11 of 12). Standardised patient questionnaires showed significantly decreased total time spent and less direct costs for patients (Δmean −170.8 min, 95% CI −246 min to −95.5 min), p<0.0001; Δmean −€14.37, 95% CI −€23.9 to −€4.8, p<0.005) and comparable time spent for physicians in the video call arm (Δmean 0.5 min, 95% CI −5.4 min to 6.4 min, p=0.86). Physician–patient relationship quality mean scores assessed by a validated standardised questionnaire were higher in the video call arm (1.13-fold, p=0.02). Interpretation Follow-up visits with the tested mobile phone video call application were feasible but software compatibility should be critically evaluated. Trial registration number DRKS00015788.
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Affiliation(s)
- Thomas Walle
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; Clinical Cooperation Unit Virotherapy, German Cancer Research Center, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, Heidelberg, Germany.
| | - Erkin Erdal
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; Department of Medicine II, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Leon Mühlsteffen
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; Minxli AG, Muenchen, Germany
| | - Hans Martin Singh
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; Clinical Cooperation Unit Virotherapy, German Cancer Research Center, Heidelberg, Germany
| | - Editha Gnutzmann
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Barbara Grün
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Helene Hofmann
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Alexandra Ivanova
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | | | - Felix Korell
- Department of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Athanasios Mavratzas
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Andreas Mock
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, Heidelberg, Germany
| | - Constantin Pixberg
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - David Schult
- Department of Hematology, University Hospital Heidelberg, Heidelberg, Germany
| | - Helen Starke
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Niels Steinebrunner
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Lena Woydack
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Andreas Schneeweiss
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Mareike Dietrich
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, Heidelberg, Germany
| | - Johannes Krisam
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Heidelberg, Baden-Württemberg, Germany
| | - Jakob N Kather
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany; German Cancer Consortium (DKTK), German Cancer Research Center, Heidelberg, Germany
| | - Eva C Winkler
- Department of Medical Oncology, National Center for Tumor Diseases, Heidelberg, Germany
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6
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Hlevnjak M, Schulze M, Elgaafary S, Fremd C, Michel L, Beck K, Pfütze K, Richter D, Wolf S, Horak P, Kreutzfeldt S, Pixberg C, Hutter B, Ishaque N, Hirsch S, Gieldon L, Stenzinger A, Springfeld C, Smetanay K, Seitz J, Mavratzas A, Brors B, Kirsten R, Schuetz F, Fröhling S, Sinn HP, Jäger D, Thewes V, Zapatka M, Lichter P, Schneeweiss A. CATCH: A Prospective Precision Oncology Trial in Metastatic Breast Cancer. JCO Precis Oncol 2021; 5:PO.20.00248. [PMID: 34036222 PMCID: PMC8140780 DOI: 10.1200/po.20.00248] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 01/13/2021] [Accepted: 03/10/2021] [Indexed: 11/20/2022] Open
Abstract
PURPOSE CATCH (Comprehensive Assessment of clinical feaTures and biomarkers to identify patients with advanced or metastatic breast Cancer for marker driven trials in Humans) is a prospective precision oncology program that uses genomics and transcriptomics to guide therapeutic decisions in the clinical management of metastatic breast cancer. Herein, we report our single-center experience and results on the basis of the first 200 enrolled patients of an ongoing trial. METHODS From June 2017 to March 2019, 200 patients who had either primary metastatic or progressive disease, with any number of previous treatment lines and at least one metastatic site accessible to biopsy, were enrolled. DNA and RNA from tumor tissue and corresponding blood-derived nontumor DNA were profiled using whole-genome and transcriptome sequencing. Identified actionable alterations were brought into clinical context in a multidisciplinary molecular tumor board (MTB) with the aim of prioritizing personalized treatment recommendations. RESULTS Among the first 200 enrolled patients, 128 (64%) were discussed in the MTB, of which 64 (50%) were subsequently treated according to MTB recommendation. Of 53 evaluable patients, 21 (40%) achieved either stable disease (n = 13, 25%) or partial response (n = 8, 15%). Furthermore, 16 (30%) of those patients showed improvement in progression-free survival of at least 30% while on MTB-recommended treatment compared with the progression-free survival of the previous treatment line. CONCLUSION The initial phase of this study demonstrates that precision oncology on the basis of whole-genome and RNA sequencing is feasible when applied in the clinical management of patients with metastatic breast cancer and provides clinical benefit to a substantial proportion of patients.
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Affiliation(s)
- Mario Hlevnjak
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Markus Schulze
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Shaymaa Elgaafary
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Carlo Fremd
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Laura Michel
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katja Beck
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Katrin Pfütze
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany
| | - Daniela Richter
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Dresden, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Stephan Wolf
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Horak
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Simon Kreutzfeldt
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Constantin Pixberg
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Barbara Hutter
- Molecular Diagnostics Program, National Center for Tumor Diseases (NCT) Heidelberg, Heidelberg, Germany.,Division of Applied Bioinformatics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Naveed Ishaque
- Heidelberg Center for Personalized Oncology (DKFZ-HIPO), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Steffen Hirsch
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Laura Gieldon
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | | | - Christoph Springfeld
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Smetanay
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Julia Seitz
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Athanasios Mavratzas
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Benedikt Brors
- Division of Applied Bioinformatics, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Romy Kirsten
- National Center for Tumor Diseases (NCT), Liquid Biobank, Heidelberg, Germany
| | - Florian Schuetz
- Department of Gynecology and Obstetrics, Heidelberg University Hospital, Heidelberg, Germany
| | - Stefan Fröhling
- Department of Translational Medical Oncology, National Center for Tumor Diseases (NCT) Heidelberg, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hans-Peter Sinn
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dirk Jäger
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
| | - Verena Thewes
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marc Zapatka
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Peter Lichter
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.,Heidelberg Center for Personalized Oncology (DKFZ-HIPO), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Andreas Schneeweiss
- Gynecologic Oncology, National Center for Tumor Diseases (NCT), University of Heidelberg and German Cancer Research Center (DKFZ), Heidelberg, Germany
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7
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Hohneck A, Reyser C, Merx K, Weingärtner S, Mavratzas A, Schumacher G, Linhuber C, Hofmann WK, Burkholder I, Hofheinz RD. Differential Effects of Sound Intervention and Rest on Cardiovascular Parameters in Cancer Patients: A Randomized Cross-over Trial. Integr Cancer Ther 2021; 20:1534735421995239. [PMID: 33813930 PMCID: PMC8024455 DOI: 10.1177/1534735421995239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Background: Music therapy or sound interventions were shown to confer beneficial effects in patients with cancer for instance in terms of pain or fear relief and improvement of other patient reported outcomes. Cardiovascular parameters, especially heart rate variability (HRV) were found to have prognostic implications in cancer patients. In this trial we aimed to investigate the effects of a sound intervention on cardiovascular parameters compared to rest in patients with cancer. Methods and results: Using a randomized cross-over design, 52 patients (male 13, female 39) with cancer were recruited to receive both a 15-minute sound intervention and a 15-minute rest intervention within 4 weeks with at least a one-week blanking period. Cardiovascular parameters (among others HRV, aortic pulse wave velocity [PWV], augmentation index [Aix], aortic blood pressure [BP], heart rate [HR]) were assessed immediately before (pre) and after (post) the intervention had taken place. HRV (Root mean square of successive RR interval differences [RMSSD, ms]) significantly increased, during sound intervention (median RMSSD pre 24 [range 5-112] vs post 22 [range 9-141], P = .03). Likewise, median PWV, as a direct marker of arterial stiffness, was significantly reduced by sound intervention ([m/s] pre 8.5 [range 5.6-19.6] vs post 8.3 [range 5.6-15.6], P = .04). For both parameters no statistically significant change during rest was observed. HR was lowered by both, rest (P < .0001) and sound intervention (P = .02), with a more pronounced effect by rest. A significant increase in systolic aortic blood pressure was shown by rest ([mmHg] median 101 [range 78-150] vs post median 103 [range 71-152], P = .04) but not during sound intervention (P = .59), while rest intervention led to a decrease in resistance index (pre median 33 [range 13-92] vs post median 32 [11-84], P = .02). Conclusion: In comparison with rest, a single sound intervention in patients with cancer improved cardiovascular parameters commonly associated with increased stress levels. Studies with longer follow-up and multiple interventions are warranted. Trial Registration: ISRCTN registry 70947363.
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Affiliation(s)
- Anna Hohneck
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christina Reyser
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Kirsten Merx
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simone Weingärtner
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Athanasios Mavratzas
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | | | - Wolf-Karsten Hofmann
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Burkholder
- University of Applied Sciences of the Saarland, Saarbrucken, Germany
| | - Ralf-Dieter Hofheinz
- University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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8
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Mavratzas A, Marmé F. Treatment of Luminal Metastatic Breast Cancer beyond CDK4/6 Inhibition: Is There a Standard of Care in Clinical Practice? Breast Care (Basel) 2021; 16:115-128. [PMID: 34012366 PMCID: PMC8114049 DOI: 10.1159/000514561] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 01/19/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND CDK4/6 inhibitors have become the standard for first-line treatment of metastatic luminal breast cancer based on consistent data from several phase 3 trials demonstrating clinically meaningful improvement of progression-free as well as overall survival. In addition, they are about to become a part of adjuvant treatment for patients with high-risk luminal disease based on positive results from the first randomized phase 3 trial on abemaciclib. Nevertheless, the majority of patients with advanced or metastatic luminal breast cancer and prospectively a relevant proportion of patients treated in the adjuvant setting will eventually develop resistance to this endocrine based combination within 12-36 months, depending on the line of treatment. CONCLUSION Potential subsequent therapies include PI3K inhibitors, mTOR inhibitors, endocrine monotherapy, PARP inhibitors, and chemotherapy. However, these therapies have mainly been developed in the pre-CDK4/6 inhibitor era and little is known about potential cross-resistance. The concept of continuing CDK4/6 inhibition beyond progression is supported by some preclinical data, but to date there is very limited clinical evidence to support this strategy. Therefore, treatment of metastatic luminal breast cancer after progression on CDK4/6 inhibitors remains a challenge. KEY MESSAGES Here we review current evidence from pro- and retrospective studies and give an outlook on future developments with respect to novel therapeutic agents, including oral SERD and AKT inhibitors, which have the potential to change the therapeutic landscape in the future. Furthermore, clinical treatment algorithms and current research will also be discussed.
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Affiliation(s)
- Athanasios Mavratzas
- Section of Conservative Gynecologic Oncology, Experimental and Translational Gynecologic Oncology, Medical Faculty Mannheim, Heidelberg University, Department of Obstetrics and Gynecology, University Hospital Mannheim, Mannheim, Germany
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9
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Abstract
Since the US FDA approval of everolimus/exemestane in July 2012, and of the first CDK 4/6 inhibitor, palbociclib, combined with endocrine treatment in February 2015, a third class of therapeutic compounds, the PI3K inhibitors, has been introduced to the arsenal of targeted therapies overcoming endocrine resistance in hormone receptor-positive metastatic breast cancer. Alpelisib (PIQRAY®) is the first of these novel agents yielding promising clinical results, giving an impetus to further development of tailored endocrine anticancer treatments. Herein, we review its pharmacodynamic and pharmacokinetic properties, safety and efficacy data, as well as Phase III SOLAR-1 trial, prompting FDA approval of alpelisib in hormone receptor-positive metastatic breast cancer harboring PIK3CA mutations. Furthermore, implications for clinical use and current research will also be discussed.
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Affiliation(s)
- Athanasios Mavratzas
- Department of Obstetrics & Gynecology Mannheim, Section of Conservative Gynecologic Oncology, Experimental & Translational Gynecologic Oncology, Medical Faculty Mannheim of University Heidelberg University Hospital, Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
| | - Frederik Marmé
- Department of Obstetrics & Gynecology Mannheim, Section of Conservative Gynecologic Oncology, Experimental & Translational Gynecologic Oncology, Medical Faculty Mannheim of University Heidelberg University Hospital, Mannheim, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany
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10
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Elgaafary S, Hlevnjak M, Schulze M, Thewes V, Seitz J, Fremd C, Michel L, Beck K, Pfütze K, Richter D, Wolf S, Pixberg C, Hutter B, Ishaque N, Hirsch S, Gieldon L, Stenzinger A, Springfeld C, Kreutzfeld S, Horak P, Smetanay K, Mavratzas A, Brors B, Kirsten R, Trumpp A, Schütz F, Fröhling S, Sinn HP, Jäger D, Zapatka M, Lichter P, Schneeweiss A. Dauerhaftes Ansprechen auf Olaparib und endokrine Therapie bei einer Patientin mit metastasiertem luminalem Mammakarzinom und gBRCA-Mutation. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714539] [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: 03/22/2023] Open
Affiliation(s)
- S Elgaafary
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - M Hlevnjak
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung für Molekulargenetik, Deutsches Krebskonsortium (DKTK), Deutsches Krebsforschungszentrum (DKFZ)
| | - M Schulze
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung für Molekulargenetik, Deutsches Krebskonsortium (DKTK), Deutsches Krebsforschungszentrum (DKFZ)
| | - V Thewes
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung für Molekulargenetik, Deutsches Krebskonsortium (DKTK), Deutsches Krebsforschungszentrum (DKFZ)
| | - J Seitz
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - C Fremd
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - L Michel
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - K Beck
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung Translationale Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT) Heidelberg/Dresden, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg/Dresden
| | - K Pfütze
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - D Richter
- Abteilung Translationale Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT) Heidelberg/Dresden, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg/Dresden
| | - S Wolf
- Kernfazilität Genomik und Proteomik, Deutsches Krebsforschungszentrum (DKFZ)
| | - C Pixberg
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - B Hutter
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung Angewandte Bioinformatik, Deutsches Krebsforschungszentrum (DKFZ)
| | - N Ishaque
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung Theoretische Bioinformatik, Deutsches Krebsforschungszentrum (DKFZ)
| | - S Hirsch
- Institut für Humangenetik, Universität Heidelberg
| | - L Gieldon
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Institut für Humangenetik, Universität Heidelberg
| | - A Stenzinger
- Institut für Pathologie, Universitätsklinikum Heidelberg
| | - C Springfeld
- Klinik für Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg
| | - S Kreutzfeld
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung Translationale Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT) Heidelberg/Dresden, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg/Dresden
| | - P Horak
- Abteilung Translationale Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT) Heidelberg/Dresden, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg/Dresden
| | - K Smetanay
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - A Mavratzas
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
| | - B Brors
- Abteilung Angewandte Bioinformatik, Deutsches Krebsforschungszentrum (DKFZ)
| | - R Kirsten
- Liquid Biobank, Nationales Zentrum für Tumorerkrankungen (NCT)
| | - A Trumpp
- Abteilung Stammzellen und Krebs, Deutsches Krebsforschungszentrum (DKFZ) und DKFZ-ZMBH-Bündnis
| | - F Schütz
- Klinik für Gynäkologie und Geburtshilfe, Universitätsklinikum Heidelberg
| | - S Fröhling
- Abteilung Translationale Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT) Heidelberg/Dresden, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg/Dresden
| | - H-P Sinn
- Institut für Pathologie, Universitätsklinikum Heidelberg
| | - D Jäger
- Klinik für Medizinische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg
| | - M Zapatka
- Abteilung für Molekulargenetik, Deutsches Krebskonsortium (DKTK), Deutsches Krebsforschungszentrum (DKFZ)
| | - P Lichter
- Molekulardiagnostik-Programm, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
- Abteilung für Molekulargenetik, Deutsches Krebskonsortium (DKTK), Deutsches Krebsforschungszentrum (DKFZ)
| | - A Schneeweiss
- Gynäkologische Onkologie, Nationales Zentrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg und Deutsches Krebsforschungszentrum (DKFZ)
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11
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Mavratzas A, Seitz J, Smetanay K, Schneeweiss A, Jäger D, Fremd C. Atezolizumab for use in PD-L1-positive unresectable, locally advanced or metastatic triple-negative breast cancer. Future Oncol 2019; 16:4439-4453. [PMID: 31829043 DOI: 10.2217/fon-2019-0468] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 02/08/2023] Open
Abstract
Since the US FDA-approval of the first immune checkpoint inhibitor, anticytotoxic T-lymphocyte antigen-4 monoclonal antibody ipilimumab, for metastatic melanoma on 28 March 2011, another six agents have been granted use among a multitude of tumors, including renal cell cancer, Hodgkin lymphoma, urothelial carcinoma and non-small-cell lung cancer. The first anti-programmed cell death ligand-1 monoclonal antibody to receive the FDA approval, atezolizumab (Tecentriq®), has yielded promising results among international Phase III trials in triple-negative breast cancer and small-cell lung cancer, expanding the field of cancer immunotherapies. Herein, we review the pharmacodynamic and pharmacokinetic properties of atezolizumab, its safety and efficacy data from early clinical trials and summarize data from Phase III IMpassion130 trial, prompting FDA and EMA approval of atezolizumab in metastatic triple-negative breast cancer. Finally, implications for clinical use and ongoing research will be briefly discussed.
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Affiliation(s)
- Athanasios Mavratzas
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Julia Seitz
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Katharina Smetanay
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Andreas Schneeweiss
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Dirk Jäger
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
| | - Carlo Fremd
- National Center for Tumor Disease, Gynecologic Oncology, University Hospital Heidelberg, Heidelberg, Germany
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12
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Schulze M, Hlevnjak M, Thewes V, Elgaafary S, Mavratzas A, Fröhling S, Seitz J, Zapatka M, Lichter P, Schneeweiss A. Improving personalised therapy in metastatic breast cancer by implementing RNA sequencing based gene expression signatures. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz413.074] [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: 11/13/2022] Open
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13
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Dieter S, Heining C, Agaimy A, Huebschmann D, Bonekamp D, Hutter B, Ehrenberg K, Fröhlich M, Schlesner M, Scholl C, Schlemmer HP, Wolf S, Mavratzas A, Jung C, Gröschel S, von Kalle C, Eils R, Brors B, Penzel R, Kriegsmann M, Reuss D, Schirmacher P, Stenzinger A, Federspil P, Weichert W, Glimm H, Fröhling S. Mutant KIT as imatinib-sensitive target in metastatic sinonasal carcinoma. Ann Oncol 2017; 28:142-148. [DOI: 10.1093/annonc/mdw446] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
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14
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Sahin U, Jaeger D, Marme F, Mavratzas A, Krauss J, De Greve J, Vergote I, Tureci O. First-in-human phase I/II dose-escalation study of IMAB027 in patients with recurrent advanced ovarian cancer (OVAR): Preliminary data of phase I part. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.5537] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [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)
| | - Dirk Jaeger
- National Center for Tumor Diseases, University Hospitals Heidelberg, Heidelberg, Germany
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15
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Krauss J, Exner E, Mavratzas A, Seeber S, Arndt MAE. High-level production of a humanized immunoRNase fusion protein from stably transfected myeloma cells. Methods Mol Biol 2009; 525:471-xiv. [PMID: 19252845 DOI: 10.1007/978-1-59745-554-1_24] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
ImmunoRNases represent a highly attractive alternative to conventional immunotoxins for cancer therapy. Quantitative production of immunoRNases in appropriate expression systems, however, remains a major challenge for further clinical development of these novel compounds. Here we describe a method for high-level production and purification of a fully functional immunoRNase fusion protein from supernatants of stably transfected mammalian cells.
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Affiliation(s)
- Jürgen Krauss
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
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