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Woelk LM, Kovacevic D, Husseini H, Förster F, Gerlach F, Möckl F, Altfeld M, Guse AH, Diercks BP, Werner R. DARTS: an open-source Python pipeline for Ca 2+ microdomain analysis in live cell imaging data. Front Immunol 2024; 14:1299435. [PMID: 38274810 PMCID: PMC10809147 DOI: 10.3389/fimmu.2023.1299435] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Abstract
Ca2+ microdomains play a key role in intracellular signaling processes. For instance, they mediate the activation of T cells and, thus, the initial adaptive immune system. They are, however, also of utmost importance for activation of other cells, and a detailed understanding of the dynamics of these spatially localized Ca2+ signals is crucial for a better understanding of the underlying signaling processes. A typical approach to analyze Ca2+ microdomain dynamics is live cell fluorescence microscopy imaging. Experiments usually involve imaging a larger number of cells of different groups (for instance, wild type and knockout cells), followed by a time consuming image and data analysis. With DARTS, we present a modular Python pipeline for efficient Ca2+ microdomain analysis in live cell imaging data. DARTS (Deconvolution, Analysis, Registration, Tracking, and Shape normalization) provides state-of-the-art image postprocessing options like deep learning-based cell detection and tracking, spatio-temporal image deconvolution, and bleaching correction. An integrated automated Ca2+ microdomain detection offers direct access to global statistics like the number of microdomains for cell groups, corresponding signal intensity levels, and the temporal evolution of the measures. With a focus on bead stimulation experiments, DARTS provides a so-called dartboard projection analysis and visualization approach. A dartboard projection covers spatio-temporal normalization of the bead contact areas and cell shape normalization onto a circular template that enables aggregation of the spatiotemporal information of the microdomain detection results for the individual cells of the cell groups of interest. The dartboard visualization allows intuitive interpretation of the spatio-temporal microdomain dynamics at the group level. The application of DARTS is illustrated by three use cases in the context of the formation of initial Ca2+ microdomains after cell stimulation. DARTS is provided as an open-source solution and will be continuously extended upon the feedback of the community. Code available at: 10.5281/zenodo.10459243.
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Affiliation(s)
- Lena-Marie Woelk
- Department of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Dejan Kovacevic
- The Calcium Signalling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Hümeyra Husseini
- Department of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fritz Förster
- Department of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Fynn Gerlach
- The Calcium Signalling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Möckl
- The Calcium Signalling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Marcus Altfeld
- Institute for Immunology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas H. Guse
- The Calcium Signalling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Björn-Philipp Diercks
- The Calcium Signalling Group, Department of Biochemistry and Molecular Cell Biology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - René Werner
- Department of Applied Medical Informatics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Center for Biomedical Artificial Intelligence (bAIome), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Förster F, Löbner M, Welzel FD, Stein J, Riedel-Heller SG. SOZIALE UND EMOTIONALE EINSAMKEIT NACH VERLUST EINES NAHESTEHENDEN
MENSCHEN IM HÖHEREN LEBENSALTER (60+): WELCHE RISIKOFAKTOREN
GIBT ES? Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753602] [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: 12/12/2022]
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Förster F, Luppa M, Pabst A, Löbner M, Scherer M, Wagner M, Riedel-Heller SG. The role of social isolation in the relationship between widowhood and depressive symptomatology. A comparison among the widowed and married oldest old in Germany. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732107] [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: 10/20/2022]
Affiliation(s)
- F Förster
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - A Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
| | - M Scherer
- Department of Primary Medical Care, Center for Psychosocial Medicine, University Medical Center Hamburg-Eppendorf
| | - M Wagner
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn
- German Center for Neurodegenerative Diseases, DZNE
| | - SG Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig
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Welzel F, Löbner M, Quittschalle J, Förster F, Pabst A, Luppa M, Stein J, Riedel-Heller SG. Trauer und Verlust im Alter – Studienprotokoll einer randomisierten klinischen Studie zur Überprüfung der Wirksamkeit des internetbasierten Selbstmanagementprogramms trauer@ktiv. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732079] [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: 10/20/2022]
Affiliation(s)
- F Welzel
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - M Löbner
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - J Quittschalle
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - F Förster
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - A Pabst
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - M Luppa
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - J Stein
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Universität Leipzig, Medizinische Fakultät
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Welzel F, Schladitz K, Förster F, Löbner M, Riedel-Heller SG. Psychosoziale Belastungen und Ressourcen älterer Menschen in der Covid-19-Pandemie: Ergebnisse einer qualitativen Interviewstudie. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732203] [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: 10/20/2022]
Affiliation(s)
- F Welzel
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - K Schladitz
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - F Förster
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - M Löbner
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Medizinische Fakultät, Universität Leipzig
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Förster F, Pabst A, Löbner M, Riedel-Heller SG. Gesundheit bis ins hohe Alter. Wie altert „Frau“ bzw. „Mann“ gesund? Ergebnisse einer qualitativen Untersuchung hochaltriger Frauen und Männern. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1731996] [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: 10/20/2022]
Affiliation(s)
- F Förster
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
| | - A Pabst
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
| | - M Löbner
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
| | - SG Riedel-Heller
- Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP)
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Lüftner D, Schuetz F, Schneeweiss A, Grischke EM, Bloch W, Decker T, Uleer C, Salat C, Förster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Guderian G, Hanson S, Fasching P. Abstract P6-18-08: Everolimus + exemestane for HR+ advanced breast cancer in routine clinical practice- Final results from the non-interventional trial, BRAWO. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-08] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In the pivotal BOLERO-2 trial, everolimus (EVE) + exemestane (EXE) more than doubled the median progression-free survival (PFS) vs EXE alone in hormone receptor positive (HR+), human epidermal growth factor-receptor 2-negative (HER2-) advanced breast cancer (ABC) recurring/progressing on/after prior non-steroidal aromatase inhibitors (NSAIs). BRAWO is a German non-interventional study conducted in patients (pts) with HR+, HER2–ABC receiving EVE + EXE, according to Summary of Product Characteristics (SmPC), in routine clinical practice. Here we report the final PFS and safety results.
Methods: This multicenter study documented 2100 pts between October 2012 and December 2017 across 341 sites in Germany. Postmenopausal women with HR+, HER2– ABC with recurrence or progression after a NSAI were included. Primary observation parameters included the evaluation of the effectiveness of EVE + EXE used in routine care for the entire pt group.
Results: In the final analysis, out of the 2100 documented pts, 2074 were included in the full analysis set. The median time since the primary diagnosis was 7.1 years and the median time from first sign of relapse (local recurrence or distant metastases) was 2.1 years. At baseline, 54.1% of pts presented with visceral metastases and 50.1% had an ECOG performance status of 0. Approximately, 63% of pts started with EVE 10 mg (median duration of exposure: 5.1 months; 95% CI, 4.6-5.4), while 34.1% started with EVE 5 mg (median duration of exposure: 4.6 months; 95% CI, 4.1-5.2).
The distribution of treatment lines was as follows: first line, 28.7% (n=595); second line, 31.9% (n=662); third line, 18.1% (n=376); fourth line, 10.7% (n=221) and, fifth line and later, 10.6% (n=220). Treatment was discontinued by 55.7% of pts (n=1170) due to progressive disease and 26% of pts (n=546) due to adverse events. The Kaplan-Meier estimate of the median PFS was 6.6 months (95% CI, 6.2-7.0). The best overall responses, based on clinical routine, were complete response, 0.8% (n=17), partial response, 7.4% (n=150), and stable disease, 41.3% (n=842). The general safety profile was consistent with the previously reported safety findings. The most common adverse events were stomatitis (any grade: 42.6%, grade 3: 3.8%, grade 4: <0.1%) and fatigue (any grade: 19.8%, grade 3: 1.5%).
Conclusions: Data from BRAWO support EVE + EXE as a suitable treatment option with a reasonable safety profile for HR+, HER2− ABC recurring or progressing on/after prior NSAIs.
Citation Format: Lüftner D, Schuetz F, Schneeweiss A, Grischke E-M, Bloch W, Decker T, Uleer C, Salat C, Förster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Guderian G, Hanson S, Fasching P. Everolimus + exemestane for HR+ advanced breast cancer in routine clinical practice- Final results from the non-interventional trial, BRAWO [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-08.
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Affiliation(s)
- D Lüftner
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - F Schuetz
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - A Schneeweiss
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - E-M Grischke
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - W Bloch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - T Decker
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Uleer
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Salat
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - F Förster
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - M Schmidt
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Mundhenke
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - H Tesch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Jackisch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - T Fischer
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - G Guderian
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - S Hanson
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - P Fasching
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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Förster F, Stein J, Löbner M, Pabst A, Angermeyer M, König HH, Riedel-Heller S. Verlusterfahrungen im Alter – Auswirkungen auf das soziale Netzwerk und die psychische Gesundheit. Psychother Psychosom Med Psychol 2018. [DOI: 10.1055/s-0038-1667945] [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: 10/28/2022]
Affiliation(s)
- F Förster
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - J Stein
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - M Löbner
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - A Pabst
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
| | - M Angermeyer
- Center for Public Mental Health, Gösing am Wagram, Austria
| | - HH König
- Universitätsklinikum Hamburg-Eppendorf, Institut für Gesundheitsökonomie und Versorgungsforschung, Hamburg, Deutschland
| | - S Riedel-Heller
- Universität Leipzig, Medizinische Fakultät, Institut für Sozialmedizin, Arbeitsmedizin und Public Health (ISAP), Leipzig, Deutschland
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Weiße Y, Gusenbauer E, Leichsenring G, Förster F, Schnabel J. Zervixkarzinom in der Schwangerschaft, Prolongation mittels Chemotherapie. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645938] [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: 10/27/2022] Open
Affiliation(s)
- Y Weiße
- DRK Krankenhaus Chemnitz Rabenstein
| | | | | | - F Förster
- Praxis für Gynäkologische Onkologie Chemnitz
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Chytka L, Avoni G, Brandt A, Cavallaro E, Davis PM, Förster F, Hrabovsky M, Huang Y, Jirakova K, Kocian M, Komarek T, Korcyl K, Lange J, Michalek V, Nozka L, Paz IL, Rijssenbeek M, Schovanek P, Sykora T, Urbasek V. Timing resolution studies of the optical part of the AFP Time-of-flight detector. Opt Express 2018; 26:8028-8039. [PMID: 29715776 DOI: 10.1364/oe.26.008028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 03/02/2018] [Indexed: 06/08/2023]
Abstract
We present results of the timing performance studies of the optical part and front-end electronics of the time-of-flight subdetector prototype for the ATLAS Forward Proton (AFP) detector obtained during the test campaigns at the CERN-SPS test-beam facility (120 GeV π+ particles) in July 2016 and October 2016. The time-of-flight (ToF) detector in conjunction with a 3D silicon pixel tracker will tag and measure protons originating in central exclusive interactions p + p → p + X + p, where the two outgoing protons are scattered in the very forward directions. The ToF is required to reduce so-called pileup backgrounds that arise from multiple proton interactions in the same bunch crossing at high luminosity. The background can fake the signal of interest, and the extra rejection from the ToF allows the proton tagger to operate at the high luminosity required for the measurement of the processes. The prototype detector uses fused silica bars emitting Cherenkov radiation as a relativistic particle passes through them. The emitted Cherenkov photons are detected by a multi-anode micro-channel plate photomultiplier tube (MCP-PMT) and processed by fast electronics.
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Kwant PB, Finocchiaro T, Förster F, Reul H, Rau G, Morshuis M, El Banayosi A, Körfer R, Schmitz-Rode T, Steinseifer U. The MiniACcor: Constructive Redesign of an Implantable Total Artificial Heart, Initial Laboratory Testing and Further Steps. Int J Artif Organs 2018; 30:345-51. [PMID: 17520573 DOI: 10.1177/039139880703000411] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 11/17/2022]
Abstract
The Aachen Total Artificial Heart (ACcor) has been under development at the Helmholtz Institute in Aachen over the last decade. It may serve as a bridge to transplant or as a long-term replacement of the natural heart. Based upon previous in vivo experiments with the ACcor total artificial heart, it was decided to optimize and redesign the pump unit. Smaller dimensions, passive filling and separability into three components were the three main design goals. The new design is called the MiniACcor, which is about 20% smaller than its predecessor, and weighs only 470 grams. Also its external driver/control unit was miniaturized and a new microcontroller was selected. To validate the design, it was extensively tested in laboratory mock loops. The MiniACcor was able to pump between 4.5 and 7 l/min at different pump rates against normal physiological pressures. Several requirements for the future compliance chamber and transcutaneous energy transmission (TET) system were also measured in the same mock loop. Further optimization and validation are being performed in cooperation with the Heart and Diabetes Centre North Rhine-Westphalia.
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Affiliation(s)
- P B Kwant
- Helmholtz Institute, Aachen, Germany.
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Bloch W, Baumann F, Zimmer P, Grischke EM, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Tesch H, Schütz F, Lüftner D, Jackisch C. Abstract P4-13-07: Impact of physical activity/exercise on adverse events and quality of life during treatment with everolimus and exemestane for ER+ women - Results of the 3rd interim analysis of BRAWO. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
BRAWO is a non-interventional study collecting data of 3000 breast cancer patients treated with everolimus and exemestane (advanced or metastatic, hormone-receptor-positive, HER2-negative breast cancer). We introduce results of the 3rd preplanned interim analysis with data cut-off 08/01/ 2015, including 1300 patients. Since physical activity/exercise was reported to influence side effects as well as quality of life (QoL) of various cancer types and therapies, this analysis focuses on the impact of the physical activity/exercise history, development on adverse effects (AE) of the medical treatment and QoL.
Methods
Patients were asked to complete the EORTC QLQ-C30 QoL questionnaire and visual analogue scales (VAS-KAS) measuring their present-, past ten year- and lifetime physical activity/exercise level. To differentiate between activity/exercise levels, VAS were divided in three equal components (inactive, somewhat active, very active). Questionnaires and information about AE (e. g. stomatitis, fatigue, nausea, diarrhea, etc.) were collected before starting the medical treatment and were repeated each three months. Logistic regression model was used to estimate the impact of baseline physical activity/exercise on AE at any time point of the therapy. ANOVA models were used to calculate the impact of the baseline activity/exercise level on QoL at the last completed data set of each patient.
Results
Median age of patients was 66 years, median weight was 70 kg, median BMI was 25.9, median time since primary diagnosis was 6.2 years, and 54.4% had visceral metastases at baseline. The median PFS for the first 1300 patients was 7.1 months (95% CI, 6.5-8.0). Patients who reported to be very active (exercise) at the week prior to baseline (4.4%) showed significant lower numbers of AE compared to patients who indicate to be somewhat (14.8%) or inactive (80.8%). In contrast to the exercise level, physical activity in everyday life did not affect the AE incidence. Neither lifetime nor past ten year activity/exercise level is associated with the occurrence of AE. Regarding QoL, very active as well as somewhat active women (measured at baseline for almost each time period) showed significant higher QoL values compared to inactive women during the last assessment before death/progress.
Conclusion
Exercise prior to medical treatment with Everolimus and Exemestane may impact AE during therapy. Since physical activity did not show such a relation, this analysis highlights the importance of specific guidelines for preventive/rehabilitative exercise programs. More knowledge about dose-response relationships is needed. Furthermore a livelong healthy, "active" lifestyle may increase QoL, even in patients with advanced and terminal breast cancer disease.
Citation Format: Bloch W, Baumann F, Zimmer P, Grischke E-M, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Tesch H, Schütz F, Lüftner D, Jackisch C. Impact of physical activity/exercise on adverse events and quality of life during treatment with everolimus and exemestane for ER+ women - Results of the 3rd interim analysis of BRAWO. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-07.
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Affiliation(s)
- W Bloch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Baumann
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - P Zimmer
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - E-M Grischke
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - PA Fasching
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - T Decker
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Uleer
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - A Schneeweiss
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Salat
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - P Wimberger
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Mundhenke
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Förster
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - B Kluth-Pepper
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - J Schubert
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - H Tesch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - F Schütz
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - D Lüftner
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
| | - C Jackisch
- University Cologne, Cologne, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; Onkologie Bethanien, Frankfurt, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; Sana Klinikum Offenbach, Offenbach, Germany
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Tesch H, Grischke EM, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Bloch W, Jackisch C, Schütz F, Lüftner D. Abstract P4-13-06: Results of the 3rd interim analysis of the non-interventional trial BRAWO – Subanalysis of patients <70 years and ≥ 70 years. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-13-06] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
BRAWO is a German non-interventional study of 3000 patients (pts) with advanced/metastatic, hormone-receptor-positive and HER2-negative breast cancer treated with everolimus and exemestane (EVE+EXE). The pivotal BOLERO-2 trial demonstrated that adding EVE to EXE improved PFS over EXE and was generally well tolerated in elderly patients with HR+ advanced breast cancer (>65 years as well as >70 years). Here we describe data of elderly patients treated with EVE+EXE in daily clinical routine.
Methods
We report data of the 3rd preplanned interim analysis (IA) of the first 1300 pts documented in BRAWO. Patient and disease characteristics in elderly patients (≥ 70 years, n=485) and patients <70 years (n=813) are described. Furthermore, safety and efficacy data for both subgroups are described.
Results
At time of data cut-off, 71% pts had discontinued the study, 29% were still ongoing. Patient and disease characteristics were comparable in both groups except for: median age (60y (range: 20-69y) vs. 75y (range 70-93y)), median time since 1st diagnosis (6.4y <70y vs. 8.8y ≥70 y), ECOG performance status 0 (56.6% <70y vs. 37.0% ≥70 y), and younger pts seemed to have less comorbidities (charlson comorbidity index (CCI)=0: 80.9% vs. 67.4%). The distribution of patients by therapy line was similar as well as tumor grading, hormone receptor status, Ki67-status and metastasis localization.
More patients in the older group received fulvestrant (20.6% vs. 16.2%), in the younger group more patients received chemotherapy (20.3% vs. 14.2%) as last antineoplastic therapy. In general, more patients in the older subgroup did not receive any chemotherapy as pretreatment (53.6% vs 40.2%).
More patients in the subgroup ≥70y received 5mg EVE as starting dose (30.3% vs. 20.8%) and had 5mg as end dose (37.9% vs. 26.9%). Median PFS was 7.1 months in the overall population, 7.0 months (6.5, 8.0; 95%CI) for pts <70y and 7.3 months (6.3, 8.6; 95%CI) for pts ≥70y. Kaplan Meier estimates for median treatment duration were longer for younger pts (167.0 days (155.0, 191.0; 95%CI vs. 128.0 days (112.0, 152.0; 95%CI)). Incidence and severity of stomatitis were comparable across subgroups (Table 1). Quality of life analysis revealed no significant differences between older and younger pts.
Table 1: Incidence and severity of stomatitis
Patient Characteristics< 70 years (n=813)≥ 70 years (n=485)Stomatitis Number of patients with at least one Stomatitis Event (based on stomatitis questionnaires)339 (41.7%)200 (41.2%)Grade 1181 (22.3%)95 (19.6%)Grade 2119 (14.6%)79 (16.3%)Grade 319 (2.3%)11 (2.3%)unknown20 (2.5%)15 (3.1%)Number of Stomatitis Events431 (100.0%)252 (100%)Grade 1237 (55.0%)125 (49.6%)Grade 2136 (31.6%)87 (34.5%)Grade 319 (4.4%)13 (5.2%)
Discussion
The data described here show that EVE+EXE treatment is effective and safe for elderly patients in daily clinical routine. This is consistent with data from an exploratory analysis of the pivotal BOLERO-2 trial, where the same differences in baseline characteristics were observed for elderly pts compared to younger pts as in BRAWO. Efficacy was also comparable to elderly pts in BOLERO-2 (mPFS 6.8 months for EVE+EXE in pts ≥70 years).
Citation Format: Tesch H, Grischke E-M, Fasching PA, Decker T, Uleer C, Schneeweiss A, Salat C, Wimberger P, Mundhenke C, Förster F, Kluth-Pepper B, Schubert J, Bloch W, Jackisch C, Schütz F, Lüftner D. Results of the 3rd interim analysis of the non-interventional trial BRAWO – Subanalysis of patients <70 years and ≥ 70 years. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-13-06.
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Affiliation(s)
- H Tesch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - E-M Grischke
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - PA Fasching
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - T Decker
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Uleer
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - A Schneeweiss
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Salat
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - P Wimberger
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Mundhenke
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - F Förster
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - B Kluth-Pepper
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - J Schubert
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - W Bloch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - C Jackisch
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - F Schütz
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
| | - D Lüftner
- Onkologie Bethanien, Frankfurt, Germany; University Hospital Tuebingen, Tuebingen, Germany; University Hospital Erlangen, Erlangen, Germany; Medical Center Onkologie Ravensburg, Ravensburg, Germany; Medical Center Hildesheim, Hildesheim, Germany; National Center for Tumor Diseases, University Hospital Heidelberg, Heidelberg, Germany; Hämato-Onkologische Schwerpunktpraxis, Munich, Germany; Technical University Dresden, Dresden, Germany; University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Novartis Pharma GmbH, Nuremberg, Germany; University Cologne, Cologne, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Heidelberg, Heidelberg, Germany; Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany
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Hanker L, Hitschold T, Grafe A, Förster F, Schröder J, Janssen J, Reichert D, Hielscher C, Keitel S, Hesse T. Abstract P4-14-08: Efficacy of trastuzumab re-therapy in the clinical routine of HER2-positive breast cancer patients who relapsed after completed anti-HER2 (neo)adjuvant therapy – 5th interim analysis of the national non-interventional study (NIS) ML21589. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-14-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
HER2 overexpression occurs in approx. 20% of breast tumors and is associated with increased aggressiveness and mortality. Anti-HER2 re-therapy with trastuzumab (Herceptin®, T) is an established therapeutic option for the treatment of recurrent/metastatic HER2-positive breast cancer (MBC). Patients (pts) receiving T re-therapy appear to benefit from the retreatment after a relapse-free (neo)adjuvant anti-HER2 therapy.
Methods
This NIS is conducted in Germany to gain additional knowledge about efficacy of 1st-line T retreatment in the clinical routine. 122 sites enrolled a total of 239 pts with locally recurrent and/or MBC who relapsed after (neo)adjuvant treatment with T in their medical history. 230 pts met the eligibility criteria. The current analysis presents data collected between 10/2008-04/2015. Tumor progression was clinically assessed by the investigator.
Results
Median observation period for the total population (n=230) was 41.7 months (m) (range 0.4-94.5).
At start of T retreatment, 20.0% (n=46) of the pts presented with local recurrence only, 79.6% (n=183) presented with distant metastases ± local recurrence and one patient (0.4%) presented with elevated tumor markers. 27.4% (n=63) of the pts developed exclusively non-visceral metastases and 52.2% (n=120) were diagnosed with visceral (± non-visceral) metastases. Median duration of T re-therapy in the first line setting was 9.0 m (95% confidence interval (CI): 7.6-10.1). In 69.6% (n=160) of the cases, T was added to chemotherapy (CT). 15.2% of the pts (n=35) were treated with T+CT + endocrine therapy (ET).
A median progression free survival (PFS) of 10.1 m was observed among all eligible patients (n = 230) (95% CI: 8.5-12.0). The evaluation by risk groups revealed a PFS of 23.7 m (95% CI: 13.3-NE*) for patients with local recurrence only, 11.8 m (95% CI: 8.3-20.1) for patients with non-visceral metastases and 7.6 m (95% CI: 6.2-9.9) for patients with visceral metastases. *Not evaluable
Median PFS according to treatment regimen was 8.3 m for pts who were treated with T+CT (n=125, 54.3%), 17.7 m in pts who received T+CT+ET (n=35, 15.2%) and 11.2 m in pts treated with T+ET (n=38, 16.5%). Pts who received T monotherapy (n=32, 13.9%) had a median PFS of 13.4 m.
Of 230 pts, 121 deaths were documented (52.6%) within the observation period. The median overall survival (OS) was 29.6 m for all pts (95% CI: 27.3-36.8). Median OS was statistically reliable for pts with visceral metastases only: 19.4 m (95% CI: 16.9-27.3). The 2-year survival rate was 62.2% for all pts, 81.9% for pts with local recurrence only, 80.7% for pts with non-visceral metastases and 45.6% for pts with visceral metastases.
Conclusions
The survival observed for pts with HER2-positive MBC receiving T re-therapy in the clinical routine is in line with the results of recently published data. In terms of the 2-year survival rate, 81.9% of the pts with local recurrence were still alive and thus show the most favourable prognosis. T re-therapy provides an efficient treatment option regardless of given as combination-therapy together with CT and/or ET or as monotherapy.
Citation Format: Hanker L, Hitschold T, Grafe A, Förster F, Schröder J, Janssen J, Reichert D, Hielscher C, Keitel S, Hesse T. Efficacy of trastuzumab re-therapy in the clinical routine of HER2-positive breast cancer patients who relapsed after completed anti-HER2 (neo)adjuvant therapy – 5th interim analysis of the national non-interventional study (NIS) ML21589. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-14-08.
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Affiliation(s)
- L Hanker
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - T Hitschold
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - A Grafe
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - F Förster
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - J Schröder
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - J Janssen
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - D Reichert
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - C Hielscher
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - S Keitel
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
| | - T Hesse
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Klinik für Frauenheilkunde und Geburtshilfe, Lübeck, Germany; Klinikum Worms, Brustzentrum, Worms, Germany; MVZ Nordhausen, Nordhausen, Germany; Schwerpunktpraxis für Gynäkologische Onkologie und Palliativmedizin, Chemnitz, Germany; Onkologische Schwerpunktpraxis, Muelheim an der Ruhr, Germany; Gemeinschaftspraxis für Hämatologie und Onkologie, Westerstede, Germany; Gynäkologie Zentrum Stralsund, Stralsund, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany; Diakoniekrankenhaus, Klinik für Frauenheilkunde, Rotenburg, Germany
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Zhang S, Menche D, Zahler S, Vollmar AM, Liebl J, Förster F. In vitro anti-cancer effects of the actin-binding natural compound rhizopodin. Pharmazie 2015; 70:610-615. [PMID: 26492647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Several natural compound interfere with microtubules or the actin cytoskeleton. Compounds interfering with the microtubules like Vinca-alkaloids or taxanes, are extensively used for cancer therapy. In contrast, knowledge about pharmacological properties of actin binding drugs is poor and drugs interfering with actin are far from clinical use. Rhizopodin is a natural compound that strongly affects the actin cytoskeleton at nanomolar concentrations. Initial work revealed interesting anti-bacterial and cytotoxic effects, but the cellular effects and pharmacological properties of rhizopodin have not been characterized. We hypothesized that rhizopodin might exert anti-cancer activity. Therefore, the aim of this study was to characterize the cellular and pharmacological effects of rhizopodin in cancer. Effects of rhizopodin demonstrated prominent effects on the actin cytoskeleton as shown in the actin-pyrene assay and by immunostaining of cancer cells. To investigate cellular effects of rhizopodin, we analyzed cell proliferation, cell death induction by propidium iodide exclusion and western blot, as well as migration by impedance measurement using the xCELLligence device in MDA-MB-231 breast cancer and T24 bladder cancer cell lines. Rhizopodin inhibited proliferation and induced cell death of MDA-MB-231 and T24 cells at nanomolar concentrations. PARP cleavage by rhizopodin suggests caspase-dependent cell death induction. Importantly, rhizopodin potently inhibited MDA-MB-231 and T24 cancer cell migration at subtoxic doses where no actin aggregation was observed, indicating a specific underlying signaling of rhizopodin. In summary, our study elucidates rhizopodin as actin-binding natural compound that exerts potent anti-cancer effects. Therefore, our work provides the basis for further in depth characterization of rhizopodin as an antitumoral agent.
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Maass N, Greiner W, Possinger K, Tesch H, Förster F, Schneeweiss A, Düwel P, Ostermann H. ACT-FASTER: Eine epidemiologische, prospektive Kohortenstude bei postmenopausalen Frauen mit fortgeschrittenem, HR-positivem Brustkrebs mit Fulvestrant und Exemestan unter Alltagsbedingungen. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388446] [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: 10/24/2022] Open
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Hanker L, Hitschold T, Grafe A, Förster F, Schröder J, Janssen J, Reichert D, Wohlfarth T, Greinemann J, Hesse T. Efficacy of Anti-Her2 Retherapy with Trastuzumab at First Relapse and/or First Occurrence of Metastases of Her2-Positive Breast Cancer in Clinical Routine – 4Th Interim Analysis of the Non-Interventional Study (Nis) Ml21589. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu329.49] [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: 11/14/2022] Open
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Fasching P, Decker T, Schneeweiss A, Uleer C, Förster F, Wimberger P, Kurbacher C, Harbeck N, Tomé O, Müller B, Mundhenke C, Kümmel S, Muth M, Kreuzeder J, Bloch W, Tesch H, Lüftner D, Jackisch C, Schütz F, Grischke E. Breast Cancer Treatment with Everolimus and Exemestane for Er+ Women - Results of the 2Nd Interim Analysis of the Non-Interventional Trial Brawo. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Schmidt M, Schneeweiss A, Förster F, Geberth M, Schumacher C, Hollburg W, Söling U, Aktas B, Kümmel S. Abstract P2-16-03: Mature results on metastatic breast cancer patients with prolonged (≥1 year) exposure to first-line bevacizumab combined with paclitaxel from a large observation study. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-16-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Bevacizumab (BEV) combined with chemotherapy (CT) significantly improves progression-free survival (PFS) and response rate (RR) vs CT alone in the 1st-line treatment of HER2-negative metastatic breast cancer (mBC). BEV was continued for ≥1 year in 20% of patients (pts) in the global ATHENA safety study. We examined a similar subgroup of pts with long-term antibody treatment in a large German observation study. Meanwhile, long-term follow-up of up to 4.5 years allows to present the final results, including mature data on overall survival.
Methods: Pts who had received no prior CT for their mBC received BEV-PAC per the European label. Efficacy and safety were documented in detail for up to 1 year (or until progression, death, or BEV discontinuation if earlier), with subsequent retrieval of long-term follow-up.
Results: By April 2013, final data were available for 865 pts, of whom 167 (20%) were recorded to have received BEV for ≥1 year. Baseline characteristics of this subset relative to the overall population are summarized in the table.
CharacteristicOverall population (n = 865)Subgroup treated with BEV for ≥1 year (n = 167)Median age, years (range)58(26-87)57(28-79)Age ≥65 years,%3230Metastatic at diagnosis,%2018Disease-free inreval <12 months,%24*14#Liver metastasis,%4235≥3 metastatic sites,%3329Triple-negative disease,%1812ECOG performance status >1,%98Prior (neo)adjuvant chemotherapy,%6661*n = 591, initially M0. #n = 113
Dose reductions of long-term BEV occurred in only 3% of cycles and (at least once) in 17% of pts. In the majority of pts treated for ≥1 year, BEV was continued as a single agent after discontinuation of CT. The overall best RR in pts treated for ≥1 year was 80% (complete response in 19%). Median PFS, based on observed events in 83% of all pts, was 18.4 months compared to 9.6 months in the overall population. Overall survival data, based on 524 deaths (61%), show a median of 21.6 months. In the subgroup with prolonged therapy, median OS amounts to 35.7 months with 40% of pts still alive after 4 years. Safety of long-term BEV is as previously reported with only a slightly increased hypertension rate (35%, grade ≥3: 11%), and no cases of gastrointestinal perforation, arterial thromboembolic event, or reversible posterior leukoencephalopathy syndrome.
Conclusions: According to the mature data of this study, including those on OS, a notable proportion of pts appear to derive benefit from prolonged exposure to first-line BEV-containing therapy. Although baseline characteristics exhibited only moderate indicators for an a priori more favorable prognostic profile in the subset of pts treated for ≥1 year, of course one has to keep in mind, that time-related efficacy data are biased towards improved outcome in those able to continue BEV for ≥1 year. However, the median survival of almost 3 years suggests that in a considerable number of pts continued first-line BEV-PAC correlates to favorable outcomes with limited adverse effects.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-16-03.
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Affiliation(s)
- M Schmidt
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - A Schneeweiss
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - F Förster
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - M Geberth
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - C Schumacher
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - W Hollburg
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - U Söling
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - B Aktas
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
| | - S Kümmel
- University Hospital, Mainz, Germany; National Center for Tumor Diseases, Heidelberg, Germany; University of Applied Sciences Zwickau, Chemnitz, Germany; SPGO-Mannheim, Mannheim, Germany; St. Elisabeth-Hospital, Köln, Germany; HOPA (Hämatologisch-Onkologische Praxis Altona) im Struenseehaus, Hamburg, Germany; Practice, Kassel, Germany; University Clinic, Essen, Germany; Kliniken Essen-Mitte, Essen, Germany
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Reuner A, Brümmer F, Schill R, Zantke J, Kube M, Kuhl H, Reinhardt R, Mali B, Frohme M, Förster F, Dandekar T. Mechanisms and molecular adaptation to extreme dehydration in tardigrades: Hsp gene expression in Milnesium tardigradum. Comp Biochem Physiol A Mol Integr Physiol 2008. [DOI: 10.1016/j.cbpa.2008.05.114] [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: 11/28/2022]
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Federspil PA, Federspil P, Schneider M, Förster F. Epithetische Versorgung von Orbitadefekten. Laryngorhinootologie 2008. [DOI: 10.1055/s-2007-997038] [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: 10/21/2022]
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Abstract
A displacement blood pump to support the natural heart of patients for recovery from end-stage heart failure has been developed. This electromechanical pusher plate pump has a very compact and extremely flat design. The design goal was achieved by developing a novel gear system based on the principle of a swash plate. The blood pump and cannulae can be placed within the thoracic cavity between the lungs and ribcage. The first labtype model delivers an output of 3.1 L/min against an aortic pressure of 100 mm Hg at 120 bpm.
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Affiliation(s)
- F Förster
- Helmholtz Institute for Biomedical Engineering, Aachen University of Technology, Aachen, Germany
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Seifert W, Förster F, Flott B, Terlau H. Effects of a neurotrophic factor (FGF) on development, regeneration and synaptic plasticity of central neurons. Adv Exp Med Biol 1990; 268:395-9. [PMID: 1963748 DOI: 10.1007/978-1-4684-5769-8_43] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
- W Seifert
- Dept. of Neurobiology, Max-Planck-Institut f. biophys. Chemie, Göttingen, W-Germany
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Menzel R, Pusch H, Ratzmann GW, Besch W, Förster F, Albrecht G, Ruhnke R. Serum magnesium in insulin-dependent diabetics and healthy subjects in relation to insulin secretion and glycemia during glucose-glucagon test. Exp Clin Endocrinol 1985; 85:81-8. [PMID: 3886415 DOI: 10.1055/s-0029-1210423] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
UNLABELLED In order to investigate the influence of insulin secretion on serum magnesium concentrations 33 insulin-dependent diabetics and 10 control subjects were studied. The residual insulin secretion (RIS) was investigated by measurement of human C-peptide (HCP) before and after stimulation during on OGTT (1.75 mg/kg)-glucagon (i.v. 0.1 mg glucagon/kg)-test. RESULTS Certain RIS existed in 11 insulin-dependent diabetics, 12 were without any RIS (uncertain RIS in 10 patients). Glucose tolerance and daily glycemia differed significantly among the two groups. However, all diabetics were far from euglycemia, (3.3-9.3 mmol/l): Fasting plasma glucose 12.0 +/- 0.9 (certain RIS), 15.0 +/- 0.8 (no RIS), 13.9 +/- 1.8 (uncertain RIS). Serum magnesium was significantly lower in all diabetics, both before and during the test. There was no change during the OGTT-glucagon-test and no difference among the three groups of insulin-dependent diabetics. So, we conclude that a small RIS in our longterm insulin-dependent diabetics has no influence on the behaviour of serum magnesium. But, magnesium depletion can influence coronary blood flow, blood clotting, and atherogenesis. Therefore, it should be necessary to pay more attention to the hypomagnesemia in insulin-dependent diabetics.
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Förster F. Weitere Beobachtungen an einem Fall von Myxoedema operativum. Dtsch Med Wochenschr 1897. [DOI: 10.1055/s-0029-1204951] [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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Förster F. Ueber einen durch Schilddrüsenfütterung erfolgreich behandelten Fall von Myxoedema operativum. Dtsch Med Wochenschr 1897. [DOI: 10.1055/s-0029-1204916] [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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Förster F. Ueber einen durch Schilddrüsenfütterung erfolgreich behandelten Fall von Myxoedema operativum (Schluss aus No. 12.). Dtsch Med Wochenschr 1897. [DOI: 10.1055/s-0029-1204927] [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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