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Dieckmann KP, Radtke A, Geczi L, Matthies C, Anheuser P, Eckardt U, Sommer J, Zengerling F, Trenti E, Pichler R, Belz H, Zastrow S, Winter A, Melchior S, Hammel J, Kranz J, Bolten M, Krege S, Haben B, Loidl W, Ruf CG, Heinzelbecker J, Heidenreich A, Cremers JF, Oing C, Hermanns T, Fankhauser CD, Gillessen S, Reichegger H, Cathomas R, Pichler M, Hentrich M, Eredics K, Lorch A, Wülfing C, Peine S, Wosniok W, Bokemeyer C, Belge G. Serum Levels of MicroRNA-371a-3p (M371 Test) as a New Biomarker of Testicular Germ Cell Tumors: Results of a Prospective Multicentric Study. J Clin Oncol 2019; 37:1412-1423. [PMID: 30875280 PMCID: PMC6544462 DOI: 10.1200/jco.18.01480] [Citation(s) in RCA: 195] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
PURPOSE Previous studies suggested that serum levels of microRNA (miR)-371a-3p (so-called M371 test) have a much higher sensitivity and specificity than the classic markers of testicular germ cell tumors (GCTs) and are applicable toward both seminoma and nonseminoma. We sought to confirm the usefulness of this test as a novel biomarker for GCT. PATIENTS AND METHODS In a prospective, multicentric study, serum samples of 616 patients with testicular GCTs and 258 male controls were examined for serum levels of miRNA-371a-3p (miR levels) by quantitative polymerase chain reaction. The GCT population encompassed 359 patients with seminoma and 257 with nonseminoma; 371 had clinical stage I disease, 201 had systemic disease, and 46 had relapses. Paired measurements before and after orchiectomy were performed in 424 patients; 118 with systemic disease had serial measurements during treatment. miR levels were compared with those of β-human chorionic gonadotropin, α-fetoprotein, and lactate dehydrogenase. RESULTS For the primary diagnosis of GCT, the M371 test showed a sensitivity of 90.1%, a specificity of 94.0%, an area under the curve of 0.966 upon receiver operating characteristic analysis, and a positive predictive value of 97.2%. α-Fetoprotein, β-human chorionic gonadotropin, and lactate dehydrogenase had sensitivities of less than 50% in seminoma and slightly higher sensitivities in nonseminomas. miR levels were significantly associated with clinical stage, primary tumor size, and response to treatment. Relapses had elevated miR levels that subsequently dropped to normal upon remission. Teratoma did not express miR-371a-3p. CONCLUSION The M371 test outperforms the classic markers of GCT with both a sensitivity and a specificity greater than 90%. All histologic subgroups, except teratoma, express this marker. The test could be considered for clinical implementation after further validation.
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Affiliation(s)
- Klaus-Peter Dieckmann
- Asklepios Klinik Altona, Hamburg, Germany.,2 Albertinen-Krankenhaus Hamburg, Hamburg, Germany
| | | | - Lajos Geczi
- 4 National Institute of Oncology, Budapest, Hungary
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- 11 Zeisigwaldkliniken, Chemnitz, Germany
| | - Stefan Zastrow
- 12 Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | | | | | | | | | | | - Susanne Krege
- 17 Klinikum Essen-Mitte Huyssenstiftung, Essen, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Anja Lorch
- 31 Urologische Universitätsklinik der Heinrich Heine Universität, Düsseldorf, Germany
| | | | - Sven Peine
- 24 Universitätsklinikum Eppendorf, Hamburg, Germany
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Fehr M, Maranta AF, Reichegger H, Gillessen S, Cathomas R. Carboplatin dose based on actual renal function: no excess of acute haematotoxicity in adjuvant treatment in seminoma stage I. ESMO Open 2018. [PMID: 29531843 PMCID: PMC5844370 DOI: 10.1136/esmoopen-2018-000320] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Introduction The practice of carboplatin dosing is not concordant among different centres and oncologists. Some clinical guidelines recommend capping of the carboplatin dose at, for example, creatinine-clearance (Crea-Cl) of 125 mL/min because of concerns of excessive toxicity. Clinical data to support such recommendations are lacking, especially in patients with seminoma. Methods This is a retrospective analysis of acute haematotoxicity of patients with stage I seminoma treated with adjuvant carboplatin area under the curve (AUC) 7 in routine practice in two Swiss centres in 2005–2015, and a comparison of incidence and grade (according to Common Terminology Criteria for Adverse Events v4.0) of haematological adverse events (hAEs) in patients with Crea-Cl <125 mL/min vs >125 mL/min without dose capping. Results 74 patients with 229 documented measurements were included (median 3/patient). A total of 151 hAEs occurred. Platelet nadir occurred earlier than median white cell/neutrophil count (median day 15 vs day 22; P<0.0001). The majority of hAEs were mild, with more than 80% being of grade 1. Only two (2.7%) clinically relevant hAEs necessitating subsequent interventions occurred (one patient received platelet transfusion, one patient with febrile neutropaenia). Haematological toxicities were not statistically different in patients dosed with Crea-Cl >125 mL/min versus those with Crea-Cl <125 mL/min. No hAEs other than grade 1 occurred before day 10 and after day 24. Conclusions Toxicity after single-dose carboplatin AUC 7 is generally mild. No excess of toxicity occurs in patients with high Crea-Cl above 125 mL/min, and therefore dose capping is not routinely necessary. In addition, this study provides a rationale for efficient use of healthcare services without compromising patients’ safety.
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Affiliation(s)
- Martin Fehr
- Clinic for Medical Oncology and Haematology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | | | - Hermann Reichegger
- Clinic for Medical Oncology and Haematology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Silke Gillessen
- Clinic for Medical Oncology and Haematology, Cantonal Hospital St Gallen, St Gallen, Switzerland
| | - Richard Cathomas
- Department of Oncology/Haematology, Cantonal Hospital Grisons, Chur, Switzerland
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Keizman D, Fosboel MO, Reichegger H, Peer A, Rosenbaum E, Desax MC, Neiman V, Petersen PM, Mueller J, Cathomas R, Gottfried M, Dresler H, Sarid D, Mermershtain W, Rouvinov K, Mortensen J, Gillessen S, Daugaard G, Omlin A. Imaging response during therapy with radium-223 for castration-resistant prostate cancer with bone metastases—analysis of an international multicenter database. Prostate Cancer Prostatic Dis 2017; 20:289-293. [DOI: 10.1038/pcan.2017.6] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2016] [Revised: 12/12/2016] [Accepted: 12/20/2016] [Indexed: 11/09/2022]
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Omlin AG, Daugaard G, Peer A, Reichegger H, Neumann A, Rosenbaum E, Desax MC, Neiman V, Petersen PM, Mueller J, Cathomas R, Gottfried M, Sarid D, Gez E, Mermershtain W, Rouvinov K, Mortensen J, Gillessen S, Keizman D. Imaging response during therapy with radium-223 (Ra-223) for castration-resistant prostate cancer (CRPC) with bone metastases (BM): A multicenter analysis. J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.5057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | | | | | | | - Avivit Neumann
- Department of Oncology, Rambam Medical Center, Haifa, Israel
| | - Eli Rosenbaum
- Department of Oncology, Rabin Medical Center, Petah Tikva, Israel
| | | | - Victoria Neiman
- Davidoff Cancer Center, Rabin Medical Center, Petach-Tikva, Israel
| | | | | | | | - Maya Gottfried
- Lung Cancer Unit, Meir Medical Center, Kfar Saba, Israel
| | - David Sarid
- Ichilov Hospital - Sourasky Medical Center, Tel Aviv, Israel
| | - Eli Gez
- Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | | | | | - Jann Mortensen
- Department of Clinical Physiology, Nuclear Medicine & PET, Rigshospitalet, Copenhagen, Denmark
| | | | - Daniel Keizman
- Genitourinary Oncology Service, Division of Oncology, Meir Medical Center, Sackler School of Medicine, Tel Aviv University, Kfar-Saba, Israel
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