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van Westen-Lagerweij NA, Plasmans MHD, Kramer I, Harteloh PPM, Poos MJJC, Hilderink HBM, Croes EA. Risk of death due to COVID-19 among current and former smokers in the Netherlands: a population-based quasi-cohort study. Int J Epidemiol 2024; 53:dyae003. [PMID: 38302746 PMCID: PMC10834359 DOI: 10.1093/ije/dyae003] [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] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 01/10/2024] [Indexed: 02/03/2024] Open
Abstract
BACKGROUND Research on smoking as a risk factor for death due to COVID-19 remains inconclusive, with different studies demonstrating either an increased or decreased risk of COVID-19 death among smokers. To investigate this controversy, this study uses data from the Netherlands to assess the relationship between smoking and death due to COVID-19. METHODS In this population-based quasi-cohort study, we linked pseudonymized individual data on smoking status from the 2016 and 2020 'Health Monitor Adults and Elderly' in the Netherlands (n = 914 494) to data from the cause-of-death registry (n = 2962). Death due to COVID-19 in 2020 or 2021 was taken as the main outcome. Poisson regression modelling was used to calculate relative risks (RRs) and 95% CIs of death due to COVID-19 for current and former smokers compared with never smokers while adjusting for relevant confounders (age, sex, educational level, body mass index and perceived health). RESULTS Former smokers had a higher risk of death due to COVID-19 compared with never smokers across unadjusted (RR, 2.22; 95% CI, 2.04-2.42), age-sex-adjusted (RR, 1.38; 95% CI, 1.22-1.55) and fully adjusted (RR, 1.30; 95% CI, 1.16-1.45) models. Current smokers had a slightly higher risk of death due to COVID-19 compared with never smokers after adjusting for age and sex (RR, 1.21; 95% CI, 1.00-1.48) and after full adjustment (RR, 1.08; 95% CI, 0.90-1.29), although the results were statistically non-significant. CONCLUSIONS People with a history of smoking appear to have a higher risk of death due to COVID-19. Further research is needed to investigate which underlying mechanisms may explain this.
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Affiliation(s)
| | - Marjanne H D Plasmans
- National Institute for Public Health and the Environment (RIVM), Bilthoven,The Netherlands
| | - Iris Kramer
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, The Netherlands
| | - Peter P M Harteloh
- Department of Health and Care, Statistics Netherlands, The Hague, The Netherlands
| | - Marinus J J C Poos
- National Institute for Public Health and the Environment (RIVM), Bilthoven,The Netherlands
| | - Henk B M Hilderink
- National Institute for Public Health and the Environment (RIVM), Bilthoven,The Netherlands
| | - Esther A Croes
- The Netherlands Expertise Centre for Tobacco Control, Trimbos Institute, Utrecht, The Netherlands
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Kramer I, Schubert M. The use of patient sitters at a Swiss hospital: A retrospective observational study. PLoS One 2023; 18:e0287317. [PMID: 37315098 DOI: 10.1371/journal.pone.0287317] [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] [Received: 10/20/2022] [Accepted: 06/04/2023] [Indexed: 06/16/2023] Open
Abstract
OBJECTIVE Patient sitters are frequently used in acute care hospitals to provide one-to-one care for agitated or disorientated patients to assure the safety and well-being of patients. However, there is still a lack of evidence on the use of patient sitters, especially in Switzerland. Therefore, the aim of this study was to describe and explore the use of patient sitters in a Swiss acute care hospital. METHODS In this retrospective, observational study we included all inpatients who were hospitalized between January and December 2018 in a Swiss acute care hospital and required a paid or volunteer patient sitter. Descriptive statistics were used to describe the extent of patient sitter use, patient characteristics, and organizational factors. For the subgroup analysis between internal medicine and surgical patients Mann-Whitney U tests and chi-square tests were used. RESULTS Of the total of 27'855 included inpatients, 631 (2.3%) needed a patient sitter. Of these, 37.5% had a volunteer patient sitter. The median patient sitter duration per patient per stay was 18.0 hours (IQR = 8.4-41.0h). The median age was 78 years (IQR = 65.0-86.0); 76.2% of patients were over the age of 64. Delirium was diagnosed in 41% of patients, and 15% had dementia. Most of the patients showed signs of disorientation (87.3%), inappropriate behavior (84.6%), and risk of falling (86.6%). Patient sitter uses varied during the year and between surgical and internal medicine units. CONCLUSIONS These results add to the limited body of evidence concerning patient sitter use in hospitals, supporting previous findings related to patient sitter use for delirious or geriatric patients. New findings include the subgroup analysis of internal medicine and surgical patients, as well as analysis of patient sitter use distribution throughout the year. These findings may contribute to the development of guidelines and policies regarding patient sitter use.
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Affiliation(s)
- Iris Kramer
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Maria Schubert
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
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3
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Kramer I, de Voer N, Croes E, Ramaekers M, Brouwer M. Effectief rookstopprogramma in Almere. Huisarts Wet 2023; 66:30-32. [PMID: 37008743 PMCID: PMC10039672 DOI: 10.1007/s12445-023-2211-1] [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] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Abstract
Huisartsen kennen de gevaren van roken, maar geven in de spreekkamer nog lang niet altijd een stoppen-met-rokenadvies. Daarbij komt dat de resultaten van stoppen-met-rokenbegeleiding soms tegenvallen. In 2019 zijn 14 huisartsenpraktijken in Almere begonnen met een intensief rookstopprogramma en behaalden daarmee stoppercentages tot 40% na 12 maanden. Innovatieve aspecten zijn de actieve voorbereiding, de sterke focus op het verslavingsaspect, de multidisciplinaire aanpak en de nazorg tot 1 jaar. Dit succes benadrukt het belang van consequente stoppen-met-rokenadviezen, zodat nog meer patiënten instromen.
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Affiliation(s)
- Iris Kramer
- grid.416017.50000 0001 0835 8259Wetenschappelijk medewerker, Trimbos-instituut, afdeling Tabak, Utrecht, Nederland
| | - Niels de Voer
- grid.416017.50000 0001 0835 8259Arts-epidemioloog, Trimbos-instituut, afdeling Tabak, Utrecht, Nederland
| | - Esther Croes
- Projectmedewerker business intelligence, Regio-organisatie Huisartsen Almere (ReHa), Almere, Nederland
| | - Maartje Ramaekers
- Projectmanager, Regio-organisatie Huisartsen Almere (ReHa), Almere, Nederland
| | - Michael Brouwer
- Huisarts en kaderarts ggz, Zorggroep Almere, Almere, Nederland
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Krul IM, Boekel NB, Kramer I, Janus CPM, Krol ADG, Nijziel MR, Zijlstra JM, van der Maazen RWM, Roesink JM, Jacobse JN, Schaapveld M, Schmidt MK, Opstal-van Winden AWJ, Sonke GS, Russell NS, Aleman BMP, van Leeuwen FE. Breast cancer and cardiovascular outcomes after breast cancer in survivors of Hodgkin lymphoma. Cancer 2022; 128:4285-4295. [PMID: 36281718 DOI: 10.1002/cncr.34464] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2021] [Revised: 02/25/2022] [Accepted: 03/24/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Hodgkin lymphoma (HL) survivors treated with chest radiotherapy have an increased risk of breast cancer (BC). Prior HL treatment and associated cardiovascular disease (CVD) risk may limit BC treatment options. It is unknown how treatment adaptations affect BC and CVD outcomes. METHODS The authors compared 195 BC patients treated with chest/axillary radiotherapy for HL (BC-HL) with 5988 age- and calendar year-matched patients with first primary BC (BC-1). Analyses included cumulative incidence functions and Cox regression models, accounting for tumor characteristics and BC treatment. RESULTS Compared to BC-1 patients, BC-HL patients received anthracycline-containing chemotherapy (23.7% vs. 43.8%, p < .001) and breast-conserving surgery followed by radiotherapy (7.1% vs. 57.7%, p < .001) less often. BC treatment considerations were reported for 71% of BC-HL patients. BC-HL patients had a significantly higher risk of 15-year overall mortality than BC-1 patients (61% vs. 23%). Furthermore, risks of BC-specific mortality and nonfatal BC events were significantly increased among BC-HL patients, also when accounting for tumor and treatment characteristics (2.2- to 4.5-fold). BC-HL patients with a screen-detected BC had a significantly reduced (61%) BC-specific mortality. One-third of BC-HL patients had CVD at BC-diagnosis, compared to <0.1% of BC-1 patients. Fifteen-year CVD-specific mortality and CVD incidence were significantly higher in BC-HL patients than in BC-1 patients (15.2% vs. 0.4% and 40.4% vs. 6.8%, respectively), which was due to HL treatment rather than BC treatment. CONCLUSIONS BC-HL patients experience a higher burden of CVD and worse BC outcomes than BC-1 patients. Clinicians should be aware of increased CVD risk when selecting BC treatment for HL survivors. LAY SUMMARY Patients with breast cancer after Hodgkin lymphoma (BC-HL) may have limited options for BC treatment, due to earlier HL treatment and an associated increased risk of cardiovascular disease (CVD). BC treatment considerations were reported for 71% of BC-HL patients. We examined whether BC-HL patients have a higher risk of CVD or BC events (recurrences/metastases) compared to patients with breast cancer that had no earlier tumors (BC-1). We observed a higher burden of CVD and worse BC outcomes in HL patients compared to BC-1 patients. Clinicians should be aware of increased CVD risk when selecting BC treatment for HL survivors.
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Affiliation(s)
- Inge M Krul
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Naomi B Boekel
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Iris Kramer
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Cécile P M Janus
- Department of Radiation Oncology, Erasmus University MC Cancer Institute, Rotterdam, The Netherlands
| | - Augustinus D G Krol
- Department of Radiotherapy, Leiden University Medical Center, Leiden, The Netherlands
| | - Marten R Nijziel
- Department of Hematology, Catharina Hospital, Eindhoven, The Netherlands
| | - Josée M Zijlstra
- Department of Hematology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Judith M Roesink
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Judy N Jacobse
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Michael Schaapveld
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Marjanka K Schmidt
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | | | - Gabe S Sonke
- Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Nicola S Russell
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Berthe M P Aleman
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - Flora E van Leeuwen
- Department of Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
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Kramer I, Zigan N, Tanner A, Schulze H, Schubert M. Soziale Roboter im Schweizer Gesundheitswesen – Einsatzmöglichkeiten, Chancen und Risiken aus der Sicht von potenziellen Anwendergruppen. Gr Interakt Org 2022. [PMCID: PMC9510382 DOI: 10.1007/s11612-022-00646-5] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Dieser Beitrag der Zeitschrift Gruppe. Interaktion. Organisation. (GIO) berichtet und vertieft die Ergebnisse eines interprofessionellen Projektes im Auftrag der TA-SWISS (Stiftung für Technologiefolgen-Abschätzung). In dem Projekt wurde u. a. untersucht, wie soziale Roboter aus der Sicht von Gesundheitsfachpersonen und von Bewohnerinnen und Bewohnern eines Alterszentrums zukünftig in der Schweiz eingesetzt werden können und welche Chancen und Risiken sie bei diesem Einsatz sehen. Hintergrund dieser Fragestellung war, dass soziale Roboter zunehmend im Gesundheitsbereich eingesetzt werden, die Perspektiven der potenziellen Anwenderinnen und Anwender jedoch nur wenig bekannt sind. Daher wurde mit einem explorativen Studiendesign im August 2020 ein Workshop („Round Table Gesundheit“) mit 26 Teilnehmenden durchgeführt, der Roboterszenarien, vier Fokusgruppeninterviews und eine Nachbefragung beinhaltete. Es zeigte sich in der vertieften Analyse, dass sich die von den Teilnehmenden genannten Einsatzmöglichkeiten von sozialen Robotern einerseits in zwei Anwendergruppen („Patientinnen/Patienten“ und „Gesundheitsfachpersonen“) und andererseits in zwei Rollen des sozialen Roboters (persönlich zugeordnet – „persönlicher Buddy/Assistent“ und nicht persönlich zugeordnet – „hilfreicher Kollege“) einteilen liessen. Die Chancen und Risiken sozialer Roboter liessen sich in die drei Spannungsfelder „Selbstbestimmung vs. soziale Isolation“, „Entlastung vs. Belastung & Abhängigkeit“ und „Sicherheit vs. Gefahren“ kategorisieren. Von potenziellen Anwenderinnen und Anwendern werden somit vielfältige Einsatzmöglichkeiten und Chancen für soziale Roboter im Gesundheitsbereich gesehen. Gleichzeitig gilt es auch die Risiken zu berücksichtigen und zu minimieren, damit soziale Roboter zukünftig erfolgreich in der Praxis eingesetzt werden können.
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Akdeniz D, Kramer I, van Deurzen CHM, Heemskerk‐Gerritsen BAM, Schaapveld M, Westenend PJ, Voogd AC, Jager A, Steyerberg EW, Sleijfer S, Schmidt MK, Hooning MJ. Risk of metachronous contralateral breast cancer in patients with primary invasive lobular breast cancer: Results from a nationwide cohort. Cancer Med 2022; 12:3123-3133. [PMID: 36127572 PMCID: PMC9939202 DOI: 10.1002/cam4.5235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/12/2022] [Accepted: 08/31/2022] [Indexed: 11/11/2022] Open
Abstract
Lobular primary breast cancer (PBC) histology has been proposed as a risk factor for contralateral breast cancer (CBC), but results have been inconsistent. We investigated CBC risk and the impact of systemic therapy in lobular versus ductal PBC. Further, CBC characteristics following these histologic subtypes were explored. We selected 74,373 women diagnosed between 2003 and 2010 with stage I-III invasive PBC from the nationwide Netherlands Cancer Registry. We assessed absolute risk of CBC taking into account competing risks among those with lobular (n = 8903), lobular mixed with other types (n = 3512), versus ductal (n = 62,230) histology. Hazard ratios (HR) for CBC were estimated in a cause-specific Cox model, adjusting for age at PBC diagnosis, radiotherapy, chemotherapy and/or endocrine therapy. Multivariable HRs for CBC were 1.18 (95% CI: 1.04-1.33) for lobular and 1.37 (95% CI: 1.16-1.63) for lobular mixed versus ductal PBC. Ten-year cumulative CBC incidences in patients with lobular, lobular mixed versus ductal PBC were 3.2%, 3.6% versus 2.8% when treated with systemic therapy and 6.6%, 7.7% versus 5.6% in patients without systemic therapy, respectively. Metachronous CBCs were diagnosed in a less favourable stage in 19%, 26% and 23% and less favourable differentiation grade in 22%, 33% and 27% than the PBCs of patients with lobular, lobular mixed and ductal PBC, respectively. In conclusion, lobular and lobular mixed PBC histology are associated with modestly increased CBC risk. Personalised CBC risk assessment needs to consider PBC histology, including systemic treatment administration. The impact on prognosis of CBCs with unfavourable characteristics warrants further evaluation.
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Affiliation(s)
- Delal Akdeniz
- Department of Medical OncologyErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - Iris Kramer
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamthe Netherlands,Division of Molecular PathologyNetherlands Cancer InstituteAmsterdamthe Netherlands
| | | | | | - Michael Schaapveld
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamthe Netherlands
| | | | - Adri C. Voogd
- Department of Research and DevelopmentNetherlands Comprehensive Cancer Organization (IKNL)Utrechtthe Netherlands,Department of EpidemiologyMaastricht UniversityMaastrichtthe Netherlands
| | - Agnes Jager
- Department of Medical OncologyErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - Ewout W. Steyerberg
- Department of Public HealthErasmus MCRotterdamthe Netherlands,Department of Biomedical Data SciencesLeiden University Medical CentreLeidenthe Netherlands
| | - Stefan Sleijfer
- Department of Medical OncologyErasmus MC Cancer InstituteRotterdamthe Netherlands
| | - Marjanka K. Schmidt
- Division of Psychosocial Research and EpidemiologyNetherlands Cancer InstituteAmsterdamthe Netherlands,Division of Molecular PathologyNetherlands Cancer InstituteAmsterdamthe Netherlands
| | - Maartje J. Hooning
- Department of Medical OncologyErasmus MC Cancer InstituteRotterdamthe Netherlands
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Kramer I, Voer N, Croes E, Brouwer M. Outcomes of an intensive smoking cessation program implemented in general practices in the Netherlands. Tob Prev Cessat 2022. [DOI: 10.18332/tpc/150931] [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: 11/24/2022]
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van der Meer DJ, Kramer I, van Maaren MC, van Diest PJ, C Linn S, Maduro JH, J A Strobbe L, Siesling S, Schmidt MK, Voogd AC. Comprehensive trends in incidence, treatment, survival and mortality of first primary invasive breast cancer stratified by age, stage and receptor subtype in the Netherlands between 1989 and 2017. Int J Cancer 2020; 148:2289-2303. [PMID: 33252836 PMCID: PMC8048677 DOI: 10.1002/ijc.33417] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/27/2020] [Accepted: 11/11/2020] [Indexed: 01/06/2023]
Abstract
Our study aimed to provide a comprehensive overview of trends in incidence, survival, mortality and treatment of first primary invasive breast cancer (BC), according to age, stage and receptor subtype in the Netherlands between 1989 and 2017. Data from all women diagnosed with first primary stage I to IV BC (N = 320 249) were obtained from the Netherlands Cancer Registry. BC mortality and general population data were retrieved from Statistics Netherlands. Age-standardised incidence and mortality rates were calculated with annual percentage change (APC) and average annual percentage change (AAPC) statistics. The relative survival (RS) was used as estimator for disease-specific survival. The BC incidence for all BC patients combined significantly increased until 2013 from 126 to 158 per 100 000 person-years, after which a declining trend was observed. Surgery became less extensive, but (neo-)adjuvant systemic treatments and their combinations were given more frequently. The RS improved for all age groups and for most stages and receptor subtypes, but remained stable for all subtypes since 2012 to 2013 and since 2000 to 2009 for Stage IV BC at 15 years of follow-up. Overall, the 5- and 10-year RS increased from 76.8% (95% confidence interval [CI]: 76.1, 77.4) and 55.9% (95% CI: 54.7, 57.1) in 1989 to 1999 to 91.0% (95% CI: 90.5, 91.5) and 82.9% (95% CI: 82.2, 83.5), respectively, in 2010 to 2016. BC mortality improved regardless of age and overall decreased from 57 to 35 per 100 000 person-years between 1989 and 2017. In conclusion, the BC incidence in the Netherlands has steadily increased since 1989, but the latest trends show promising declines. Survival improved markedly for most patients and the mortality decreased regardless of age.
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Affiliation(s)
- Daniël J van der Meer
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands.,Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht
| | - Iris Kramer
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Marissa C van Maaren
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht.,Department of Health Technology and Services Research, Technical Medical Center, University of Twente, Enschede
| | - Paul J van Diest
- Department of Pathology, University Medical Center Utrecht, Utrecht
| | | | - John H Maduro
- Department of radiation Oncology, University of Groningen, University Medical Center Groningen, Groningen
| | - Luc J A Strobbe
- Department of Surgery, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht.,Department of Health Technology and Services Research, Technical Medical Center, University of Twente, Enschede
| | - Marjanka K Schmidt
- Division of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Adri C Voogd
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht.,Department of Epidemiology, Maastricht University, Maastricht
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9
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Kramer I, Hooning MJ, Mavaddat N, Hauptmann M, Keeman R, Steyerberg EW, Giardiello D, Antoniou AC, Pharoah PDP, Canisius S, Abu-Ful Z, Andrulis IL, Anton-Culver H, Aronson KJ, Augustinsson A, Becher H, Beckmann MW, Behrens S, Benitez J, Bermisheva M, Bogdanova NV, Bojesen SE, Bolla MK, Bonanni B, Brauch H, Bremer M, Brucker SY, Burwinkel B, Castelao JE, Chan TL, Chang-Claude J, Chanock SJ, Chenevix-Trench G, Choi JY, Clarke CL, Collée JM, Couch FJ, Cox A, Cross SS, Czene K, Daly MB, Devilee P, Dörk T, Dos-Santos-Silva I, Dunning AM, Dwek M, Eccles DM, Evans DG, Fasching PA, Flyger H, Gago-Dominguez M, García-Closas M, García-Sáenz JA, Giles GG, Goldgar DE, González-Neira A, Haiman CA, Håkansson N, Hamann U, Hartman M, Heemskerk-Gerritsen BAM, Hollestelle A, Hopper JL, Hou MF, Howell A, Ito H, Jakimovska M, Jakubowska A, Janni W, John EM, Jung A, Kang D, Kets CM, Khusnutdinova E, Ko YD, Kristensen VN, Kurian AW, Kwong A, Lambrechts D, Le Marchand L, Li J, Lindblom A, Lubiński J, Mannermaa A, Manoochehri M, Margolin S, Matsuo K, Mavroudis D, Meindl A, Milne RL, Mulligan AM, Muranen TA, Neuhausen SL, Nevanlinna H, Newman WG, Olshan AF, Olson JE, Olsson H, Park-Simon TW, Peto J, Petridis C, Plaseska-Karanfilska D, Presneau N, Pylkäs K, Radice P, Rennert G, Romero A, Roylance R, Saloustros E, Sawyer EJ, Schmutzler RK, Schwentner L, Scott C, See MH, Shah M, Shen CY, Shu XO, Siesling S, Slager S, Sohn C, Southey MC, Spinelli JJ, Stone J, Tapper WJ, Tengström M, Teo SH, Terry MB, Tollenaar RAEM, Tomlinson I, Troester MA, Vachon CM, van Ongeval C, van Veen EM, Winqvist R, Wolk A, Zheng W, Ziogas A, Easton DF, Hall P, Schmidt MK. Breast Cancer Polygenic Risk Score and Contralateral Breast Cancer Risk. Am J Hum Genet 2020; 107:837-848. [PMID: 33022221 PMCID: PMC7675034 DOI: 10.1016/j.ajhg.2020.09.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 09/02/2020] [Indexed: 12/18/2022] Open
Abstract
Previous research has shown that polygenic risk scores (PRSs) can be used to stratify women according to their risk of developing primary invasive breast cancer. This study aimed to evaluate the association between a recently validated PRS of 313 germline variants (PRS313) and contralateral breast cancer (CBC) risk. We included 56,068 women of European ancestry diagnosed with first invasive breast cancer from 1990 onward with follow-up from the Breast Cancer Association Consortium. Metachronous CBC risk (N = 1,027) according to the distribution of PRS313 was quantified using Cox regression analyses. We assessed PRS313 interaction with age at first diagnosis, family history, morphology, ER status, PR status, and HER2 status, and (neo)adjuvant therapy. In studies of Asian women, with limited follow-up, CBC risk associated with PRS313 was assessed using logistic regression for 340 women with CBC compared with 12,133 women with unilateral breast cancer. Higher PRS313 was associated with increased CBC risk: hazard ratio per standard deviation (SD) = 1.25 (95%CI = 1.18-1.33) for Europeans, and an OR per SD = 1.15 (95%CI = 1.02-1.29) for Asians. The absolute lifetime risks of CBC, accounting for death as competing risk, were 12.4% for European women at the 10th percentile and 20.5% at the 90th percentile of PRS313. We found no evidence of confounding by or interaction with individual characteristics, characteristics of the primary tumor, or treatment. The C-index for the PRS313 alone was 0.563 (95%CI = 0.547-0.586). In conclusion, PRS313 is an independent factor associated with CBC risk and can be incorporated into CBC risk prediction models to help improve stratification and optimize surveillance and treatment strategies.
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Affiliation(s)
- Iris Kramer
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Pathology, Amsterdam 1066 CX, the Netherlands
| | - Maartje J Hooning
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam 3015 CN, the Netherlands
| | - Nasim Mavaddat
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge CB1 8RN, UK
| | - Michael Hauptmann
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Epidemiology and Biostatistics, Amsterdam 1066 CX, the Netherlands; Brandenburg Medical School Theodor Fontane, Institute of Biostatistics and Registry Research, Neuruppin 16816, Germany
| | - Renske Keeman
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Pathology, Amsterdam 1066 CX, the Netherlands
| | - Ewout W Steyerberg
- Leiden University Medical Center, Department of Biomedical Data Sciences, Leiden 2333 ZA, the Netherlands; Erasmus MC, Department of Public Health, Rotterdam 3015 GD, the Netherlands
| | - Daniele Giardiello
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Pathology, Amsterdam 1066 CX, the Netherlands; Leiden University Medical Center, Department of Biomedical Data Sciences, Leiden 2333 ZA, the Netherlands
| | - Antonis C Antoniou
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge CB1 8RN, UK
| | - Paul D P Pharoah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge CB1 8RN, UK; University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge CB1 8RN, UK
| | - Sander Canisius
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Pathology, Amsterdam 1066 CX, the Netherlands; The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Carcinogenesis, Amsterdam 1066 CX, the Netherlands
| | - Zumuruda Abu-Ful
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa 35254, Israel
| | - Irene L Andrulis
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Fred A. Litwin Center for Cancer Genetics, Toronto, ON M5G 1X5, Canada; University of Toronto, Department of Molecular Genetics, Toronto, ON M5S 1A8, Canada
| | - Hoda Anton-Culver
- University of California Irvine, Department of Epidemiology, Genetic Epidemiology Research Institute, Irvine, CA 92617, USA
| | - Kristan J Aronson
- Queen's University, Department of Public Health Sciences, and Cancer Research Institute, Kingston, ON K7L 3N6, Canada
| | - Annelie Augustinsson
- Lund University, Department of Cancer Epidemiology, Clinical Sciences, Lund 222 42, Sweden
| | - Heiko Becher
- University Medical Center Hamburg-Eppendorf, Institute of Medical Biometry and Epidemiology, Hamburg 20246, Germany; Charité -Universitätsmedizin Berlin, Institute of Biometry and Clinical Epidemiology, Berlin 10117, Germany
| | - Matthias W Beckmann
- University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, Erlangen 91054, Germany
| | - Sabine Behrens
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg 69120, Germany
| | - Javier Benitez
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid 28029, Spain; Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid 28029, Spain
| | - Marina Bermisheva
- Ufa Federal Research Centre of the Russian Academy of Sciences, Institute of Biochemistry and Genetics, Ufa 450054, Russia
| | - Natalia V Bogdanova
- Hannover Medical School, Department of Radiation Oncology, Hannover 30625, Germany; Hannover Medical School, Gynaecology Research Unit, Hannover 30625, Germany; N.N. Alexandrov Research Institute of Oncology and Medical Radiology, Minsk 223040, Belarus
| | - Stig E Bojesen
- Copenhagen University Hospital, Copenhagen General Population Study, Herlev and Gentofte Hospital, Herlev 2730, Denmark; Copenhagen University Hospital, Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Herlev 2730, Denmark; University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen 2200, Denmark
| | - Manjeet K Bolla
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge CB1 8RN, UK
| | - Bernardo Bonanni
- IEO, European Institute of Oncology IRCCS, Division of Cancer Prevention and Genetics, Milan 20141, Italy
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart 70376, Germany; University of Tübingen, iFIT-Cluster of Excellence, Tübingen 72074, Germany; German Cancer Research Center (DKFZ), German Cancer Consortium (DKTK), Partner Site Tübingen, Tübingen 72074, Germany
| | - Michael Bremer
- Hannover Medical School, Department of Radiation Oncology, Hannover 30625, Germany
| | - Sara Y Brucker
- University of Tübingen, Department of Gynecology and Obstetrics, Tübingen 72076, Germany
| | - Barbara Burwinkel
- German Cancer Research Center (DKFZ), Molecular Epidemiology Group, C080, Heidelberg 69120, Germany; University of Heidelberg, Molecular Biology of Breast Cancer, University Womens Clinic Heidelberg, Heidelberg 69120, Germany
| | - Jose E Castelao
- Instituto de Investigacion Sanitaria Galicia Sur (IISGS), Xerencia de Xestion Integrada de Vigo-SERGAS, Oncology and Genetics Unit, Vigo 36312, Spain
| | - Tsun L Chan
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong; Hong Kong Sanatorium and Hospital, Department of Pathology, Happy Valley, Hong Kong
| | - Jenny Chang-Claude
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg 69120, Germany; University Medical Center Hamburg-Eppendorf, Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), Hamburg 20246, Germany
| | - Stephen J Chanock
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20850, USA
| | - Georgia Chenevix-Trench
- QIMR Berghofer Medical Research Institute, Department of Genetics and Computational Biology, Brisbane, QLD 4006, Australia
| | - Ji-Yeob Choi
- Seoul National University Graduate School, Department of Biomedical Sciences, Seoul 03080, Korea; Seoul National University, Cancer Research Institute, Seoul 03080, Korea
| | - Christine L Clarke
- University of Sydney, Westmead Institute for Medical Research, Sydney, NSW 2145, Australia
| | - J Margriet Collée
- Erasmus University Medical Center, Department of Clinical Genetics, Rotterdam 3015 CN, the Netherlands
| | - Fergus J Couch
- Mayo Clinic, Department of Laboratory Medicine and Pathology, Rochester, MN 55905, USA
| | - Angela Cox
- University of Sheffield, Sheffield Institute for Nucleic Acids (SInFoNiA), Department of Oncology and Metabolism, Sheffield S10 2TN, UK
| | - Simon S Cross
- University of Sheffield, Academic Unit of Pathology, Department of Neuroscience, Sheffield S10 2TN, UK
| | - Kamila Czene
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm 171 65, Sweden
| | - Mary B Daly
- Fox Chase Cancer Center, Department of Clinical Genetics, Philadelphia, PA 19111, USA
| | - Peter Devilee
- Leiden University Medical Center, Department of Pathology, Leiden 2333 ZA, the Netherlands; Leiden University Medical Center, Department of Human Genetics, Leiden 2333 ZA, the Netherlands
| | - Thilo Dörk
- Hannover Medical School, Gynaecology Research Unit, Hannover 30625, Germany
| | - Isabel Dos-Santos-Silva
- London School of Hygiene and Tropical Medicine, Department of Non-Communicable Disease Epidemiology, London WC1E 7HT, UK
| | - Alison M Dunning
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge CB1 8RN, UK
| | - Miriam Dwek
- University of Westminster, School of Life Sciences, London W1B 2HW, UK
| | - Diana M Eccles
- University of Southampton, Faculty of Medicine, Southampton SO17 1BJ, UK
| | - D Gareth Evans
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester M13 9WL, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester M13 9WL, UK
| | - Peter A Fasching
- University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, Erlangen 91054, Germany; University of California at Los Angeles, David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, Los Angeles, CA 90095, USA
| | - Henrik Flyger
- Copenhagen University Hospital, Department of Breast Surgery, Herlev and Gentofte Hospital, Herlev 2730, Denmark
| | - Manuela Gago-Dominguez
- Grupo de Medicina Xenómica, Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Fundación Pública Galega de Medicina Xenómica, Santiago de Compostela 15706, Spain; University of California San Diego, Moores Cancer Center, La Jolla, CA 92037, USA
| | - Montserrat García-Closas
- National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, Bethesda, MD 20850, USA
| | - José A García-Sáenz
- Instituto de Investigación Sanitaria San Carlos (IdISSC), Centro Investigación Biomédica en Red de Cáncer (CIBERONC), Medical Oncology Department, Hospital Clínico San Carlos, Madrid 28040, Spain
| | - Graham G Giles
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC 3004, Australia; The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, VIC 3168, Australia
| | - David E Goldgar
- Huntsman Cancer Institute, University of Utah School of Medicine, Department of Dermatology, Salt Lake City, UT 84112, USA
| | - Anna González-Neira
- Spanish National Cancer Research Centre (CNIO), Human Cancer Genetics Programme, Madrid 28029, Spain
| | - Christopher A Haiman
- University of Southern California, Department of Preventive Medicine, Keck School of Medicine, Los Angeles, CA 90033, USA
| | - Niclas Håkansson
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm 171 77, Sweden
| | - Ute Hamann
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg 69120, Germany
| | - Mikael Hartman
- National University of Singapore and National University Health System, Saw Swee Hock School of Public Health, Singapore 119077, Singapore; National University Health System, Department of Surgery, Singapore 119228, Singapore
| | | | - Antoinette Hollestelle
- Erasmus MC Cancer Institute, Department of Medical Oncology, Rotterdam 3015 CN, the Netherlands
| | - John L Hopper
- The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia
| | - Ming-Feng Hou
- Kaohsiung Medical University, Chung-Ho Memorial Hospital, Kaohsiung 807, Taiwan
| | - Anthony Howell
- University of Manchester, Division of Cancer Sciences, Manchester M13 9PL, UK
| | - Hidemi Ito
- Aichi Cancer Center Research Institute, Division of Cancer Epidemiology and Prevention, Nagoya 464-8681, Japan; Nagoya University Graduate School of Medicine, Division of Cancer Epidemiology, Nagoya 466-8550, Japan
| | - Milena Jakimovska
- MASA, Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje 1000, Republic of North Macedonia
| | - Anna Jakubowska
- Pomeranian Medical University, Department of Genetics and Pathology, Szczecin 71-252, Poland; Pomeranian Medical University, Independent Laboratory of Molecular Biology and Genetic Diagnostics, Szczecin 71-252, Poland
| | - Wolfgang Janni
- University Hospital Ulm, Department of Gynaecology and Obstetrics, Ulm 89075, Germany
| | - Esther M John
- Stanford Cancer Institute, Stanford University School of Medicine, Department of Epidemiology & Population Health, Stanford, CA 94304, USA
| | - Audrey Jung
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg 69120, Germany
| | - Daehee Kang
- Seoul National University Graduate School, Department of Biomedical Sciences, Seoul 03080, Korea; Seoul National University, Cancer Research Institute, Seoul 03080, Korea; Seoul National University College of Medicine, Department of Preventive Medicine, Seoul 03080, Korea
| | - C Marleen Kets
- the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Department of Clinical Genetics, Amsterdam 1066 CX, the Netherlands
| | - Elza Khusnutdinova
- Ufa Federal Research Centre of the Russian Academy of Sciences, Institute of Biochemistry and Genetics, Ufa 450054, Russia; Bashkir State University, Department of Genetics and Fundamental Medicine, Ufa 450000, Russia
| | - Yon-Dschun Ko
- Johanniter Krankenhaus, Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Bonn 53177, Germany
| | - Vessela N Kristensen
- Oslo University Hospital-Radiumhospitalet, Department of Cancer Genetics, Institute for Cancer Research, Oslo 0379, Norway; Oslo University Hospital and University of Olso, Department of Medical Genetics, Oslo 0379, Norway
| | - Allison W Kurian
- Stanford Cancer Institute, Stanford University School of Medicine, Department of Epidemiology & Population Health, Stanford, CA 94304, USA; Stanford University School of Medicine, Department of Health Research and Policy, Stanford, CA 94305, USA
| | - Ava Kwong
- Hong Kong Hereditary Breast Cancer Family Registry, Hong Kong; The University of Hong Kong, Department of Surgery, Pok Fu Lam, Hong Kong; Hong Kong Sanatorium and Hospital, Cancer Genetics Center and Department of Surgery, Happy Valley, Hong Kong
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven 3001, Belgium; University of Leuven, Laboratory for Translational Genetics, Department of Human Genetics, Leuven 3000, Belgium
| | - Loic Le Marchand
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI 96813, USA
| | - Jingmei Li
- Genome Institute of Singapore, Human Genetics Division, Singapore 138672, Singapore
| | - Annika Lindblom
- Karolinska Institutet, Department of Molecular Medicine and Surgery, Stockholm 171 76, Sweden; Karolinska University Hospital, Department of Clinical Genetics, Stockholm 171 76, Sweden
| | - Jan Lubiński
- Pomeranian Medical University, Department of Genetics and Pathology, Szczecin 71-252, Poland
| | - Arto Mannermaa
- University of Eastern Finland, Translational Cancer Research Area, Kuopio 70210, Finland; University of Eastern Finland, Institute of Clinical Medicine, Pathology and Forensic Medicine, Kuopio 70210, Finland; Kuopio University Hospital, Biobank of Eastern Finland, Kuopio 70210, Finland
| | - Mehdi Manoochehri
- German Cancer Research Center (DKFZ), Molecular Genetics of Breast Cancer, Heidelberg 69120, Germany
| | - Sara Margolin
- Södersjukhuset, Department of Oncology, Stockholm 118 83, Sweden; Karolinska Institutet, Department of Clinical Science and Education, Södersjukhuset, Stockholm 118 83, Sweden
| | - Keitaro Matsuo
- Aichi Cancer Center Research Institute, Division of Cancer Epidemiology and Prevention, Nagoya 464-8681, Japan; Nagoya University Graduate School of Medicine, Division of Cancer Epidemiology, Nagoya 466-8550, Japan
| | - Dimitrios Mavroudis
- University Hospital of Heraklion, Department of Medical Oncology, Heraklion 711 10, Greece
| | - Alfons Meindl
- University of Munich, Campus Großhadern, Department of Gynecology and Obstetrics, Munich 81377, Germany
| | - Roger L Milne
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC 3004, Australia; The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, VIC 3168, Australia
| | - Anna Marie Mulligan
- University of Toronto, Department of Laboratory Medicine and Pathobiology, Toronto, ON M5S 1A8, Canada; University Health Network, Laboratory Medicine Program, Toronto, ON M5G 2C4, Canada
| | - Taru A Muranen
- Helsinki University Hospital, Department of Obstetrics and Gynecology, University of Helsinki, Helsinki 00290, Finland
| | - Susan L Neuhausen
- Beckman Research Institute of City of Hope, Department of Population Sciences, Duarte, CA 91010, USA
| | - Heli Nevanlinna
- Helsinki University Hospital, Department of Obstetrics and Gynecology, University of Helsinki, Helsinki 00290, Finland
| | - William G Newman
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester M13 9WL, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester M13 9WL, UK
| | - Andrew F Olshan
- University of North Carolina at Chapel Hill, Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
| | - Janet E Olson
- Mayo Clinic, Department of Health Sciences Research, Rochester, MN 55905, USA
| | - Håkan Olsson
- Lund University, Department of Cancer Epidemiology, Clinical Sciences, Lund 222 42, Sweden
| | | | - Julian Peto
- London School of Hygiene and Tropical Medicine, Department of Non-Communicable Disease Epidemiology, London WC1E 7HT, UK
| | - Christos Petridis
- King's College London, Research Oncology, Guy's Hospital, London SE1 9RT, UK
| | - Dijana Plaseska-Karanfilska
- MASA, Research Centre for Genetic Engineering and Biotechnology 'Georgi D. Efremov', Skopje 1000, Republic of North Macedonia
| | - Nadege Presneau
- University of Westminster, School of Life Sciences, London W1B 2HW, UK
| | - Katri Pylkäs
- University of Oulu, Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, Oulu 90220, Finland; Northern Finland Laboratory Centre Oulu, Laboratory of Cancer Genetics and Tumor Biology, Oulu 90220, Finland
| | - Paolo Radice
- Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Research, Milan 20133, Italy
| | - Gad Rennert
- Carmel Medical Center and Technion Faculty of Medicine, Clalit National Cancer Control Center, Haifa 35254, Israel
| | - Atocha Romero
- Hospital Universitario Puerta de Hierro, Medical Oncology Department, Madrid 28222, Spain
| | - Rebecca Roylance
- UCLH Foundation Trust, Department of Oncology, London NW1 2PG, UK
| | | | - Elinor J Sawyer
- King's College London, School of Cancer & Pharmaceutical Sciences, Comprehensive Cancer Centre, Guy's Campus, London SE1 1UL, UK
| | - Rita K Schmutzler
- Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Familial Breast and Ovarian Cancer, Cologne 50937, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Integrated Oncology (CIO), Cologne 50937, Germany; Faculty of Medicine and University Hospital Cologne, University of Cologne, Center for Molecular Medicine Cologne (CMMC), Cologne 50931, Germany
| | - Lukas Schwentner
- University Hospital Ulm, Department of Gynaecology and Obstetrics, Ulm 89075, Germany
| | - Christopher Scott
- Mayo Clinic, Department of Health Sciences Research, Rochester, MN 55905, USA
| | - Mee-Hoong See
- University of Malaya, Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, Kuala Lumpur 50603, Malaysia
| | - Mitul Shah
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge CB1 8RN, UK
| | - Chen-Yang Shen
- Academia Sinica, Institute of Biomedical Sciences, Taipei 115, Taiwan; China Medical University, School of Public Health, Taichung 40402, Taiwan
| | - Xiao-Ou Shu
- Vanderbilt University School of Medicine, Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA
| | - Sabine Siesling
- Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research, Utrecht 3511 DT, the Netherlands; University of Twente, Department of Health Technology and Service Research, Technical Medical Center, Enschede 7522 NB, the Netherlands
| | - Susan Slager
- Mayo Clinic, Department of Health Sciences Research, Rochester, MN 55905, USA
| | - Christof Sohn
- University Hospital and German Cancer Research Center, National Center for Tumor Diseases, Heidelberg 69120, Germany
| | - Melissa C Southey
- Cancer Council Victoria, Cancer Epidemiology Division, Melbourne, VIC 3004, Australia; Monash University, Precision Medicine, School of Clinical Sciences at Monash Health, Clayton, VIC 3168, Australia; The University of Melbourne, Department of Clinical Pathology, Melbourne, VIC 3010, Australia
| | - John J Spinelli
- BC Cancer, Population Oncology, Vancouver, BC V5Z 1G1, Canada; University of British Columbia, School of Population and Public Health, Vancouver, BC V6T 1Z4, Canada
| | - Jennifer Stone
- The University of Melbourne, Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, Melbourne, VIC 3010, Australia; Curtin University and University of Western Australia, The Curtin UWA Centre for Genetic Origins of Health and Disease, Perth, WA 6000, Australia
| | - William J Tapper
- University of Southampton, Faculty of Medicine, Southampton SO17 1BJ, UK
| | - Maria Tengström
- University of Eastern Finland, Translational Cancer Research Area, Kuopio 70210, Finland; Kuopio University Hospital, Department of Oncology, Cancer Center, Kuopio 70210, Finland; University of Eastern Finland, Institute of Clinical Medicine, Oncology, Kuopio 70210, Finland
| | - Soo Hwang Teo
- Cancer Research Malaysia, Breast Cancer Research Programme, Subang Jaya, Selangor 47500, Malaysia; University of Malaya, Department of Surgery, Faculty of Medicine, Kuala Lumpur 50603, Malaysia
| | - Mary Beth Terry
- Columbia University, Department of Epidemiology, Mailman School of Public Health, New York, NY 10032, USA
| | - Rob A E M Tollenaar
- Leiden University Medical Center, Department of Surgery, Leiden 2333 ZA, the Netherlands
| | - Ian Tomlinson
- University of Birmingham, Institute of Cancer and Genomic Sciences, Birmingham B15 2TT, UK; University of Oxford, Wellcome Trust Centre for Human Genetics and Oxford NIHR Biomedical Research Centre, Oxford OX3 7BN, UK
| | - Melissa A Troester
- University of North Carolina at Chapel Hill, Department of Epidemiology, Gillings School of Global Public Health and UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC 27599, USA
| | - Celine M Vachon
- Mayo Clinic, Department of Health Science Research, Division of Epidemiology, Rochester, MN 55905, USA
| | - Chantal van Ongeval
- Leuven Cancer Institute, University Hospitals Leuven, Leuven Multidisciplinary Breast Center, Department of Radiology, Leuven 3000, Belgium
| | - Elke M van Veen
- University of Manchester, Manchester Academic Health Science Centre, Division of Evolution and Genomic Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, Manchester M13 9WL, UK; St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester M13 9WL, UK
| | - Robert Winqvist
- University of Oulu, Laboratory of Cancer Genetics and Tumor Biology, Cancer and Translational Medicine Research Unit, Biocenter Oulu, Oulu 90220, Finland; Northern Finland Laboratory Centre Oulu, Laboratory of Cancer Genetics and Tumor Biology, Oulu 90220, Finland
| | - Alicja Wolk
- Karolinska Institutet, Institute of Environmental Medicine, Stockholm 171 77, Sweden; Uppsala University, Department of Surgical Sciences, Uppsala 751 05, Sweden
| | - Wei Zheng
- Vanderbilt University School of Medicine, Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Nashville, TN 37232, USA
| | - Argyrios Ziogas
- University of California Irvine, Department of Epidemiology, Genetic Epidemiology Research Institute, Irvine, CA 92617, USA
| | - Douglas F Easton
- University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Cambridge CB1 8RN, UK; University of Cambridge, Centre for Cancer Genetic Epidemiology, Department of Oncology, Cambridge CB1 8RN, UK
| | - Per Hall
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm 171 65, Sweden; Södersjukhuset, Department of Oncology, Stockholm 118 83, Sweden
| | - Marjanka K Schmidt
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Division of Molecular Pathology, Amsterdam 1066 CX, the Netherlands; The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Division of Psychosocial Research and Epidemiology, Amsterdam 1066 CX, the Netherlands.
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Giardiello D, Kramer I, Hooning MJ, Hauptmann M, Lips EH, Sawyer E, Thompson AM, de Munck L, Siesling S, Wesseling J, Steyerberg EW, Schmidt MK. Contralateral breast cancer risk in patients with ductal carcinoma in situ and invasive breast cancer. NPJ Breast Cancer 2020; 6:60. [PMID: 33298933 PMCID: PMC7609533 DOI: 10.1038/s41523-020-00202-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/01/2020] [Indexed: 12/11/2022] Open
Abstract
We aimed to assess contralateral breast cancer (CBC) risk in patients with ductal carcinoma in situ (DCIS) compared with invasive breast cancer (BC). Women diagnosed with DCIS (N = 28,003) or stage I-III BC (N = 275,836) between 1989 and 2017 were identified from the nationwide Netherlands Cancer Registry. Cumulative incidences were estimated, accounting for competing risks, and hazard ratios (HRs) for metachronous invasive CBC. To evaluate effects of adjuvant systemic therapy and screening, separate analyses were performed for stage I BC without adjuvant systemic therapy and by mode of first BC detection. Multivariable models including clinico-pathological and treatment data were created to assess CBC risk prediction performance in DCIS patients. The 10-year cumulative incidence of invasive CBC was 4.8% for DCIS patients (CBC = 1334). Invasive CBC risk was higher in DCIS patients compared with invasive BC overall (HR = 1.10, 95% confidence interval (CI) = 1.04-1.17), and lower compared with stage I BC without adjuvant systemic therapy (HR = 0.87; 95% CI = 0.82-0.92). In patients diagnosed ≥2011, the HR for invasive CBC was 1.38 (95% CI = 1.35-1.68) after screen-detected DCIS compared with screen-detected invasive BC, and was 2.14 (95% CI = 1.46-3.13) when not screen-detected. The C-index was 0.52 (95% CI = 0.50-0.54) for invasive CBC prediction in DCIS patients. In conclusion, CBC risks are low overall. DCIS patients had a slightly higher risk of invasive CBC compared with invasive BC, likely explained by the risk-reducing effect of (neo)adjuvant systemic therapy among BC patients. For support of clinical decision making more information is needed to differentiate CBC risks among DCIS patients.
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Affiliation(s)
- Daniele Giardiello
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
| | - Iris Kramer
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Maartje J Hooning
- Department of Medical Oncology-Cancer Epidemiology, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Michael Hauptmann
- Institute of Biostatistics and Registry Research, Brandenburg Medical School, Neuruppin, Germany
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Esther H Lips
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Elinor Sawyer
- School of Cancer & Pharmaceutical Sciences, Kings College London, London, UK
| | - Alastair M Thompson
- Department of Surgery, Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, USA
| | - Linda de Munck
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
| | - Sabine Siesling
- Department of Research and Development, Netherlands Comprehensive Cancer Organisation, Utrecht, the Netherlands
- Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, Enschede, the Netherlands
| | - Jelle Wesseling
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands
- Department of Public Health, Erasmus MC, Rotterdam, the Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.
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11
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Giardiello D, Kramer I, Hooning M, Hauptmann M, Lips E, Sawley E, Thompson A, de Munck L, Siesling S, Wesseling J, Steyerberg E, Schmidt M. Contralateral breast cancer in patients with ductal carcinoma in situ and invasive breast cancer in the Netherlands. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30553-0] [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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van der Meer D, Kramer I, van Maaren M, Siesling S, Schmidt M, Voogd A. Trends in incidence, mortality, survival and treatment of primary invasive breast cancer in the Netherlands for women diagnosed between 1989–2017. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30541-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Kramer I, Schaapveld M, Oldenburg HSA, Sonke GS, McCool D, van Leeuwen FE, Van de Vijver KK, Russell NS, Linn SC, Siesling S, Menke-van der Houven van Oordt CW, Schmidt MK. The Influence of Adjuvant Systemic Regimens on Contralateral Breast Cancer Risk and Receptor Subtype. J Natl Cancer Inst 2020; 111:709-718. [PMID: 30698719 DOI: 10.1093/jnci/djz010] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2018] [Revised: 08/01/2018] [Accepted: 10/15/2018] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND An increasing number of breast cancer (BC) survivors are at risk of developing contralateral breast cancer (CBC). We aimed to investigate the influence of various adjuvant systemic regimens on, subtype-specific, risk of CBC. METHODS This population-based cohort study included female patients diagnosed with first invasive BC between 2003 and 2010; follow-up was complete until 2016. Clinico-pathological data were obtained from the Netherlands Cancer Registry and additional data on receptor status through linkage with PALGA: the Dutch Pathology Registry. Cumulative incidences (death and distant metastases as competing risk) and hazard ratios (HRs) were estimated for all invasive metachronous CBC and CBC subtypes. RESULTS Of 83 144 BC patients, 2816 developed a CBC; the 10-year cumulative incidence was 3.8% (95% confidence interval [CI] = 3.7% to 4.0%). Overall, adjuvant chemotherapy (HR = 0.70, 95% CI = 0.62 to 0.80), endocrine therapy (HR = 0.46, 95% CI = 0.41 to 0.52), and trastuzumab with chemotherapy (HR = 0.57, 95% CI = 0.45 to 0.73) were strongly associated with a reduced CBC risk. Specifically, taxane-containing chemotherapy (HR = 0.48, 95% CI = 0.36 to 0.62) and aromatase inhibitors (HR = 0.32, 95% CI = 0.23 to 0.44) were associated with a large CBC risk reduction. More detailed analyses showed that endocrine therapy statistically significantly decreased the risk of estrogen receptor (ER)-positive CBC (HR = 0.41, 95% CI = 0.36 to 0.47) but not ER-negative CBC (HR = 1.32, 95% CI = 0.90 to 1.93) compared with no endocrine therapy. Patients receiving chemotherapy for ER-negative first BC had a higher risk of ER-negative CBC from 5 years of follow-up (HR = 2.84, 95% CI = 1.62 to 4.99) compared with patients not receiving chemotherapy for ER-negative first BC. CONCLUSION Endocrine therapy, chemotherapy, as well as trastuzumab with chemotherapy reduce CBC risk. However, each adjuvant therapy regimen had a different impact on the CBC subtype distribution. Taxane-containing chemotherapy and aromatase inhibitors were associated with the largest CBC risk reduction.
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Affiliation(s)
- Iris Kramer
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | - Hester S A Oldenburg
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | | | | | | | - Koen K Van de Vijver
- Department of Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Nicola S Russell
- Department of Radiation Oncology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Sabine C Linn
- Department of Surgical Oncology.,Department of Pathology, University Medical Centre Utrecht, Utrecht, the Netherlands
| | - Sabine Siesling
- Department of Research, Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, the Netherlands.,Department of Health Technology and Service Research, Technical Medical Center, University of Twente, Enschede, the Netherlands
| | | | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute, Amsterdam, the Netherlands.,Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, the Netherlands
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14
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Giardiello D, Hauptmann M, Steyerberg EW, Adank MA, Akdeniz D, Blom JC, Blomqvist C, Bojesen SE, Bolla MK, Brinkhuis M, Chang-Claude J, Czene K, Devilee P, Dunning AM, Easton DF, Eccles DM, Fasching PA, Figueroa J, Flyger H, García-Closas M, Haeberle L, Haiman CA, Hall P, Hamann U, Hopper JL, Jager A, Jakubowska A, Jung A, Keeman R, Koppert LB, Kramer I, Lambrechts D, Le Marchand L, Lindblom A, Lubiński J, Manoochehri M, Mariani L, Nevanlinna H, Oldenburg HSA, Pelders S, Pharoah PDP, Shah M, Siesling S, Smit VTHBM, Southey MC, Tapper WJ, Tollenaar RAEM, van den Broek AJ, van Deurzen CHM, van Leeuwen FE, van Ongeval C, Van't Veer LJ, Wang Q, Wendt C, Westenend PJ, Hooning MJ, Schmidt MK. Prediction of contralateral breast cancer: external validation of risk calculators in 20 international cohorts. Breast Cancer Res Treat 2020; 181:423-434. [PMID: 32279280 PMCID: PMC8380991 DOI: 10.1007/s10549-020-05611-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/21/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Three tools are currently available to predict the risk of contralateral breast cancer (CBC). We aimed to compare the performance of the Manchester formula, CBCrisk, and PredictCBC in patients with invasive breast cancer (BC). METHODS We analyzed data of 132,756 patients (4682 CBC) from 20 international studies with a median follow-up of 8.8 years. Prediction performance included discrimination, quantified as a time-dependent Area-Under-the-Curve (AUC) at 5 and 10 years after diagnosis of primary BC, and calibration, quantified as the expected-observed (E/O) ratio at 5 and 10 years and the calibration slope. RESULTS The AUC at 10 years was: 0.58 (95% confidence intervals [CI] 0.57-0.59) for CBCrisk; 0.60 (95% CI 0.59-0.61) for the Manchester formula; 0.63 (95% CI 0.59-0.66) and 0.59 (95% CI 0.56-0.62) for PredictCBC-1A (for settings where BRCA1/2 mutation status is available) and PredictCBC-1B (for the general population), respectively. The E/O at 10 years: 0.82 (95% CI 0.51-1.32) for CBCrisk; 1.53 (95% CI 0.63-3.73) for the Manchester formula; 1.28 (95% CI 0.63-2.58) for PredictCBC-1A and 1.35 (95% CI 0.65-2.77) for PredictCBC-1B. The calibration slope was 1.26 (95% CI 1.01-1.50) for CBCrisk; 0.90 (95% CI 0.79-1.02) for PredictCBC-1A; 0.81 (95% CI 0.63-0.99) for PredictCBC-1B, and 0.39 (95% CI 0.34-0.43) for the Manchester formula. CONCLUSIONS Current CBC risk prediction tools provide only moderate discrimination and the Manchester formula was poorly calibrated. Better predictors and re-calibration are needed to improve CBC prediction and to identify low- and high-CBC risk patients for clinical decision-making.
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Affiliation(s)
- Daniele Giardiello
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Michael Hauptmann
- Brandenburg Medical School, Institute of Biostatistics and Registry Research, Neuruppin, Germany
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Muriel A Adank
- Family Cancer Clinic, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Delal Akdeniz
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jannet C Blom
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mariël Brinkhuis
- Laboratory for Pathology, East-Netherlands, Hengelo, The Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- University Medical Center Hamburg-Eppendorf, Cancer Epidemiology, University Cancer Center Hamburg (UCCH), Hamburg, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Diana M Eccles
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Peter A Fasching
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California At Los Angeles, Los Angeles, CA, USA
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jonine Figueroa
- The University of Edinburgh Medical School, Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Edinburgh, UK
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Montserrat García-Closas
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Lothar Haeberle
- University Hospital Erlangen, Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Linetta B Koppert
- Department of Surgical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Iris Kramer
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Diether Lambrechts
- VIB Center for Cancer Biology, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Loic Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale Dei Tumori, Milan, Italy
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hester S A Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Saskia Pelders
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Sabine Siesling
- Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Vincent T H B M Smit
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexandra J van den Broek
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Chantal van Ongeval
- Leuven Cancer Institute, Leuven Multidisciplinary Breast Center, Department of Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Laura J Van't Veer
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Camilla Wendt
- Department of Clinical Science and Education, Karolinska Institutet, Södersjukhuset, Stockholm, Sweden
| | | | - Maartje J Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni Van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Netherlands Cancer Institute, Plesmanlaan 121, 1066 CX, Amsterdam, The Netherlands.
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15
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Giardiello D, Steyerberg EW, Hauptmann M, Adank MA, Akdeniz D, Blomqvist C, Bojesen SE, Bolla MK, Brinkhuis M, Chang-Claude J, Czene K, Devilee P, Dunning AM, Easton DF, Eccles DM, Fasching PA, Figueroa J, Flyger H, García-Closas M, Haeberle L, Haiman CA, Hall P, Hamann U, Hopper JL, Jager A, Jakubowska A, Jung A, Keeman R, Kramer I, Lambrechts D, Le Marchand L, Lindblom A, Lubiński J, Manoochehri M, Mariani L, Nevanlinna H, Oldenburg HSA, Pelders S, Pharoah PDP, Shah M, Siesling S, Smit VTHBM, Southey MC, Tapper WJ, Tollenaar RAEM, van den Broek AJ, van Deurzen CHM, van Leeuwen FE, van Ongeval C, Van't Veer LJ, Wang Q, Wendt C, Westenend PJ, Hooning MJ, Schmidt MK. Prediction and clinical utility of a contralateral breast cancer risk model. Breast Cancer Res 2019; 21:144. [PMID: 31847907 PMCID: PMC6918633 DOI: 10.1186/s13058-019-1221-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 10/29/2019] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Breast cancer survivors are at risk for contralateral breast cancer (CBC), with the consequent burden of further treatment and potentially less favorable prognosis. We aimed to develop and validate a CBC risk prediction model and evaluate its applicability for clinical decision-making. METHODS We included data of 132,756 invasive non-metastatic breast cancer patients from 20 studies with 4682 CBC events and a median follow-up of 8.8 years. We developed a multivariable Fine and Gray prediction model (PredictCBC-1A) including patient, primary tumor, and treatment characteristics and BRCA1/2 germline mutation status, accounting for the competing risks of death and distant metastasis. We also developed a model without BRCA1/2 mutation status (PredictCBC-1B) since this information was available for only 6% of patients and is routinely unavailable in the general breast cancer population. Prediction performance was evaluated using calibration and discrimination, calculated by a time-dependent area under the curve (AUC) at 5 and 10 years after diagnosis of primary breast cancer, and an internal-external cross-validation procedure. Decision curve analysis was performed to evaluate the net benefit of the model to quantify clinical utility. RESULTS In the multivariable model, BRCA1/2 germline mutation status, family history, and systemic adjuvant treatment showed the strongest associations with CBC risk. The AUC of PredictCBC-1A was 0.63 (95% prediction interval (PI) at 5 years, 0.52-0.74; at 10 years, 0.53-0.72). Calibration-in-the-large was -0.13 (95% PI: -1.62-1.37), and the calibration slope was 0.90 (95% PI: 0.73-1.08). The AUC of Predict-1B at 10 years was 0.59 (95% PI: 0.52-0.66); calibration was slightly lower. Decision curve analysis for preventive contralateral mastectomy showed potential clinical utility of PredictCBC-1A between thresholds of 4-10% 10-year CBC risk for BRCA1/2 mutation carriers and non-carriers. CONCLUSIONS We developed a reasonably calibrated model to predict the risk of CBC in women of European-descent; however, prediction accuracy was moderate. Our model shows potential for improved risk counseling, but decision-making regarding contralateral preventive mastectomy, especially in the general breast cancer population where limited information of the mutation status in BRCA1/2 is available, remains challenging.
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Affiliation(s)
- Daniele Giardiello
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - Ewout W Steyerberg
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
- Department of Public Health, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Michael Hauptmann
- Institute of Biometry and Registry Research, Brandenburg Medical School, Neuruppin, Germany
- Department of Epidemiology and Biostatistics, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Muriel A Adank
- The Netherlands Cancer Institute - Antoni van Leeuwenhoek hospital, Family Cancer Clinic, Amsterdam, The Netherlands
| | - Delal Akdeniz
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Carl Blomqvist
- Department of Oncology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
- Department of Oncology, Örebro University Hospital, Örebro, Sweden
| | - Stig E Bojesen
- Copenhagen General Population Study, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Department of Clinical Biochemistry, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Mariël Brinkhuis
- East-Netherlands, Laboratory for Pathology, Hengelo, The Netherlands
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Cancer Epidemiology Group, University Cancer Center Hamburg (UCCH), University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
| | - Peter Devilee
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Diana M Eccles
- Cancer Sciences Academic Unit, Faculty of Medicine, University of Southampton, Southampton, UK
| | - Peter A Fasching
- Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA, USA
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Jonine Figueroa
- Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh Medical School, Edinburgh, UK
- Cancer Research UK Edinburgh Centre, Edinburgh, UK
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Henrik Flyger
- Department of Breast Surgery, Herlev and Gentofte Hospital, Copenhagen University Hospital, Herlev, Denmark
| | - Montserrat García-Closas
- Department of Health and Human Services, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research, London, UK
| | - Lothar Haeberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center ER-EMN, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nuremberg, Erlangen, Germany
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden
- Department of Oncology, Södersjukhuset, Stockholm, Sweden
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Independent Laboratory of Molecular Biology and Genetic Diagnostics, Pomeranian Medical University, Szczecin, Poland
| | - Audrey Jung
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Renske Keeman
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Iris Kramer
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Diether Lambrechts
- VIB Center for Cancer Biology, VIB, Leuven, Belgium
- Laboratory for Translational Genetics, Department of Human Genetics, University of Leuven, Leuven, Belgium
| | - Loic Le Marchand
- University of Hawaii Cancer Center, Epidemiology Program, Honolulu, HI, USA
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Karolinska University Hospital, Stockholm, Sweden
| | - Jan Lubiński
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Mehdi Manoochehri
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Luigi Mariani
- Unit of Clinical Epidemiology and Trial Organization, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hester S A Oldenburg
- Department of Surgical Oncology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Saskia Pelders
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Sabine Siesling
- Department of Research, Netherlands Comprehensive Cancer Organisation, Utrecht, The Netherlands
| | - Vincent T H B M Smit
- Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Melissa C Southey
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
- Department of Clinical Pathology, The University of Melbourne, Melbourne, Victoria, Australia
| | | | - Rob A E M Tollenaar
- Department of Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - Alexandra J van den Broek
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | - Flora E van Leeuwen
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands
| | - Chantal van Ongeval
- Leuven Multidisciplinary Breast Center, Department of Oncology, Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium
| | - Laura J Van't Veer
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Camilla Wendt
- Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden
| | | | - Maartje J Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Marjanka K Schmidt
- Division of Molecular Pathology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
- Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital, Plesmanlaan 121, 1066, CX, Amsterdam, The Netherlands.
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16
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Korn P, Kramer I, Schlottig F, Tödtman N, Eckelt U, Bürki A, Ferguson SJ, Kautz A, Schnabelrauch M, Range U, Kneissel M, Stadlinger B, Stadlinger B. Systemic sclerostin antibody treatment increases osseointegration and biomechanical competence of zoledronic-acid-coated dental implants in a rat osteoporosis model. Eur Cell Mater 2019; 37:333-346. [PMID: 31112281 DOI: 10.22203/ecm.v037a20] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Osseointegration of dental implants can be promoted by implant-surface modifications using bisphosphonate coatings. In addition, it is of clinical interest to promote peri-implant bone formation and to restore bony structure in low bone-mass patients. The present study evaluated a combination of an anti-resorptive zoledronic acid (ZOL) implant-coating and a systemically applied sclerostin antibody, a known bone anabolic treatment principle, versus sole sclerostin antibody treatment or ZOL implant-coating in a rat osteoporosis model. Uncoated reference surface implants or ZOL-coated implants (n = 64/group) were inserted into the proximal tibia of aged osteoporotic rats three months following ovariectomy. 32 animals of each group received once weekly sclerostin antibody therapy. Osseointegration was assessed 2 or 4 weeks post-implantation by ex vivo µCT, histology and biomechanical testing. Overall implant survival rate was 97 %. Histomorphology revealed pronounced bone formation along the entire implant length of ZOL-coated implants. At 4 weeks following implant insertion, bone-implant contact, cancellous bone mineral density and bone volume/tissue volume were significantly increased for the combination of ZOL and sclerostin antibody as compared to sclerostin antibody or ZOL implant-coating alone. Removal torque was also significantly increased in the combination therapy group relative to animals receiving only sclerostin antibody therapy or ZOL-coated implants. In an osteoporotic rat model, the combination of anti-resorptive ZOL implant-coating and systemically applied sclerostin antibody led to significantly increased peri-implant bone formation. Therefore, the combination of ZOL and the osteoanabolic sclerostin antibody was more effective than either agent alone.
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Affiliation(s)
- P Korn
- Department of Oral and Maxillofacial Surgery, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Augustenburger Platz 1, 13353 Berlin,
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Kramer I, Hooning MJ, Mavaddat N, Canisius S, Keeman R, van den Broek AJ, Steyerberg E, Hauptmann M, Pharoah PD, Easton DF, Hall P, Schmidt MK. Abstract P1-09-04: Association between a breast cancer polygenic risk score and contralateral breast cancer risk. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-09-04] [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
Breast cancer patients are at significant risk of a second contralateral, breast cancer (CBC). Identification of women at high or low CBC risk could improve patient management decisions. Previous research has shown that breast cancer-associated single nucleotide polymorphisms (SNPs) summarized in a polygenic risk score (PRS) predict the risk of a first breast cancer with an odds ratio (OR) per 1 SD of 1.55 (95% confidence interval (95%CI)=1.52-1.58) (77-SNP PRS). The aim of this study was to evaluate the association between a recently developed PRS and CBC risk.
Methods
We identified 19 studies from the Breast Cancer Association Consortium (BCAC) with follow-up information on participating patients and at least 10 patients diagnosed with CBC. This included 38,228 females of European ancestry diagnosed with first invasive breast cancer since 1990. Genotyping was done using the iCOGS array or OncoArray, with genotypes for SNPs not on the arrays estimated by imputation. We used a 313-SNP PRS, optimized for prediction of overall (first) breast cancer in the BCAC dataset. Metachronous CBC risk by PRS was quantified using univariable and multivariable Cox regression analyses stratified by country and adjusted for multiple patient, tumor, and treatment characteristics. We assessed PRS interaction with age, family history, adjuvant systemic therapy, and ER-status.
Results
Median time to develop a CBC (N=1,046) after a first breast cancer was 5.8 years (range 0.3-21.9). Higher PRS was associated with increased CBC risk: hazard ratio (HR) per 1 SD=1.31 (95%CI=1.23-1.39). Patients in the highest and lowest 5% of the PRS had 1.95 fold and 0.67 fold risks of CBC, respectively, compared with patients in the middle quintile. Adjustments for age, year of diagnosis, family history, tumor size, nodal status, ER-status, or treatment (chemotherapy, endocrine therapy, radiotherapy) did not substantially alter these results. We found an interaction with age at first breast cancer diagnosis (Pinteraction=.002); the PRS was associated with an increased CBC risk for patients aged ≥40 years (HR=1.37, 95%CI=1.28-1.47), but not for patients <40 years (HR=1.06, 95%CI=0.93-1.21).
Conclusion
The PRS is predictive for the development of CBC in patients ≥40 years at first breast cancer diagnosis. For this group, the PRS could be incorporated in CBC risk prediction models to help define high and low risk patients, and hence optimize screening and treatment strategies.
Citation Format: Kramer I, Hooning MJ, Breast Cancer Association Consortium (BCAC), Mavaddat N, Canisius S, Keeman R, van den Broek AJ, Steyerberg E, Hauptmann M, Pharoah PD, Easton DF, Hall P, Schmidt MK. Association between a breast cancer polygenic risk score and contralateral breast cancer risk [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 P1-09-04.
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Affiliation(s)
- I Kramer
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - MJ Hooning
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - N Mavaddat
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - S Canisius
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - R Keeman
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - AJ van den Broek
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - E Steyerberg
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - M Hauptmann
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - PD Pharoah
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - DF Easton
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - P Hall
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
| | - MK Schmidt
- Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus Medical Centre, Rotterdam, Netherlands; University of Cambridge, Cambridge, United Kingdom; Leiden University Medical Centre, Leiden, Netherlands; Karolinska Institutet, Stockholm, Sweden; South General Hospital, Stockholm, Sweden
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Akdeniz D, Kramer I, van Deurzen CH, Schaapveld M, Westenend PJ, Voogd AC, Jager A, Steyerberg EW, Sleijfer S, Schmidt MK, Hooning MJ. Abstract P4-09-07: Higher risk of metachronous contralateral breast cancer in patients with invasive lobular breast cancer. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-09-07] [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
Background: Risk of metachronous contralateral breast cancer (CBC) is an important health issue in primary breast cancer (PBC) survivors. Individualized CBC risk prediction can help identify patients at high or low risk who may or may not benefit from additional surveillance and treatment. For lobular PBC, inconsistent results have been reported on an association with increased risk of CBC. We investigated CBC risk in lobular versus ductal PBC using a large nationwide dataset and taking into account age at PBC and (neo-)adjuvant systemic therapy effects.
Patients and Methods: We selected women diagnosed between 2003 and 2010 with early invasive lobular, lobular mixed with other types, or ductal PBC from the Netherlands Cancer Registry. Categorical and continuous characteristics between the 3 groups were compared using the chi-square statistics and the Kruskal-Wallis test, respectively. Competing risk analyses were applied to determine CBC incidence. Multivariable subdistribution hazard ratios (SHRs) were adjusted for primary tumor stage, age at PBC diagnosis, radiotherapy, (neo-)adjuvant chemotherapy and endocrine therapy.
Results: We selected 74,373 women aged >18 years with lobular (n=8,903), lobular mixed (n=3,512), and ductal (n=62,230) PBC. Women with lobular PBC were older at diagnosis than women with lobular mixed or ductal PBC (61 vs. 58 vs. 58 years, respectively), more often had ER-positive PBC (95.7% vs. 94.1% vs. 79.6%) and were more often systemically treated with only endocrine therapy (30.7% vs. 24.9% vs. 19.7%), while less often treated with only chemotherapy (4.2% vs. 5.3% vs. 15.4%).
Ten-year cumulative CBC incidences in women with lobular, lobular mixed or ductal PBC were 3.2%, 3.6% and 2.8% when treated with systemic therapy (chemotherapy and/or endocrine therapy) and 6.6%, 7.7% and 5.6% without systemic therapy, respectively. Multivariable SHRs were 1.19 (95% CI: 1.05-1.34) for lobular and 1.39 (95% CI: 1.17-1.65) for lobular mixed versus ductal PBC; for women <50 years, risk differences were larger: 1.60 (95% CI: 1.26-2.05) and 1.43 (95% CI: 1.00-2.06), respectively.
Conclusion: Lobular histology and lobular mixed histology are independent risk factors for CBC development, and should be considered as prognostic factors when refining CBC risk prediction models.
Citation Format: Akdeniz D, Kramer I, van Deurzen CH, Schaapveld M, Westenend PJ, Voogd AC, Jager A, Steyerberg EW, Sleijfer S, Schmidt MK, Hooning MJ. Higher risk of metachronous contralateral breast cancer in patients with invasive lobular breast cancer [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 P4-09-07.
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Affiliation(s)
- D Akdeniz
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - I Kramer
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - CH van Deurzen
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - M Schaapveld
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - PJ Westenend
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - AC Voogd
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - A Jager
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - EW Steyerberg
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - S Sleijfer
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - MK Schmidt
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
| | - MJ Hooning
- Erasmus MC Cancer Institute, Rotterdam, Netherlands; Netherlands Cancer Institute, Amsterdam, Netherlands; Erasmus MC, Rotterdam, Netherlands; Albert Schweitzer Hospital, Dordrecht, Netherlands; Netherlands Comprehensive Cancer Organization (IKNL), Utrecht, Netherlands; Maastricht University, Maastricht, Netherlands; Leiden University Medical Center, Leiden, Netherlands
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Accart N, Dawson J, Kolbinger F, Kramer I, Beckmann N. Non-invasive imaging demonstrates clinical features of ankylosing spondylitis in a rat adjuvant model: a case study. Eur J Histochem 2016; 60:2667. [PMID: 28076929 PMCID: PMC5134681 DOI: 10.4081/ejh.2016.2667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 09/22/2016] [Accepted: 09/22/2016] [Indexed: 12/19/2022] Open
Abstract
Main features of ankylosing spondylitis like inflammatory erosive osteopenia and bony overgrowth are recapitulated in rats challenged with complete Freund’s adjuvant. In vivo changes induced in the rat spine were followed longitudinally by magnetic resonance imaging (MRI) and assessed terminally by micro-computerized tomography (micro-CT) and histology. Signals reflecting inflammation were detected by MRI at levels L5-L6 throughout the experiment, peaking at day 27 after adjuvant. Bone erosion and formation occurred from this time point onward, as confirmed by micro-CT. Histology confirmed the inflammation and bone remodeling. The present study demonstrates the potential of imaging for longitudinal assessments of spinal changes in this animal model and the excellent correlation between in vivo images and histology underlines its fundamental role in the validation of non-invasive imaging.
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Affiliation(s)
- N Accart
- Novartis Institute for Biomedical Research.
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Wehmeyer C, Frank S, Beckmann D, Böttcher M, Cromme C, König U, Fennen M, Held A, Paruzel P, Hartmann C, Stratis A, Korb-Pap A, Kamradt T, Kramer I, van den Berg W, Kneissel M, Pap T, Dankbar B. A10.14 Inhibition of sclerostin accelerates TNFα-mediated bone destruction. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-209124.186] [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: 11/04/2022]
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Dorhout Mees SM, Algra A, Wong GKC, Poon WS, Bradford CM, Saver JL, Starkman S, Rinkel GJE, van den Bergh WM, van Kooten F, Dirven CM, van Gijn J, Vermeulen M, Rinkel GJE, Boet R, Chan MTV, Gin T, Ng SCP, Zee BCY, Al-Shahi Salman R, Boiten J, Kuijsten H, Lavados PM, van Oostenbrugge RJ, Vandertop WP, Finfer S, O'Connor A, Yarad E, Firth R, McCallister R, Harrington T, Steinfort B, Faulder K, Assaad N, Morgan M, Starkman S, Eckstein M, Stratton SJ, Pratt FD, Hamilton S, Conwit R, Liebeskind DS, Sung G, Kramer I, Moreau G, Goldweber R, Sanossian N. Early Magnesium Treatment After Aneurysmal Subarachnoid Hemorrhage: Individual Patient Data Meta-Analysis. Stroke 2015; 46:3190-3. [PMID: 26463689 DOI: 10.1161/strokeaha.115.010575] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 09/08/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND PURPOSE Delayed cerebral ischemia (DCI) is an important cause of poor outcome after aneurysmal subarachnoid hemorrhage (SAH). Trials of magnesium treatment starting <4 days after symptom onset found no effect on poor outcome or DCI in SAH. Earlier installment of treatment might be more effective, but individual trials had not enough power for such a subanalysis. We performed an individual patient data meta-analysis to study whether magnesium is effective when given within different time frames within 24 hours after the SAH. METHODS Patients were divided into categories according to the delay between symptom onset and start of the study medication: <6, 6 to 12, 12 to 24, and >24 hours. We calculated adjusted risk ratios with corresponding 95% confidence intervals for magnesium versus placebo treatment for poor outcome and DCI. RESULTS We included 5 trials totaling 1981 patients; 83 patients started treatment<6 hours. For poor outcome, the adjusted risk ratios of magnesium treatment for start <6 hours were 1.44 (95% confidence interval, 0.83-2.51); for 6 to 12 hours 1.03 (0.65-1.63), for 12 to 24 hours 0.84 (0.65-1.09), and for >24 hours 1.06 (0.87-1.31), and for DCI, <6 hours 1.76 (0.68-4.58), for 6 to 12 hours 2.09 (0.99-4.39), for 12 to 24 hours 0.80 (0.56-1.16), and for >24 hours 1.08 (0.88-1.32). CONCLUSIONS This meta-analysis suggests no beneficial effect of magnesium treatment on poor outcome or DCI when started early after SAH onset. Although the number of patients was small and a beneficial effect cannot be definitively excluded, we found no justification for a new trial with early magnesium treatment after SAH.
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Affiliation(s)
- Sanne M Dorhout Mees
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Ale Algra
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - George K C Wong
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Wai S Poon
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Celia M Bradford
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Jeffrey L Saver
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Sidney Starkman
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Gabriel J E Rinkel
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.)
| | - Walter M van den Bergh
- From the Department of Neurology and Neurosurgery, Rudolf Magnus Institute of Neuroscience (S.M.D.M., A.A., G.J.E.R.) and Julius Center for Health Sciences and Primary Care (A.A.), University Medical Center Utrecht, Utrecht, The Netherlands; Division of Neurosurgery, Department of Critical Care, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China (G.K.C.W., W.S.P.); Department of Critical Care, Royal North Shore Hospital, Sydney, Australia (C.M.B.); Department of Neurology (J.L.S.) and Departments of Emergency Medicine and Neurology (S.S.), Comprehensive Stroke Center, David Geffen School of Medicine at the University of California, Los Angeles; and Department of Critical Care, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands (W.M.v.d.B.).
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Simons C, Hartmann J, Kramer I, Menne-Lothmann C, Höhn P, van Bemmel A, Myin-Germeys I, Delespaul P, van Os J, Wichers M. Effects of momentary self-monitoring on empowerment in a randomized controlled trial in patients with depression. Eur Psychiatry 2015; 30:900-6. [DOI: 10.1016/j.eurpsy.2015.09.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Revised: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 12/17/2022] Open
Abstract
AbstractBackgroundInterventions based on the experience sampling method (ESM) are ideally suited to provide insight into personal, contextualized affective patterns in the flow of daily life. Recently, we showed that an ESM-intervention focusing on positive affect was associated with a decrease in symptoms in patients with depression. The aim of the present study was to examine whether ESM-intervention increased patient empowerment.MethodsDepressed out-patients (n = 102) receiving psychopharmacological treatment who had participated in a randomized controlled trial with three arms: (i) an experimental group receiving six weeks of ESM self-monitoring combined with weekly feedback sessions, (ii) a pseudo-experimental group participating in six weeks of ESM self-monitoring without feedback, and (iii) a control group (treatment as usual only). Patients were recruited in the Netherlands between January 2010 and February 2012. Self-report empowerment scores were obtained pre- and post-intervention.ResultsThere was an effect of group × assessment period, indicating that the experimental (B = 7.26, P = 0.061, d = 0.44, statistically imprecise) and pseudo-experimental group (B = 11.19, P = 0.003, d = 0.76) increased more in reported empowerment compared to the control group. In the pseudo-experimental group, 29% of the participants showed a statistically reliable increase in empowerment score and 0% reliable decrease compared to 17% reliable increase and 21% reliable decrease in the control group. The experimental group showed 19% reliable increase and 4% reliable decrease.ConclusionsThese findings tentatively suggest that self-monitoring to complement standard antidepressant treatment may increase patients’ feelings of empowerment. Further research is necessary to investigate long-term empowering effects of self-monitoring in combination with person-tailored feedback.
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van Tok M, van Duivenvoorde L, Kramer I, Ingold P, Taurog J, Kolbinger F, Baeten D. OP0202 Anti-IL-17A Treatment Blocks Inflammation and New Bone Formation in Experimental Spondyloarthritis in HLA-B27 Transgenic Rats. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.3382] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Morse A, Yu NYC, Peacock L, Mikulec K, Kramer I, Kneissel M, McDonald MM, Little DG. Endochondral fracture healing with external fixation in the Sost knockout mouse results in earlier fibrocartilage callus removal and increased bone volume fraction and strength. Bone 2015; 71:155-63. [PMID: 25445453 DOI: 10.1016/j.bone.2014.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Revised: 09/24/2014] [Accepted: 10/24/2014] [Indexed: 12/11/2022]
Abstract
Sclerostin deficiency, via genetic knockout or anti-Sclerostin antibody treatment, has been shown to cause increased bone volume, density and strength of calluses following endochondral bone healing. However, there is limited data on the effect of Sclerostin deficiency on the formative early stage of fibrocartilage (non-bony tissue) formation and removal. In this study we extensively investigate the early fibrocartilage callus. Closed tibial fractures were performed on Sost(-/-) mice and age-matched wild type (C57Bl/6J) controls and assessed at multiple early time points (7, 10 and 14days), as well as at 28days post-fracture after bony union. External fixation was utilized, avoiding internal pinning and minimizing differences in stability stiffness, a variable that has confounded previous research in this area. Normal endochondral ossification progressed in wild type and Sost(-/-) mice with equivalent volumes of fibrocartilage formed at early day 7 and day 10 time points, and bony union in both genotypes by day 28. There were no significant differences in rate of bony union; however there were significant increases in fibrocartilage removal from the Sost(-/-) fracture calluses at day 14 suggesting earlier progression of endochondral healing. Earlier bone formation was seen in Sost(-/-) calluses over wild type with greater bone volume at day 10 (221%, p<0.01). The resultant Sost(-/-) united bony calluses at day 28 had increased bone volume fraction compared to wild type calluses (24%, p<0.05), and the strength of the fractured Sost(-/-) tibiae was greater than that that of wild type fractured tibiae. In summary, bony union was not altered by Sclerostin deficiency in externally-fixed closed tibial fractures, but fibrocartilage removal was enhanced and the resultant united bony calluses had increased bone fraction and increased strength.
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Affiliation(s)
- A Morse
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
| | - N Y C Yu
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
| | - L Peacock
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia.
| | - K Mikulec
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia.
| | - I Kramer
- Novartis Pharma, Basel, Switzerland.
| | | | - M M McDonald
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia.
| | - D G Little
- Orthopaedic Research & Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia.
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Morse A, McDonald MM, Kelly NH, Melville KM, Schindeler A, Kramer I, Kneissel M, van der Meulen MCH, Little DG. Mechanical load increases in bone formation via a sclerostin-independent pathway. J Bone Miner Res 2014; 29:2456-67. [PMID: 24821585 PMCID: PMC4501925 DOI: 10.1002/jbmr.2278] [Citation(s) in RCA: 85] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2014] [Revised: 04/22/2014] [Accepted: 05/06/2014] [Indexed: 01/24/2023]
Abstract
Sclerostin, encoded by the Sost gene, is an important negative regulator of bone formation that has been proposed to have a key role in regulating the response to mechanical loading. To investigate the effect of long-term Sclerostin deficiency on mechanotransduction in bone, we performed experiments on unloaded or loaded tibiae of 10 week old female Sost-/- and wild type mice. Unloading was induced via 0.5U botulinum toxin (BTX) injections into the right quadriceps and calf muscles, causing muscle paralysis and limb disuse. On a separate group of mice, increased loading was performed on the left tibiae through unilateral cyclic axial compression of equivalent strains (+1200 µe) at 1200 cycles/day, 5 days/week. Another cohort of mice receiving equivalent loads (-9.0 N) also were assessed. Contralateral tibiae served as normal load controls. Loaded/unloaded and normal load tibiae were assessed at day 14 for bone volume (BV) and formation changes. Loss of BV was seen in the unloaded tibiae of wild type mice, but BV was not different between normal load and unloaded Sost-/- tibiae. An increase in BV was seen in the loaded tibiae of wild type and Sost-/- mice over their normal load controls. The increased BV was associated with significantly increased mid-shaft periosteal mineralizing surface/bone surface (MS/BS), mineral apposition rate (MAR), and bone formation rate/bone surface (BFR/BS), and endosteal MAR and BFR/BS. Notably, loading induced a greater increase in periosteal MAR and BFR/BS in Sost-/- mice than in wild type controls. Thus, long-term Sclerostin deficiency inhibits the bone loss normally induced with decreased mechanical load, but it can augment the increase in bone formation with increased load.
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Affiliation(s)
- A Morse
- Orthopaedic Research and Biotechnology Unit, The Children's Hospital at Westmead, Sydney, Australia; Discipline of Paediatrics and Child Health, Sydney Medical School, University of Sydney, Sydney, Australia
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Schauenstein E, Wöhl W, Kramer I. Über den Einfluß von Hydroxyenalen (4-Hydroxypent-2.3-trans-en-al-1) auf DNS und RNS von Ehrlich-Ascites-Tumorzellen. ACTA ACUST UNITED AC 2014. [DOI: 10.1515/znb-1968-0421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Die cytotoxischen Wirkungen von HPE bei einer Konzentration von 5·10-3 Mol/l während 30 Min. aerober Inkubation auf Ehrlich-Ascites-Tumorzellen werden cytospektrometrisch untersucht:
1. Der Gehalt an DNS, untersucht mit der Feulgen - Reaktion, erfährt keine signifikante Veränderung.
2. Die Intensität der Methylenblau-Färbung nimmt nach HPE-Behandlung drastisch ab, woraus auf einen teilweisen Verlust an RNS geschlossen wird.
3. In den unter HPE-Einwirkung entstandenen Plasmaextrusionen werden tatsächlich typische Nucleinsäure-Spektren erhalten, die der ausgetretenen RNS zugeordnet werden. Da diese Plasmaextrusionen jedoch auch sicher noch zusätzlich Proteine enthalten, werden sie als Ausdruck einer Desintegration des Cytoplasmas aufgefaßt. Die geschilderten Effekte konnten bei gesunden Leber-, Nieren- und weißen Blutzellen auch bei Anwendung viel höherer HPE-Konzentrationen nicht beobachtet werden.
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Affiliation(s)
| | - W. Wöhl
- Lehrkanzel für Biochemie der Universität Graz, Österreich
| | - I. Kramer
- Lehrkanzel für Biochemie der Universität Graz, Österreich
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Abstract
Bietet man 4-Hydroxy-2.3-trans-alkenale und 2.3-trans-alkenale in vivo Ehrlich-Ascites-Tumor-, Leber-, Nierenzellen, Leukozyten und Gefrierschnitten von Geweben an, so bleibt - im Gegensatz zu gesättigten Aldehyden - die Aldehydgruppe reagibel und läßt sich in den Zellen und Geweben mit Hilfe der Schiff sehen Reaktion am histologischen Präparat qualitativ, bzw. mit 2.4-DNP-Hydrazin an den suspendierten Zellen cytospektrometrisch nachweisen. Auf Grund von Modellversuchen mit SH-Verbindungen und mit Proteinen läßt sich sagen, daß die α,β-ungesättigten Aldehyde höchstwahrscheinlich mit den SH-Gruppen der Zell- und Gewebsproteine reagieren und so an die Proteine gebunden werden. Die positive Reaktion mit den Aldehydreagenzien und insbesondere die Absorptionslage der mit dem Hydrazinreagenz intrazellulär gebildeten Hydrazone sprechen dafür, daß die Doppelbindung der α,β-Enale mit den Protein-SH-Gruppen in Reaktion tritt. Bemerkenswert ist, daß die Hydroxy-enale in alle genannten Testobjekte eindringen können, jedoch bisher nur bei den Tumorzellen cytotoxische Wirkungen beobachtet werden konnten.
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Affiliation(s)
- W. Burkl
- Institut für Histologie und Embryologie der Universiät Graz (Vorstand: Prof. Dr. W. BURKL) und Lehrkanzel für Biochemie der Universität Graz
| | - I. Kramer
- Institut für Histologie und Embryologie der Universiät Graz (Vorstand: Prof. Dr. W. BURKL) und Lehrkanzel für Biochemie der Universität Graz
| | - E. Schauenstein
- Institut für Histologie und Embryologie der Universiät Graz (Vorstand: Prof. Dr. W. BURKL) und Lehrkanzel für Biochemie der Universität Graz
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Stadlinger B, Korn P, Tödtmann N, Eckelt U, Range U, Bürki A, Ferguson SJ, Kramer I, Kautz A, Schnabelrauch M, Kneissel M, Schlottig F. Osseointegration of biochemically modified implants in an osteoporosis rodent model. Eur Cell Mater 2013; 25:326-40; discussion 339-40. [PMID: 23832686 DOI: 10.22203/ecm.v025a23] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
The present study examined the impact of implant surface modifications on osseointegration in an osteoporotic rodent model. Sandblasted, acid-etched titanium implants were either used directly (control) or were further modified by surface conditioning with NaOH or by coating with one of the following active agents: collagen/chondroitin sulphate, simvastatin, or zoledronic acid. Control and modified implants were inserted into the proximal tibia of aged ovariectomised (OVX) osteoporotic rats (n = 32/group). In addition, aged oestrogen competent animals received either control or NaOH conditioned implants. Animals were sacrificed 2 and 4 weeks post-implantation. The excised tibiae were utilised for biomechanical and morphometric readouts (n = 8/group/readout). Biomechanical testing revealed at both time points dramatically reduced osseointegration in the tibia of oestrogen deprived osteoporotic animals compared to intact controls irrespective of NaOH exposure. Consistently, histomorphometric and microCT analyses demonstrated diminished bone-implant contact (BIC), peri-implant bone area (BA), bone volume/tissue volume (BV/TV) and bone-mineral density (BMD) in OVX animals. Surface coating with collagen/chondroitin sulphate had no detectable impact on osseointegration. Interestingly, statin coating resulted in a transient increase in BIC 2 weeks post-implantation; which, however, did not correspond to improvement of biomechanical readouts. Local exposure to zoledronic acid increased BIC, BA, BV/TV and BMD at 4 weeks. Yet this translated only into a non-significant improvement of biomechanical properties. In conclusion, this study presents a rodent model mimicking severely osteoporotic bone. Contrary to the other bioactive agents, locally released zoledronic acid had a positive impact on osseointegration albeit to a lesser extent than reported in less challenging models.
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Affiliation(s)
- B Stadlinger
- Clinic of Cranio-Maxillofacial and Oral Surgery, University of Zurich, Plattenstr. 11, CH-8032 Zurich, Switzerland.
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Wehmeyer C, Stratis A, Kramer I, Kneissel M, Pap T, Dankbar B. Loss of the Wnt inhibitor sclerostin promotes pannus formation and accelerates joint destruction in the hTNFtg mouse model of rheumatoid arthritis. Ann Rheum Dis 2011. [DOI: 10.1136/ard.2010.149013.16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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30
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Kramer I, Pilhofer I, Zimmermann E, Dewey M, Greupner J. CT des Herzens (Toshiba Aquilion 64 und Aquilion ONE). ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1252988] [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: 10/19/2022]
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31
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Kramer I, Pilhofer I, Dewey M, Deissenrieder F. CT des Herzens (Toshiba Aquilion 64 und Aquilion ONE). ROFO-FORTSCHR RONTG 2009. [DOI: 10.1055/s-0029-1221701] [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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32
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Sockoll I, Kramer I, Bödeker W. Evidenzbasis für die Wirksamkeit und den Nutzen betrieblicher Gesundheitsförderung und Prävention. Gesundheitswesen 2009. [DOI: 10.1055/s-0028-1086264] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [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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33
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Kramer I, Bödeker W. Prospektiver Return on Investment zur Berechnung des ökonomischen Nutzens von Maßnahmen der betrieblichen Gesundheitsförderung. Gesundheitswesen 2008. [DOI: 10.1055/s-0028-1086424] [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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34
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Dewey M, Pilhofer I, Kramer I, Zimmermann E. CT des Herzens, 64 Zeilen (Toshiba Aquilion 64). ROFO-FORTSCHR RONTG 2008. [DOI: 10.1055/s-2008-1073917] [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
Constitutively active Rac stimulates Akt activity in T lymphocytes cultured in suspension. This regulation contrasts with findings obtained in fibroblasts, endothelial or neuronal cells grown on substrate, where Akt stimulation occurs independently of Rac. We now show that V12Rac-mediated stimulation of Akt is not restricted to the hematopoietic lineage but is dependent on the adherence status of the cell. V12Rac-mediated stimulation of Akt as well as molecular association between Rac and Akt occurred exclusively in cells kept in suspension. Stimulation and complex formation are dependent on SHIP but in a manner that differs from its role in dephosphorylation of phosphoinositide lipids. Adherent cells lacking SHIP, but not those lacking PTEN, are able to activate Akt through the Rac pathway. Our data reveal the existence of a bona fide Rac to Akt signaling pathway, tightly regulated by SHIP and operational in suspended cells only. This pathway may point to an alternative survival signal that is called into action when cells lose contact with the substrate and/or with other cells.
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Affiliation(s)
- B Chaigne-Delalande
- European Institute of Chemistry and Biology, University of Bordeaux I, Pessac, France
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36
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Nelson B, Strother C, Tulton L, Kramer I, Batts R. 414: Continuous Positive Airway Pressure Improves Respiratory Function in Acute Asthma. Ann Emerg Med 2007. [DOI: 10.1016/j.annemergmed.2007.06.463] [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: 11/16/2022]
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37
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Dewey M, Zimmermann E, Pilhofer I, Kramer I. CT des Herzens (Toshiba Aquilion 64). ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977259] [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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38
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Dewey M, Zimmermann E, Pilhofer I, Kramer I. CT des Herzens (Toshiba Aquilion 64). ROFO-FORTSCHR RONTG 2007. [DOI: 10.1055/s-2007-977267] [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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39
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Tyryshkin LG, Gul’tyaeva EI, Alpat’eva NV, Kramer I. Identification of effective leaf-rust resistance genes in wheat (Triticum aestivum) using STS markers. RUSS J GENET+ 2006. [DOI: 10.1134/s1022795406060111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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40
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Tyryshkin LG, Gul'tiaeva EI, Alpat'eva NV, Kramer I. [Identification of efficient leaf-rust resistance genes in wheat (Triticum aestivum) using STS markers]. Genetika 2006; 42:812-7. [PMID: 16871786] [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: 05/11/2023]
Abstract
Molecular STS markers J13, Gb, and J09 were used for screening wheat (Triticum aestivum L.) accessions previously found to possess leaf-rust resistance genes according to test crosses or phytopathological tests. Specific amplicons were detected in all accessions assumed to possess the Lr9 gene, in nine of ten accessions with the conjectured Lr19 gene, and in 13 of 29 accessions with the conjectured Lr24 gene. Application of STS markers to identification of accessions possessing efficient leaf-rust resistance genes is discussed.
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41
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Dewey M, Pilhofer I, Kramer I. CT des Herzens (Toshiba Aquilion 64). ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941040] [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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42
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Dewey M, Pilhofer I, Kramer I. CT des Herzens (Toshiba Aquilion 64). ROFO-FORTSCHR RONTG 2006. [DOI: 10.1055/s-2006-941051] [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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Dewey M, Pilhofer I, Kramer I. Herz CT am Toshiba Aquilion 64. ROFO-FORTSCHR RONTG 2005. [DOI: 10.1055/s-2005-868400] [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: 10/19/2022]
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44
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Koefoed P, Dalhoff K, Dissing J, Kramer I, Milman N, Pedersen P, Simonsen K, Tygstrup N, Nielsen FC. HFE mutations and hemochromatosis in Danish patients admitted for HFE genotyping. Scand J Clin Lab Invest 2003; 62:527-35. [PMID: 12512743 DOI: 10.1080/003655102321004549] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Analysis of the common C282Y and H63D mutations in the HFE gene is widely used to diagnose hereditary hemochromatosis (HH). The aim of this study was to evaluate the efficiency with which different hospitals and general practitioners select patients for HH genotype and to determine the distribution of HFE mutations in such patients. Nine hundred unrelated patients from Danish hospitals and general practitioners (group A) and 69 consecutive patients from a specialized liver unit (group B) were examined for HFE substitutions using multiplex real-time polymerase chain reaction. In group A we found 13.0% (0%) C282Y homozygotes, 5.8% (2.6%) H63D/C282Y compound heterozygotes and 1.9% (3.1%) S65C heterozygotes. The values for 420 Danish blood donors are shown in parentheses. The distribution of genotypes in group B was similar to that of the blood donors. Serum ferritin, transferrin iron saturation and pathological data were collected from 38 randomly selected C282Y homozygotes, 36 H63D/C282Y compound heterozygotes, 19 H63D heterozygotes, 17 S65C heterozygotes and 144 wild-types. All of the C282Y homozygotes and 28% of the compound heterozygotes were diagnosed as HH patients. There was no evidence of HH in the H63D homozygotes or S65C heterozygotes. Moreover, 7 wild-type patients, 2 C282Y heterozygote patients and one H63D heterozygote patient fulfilled the criteria for HH. The significant enrichment of HH among associated genotype samples submitted for HFE testing indicates that the clinical selection is generally adequate. However, the study showed substantial deviation in the selection efficiency among the various hospitals and general practitioners.
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Affiliation(s)
- P Koefoed
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
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Kramer I, Shearer G. Quantifying the strength and durability of induced immunity to HIV infection in women engaging in unprotected sexual contacts with infected men. ACTA ACUST UNITED AC 2002. [DOI: 10.1016/s0895-7177(02)00299-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pukall R, Kramer I, Rohde M, Stackebrandt E. Microbial diversity of cultivatable bacteria associated with the North Sea bryozoan Flustra foliacea. Syst Appl Microbiol 2001; 24:623-33. [PMID: 11876370 DOI: 10.1078/0723-2020-00073] [Citation(s) in RCA: 18] [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: 11/18/2022]
Abstract
The microbial diversity of cultivatable bacteria associated with the bryozoan species Flustra foliacea from the North Sea was investigated by a molecular approach. Amplified ribosomal RNA restriction analyses (ARDRA) and 16S rDNA partial sequence analysis revealed differences in the composition of cultivatable bacteria populations from single bryozoan colonies collected from two different sampling sites in the North Sea as well from one site taken at different points in time. Whereas gamma-Proteobacteria identified as Shewanella frigidimarina, Pseudoalteromonas ssp. and Psycbrobacter ssp. were predominant on samples of Flustra I (taken near the island of Helgoland), most bacteria isolated from Flustra II, originating from the Steingrund, could be affiliated to Gram-positive taxa. Survey of the bryozoan samples from the latter site in February 2000 led to the detection of a phylogenetically mixed bacterial population, consisting of gamma-, and alpha-Proteobacteria and Gram-positive bacteria with low and high GC-content (Flustra III). As these bacteria are among the most widely isolated organisms from the marine environment, it may be concluded that the bryozoan Flustra foliacea accepts colonization of surfaces by bacteria which are common inhabitants of the marine environment and which may have been transferred into this environment from terrestrial sites.
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MESH Headings
- Animals
- Base Sequence
- Bryozoa/microbiology
- Bryozoa/ultrastructure
- Cluster Analysis
- DNA Restriction Enzymes/chemistry
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- Electrophoresis, Agar Gel
- Gram-Positive Bacteria/genetics
- Gram-Positive Bacteria/isolation & purification
- Gram-Positive Bacteria/metabolism
- Microscopy, Electron, Scanning
- Molecular Sequence Data
- North Sea
- Phylogeny
- Polymerase Chain Reaction
- Proteobacteria/genetics
- Proteobacteria/isolation & purification
- Proteobacteria/metabolism
- RNA, Ribosomal, 16S/chemistry
- RNA, Ribosomal, 16S/genetics
- Ribotyping
- Sequence Analysis, DNA
- Sequence Homology, Nucleic Acid
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Affiliation(s)
- R Pukall
- DSMZ-Deutsche Sammlung von Mikroorganismen und Zellkulturen GmbH, Germany.
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Abstract
We report two patients with epileptic syndromes who developed non-convulsive status epilepticus under adjunctive antiepileptic therapy with tiagabine. The paradoxical effect may be the result of a difference in effects between GABAA and GABAB receptors, or between GABA receptors in different regions of the brain.
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Affiliation(s)
- S Skodda
- Department of Neurology, Ruhr-Universität Bochum, Knappschaftskrankenhaus, In der Schornau 23-25, 44892 Bochum, Germany
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Schumann P, Tindall BJ, Mendrock U, Kramer I, Stackebrandt E. Pelczaria aurantia ATCC 49321T (=DSM 12801T) is a strain of Kocuria rosea (Flügge 1886) Stackebrandt et al. 1995. Int J Syst Evol Microbiol 2000; 50 Pt 4:1421-1424. [PMID: 10939645 DOI: 10.1099/00207713-50-4-1421] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Phylogenetic and chemotaxonomic analyses of Pelczaria aurantia ATCC 49321T (= DSM 12801T) indicate that this species is very closely related to Kocuria rosea. The DNA-DNA reassociation value of 87.1% determined for the type strains of the two species supports this finding. The results of phylogenetic analysis of the 16S rDNA of a subculture of the original strain of Pelczaria aurantia, deposited at the National Institutes of Health, Bethesda, MD, USA, as 'Neisseria aurantia', are identical to those for strain ATCC 49321T and indicate that Pelczaria aurantia ATCC 49321T is an authentic subculture of the original culture described by Poston (1993). On the basis of these findings it is concluded that P. aurantia ATCC 49321T and K. rosea DSM 20447T are members of the same taxon. The taxonomic consequences of this union are discussed.
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Groth I, Schumann P, Schuetze B, Augsten K, Kramer I, Stackebrandt E. Beutenbergia cavernae gen. nov., sp. nov., an L-lysine-containing actinomycete isolated from a cave. Int J Syst Bacteriol 1999; 49 Pt 4:1733-40. [PMID: 10555355 DOI: 10.1099/00207713-49-4-1733] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Two aerobic, Gram-positive bacteria, strains HKI 0122T and HKI 0132, were isolated from a cave. Cells are not acid-fast, non-motile, non-spore-forming and exhibit a rod-coccus growth cycle. The cell wall peptidoglycan contains lysine in position 3 of the peptide subunit and an interpeptide bridge of L-Lys<--L-Glu. The major menaquinone is MK-8(H4), 13-methyl and 12-methyl tetradecanoic acids are the predominating fatty acids. The polar lipids consist of phosphatidylinositol, diphosphatidylglycerol and three unknown phospholipids. Mycolic acids are absent. The DNA base composition is 71 mol% G + C. Phylogenetic analysis revealed that strain HKI 0122T forms a novel taxon among the families and unassigned genera of the suborder Micrococcineae, within the order Actinomycetales. On the basis of the genotypic, chemotaxonomic, morphological and physiological characteristics of these two isolates it is proposed to assign strains HKI 0122T and HKI 0132 to a new genus and species for which the name Beutenbergia cavernae gen. nov., sp. nov. is proposed. The type strain is HKI 0122T (= DSM 12333T).
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Affiliation(s)
- I Groth
- Hans-Knöll-Institut für Naturstoff-Forschung e.V., Jena, Germany.
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50
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Groth I, Schumann P, Martin K, Schuetze B, Augsten K, Kramer I, Stackebrandt E. Ornithinicoccus hortensis gen. nov., sp. nov., a soil actinomycete which contains L-ornithine. Int J Syst Bacteriol 1999; 49 Pt 4:1717-24. [PMID: 10555353 DOI: 10.1099/00207713-49-4-1717] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Two Gram-positive coccoid, non-motile bacteria with L-ornithine as diagnostic diamino acid of the peptidoglycan and an interpeptide bridge of L-Orn<--Gly(1,2)<--D-Glu were isolated from a sample of garden soil. The major menaquinone is MK-8(H4). 13-methyl and 12-methyl tetradecanoic acids are the predominant fatty acids. The polar lipids are phosphatidylinositol, phosphatidylglycerol, diphosphatidylglycerol, phosphatidylserine and two unknown phospholipids. Mycolic acids are absent. The DNA base composition is 72 mol% G + C. Recent comparative 16S rDNA studies revealed that strains HKI 0125T and HKI 0131 represent a novel lineage adjacent to the family Intrasporangiaceae of the order Actinomycetales but distinct from the previously described genera of this family. On the basis of the genotypic, chemotaxonomic, morphological and physiological characteristics of these two isolates it is proposed to classify HKI 0125T and HKI 0131 in a new genus and species for which the name Ornithinicoccus hortensis gen. nov., sp. nov. is proposed. The type strain is HKI 0125T (= DSM 12335T).
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Affiliation(s)
- I Groth
- Hans-Knöll-Institut für Naturstoff-Forschung e.V., Jena, Germany.
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