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Zimmer J, Mueller L, Frank-Herrmann P, Rehnitz J, Dietrich JE, Bettendorf M, Strowitzki T, Krivega M. Low androgen signaling rescues genome integrity with innate immune response by reducing fertility in humans. Cell Death Dis 2024; 15:30. [PMID: 38212646 PMCID: PMC10784536 DOI: 10.1038/s41419-023-06397-5] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/13/2024]
Abstract
Development of the gonads under complex androgen regulation is critical for germ cells specification. In this work we addressed the relationship between androgens and genomic integrity determining human fertility. We used different study groups: individuals with Differences of Sex Development (DSD), including Complete Androgen Insensitivity Syndrome (CAIS) due to mutated androgen receptor (AR), and men with idiopathic nonobstructive azoospermia. Both showed genome integrity status influenced by androgen signaling via innate immune response activation in blood and gonads. Whole proteome analysis connected low AR to interleukin-specific gene expression, while compromised genome stability and tumorigenesis were also supported by interferons. AR expression was associated with predominant DNA damage phenotype, that eliminated AR-positive Sertoli cells as the degeneration of gonads increased. Low AR contributed to resistance from the inhibition of DNA repair in primary leukocytes. Downregulation of androgen promoted apoptosis and specific innate immune response with higher susceptibility in cells carrying genomic instability.
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Affiliation(s)
- J Zimmer
- Research Group of Gonadal Differentiation and Embryonic Development, Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - L Mueller
- Research Group of Gonadal Differentiation and Embryonic Development, Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - P Frank-Herrmann
- Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - J Rehnitz
- Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - J E Dietrich
- Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - M Bettendorf
- Division of Pediatric Endocrinology, Children's Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - T Strowitzki
- Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany
| | - M Krivega
- Research Group of Gonadal Differentiation and Embryonic Development, Department of Gynecological Endocrinology & Fertility Disorders, Women Hospital, University of Heidelberg, 69120, Heidelberg, Germany.
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Heinrich K, Karthaus M, Fruehauf S, Graeven U, Mueller L, König AO, von Weikersthal LF, Caca K, Kretzschmar A, Goekkurt E, Haas S, Alig AHS, Kurreck A, Stahler A, Held S, Sommerhäuser G, Heinemann V, Stintzing S, Trarbach T, Modest DP. Impact of sex on the efficacy and safety of panitumumab plus fluorouracil and folinic acid versus fluorouracil and folinic acid alone as maintenance therapy in RAS WT metastatic colorectal cancer (mCRC). Subgroup analysis of the PanaMa-study (AIO-KRK-0212). ESMO Open 2023; 8:101568. [PMID: 37441876 PMCID: PMC10507735 DOI: 10.1016/j.esmoop.2023.101568] [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: 02/01/2023] [Revised: 04/11/2023] [Accepted: 04/24/2023] [Indexed: 07/15/2023] Open
Abstract
BACKGROUND Clinical trials in metastatic colorectal cancer (mCRC) are usually conducted irrespective of sex. Sex-associated differences relating to safety and efficacy in the treatment of mCRC, however, are gaining interest. METHODS PanaMa investigated the efficacy of panitumumab (Pmab) plus fluorouracil and folinic acid (FU/FA) versus FU/FA alone after induction therapy with six cycles of FU/FA and oxaliplatin plus Pmab in patients with RAS wild-type mCRC. In this post hoc analysis, the study population was stratified for sex. Evaluated efficacy endpoints during maintenance treatment were progression-free survival (PFS, primary endpoint of the trial), overall survival (OS) and objective response rate during maintenance therapy. Safety endpoints were rates of any grade and grade 3/4 adverse events during maintenance therapy. RESULTS In total, 165 male and 83 female patients were randomized and treated. Male and female patients showed numerically better objective response rates with Pmab, without reaching statistical significance. Male patients derived a significant benefit from the addition of Pmab to maintenance treatment with regard to PFS [hazard ratio (HR) 0.63; 95% confidence interval (CI) 0.45-0.88; P = 0.006] that was not observed in female patients (HR 0.85; 95% CI 0.53-1.35; P = 0.491). The better PFS for male patients treated with Pmab did not translate into improved OS (HR 0.85; 95% CI 0.55-1.30; P = 0.452). Female patients showed numerically improved OS when treated with Pmab. There was no difference in the total of grade ≥3 adverse events during maintenance regarding sex (P = 0.791). Female patients, however, had a higher rate of any grade nausea, diarrhea and stomatitis. CONCLUSIONS In the PanaMa trial, the addition of Pmab to maintenance treatment of RAS wild-type mCRC with FU/FA improved the outcome in terms of the primary endpoint (PFS) particularly in male patients. Female patients did not show the same benefit while experiencing higher rates of adverse events. Our results support the development of sex-specific protocols.
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Affiliation(s)
- K Heinrich
- Department of Medicine III, University Hospital, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich. https://twitter.com/heinrich_kat
| | - M Karthaus
- Department of Hematology and Oncology, Munich Hospital Neuperlach, Munich
| | | | - U Graeven
- Kliniken Maria Hilf GmbH, Moenchengladbach
| | | | - A O König
- Department of Gastroenterology, University Medicine Göttingen, Goettingen
| | | | - K Caca
- Department of Gastroenterology, Hematology and Oncology, Hospital Ludwigsburg, Ludwigsburg
| | | | - E Goekkurt
- Practice of Hematology and Oncology (HOPE), Hamburg; University Cancer Center Hamburg (UCCH), Hamburg
| | - S Haas
- Department of Hematology and Oncology, Friedrich-Ebert-Hospital, Neumünster
| | - A H S Alig
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - A Kurreck
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - A Stahler
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - S Held
- ClinAssess GmbH, Leverkusen
| | - G Sommerhäuser
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich; Comprehensive Cancer Center, University Hospital (LMU), Munich
| | - S Stintzing
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - T Trarbach
- Reha-Zentrum am Meer, Bad Zwischenahn; Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen, Germany
| | - D P Modest
- Department of Hematology, Oncology and Cancer Immunology, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin; German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg.
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Hussein M, Mueller L, Issa PP, Haidari M, Trinh L, Toraih E, Kandil E. Sexual disparity and the risk of second primary thyroid cancer: a paradox. Gland Surg 2023; 12:432-441. [DOI: 10.21037/gs-22-411] [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] [Received: 07/15/2022] [Accepted: 02/19/2023] [Indexed: 03/30/2023]
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Mueller L, Morenas R, Loe M, Toraih E, Turner J. Gender and Race Demographics of Fellowships After General Surgery Training in the United States: A Five-Year Analysis in Applicant and Resident Trends. Am Surg 2022:31348221146945. [PMID: 36565153 DOI: 10.1177/00031348221146945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION The gender and minority gap in general surgery residency is narrowing; however, literature lacks comprehensive data regarding the demographics of fellowship programs following general surgery training. METHODS Data from 2017 to 2021 for gender, ethnicity, and surgical subspecialty are publicly available from the ERAS database and ACGME yearly data reports. Cochran-Armitage trend tests were used to determine statistical significance in trends for female and minority applicants and trainees. RESULTS The overall trend of female applicants to surgical specialties remained stagnant. However, female applicants to vascular surgery increased significantly from 25% to 35% (P = .045). There was no significant increase in female trainees in any surgical specialties evaluated. Furthermore, the overall trend of minority applicants to surgical specialties also remained stagnant, except for pediatric surgery, which showed significantly fewer minority applicants. Despite pediatric surgery having fewer applicants, minority trainees in this specialty increased significantly from 8% to 19% (P = .008). CONCLUSION Several current initiatives, such as intentional mentorship, are being reported to promote diverse and equal representation among female and minority applicants and trainees. However, the current overall margin of increase in diversity among surgical specialty applicants and trainees is minimal, indicating that continued efforts are needed to diversify surgical specialty training programs.
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Affiliation(s)
- Lauren Mueller
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Rohan Morenas
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Mallory Loe
- School of Medicine, 12255Tulane University, New Orleans, LA, USA
| | - Eman Toraih
- Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, 12255Tulane University, New Orleans, LA, USA.,Genetics Unit, Department of Histology and Cell Biology, 12255Suez Canal University, Ismailia, Egypt
| | - Jacquelyn Turner
- Department of Surgery, Division of Colon and Rectal Surgery, 12255Tulane University School of Medicine, New Orleans, LA, USA
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Taghavi S, Abdullah S, Shaheen F, Mueller L, Gagen B, Duchesne J, Steele C, Pociask D, Kolls J, Jackson-Weaver O. Glycocalyx degradation and the endotheliopathy of viral infection. PLoS One 2022; 17:e0276232. [PMID: 36260622 PMCID: PMC9581367 DOI: 10.1371/journal.pone.0276232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 10/03/2022] [Indexed: 11/05/2022] Open
Abstract
The endothelial glycocalyx (EGX) contributes to the permeability barrier of vessels and regulates the coagulation cascade. EGX damage, which occurs in numerous disease states, including sepsis and trauma, results in endotheliopathy. While influenza and other viral infections are known to cause endothelial dysfunction, their effect on the EGX has not been described. We hypothesized that the H1N1 influenza virus would cause EGX degradation. Human umbilical vein endothelial cells (HUVECs) were exposed to varying multiplicities of infection (MOI) of the H1N1 strain of influenza virus for 24 hours. A dose-dependent effect was examined by using an MOI of 5 (n = 541), 15 (n = 714), 30 (n = 596), and 60 (n = 653) and compared to a control (n = 607). Cells were fixed and stained with FITC-labelled wheat germ agglutinin to quantify EGX. There was no difference in EGX intensity after exposure to H1N1 at an MOI of 5 compared to control (6.20 vs. 6.56 Arbitrary Units (AU), p = 0.50). EGX intensity was decreased at an MOI of 15 compared to control (5.36 vs. 6.56 AU, p<0.001). The degree of EGX degradation was worse at higher doses of the H1N1 virus; however, the decrease in EGX intensity was maximized at an MOI of 30. Injury at MOI of 60 was not worse than MOI of 30. (4.17 vs. 4.47 AU, p = 0.13). The H1N1 virus induces endothelial dysfunction by causing EGX degradation in a dose-dependent fashion. Further studies are needed to characterize the role of this EGX damage in causing clinically significant lung injury during acute viral infection.
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Affiliation(s)
- Sharven Taghavi
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Sarah Abdullah
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Farhana Shaheen
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Lauren Mueller
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Brennan Gagen
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Juan Duchesne
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Chad Steele
- Department of Microbiology, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Derek Pociask
- Department of Internal Medicine, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Jay Kolls
- Center for Translational Research in Infection and Inflammation, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
| | - Olan Jackson-Weaver
- Department of Surgery, Tulane University School of Medicine, New Orleans, Louisiana, United States of American
- * E-mail:
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Issa PP, Mueller L, Hussein M, Albuck A, Shama M, Toraih E, Kandil E. Radiologist versus Non-Radiologist Detection of Lymph Node Metastasis in Papillary Thyroid Carcinoma by Ultrasound: A Meta-Analysis. Biomedicines 2022; 10:biomedicines10102575. [PMID: 36289838 PMCID: PMC9599420 DOI: 10.3390/biomedicines10102575] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 08/30/2022] [Revised: 10/08/2022] [Accepted: 10/09/2022] [Indexed: 11/16/2022] Open
Abstract
Papillary thyroid carcinoma (PTC) is the most common thyroid cancer worldwide and is known to spread to adjacent neck lymphatics. Lymph node metastasis (LNM) is a known predictor of disease recurrence and is an indicator for aggressive resection. Our study aims to determine if ultrasound sonographers’ degree of training influences overall LNM detection. PubMed, Embase, and Scopus articles were searched and screened for relevant articles. Two investigators independently screened and extracted the data. Diagnostic test parameters were determined for all studies, studies reported by radiologists, and studies reported by non-radiologists. The total sample size amounted to 5768 patients and 10,030 lymph nodes. Radiologists performed ultrasounds in 18 studies, while non-radiologists performed ultrasounds in seven studies, corresponding to 4442 and 1326 patients, respectively. The overall sensitivity of LNM detection by US was 59% (95%CI = 58–60%), and the overall specificity was 85% (95%CI = 84–86%). The sensitivity and specificity of US performed by radiologists were 58% and 86%, respectively. The sensitivity and specificity of US performed by non-radiologists were 62% and 78%, respectively. Summary receiver operating curve (sROC) found radiologists and non-radiologists to detect LNM on US with similar accuracy (p = 0.517). Our work suggests that both radiologists and non-radiologists alike detect overall LNM with high accuracy on US.
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Affiliation(s)
- Peter P. Issa
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Lauren Mueller
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Mohammad Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Aaron Albuck
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Mohamed Shama
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Eman Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
| | - Emad Kandil
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Correspondence: ; Tel.: +1-504-988-7407; Fax: +1-504-988-4762
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Hussein M, Mueller L, Issa PP, Haidari M, Trinh L, Toraih E, Kandil E. Latency Trend Analysis as a Guide to Screening Malignancy Survivors for Second Primary Thyroid Cancer. Biomedicines 2022; 10:biomedicines10081984. [PMID: 36009531 PMCID: PMC9406053 DOI: 10.3390/biomedicines10081984] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/10/2022] [Accepted: 08/11/2022] [Indexed: 11/29/2022] Open
Abstract
Primary cancer survivors have a higher risk of developing second primary thyroid cancer (SPTC). Patients with SPTC who survived primary malignancies, diagnosed from 1975 to 2016, were identified from the Surveillance, Epidemiology, and End Results (SEER) database (SEER 18 Registry). A total of 33,551 cancer cases were enrolled in the final analysis. Individuals with a primary malignancy were at a significant 90% increased risk of developing SPTC (SIR = 1.90, 95%CI = 1.86−1.93, p < 0.05) compared to the general population. More than half (54.7%) of SPTC diagnoses were made in the first three years after primary cancer diagnosis, and the most aggressive presentations of SPTC occurred within the first year following malignancy. A latency trend analysis identified persistent high risk for development of SPTC after diagnosis of lymphoma, leukemia, soft tissue tumors, kidney, breast, and uterine cancer; elevated 10-year risk for most cancers such as salivary gland, melanoma, stomach, lung, colon, ovarian, pancreas, prostate, and bladder; and high 5-year risk after cancers such as larynx, oral, orbit, bone, small intestine, and liver. Our latency period model identifying risk according to each type of primary cancer may aid clinicians in identifying at-risk patients to be screened for thyroid cancer and guide them in developing a surveillance plan according to the latency period attributed to a patient’s primary cancer.
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Affiliation(s)
- Mohammad Hussein
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Lauren Mueller
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Peter P. Issa
- School of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA 70112, USA
| | - Muhib Haidari
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
| | - Lily Trinh
- School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Division of Thyroid and Parathyroid Endocrine Surgery, Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA 02114, USA
| | - Eman Toraih
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
- Genetics Unit, Department of Histology and Cell Biology, Faculty of Medicine, Suez Canal University, Ismailia 41522, Egypt
- Correspondence: ; Tel.: +1-504-988-2301; Fax: +1-504-988-4762
| | - Emad Kandil
- Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA
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Raimondi A, Morano F, Trarbach T, Karthaus M, Lonardi S, Fruehauf S, Cremolini C, Graeven U, Bittoni A, Mueller L, Sartore Bianchi A, Aranda E, Boige V, Stintzing S, Di Bartolomeo M, Koenig A, Pietrantonio F, Modest D. SO-21 Optimal maintenance treatment strategy following an anti-EGFR-based first-line induction therapy in patients with RAS wild type metastatic colorectal cancer: An individual patient data pooled analysis of clinical trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.420] [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: 11/01/2022] Open
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Gerwert K, Schörner S, Großerueschkamp F, Kraeft A, Schuhmacher D, Lugnier C, Heuer V, Teschendorf C, Mueller L, Mosig A, Arnold D, Reinacher-Schick A. PD-11 In depth analysis of label-free infrared (IR) imaging-based microsatellite instability (MSI) classification in early colon cancer (CC) on samples from the AIO ColoPredictPlus 2.0 (CPP) registry trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.089] [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] Open
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Großerüschkamp F, Schörner S, Kraeft AL, Schuhmacher D, Sternemann C, Jütte H, Feder I, Wisser S, Lugnier C, Overheu O, Arnold D, Teschendorf C, Mueller L, Uhl W, Timmesfeld N, Mosig A, Reinacher-Schick A, Gerwert K, Tannapfel A. 385O Automated detection of microsatellite status in early colon cancer (CC) using artificial intelligence (AI) integrated infrared (IR) imaging on unstained samples from the AIO ColoPredictPlus 2.0 (CPP) registry study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.907] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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von Stumm M, Florian D, Holst T, Gross TMS, Mueller L, Pausch J, Sinning C, Reichenspurner H, Girdauskas E. Predicting Clinical Outcome by Indexed Mitral Valve Tenting in Functional Mitral Valve Regurgitation. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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von Stumm M, Van Erckelens J, Gross TMS, Mueller L, Reichenspurner H, Girdauskas E. Thromboembolic and Bleeding Complications Due to Oral Anticoagulation following an Isolated Mitral Valve Repair. Thorac Cardiovasc Surg 2021. [DOI: 10.1055/s-0041-1725724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hussein M, Toraih E, Fouad AM, Mueller L, Blum A, Al-Qurayshi Z, Borchardt J, Kandil E. National perspective on hospital readmissions following adrenalectomy. Gland Surg 2021; 11:970-980. [DOI: 10.21037/gs-22-18] [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] [Received: 01/09/2022] [Accepted: 04/13/2022] [Indexed: 11/06/2022]
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Moehler M, Maderer A, Thuss-Patience PC, Brenner B, Meiler J, Ettrich TJ, Hofheinz RD, Al-Batran SE, Vogel A, Mueller L, Lutz MP, Lordick F, Alsina M, Borchert K, Greil R, Eisterer W, Schad A, Slotta-Huspenina J, Van Cutsem E, Lorenzen S. Cisplatin and 5-fluorouracil with or without epidermal growth factor receptor inhibition panitumumab for patients with non-resectable, advanced or metastatic oesophageal squamous cell cancer: a prospective, open-label, randomised phase III AIO/EORTC trial (POWER). Ann Oncol 2019; 31:228-235. [PMID: 31959339 DOI: 10.1016/j.annonc.2019.10.018] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [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: 06/17/2019] [Revised: 10/10/2019] [Accepted: 10/15/2019] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Palliative chemotherapy of advanced oesophageal squamous cell cancer (ESCC) consists of cisplatin/5-fluorouracil (CF) to target epidermal growth factor receptor (EGFR) with panitumumab (P); chemotherapy enhanced overall survival (OS) in advanced colorectal or squamous cell head and neck cancers. With prospective serum and tumour biomarkers, we tested if P added to CF (CFP) improved OS in advanced ESCC. PATIENTS AND METHODS Eligible patients with confirmed ESCC that was not curatively resectable or did not qualify for definitive radiochemotherapy, were randomised 1 : 1 to receive CF [cisplatin (C) 100 mg/m2 i.v., day 1; 5-fluorouracil (F) 1000 mg/m2 i.v., days 1-4] or CF plus P (9 mg/kg, i.v., day 1, each q3-week cycle) until progressive disease or unacceptable toxicity. Safety was reviewed by the Data Safety Monitoring Board after 40, 70 and 100 patients who completed at least one cycle. After 53 enrolled patients, cisplatin was reduced from 100 mg/m2 to 80 mg/m2. RESULTS The trial was stopped early based on interim efficacy results triggered by the third safety analysis: median OS (mOS) favoured CF over CFP, regardless of cisplatin dose [hazard ratio (HR) 1.77, 95% confidence interval (CI) 1.06-2.98; P = 0.028]. In the final analysis, mOS was 10.2 versus 9.4 months for CF versus CFP, respectively (HR 1.17, 95% CI 0.79-1.75; P = 0.43). One hundred (70.4%) of 142 patients in the safety population died, 51 (51.0%) with CFP. Most deaths were related to disease progression [44/49 (90%) deaths in CF versus 34/51 (67%) deaths in CFP]; objective responses [27/73 (37.0%)] were identical. The most common serious adverse events were kidney injury [3 (4.3%) versus 7 (9.7%)], general health deterioration [5 (7.1%) versus 5 (6.9%)] and dysphagia [4 (5.7%) versus 4 (5.6%)] in CF versus CFP, respectively. There were three (4.3%) and 17 (23.6%) common terminology criteria for adverse events (CTCAE) grade 5 events in CF versus CFP, respectively. Low soluble (s)EGFR levels were associated with better progression-free survival; sEGFR was induced under CFP. CONCLUSION EGFR inhibition added to CF did not improve survival in unselected advanced ESCC patients. The results support further liquid biopsy studies. TRIAL REGISTRATION ClinicalTrials.gov (NCT01627379) and EudraCT (2010-020606-15).
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Affiliation(s)
- M Moehler
- 1st Department of Internal Medicine, Johannes Gutenberg-University Mainz, Mainz, Germany.
| | - A Maderer
- 1st Department of Internal Medicine, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - P C Thuss-Patience
- Medical Department, Division of Hematology, Oncology and Tumor Immunology, Charité - University Medicine Berlin, Berlin, Germany
| | - B Brenner
- Institute of Oncology, Davidoff Center, Rabin Medical Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - J Meiler
- Department of Internal Medicine, University Hospital Essen, Essen, Germany
| | - T J Ettrich
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - R-D Hofheinz
- Medical Department III, University Hospital Mannheim, Mannheim, Germany
| | - S E Al-Batran
- Institute of Clinical Cancer Research, Hospital North-West, Frankfurt, Germany
| | - A Vogel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - L Mueller
- Oncology Leer-Emden-Papenburg, Leer, Germany
| | - M P Lutz
- Gastroenterology, Caritas Hospital, Saarbrücken, Germany
| | - F Lordick
- 1st Medical Department and University Cancer Center Leipzig, University of Leipzig Medical Center, Leipzig, Germany
| | - M Alsina
- Department of Medical Oncology, Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - K Borchert
- Medical Department III, University Hospital Rostock, Rostock, Germany
| | - R Greil
- 3rd Medical Department, Cancer Research Institute, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - W Eisterer
- Department of Internal Medicine V, Medical University Innsbruck, Innsbruck, Austria
| | - A Schad
- Institute of Pathology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - J Slotta-Huspenina
- Institute of Pathology, School of Medicine, Technical University of Munich, Munich, Germany
| | - E Van Cutsem
- University Hospitals Gasthuisberg Leuven and KU Leuven, Leuven, Belgium
| | - S Lorenzen
- Medical Department III, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Seufferlein T, Ettrich T, Stein A, Arnold D, Prager G, Kasper S, Niedermeier M, Mueller L, Kubicka S, König AO, Büchner-Steudel P, Wille K, Kestler A, Hann A, Perkhofer L, Berger A, Lausser L, Kestler H. A biomarker combination indicating resistance to FOLFOX plus bevacizumab in metastatic colorectal cancer: Results of phase I of the PERMAD trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz246.058] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
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Pape UF, Kasper S, Meiler J, Sinn M, Vogel A, Mueller L, Burkhard O, Caca K, Heeg S, Rodriguez Laval V, Kuhl A, Arsenic R, Jansen H, Mehrling T, Hilgier K, Wagner I, Utku N. Post-hoc analyses of a subgroup of patients with advanced biliary tract cancer (BTC) who crossed over to treatment with etoposide toniribate (EDO-S7.1) in a randomized phase II study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz247.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Goebell P, Mueller L, Grüllich C, Reichert D, Bögemann M, Dörfel S, von der Heyde E, Binninger A, Jänicke M, Merling M, Marschner N, Staehler M, Grünwald V. Advanced renal cell carcinoma: First results from the prospective research platform CARAT for patients with mRCC in Germany. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Spoerke JM, Daemen A, Chang CW, Giltnane J, Metcalfe C, Dickler MN, Bardia A, Perez Fidalgo JA, Mayer IA, Boni V, Winer EP, Hamilton EP, Bellet M, Urruticoechea A, Gonzalez Martin A, Cortes J, Martin M, Gates M, Cheeti S, Fredrickson J, Wang X, Friedman LS, Liu L, Li R, Chan IT, Mueller L, Milan S, Lauchle J, Humke EW, Lackner MR. Abstract P5-11-01: Phamacodynamic and circulating tumor DNA evaluation in a phase I study of GDC-0927, a selective estrogen receptor antagonist/ degrader (SERD). Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-11-01] [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: Modulation of estrogen activity and/or synthesis is the mainstay therapeutic strategy in the treatment of ER positive breast cancer. However, despite the effectiveness of available endocrine therapies, many patients ultimately relapse or develop resistance to these agents via estrogen-dependent and estrogen-independent mechanisms, including mutations in ESR1 affecting the ER ligand binding domain that drive ER-dependent transcription and proliferation in the absence of estrogen. Based on preclinical and clinical data, SERDs are expected be effective in patients harboring ESR1 mutations. Biomarker analysis was performed on plasma and tumor samples from the Phase I study of GDC-0927 in metastatic breast cancer (Dickler et al, SABCS 2017) with the goal of evaluating activity in both ESR1 mutant and wildtype tumors, and to assess ER pathway modulation.
Methods: Hotspot mutations in ESR1, PIK3CA, and AKT1 were analyzed in baseline, on-treatment and end of treatment plasma derived circulating tumor DNA (ctDNA) using the BEAMing assay in patients treated at multiple dose levels of GDC-0927. A subset of samples was analyzed with Foundation Medicine's next generation sequencing ctDNA assay (FACT), which covers genomic alterations in 62 commonly altered genes. Paired pre- and on-treatment biopsies were collected to assess ER pathway modulation. ER, PR, and Ki67 protein levels were analyzed by immunohistochemistry. Gene expression analysis was performed using Illumina's RNA Access library preparation kit followed by paired-end (2x50b, 50M reads) sequencing on the HiSeq.
Results: Baseline and on-treatment plasma samples were available for 40 patients. ESR1 and PIK3CA mutations were observed in 52% and 33% of patient baseline samples, respectively (BEAMing method). Mutant allele frequencies (MAF) generally declined in the first on-treatment samples collected for both ESR1 (16 out of 21 samples) and PIK3CA (7 out of 12 samples). The majority of the reductions were greater than 95% relative to baseline. Increases in ESR1 MAFs were observed in later time-points and were not associated with any particular ESR1 mutation. There were six instances for which an ESR1 mutation was detected in an on-treatment sample that was not detected in the baseline sample, three at L536P and one each at D538G, L536H, and S463P, and four out of six with MAFs close to the limit of detection. The FACT assay also detected alterations in CDH1, NF1, PTEN, and TP53 in baseline samples. The relationship between MAF changes and clinical benefit to GDC-0927 will be presented. A predefined, experimentally-derived set of ER target genes were evaluated in pre- and on-treatment tumor biopsy pairs from six patients. Four of the six patients showed evidence of suppression in ER pathway activity, one patient treated at the 1000 mg dose level and three at the 1400 mg dose. The degree of pathway suppression was associated with pre-treatment pathway levels and decreases of ER and Ki67 protein levels.
Conclusions: We report here evidence of consistent reduction of ESR1 and PIK3CA ctDNA in patients treated with GDC-0927. ER pathway suppression was observed at both the transcript and protein level confirming pharmacodynamic activity of the SERD.
Citation Format: Spoerke JM, Daemen A, Chang C-W, Giltnane J, Metcalfe C, Dickler MN, Bardia A, Perez Fidalgo JA, Mayer IA, Boni V, Winer EP, Hamilton EP, Bellet M, Urruticoechea A, Gonzalez Martin A, Cortes J, Martin M, Gates M, Cheeti S, Fredrickson J, Wang X, Friedman LS, Liu L, Li R, Chan IT, Mueller L, Milan S, Lauchle J, Humke EW, Lackner MR. Phamacodynamic and circulating tumor DNA evaluation in a phase I study of GDC-0927, a selective estrogen receptor antagonist/ degrader (SERD) [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 P5-11-01.
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Affiliation(s)
- JM Spoerke
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - A Daemen
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - C-W Chang
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - J Giltnane
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - C Metcalfe
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - MN Dickler
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - A Bardia
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - JA Perez Fidalgo
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - IA Mayer
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - V Boni
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - EP Winer
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - EP Hamilton
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - M Bellet
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - A Urruticoechea
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - A Gonzalez Martin
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - J Cortes
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - M Martin
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - M Gates
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - S Cheeti
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - J Fredrickson
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - X Wang
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - LS Friedman
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - L Liu
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - R Li
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - IT Chan
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - L Mueller
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - S Milan
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - J Lauchle
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - EW Humke
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
| | - MR Lackner
- Genentech, Inc., South San Francisco, CA; Eli Lilly, Indianapolis, IN; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA; Hospital Clinico Universitario de Valencia, INCLIVA, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; START Madrid-CIOCC, Hm Hospital Sanchinarro, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute / Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Ramon y Cajal University Hospital, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Ideaya Biosciences, South San Francisco, CA
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Oezpeker C, Barbieri F, Bonaros N, Grimm M, Hoefer D, Mueller L. Partial Upper Sternotomy versus full Sternotomy for Mitral Valve Surgery: A Propensity Score Matched Analysis. Thorac Cardiovasc Surg 2019. [DOI: 10.1055/s-0039-1678891] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- C.U. Oezpeker
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - F. Barbieri
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - N. Bonaros
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - M. Grimm
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - D. Hoefer
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
| | - L. Mueller
- Department of Cardiac Surgery, Medical University Innsbruck, Innsbruck, Austria
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Reinacher-Schick A, Juette H, Noepel-Duennebacke S, Arnold D, Basara N, Boehner H, Dahm T, Feder I, Herzog T, Hiller W, Mueller L, Engel L, Senkal M, Teschendorf C, Trenn G, Verdoodt B, Wolters H, Uhl W, Tannapfel A. Microsatellite instability is associated with distinct clinical and molecular characteristics in early colon cancer: Analysis of a molecular registry of the AIO colorectal study group - Colopredict Plus. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy281.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Moehler M, Maderer A, Thuss-Patience P, Brenner B, Hecker J, Muñoz FL, Meiler J, Ettrich T, Hofheinz R, Al-Batran S, Vogel A, Mueller L, Lutz M, Borchert K, Greil R, Alsina M, Karatas A, Van Cutsem E, Keller R, Larcher-Senn J, Lorenzen S. Cisplatin/5-fluorouracil +/- panitumumab for patients with non-resectable, advanced or metastatic esophageal squamous cell cancer: A randomized phase III AIO/EORTC trial with an extensive biomarker program. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.009] [Citation(s) in RCA: 1] [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: 11/12/2022] Open
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Dickler MN, Villanueva R, Perez Fidalgo JA, Mayer IA, Boni V, Winer EP, Hamilton EP, Bellet M, Urruticoechea A, Gonzalez-Martin A, Cortes J, Martin M, Giltnane J, Gates M, Cheeti S, Fredrickson J, Wang X, Friedman LS, Spoerke JM, Metcalfe C, Liu L, Li R, Morley R, McCurry U, Chan IT, Mueller L, Milan S, Lauchle J, Humke EW, Bardia A. Abstract PD5-10: A first-in-human phase I study to evaluate the oral selective estrogen receptor degrader (SERD), GDC-0927, in postmenopausal women with estrogen receptor positive (ER+) HER2-negative metastatic breast cancer (BC). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd5-10] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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: Modulation of estrogen activity and/or synthesis is the mainstay therapeutic strategy in the treatment of ER+ BC. However, despite the effectiveness of available endocrine therapies, many patients ultimately relapse or develop resistance to these agents via estrogen-dependent and estrogen-independent mechanisms, including mutations in ESR1 affecting the ER ligand binding domain that drive ER-dependent transcription and proliferation in the absence of estrogen. ER antagonists that are efficacious against ligand-dependent and ligand-independent, constitutively active ESR1 mutant tumors may be of substantial therapeutic benefit. GDC-0927 (formerly known as SRN-927) is a novel, potent, non-steroidal, orally bioavailable, selective ER antagonist/ER degrader (SERD) that induces tumor regression in ER+ BC patient-derived xenograft models.
Methods: A phase I dose escalation study with 3+3 design was conductedin postmenopausal women with ER+ (HER2-) metastatic BC (progressing ≥ 6 months on endocrine therapy and with ≤ 2 prior chemotherapies in the advanced or metastatic setting) to determine the safety, pharmacokinetics (PK) and the recommended Phase 2 dose (RP2D) of GDC-0927. Pharmacodynamic (PD) activity was assessed with [18F]-fluoroestradiol (FES)-PET scans. Plasma PK samples (after single dose and at steady state), CT scans, and when feasible, pre and on-study tumor biopsies were obtained
Results: From March 16, 2015 to March 17, 2017 patients (pts) with a median age of 53 years (range 44-69) and a median number of prior therapies for MBC 4 (range 1-7) were enrolled at 3 total daily dose levels (600, 1000, 1400 mg) once daily (QD) given orally with fasting (n = 12). Increases in GDC-0927 exposure were approximately dose proportional. Treatment related adverse events (AEs) were all grade 1 or 2. The most common treatment-related AEs were nausea (54%, n = 7), diarrhea (46%, n = 6), elevated aspartate aminotransferase (39%, n = 5) and anemia, constipation, (each 31%, n = 4). Treatment interruption was required for 2 pts due to nausea and vomiting. Of those pts with FES-PET avid disease at baseline (9 of 12), all post-therapy scans showed complete or near complete (> 90%) suppression of FES uptake to background levels, including pts with ESR1 mutations. Evidence of reduced ER levels and Ki67 staining was observed in on-treatment biopsies. Five of 12 pts (1 at 600 mg and 4 at 1400 mg) were on study ≥ 24 weeks (CBR = 41.6 %) with the best overall response of stable disease with 1 patient (ESR1 mt+ D538G) on study for over 490 days. There were no dose limiting toxicities and no SAEs related to study drug. R2PD was 1400 mg and was selected for single arm dose-expansion which is now complete with last patient enrolled on March 17, 2017. Updated results from dose-escalation and dose-expansion will be presented at the meeting (N = 43).
Conclusions: GDC-0927 appears well-tolerated to date with PK exposure supporting QD dosing, evidence of robust PD target engagement, and encouraging anti-tumor activity in heavily pretreated pts with advanced or metastatic ER+ BC, including pts with ESR1 mutations.
Citation Format: Dickler MN, Villanueva R, Perez Fidalgo JA, Mayer IA, Boni V, Winer EP, Hamilton EP, Bellet M, Urruticoechea A, Gonzalez-Martin A, Cortes J, Martin M, Giltnane J, Gates M, Cheeti S, Fredrickson J, Wang X, Friedman LS, Spoerke JM, Metcalfe C, Liu L, Li R, Morley R, McCurry U, Chan IT, Mueller L, Milan S, Lauchle J, Humke EW, Bardia A. A first-in-human phase I study to evaluate the oral selective estrogen receptor degrader (SERD), GDC-0927, in postmenopausal women with estrogen receptor positive (ER+) HER2-negative metastatic breast cancer (BC) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD5-10.
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Affiliation(s)
- MN Dickler
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - R Villanueva
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - JA Perez Fidalgo
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - IA Mayer
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - V Boni
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - EP Winer
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - EP Hamilton
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Bellet
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - A Urruticoechea
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - A Gonzalez-Martin
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - J Cortes
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Martin
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - J Giltnane
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - M Gates
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - S Cheeti
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - J Fredrickson
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - X Wang
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - LS Friedman
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - JM Spoerke
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - C Metcalfe
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - L Liu
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - R Li
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - R Morley
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - U McCurry
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - IT Chan
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - L Mueller
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - S Milan
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - J Lauchle
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - EW Humke
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - A Bardia
- Memorial Sloan Kettering Cancer Center, New York, NY; Institut Català d'Oncologia- Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain; Hospital Clinico Universitario de Valencia, INCLIVA, CIBERONC, Valencia, Spain; Vanderbilt University Medical Center, Nashville, TN; HM Sanchinarro – CIOCC, Madrid, Spain; Dana Farber Cancer Institute, Boston, MA; Sarah Cannon Research Institute/Tennessee Oncology, Nashville, TN; Hospital Universitari Vall d'Hebron and Vall d'Hebron Institute of Oncology (VHIO), Barcelona, Spain; Onkologikoa, San Sebastian, Spain; Clinica Universidad de Navarra, Madrid, Spain; Hospital Universitario Ramon y Cajal, Madrid, Spain; Hospital General Universitario Gregorio Marañon, Madrid, Spain; Genentech, Inc., South San Francisco, CA; Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
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Matz M, Coleman MP, Sant M, Chirlaque MD, Visser O, Gore M, Allemani C, Bouzbid S, Hamdi-Chérif M, Zaidi Z, Bah E, Swaminathan R, Nortje S, El Mistiri M, Bayo S, Malle B, Manraj S, Sewpaul-Sungkur R, Fabowale A, Ogunbiyi O, Bradshaw D, Somdyala N, Stefan D, Abdel-Rahman M, Jaidane L, Mokni M, Kumcher I, Moreno F, González M, Laura E, Espinola S, Calabrano G, Carballo Quintero B, Fita R, Garcilazo D, Giacciani P, Diumenjo M, Laspada W, Green M, Lanza M, Ibañez S, Lima C, Lobo de Oliveira E, Daniel C, Scandiuzzi C, De Souza P, Melo C, Del Pino K, Laporte C, Curado M, de Oliveira J, Veneziano C, Veneziano D, Latorre M, Tanaka L, Azevedo e Silva G, Galaz J, Moya J, Herrmann D, Vargas S, Herrera V, Uribe C, Bravo L, Arias-Ortiz N, Jurado D, Yépez M, Galán Y, Torres P, Martínez-Reyes F, Pérez-Meza M, Jaramillo L, Quinto R, Cueva P, Yépez J, Torres-Cintrón C, Tortolero-Luna G, Alonso R, Barrios E, Nikiforuk C, Shack L, Coldman A, Woods R, Noonan G, Turner D, Kumar E, Zhang B, McCrate F, Ryan S, Hannah H, Dewar R, MacIntyre M, Lalany A, Ruta M, Marrett L, Nishri D, McClure C, Vriends K, Bertrand C, Louchini R, Robb K, Stuart-Panko H, Demers S, Wright S, George J, Shen X, Brockhouse J, O'Brien D, Ward K, Almon L, Bates J, Rycroft R, Mueller L, Phillips C, Brown H, Cromartie B, Schwartz A, Vigneau F, MacKinnon J, Wohler B, Bayakly A, Clarke C, Glaser S, West D, Green M, Hernandez B, Johnson C, Jozwik D, Charlton M, Lynch C, Huang B, Tucker T, Deapen D, Liu L, Hsieh M, Wu X, Stern K, Gershman S, Knowlton R, Alverson J, Copeland G, Rogers D, Lemons D, Williamson L, Hood M, Hosain G, Rees J, Pawlish K, Stroup A, Key C, Wiggins C, Kahn A, Schymura M, Leung G, Rao C, Giljahn L, Warther B, Pate A, Patil M, Schubert S, Rubertone J, Slack S, Fulton J, Rousseau D, Janes T, Schwartz S, Bolick S, Hurley D, Richards J, Whiteside M, Nogueira L, Herget K, Sweeney C, Martin J, Wang S, Harrelson D, Keitheri Cheteri M, Farley S, Hudson A, Borchers R, Stephenson L, Espinoza J, Weir H, Edwards B, Wang N, Yang L, Chen J, Song G, Gu X, Zhang P, Ge H, Zhao D, Zhang J, Zhu F, Tang J, Shen Y, Wang J, Li Q, Yang X, Dong J, Li W, Cheng L, Chen J, Huang Q, Huang S, Guo G, Wei K, Chen W, Zeng H, Demetriou A, Pavlou P, Mang W, Ngan K, Swaminathan R, Kataki A, Krishnatreya M, Jayalekshmi P, Sebastian P, Sapkota S, Verma Y, Nandakumar A, Suzanna E, Keinan-Boker L, Silverman B, Ito H, Nakagawa H, Hattori M, Kaizaki Y, Sugiyama H, Utada M, Katayama K, Narimatsu H, Kanemura S, Koike T, Miyashiro I, Yoshii M, Oki I, Shibata A, Matsuda T, Nimri O, Ab Manan A, Bhoo-Pathy N, Tuvshingerel S, Chimedsuren O, Al Khater A, El Mistiri M, Al-Eid H, Jung K, Won Y, Chiang C, Lai M, Suwanrungruang K, Wiangnon S, Daoprasert K, Pongnikorn D, Geater S, Sriplung H, Eser S, Yakut C, Hackl M, Mühlböck H, Oberaigner W, Zborovskaya A, Aleinikova O, Henau K, Van Eycken L, Dimitrova N, Valerianova Z, Šekerija M, Zvolský M, Engholm G, Storm H, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier A, Faivre J, Guizard A, Bouvier V, Launoy G, Arveux P, Maynadié M, Mounier M, Fournier E, Woronoff A, Daoulas M, Clavel J, Le Guyader-Peyrou S, Monnereau A, Trétarre B, Colonna M, Cowppli-Bony A, Molinié F, Bara S, Degré D, Ganry O, Lapôtre-Ledoux B, Grosclaude P, Estève J, Bray F, Piñeros M, Sassi F, Stabenow R, Eberle A, Erb C, Nennecke A, Kieschke J, Sirri E, Kajueter H, Emrich K, Zeissig S, Holleczek B, Eisemann N, Katalinic A, Brenner H, Asquez R, Kumar V, Ólafsdóttir E, Tryggvadóttir L, Comber H, Walsh P, Sundseth H, Devigili E, Mazzoleni G, Giacomin A, Bella F, Castaing M, Sutera A, Gola G, Ferretti S, Serraino D, Zucchetto A, Lillini R, Vercelli M, Busco S, Pannozzo F, Vitarelli S, Ricci P, Pascucci C, Autelitano M, Cirilli C, Federico M, Fusco M, Vitale M, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Maule M, Sacerdote C, Tumino R, Di Felice E, Vicentini M, Falcini F, Cremone L, Budroni M, Cesaraccio R, Contrino M, Tisano F, Fanetti A, Maspero S, Candela G, Scuderi T, Gentilini M, Piffer S, Rosso S, Sacchetto L, Caldarella A, La Rosa F, Stracci F, Contiero P, Tagliabue G, Dei Tos A, Zorzi M, Zanetti R, Baili P, Berrino F, Gatta G, Sant M, Capocaccia R, De Angelis R, Liepina E, Maurina A, Smailyte G, Agius D, Calleja N, Siesling S, Visser O, Larønningen S, Møller B, Dyzmann-Sroka A, Trojanowski M, Góźdż S, Mężyk R, Grądalska-Lampart M, Radziszewska A, Didkowska J, Wojciechowska U, Błaszczyk J, Kępska K, Bielska-Lasota M, Kwiatkowska K, Forjaz G, Rego R, Bastos J, Silva M, Antunes L, Bento M, Mayer-da-Silva A, Miranda A, Coza D, Todescu A, Valkov M, Adamcik J, Safaei Diba C, Primic-Žakelj M, Žagar T, Stare J, Almar E, Mateos A, Quirós J, Bidaurrazaga J, Larrañaga N, Díaz García J, Marcos A, Marcos-Gragera R, Vilardell Gil M, Molina E, Sánchez M, Franch Sureda P, Ramos Montserrat M, Chirlaque M, Navarro C, Ardanaz E, Moreno-Iribas C, Fernández-Delgado R, Peris-Bonet R, Galceran J, Khan S, Lambe M, Camey B, Bouchardy C, Usel M, Ess S, Herrmann C, Bulliard J, Maspoli-Conconi M, Frick H, Kuehni C, Schindler M, Bordoni A, Spitale A, Chiolero A, Konzelmann I, Dehler S, Matthes K, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Bannon F, Black R, Brewster D, Huws D, White C, Finan P, Allemani C, Bonaventure A, Carreira H, Coleman M, Di Carlo V, Harewood R, Liu K, Matz M, Montel L, Nikšić M, Rachet B, Sanz N, Spika D, Stephens R, Peake M, Chalker E, Newman L, Baker D, Soeberg M, Aitken J, Scott C, Stokes B, Venn A, Farrugia H, Giles G, Threlfall T, Currow D, You H, Hendrix J, Lewis C. Erratum to “The histology of ovarian cancer: Worldwide distribution and implications for international survival comparisons (CONCORD-2)” [Gynecol. Oncol. 144 (2017) 405–413]. Gynecol Oncol 2017; 147:726. [DOI: 10.1016/j.ygyno.2017.06.032] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mueller L, Sanmugalingham G, Ozoya O, Wilson J. 139 Successful Initiation of an Emergency Department-Based HIV and HCV Screening Program. Ann Emerg Med 2017. [DOI: 10.1016/j.annemergmed.2017.07.165] [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: 10/18/2022]
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Mercuri E, Kirschner J, Baranello G, Servais L, Goemans N, Pera M, Marquet A, Seabrook T, Sturm S, Armstrong G, Kletzl H, Czech C, Kraus D, Abdallah H, Mueller L, Gorni K, Khwaja O. Clinical studies of RG7916 in patients with spinal muscular atrophy: SUNFISH part 1 study update. Neuromuscul Disord 2017. [DOI: 10.1016/j.nmd.2017.06.415] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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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Götze T, Al-Batran SE, Zander T, Reichart A, Lindig U, Kleiss M, Mueller L, Bolling C, Seufferlein T, Reichardt P, Kullmann F, Eschenburg H, Schmittel A, Egger M, Block A, Pauligk C, Schmalenberg H. A multicentre, phase II study with cabazitaxel in previously treated patients with advanced or metastatic adenocarcinoma of the oesophagogastric junction and stomach (CABAGAST). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Della-Flora Nunes G, Mueller L, Silvestri N, Patel MS, Wrabetz L, Feltri ML, Poitelon Y. Acetyl-CoA production from pyruvate is not necessary for preservation of myelin. Glia 2017; 65:1626-1639. [PMID: 28657129 DOI: 10.1002/glia.23184] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Revised: 05/26/2017] [Accepted: 06/02/2017] [Indexed: 12/11/2022]
Abstract
Oligodendrocytes and Schwann cells not only form myelin in the central and peripheral nervous system, but also provide metabolic and trophic support to the axons they ensheathe. Acetyl-CoA is potentially a key molecule in Schwann cells and oligodendrocytes because it is at the crossroads of cellular lipid biosynthesis and energy generation. The main route for acetyl-CoA production is the oxidation of pyruvate by the pyruvate dehydrogenase complex (PDC). PDC deficiency in humans results in neurodegeneration and developmental impairments in both white and gray matter structures. To address the importance of PDC in myelinating glia, we deleted Pdha1 gene specifically in oligodendrocytes and Schwann cells. Surprisingly, sciatic and optic nerve morphology and the motor performance of Pdha1f/Y; CnpCre/+ mice are undistinguishable from those of controls at 1 month of age. In addition, myelin is stably maintained for at least 10 months. However, Pdha1f/Y; CnpCre/+ mice showed reduced fiber density and signs of axonal degeneration in both sciatic and optic nerves from 6 months of age. In contrast, 10 month-old mice bearing a floxed Pdha1 gene with either P0-Cre (expressed only by Schwann cells) or NG2-CreER (expressed in oligodendrocyte precursor cells) do not show any sign of axonal pathology or alterations in myelin structure or thickness. This indicates that the axonopathy is specific to the Pdha1f/Y; CnpCre/+ mice. Taken together, these results suggest that acetyl-CoA derived from pyruvate is not necessary for myelin maintenance and, thus, myelin-forming cells are not likely to contribute to the pathophysiology of PDC deficiency.
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Affiliation(s)
- Gustavo Della-Flora Nunes
- Hunter James Kelly Research Institute, University at Buffalo, Buffalo, New York, 14203.,Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203
| | - Lauren Mueller
- Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203
| | - Nicholas Silvestri
- Deptartment of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, 14203
| | - Mulchand S Patel
- Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203
| | - Lawrence Wrabetz
- Hunter James Kelly Research Institute, University at Buffalo, Buffalo, New York, 14203.,Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203.,Deptartment of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, 14203
| | - M Laura Feltri
- Hunter James Kelly Research Institute, University at Buffalo, Buffalo, New York, 14203.,Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203.,Deptartment of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, 14203
| | - Yannick Poitelon
- Hunter James Kelly Research Institute, University at Buffalo, Buffalo, New York, 14203.,Department of Biochemistry, University at Buffalo, Buffalo, New York, 14203
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Mueller L, Pult F, Meisterernst J, Heldner MR, Mono ML, Kurmann R, Buehlmann M, Fischer U, Mattle HP, Arnold M, Mordasini P, Gralla J, Schroth G, El-Koussy M, Jung S. Impact of intravenous thrombolysis on recanalization rates in patients with stroke treated with bridging therapy. Eur J Neurol 2017. [DOI: 10.1111/ene.13330] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- L. Mueller
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - F. Pult
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
| | - J. Meisterernst
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - M. R. Heldner
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - M.-L. Mono
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - R. Kurmann
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - M. Buehlmann
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - U. Fischer
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - H. P. Mattle
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - M. Arnold
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
| | - P. Mordasini
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
| | - J. Gralla
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
| | - G. Schroth
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
| | - M. El-Koussy
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
| | - S. Jung
- Department of Neurology; Inselspital; University Hospital Bern, Bern and University of Bern; Bern
- Department of Diagnostic and Interventional Neuroradiology; Inselspital; University Hospital Bern and University of Bern; Bern Switzerland
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Herrmann AJ, Techritz S, Jakubowski N, Haase A, Luch A, Panne U, Mueller L. A simple metal staining procedure for identification and visualization of single cells by LA-ICP-MS. Analyst 2017; 142:1703-1710. [DOI: 10.1039/c6an02638a] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
High lateral resolution of metal detection in single cells by use of laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) demands powerful staining methods.
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Affiliation(s)
- A. J. Herrmann
- Bundesanstalt für Materialforschung und -prüfung (BAM)
- Division 1.1 Inorganic Trace Analysis
- 12489 Berlin
- Germany
- Humboldt-Universität zu Berlin
| | - S. Techritz
- Bundesanstalt für Materialforschung und -prüfung (BAM)
- Division 1.1 Inorganic Trace Analysis
- 12489 Berlin
- Germany
| | - N. Jakubowski
- Bundesanstalt für Materialforschung und -prüfung (BAM)
- Division 1.1 Inorganic Trace Analysis
- 12489 Berlin
- Germany
| | - A. Haase
- Federal Institute for Risk Assessment
- Department of Chemical and Product Safety
- 10589 Berlin
- Germany
| | - A. Luch
- Federal Institute for Risk Assessment
- Department of Chemical and Product Safety
- 10589 Berlin
- Germany
| | - U. Panne
- Bundesanstalt für Materialforschung und -prüfung (BAM)
- Division 1.1 Inorganic Trace Analysis
- 12489 Berlin
- Germany
- Humboldt-Universität zu Berlin
| | - L. Mueller
- Bundesanstalt für Materialforschung und -prüfung (BAM)
- Division 1.1 Inorganic Trace Analysis
- 12489 Berlin
- Germany
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Joerger M, von Pawel J, Kraff S, Fischer JR, Eberhardt W, Gauler TC, Mueller L, Reinmuth N, Reck M, Kimmich M, Mayer F, Kopp HG, Behringer DM, Ko YD, Hilger RA, Roessler M, Kloft C, Henrich A, Moritz B, Miller MC, Salamone SJ, Jaehde U. Open-label, randomized study of individualized, pharmacokinetically (PK)-guided dosing of paclitaxel combined with carboplatin or cisplatin in patients with advanced non-small-cell lung cancer (NSCLC). Ann Oncol 2016; 27:1895-902. [PMID: 27502710 DOI: 10.1093/annonc/mdw290] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 07/14/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Variable chemotherapy exposure may cause toxicity or lack of efficacy. This study was initiated to validate pharmacokinetically (PK)-guided paclitaxel dosing in patients with advanced non-small-cell lung cancer (NSCLC) to avoid supra- or subtherapeutic exposure. PATIENTS AND METHODS Patients with newly diagnosed, advanced NSCLC were randomly assigned to receive up to 6 cycles of 3-weekly carboplatin AUC 6 or cisplatin 80 mg/m(2) either with standard paclitaxel at 200 mg/m(2) (arm A) or PK-guided dosing of paclitaxel (arm B). In arm B, initial paclitaxel dose was adjusted to body surface area, age, sex, and subsequent doses were guided by neutropenia and previous-cycle paclitaxel exposure [time above a plasma concentration of 0.05 µM (Tc>0.05)] determined from a single blood sample on day 2. The primary end point was grade 4 neutropenia; secondary end points included neuropathy, radiological response, progression-free survival (PFS) and overall survival (OS). RESULTS Among 365 patients randomly assigned, grade 4 neutropenia was similar in both arms (19% versus 16%; P = 0.10). Neuropathy grade ≥2 (38% versus 23%, P < 0.001) and grade ≥3 (9% versus 2%, P < 0.001) was significantly lower in arm B, independent of the platinum drug used. The median final paclitaxel dose was significantly lower in arm B (199 versus 150 mg/m(2), P < 0.001). Response rate was similar in arms A and B (31% versus 27%, P = 0.405), as was adjusted median PFS [5.5 versus 4.9 months, hazard ratio (HR) 1.16, 95% confidence interval (CI) 0.91-1.49, P = 0.228] and OS (10.1 versus 9.5 months, HR 1.05, 95% CI 0.81-1.37, P = 0.682). CONCLUSION PK-guided dosing of paclitaxel does not improve severe neutropenia, but reduces paclitaxel-associated neuropathy and thereby improves the benefit-risk profile in patients with advanced NSCLC. CLINICAL TRIAL INFORMATION NCT01326767 (https://clinicaltrials.gov/ct2/show/NCT01326767).
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Affiliation(s)
- M Joerger
- Department of Medical Oncology, Cantonal Hospital, St Gallen, Switzerland
| | - J von Pawel
- Pneumology Clinic, Asklepios Fachkliniken, Gauting
| | - S Kraff
- Institute of Pharmacy, Clinical Pharmacy, University of Bonn, Bonn
| | - J R Fischer
- Department of Medical Oncology, Klinik Löwenstein, Löwenstein
| | - W Eberhardt
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, Essen
| | - T C Gauler
- Department of Medical Oncology (Cancer Research), West German Cancer Center, University Hospital Essen of University Duisburg-Essen, Essen
| | - L Mueller
- Oncological Practice, Praxis Leer, Leer
| | - N Reinmuth
- Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf
| | - M Reck
- Lung Clinic Grosshansdorf, Airway Research Center North (ARCN), Member of the German Center for Lung Research (DZL), Grosshansdorf
| | - M Kimmich
- Pulmonology and Oncology, Klinik Schillerhöhe, Gerlingen
| | - F Mayer
- Department of Oncology and Hematology, University Hospital, Medical Center II, Tübingen
| | - H-G Kopp
- Department of Oncology and Hematology, Eberhard Karls University Medical Center, Tübingen
| | | | - Y-D Ko
- Medical Oncology, Johanniter-Krankenhaus Bonn, Bonn
| | - R A Hilger
- Cancer Research, University Hospital Essen, Essen, Germany
| | - M Roessler
- CESAR Central Office (CCO), Vienna CESAR Central European Society for Anticancer Drug Research-EWIV, Vienna, Austria
| | - C Kloft
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Free University Berlin, Berlin, Germany
| | - A Henrich
- Department of Clinical Pharmacy and Biochemistry, Institute of Pharmacy, Free University Berlin, Berlin, Germany
| | - B Moritz
- CESAR Central Office (CCO), Vienna CESAR Central European Society for Anticancer Drug Research-EWIV, Vienna, Austria
| | - M C Miller
- Saladax Biomedical, Inc., Bethlehem, USA
| | | | - U Jaehde
- Institute of Pharmacy, Clinical Pharmacy, University of Bonn, Bonn
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Mannix LK, Loder E, Nett R, Mueller L, Rodgers A, Hustad CM, Ramsey KE, Skobieranda F. Rizatriptan for the Acute Treatment of ICHD-II Proposed Menstrual Migraine: Two Prospective, Randomized, Placebo-Controlled, Double-Blind Studies. Cephalalgia 2016; 27:414-21. [PMID: 17448179 DOI: 10.1111/j.1468-2982.2007.01313.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [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: 11/28/2022]
Abstract
These are the first prospective studies to use criteria for menstrual migraine proposed in the 2004 revision of the International Classification of Headache Disorders (ICHD-II) to examine the efficacy of rizatriptan for treatment of a menstrual attack. Two identical protocols (MM1 and MM2) were randomized, parallel, placebo-controlled, double-blind studies. Adult women with ICHD-II menstrual migraine were assigned to either rizatriptan 10-mg tablet or placebo in a 2 : 1 ratio. Patients treated a single menstrual migraine attack of moderate or severe pain intensity. The primary end-point was 2-h pain relief and the secondary end-point was 24-h sustained pain relief. A total of 707 patients (MM1 357, MM2 350) treated a menstrual migraine attack. The percentage of patients reporting 2-h pain relief was significantly greater for rizatriptan than for placebo (MM1 70% vs. 53%, MM2 73% vs. 50%), as was the percentage of patients reporting 24-h sustained pain relief (MM1 46% vs. 33%; MM2 46% vs. 33%). Rizatriptan 10 mg was effective for the treatment of ICHD-II menstrual migraine, as measured by 2-h pain relief and 24-h sustained pain relief.
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Affiliation(s)
- L K Mannix
- Headache Associates and ClinExcel Research, West Chester, OH 45069, USA.
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Croy I, Olgun S, Mueller L, Schmidt A, Muench M, Gisselmann G, Hatt H, Hummel T. [Specific anosmia as a principle of olfactory perception]. HNO 2016; 64:292-5. [PMID: 26879880 DOI: 10.1007/s00106-016-0119-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Specific anosmia, the inability to perceive a specific odor, while olfactory perception is otherwise intact, is known as a rather seldom phenomenon. By testing the prevalence of specific anosmia to 20 different odors in a sample of 1600 people, we were able to estimate the general prevalence of anosmia. This revealed that specific anosmia is not rare at all. In contrast, the general likelihood for specific anosmia approaches 1. In addition, specific anosmia can be very well reversed by "smell training" during the course of 3 months. To summarize, specific anosmia seems to be a rule, not an exception, of olfactory sensation. The lack of perception of certain odors may constitute a flexible peripheral filter mechanism, which can be adapted by exposure to odors.
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Affiliation(s)
- I Croy
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland. .,Klinik und Poliklinik für Psychotherapie und Psychosomatik, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
| | - S Olgun
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - L Mueller
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - A Schmidt
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - M Muench
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
| | - G Gisselmann
- Institut für Zellphysiologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - H Hatt
- Institut für Zellphysiologie, Ruhr-Universität Bochum, Bochum, Deutschland
| | - T Hummel
- Klinik und Poliklinik für Hals-, Nasen- und Ohrenheilkunde, Interdisziplinäres Zentrum für Riechen und Schmecken, Universitätsklinikum Carl Gustav Carus Dresden, Fetscherstraße 74, 01307, Dresden, Deutschland
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Kanje S, Herrmann AJ, Hober S, Mueller L. Next generation of labeling reagents for quantitative and multiplexing immunoassays by the use of LA-ICP-MS. Analyst 2016; 141:6374-6380. [DOI: 10.1039/c6an01878e] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel labeling strategy – which results in one label per antibody molecule – was used for multiplex and quantitative immuno imaging by use of LA-ICP-MS.
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Affiliation(s)
- S. Kanje
- Alba Nova University Center
- KTH-Royal Institute of Technology
- Division of Protein Technology
- Stockholm
- Sweden
| | - A. J. Herrmann
- Bundesanstalt für Materialforschung und-prüfung (BAM)
- 1.1 Division Inorganic Trace Analysis
- 12489 Berlin
- Germany
- Humboldt-Universität zu Berlin
| | - S. Hober
- Alba Nova University Center
- KTH-Royal Institute of Technology
- Division of Protein Technology
- Stockholm
- Sweden
| | - L. Mueller
- Bundesanstalt für Materialforschung und-prüfung (BAM)
- 1.1 Division Inorganic Trace Analysis
- 12489 Berlin
- Germany
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Joerger M, Von Pawel J, Kraff S, Fischer J, Gauler T, Mueller L, Reinmuth N, Reck M, Kimmich M, Frank M, Kopp H, Behringer D, Ko Y, Ralf H, Roessler M, Kloft C, Henrich A, Moritz B, Jaehde U. 3066 Pharmacokinetically (PK)-guided dosing of paclitaxel in combination with carboplatin in advanced non-small cell lung cancer (NSCLC) is gender dependent: Updated results of the randomized CEPAC-TDM study. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31708-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Kofler M, Stastny L, Schachner T, Kilo J, Grimm M, Mueller L, Bonatti J, Bonaros N. 138 * ROBOTIC VERSUS CONVENTIONAL CORONARY ARTERY BYPASS GRAFT: A PROPENSITY SCORE-BASED COMPARISON OF PERIOPERATIVE AND LONG-TERM RESULTS. Interact Cardiovasc Thorac Surg 2014. [DOI: 10.1093/icvts/ivu276.138] [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: 11/14/2022] Open
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Semsroth S, Heinz A, Dumfarth J, Mueller L, Grimm M, Ruttmann-Ulmer E. 317 * COMPARISON OF ANTEROLATERAL MINITHORACOTOMY VERSUS HEMISTERNOTOMY IN MINIMALLY INVASIVE AORTIC VALVE REPLACEMENT: A SINGLE-CENTRE STUDY. Interact Cardiovasc Thorac Surg 2013. [DOI: 10.1093/icvts/ivt372.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lambing A, Kuriakose P, Kachalsky E, Mueller L. The challenges of the homeless haemophilia patient. Haemophilia 2013; 19:546-50. [PMID: 23557394 DOI: 10.1111/hae.12124] [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] [Accepted: 01/18/2013] [Indexed: 11/30/2022]
Abstract
The current economic hardships within the United States can increase the risk of persons becoming homeless. In 2001, it was estimated that between 0.1% and 2.1% of the population were homeless every night and that 2.3 - 3.5 million persons could become homeless every year [1]. Many issues can increase the risk of homelessness including: home foreclosure, declining work force due to declining wages, low-wage opportunities and less secure jobs, decline in public assistance, lack of affordable housing with limited housing assistance programs, poverty, lack of affordable health care, domestic violence, mental illness, and addiction disorders. Many on the streets may suffer from mental illness, developmental disabilities, and or chronic physical illness [6]. Given these issues, the Hemophilia Treatment Center (HTC) can expect to experience the issue of homelessness within their own population of persons with hemophilia. Currently, there are no studies that address the issue of the person with hemophilia who may become homeless. This presents unique challenges that this population may encounter to survive in addition to managing bleeding issues related to the diagnosis of hemophilia. This article will review the issues related to homelessness in the general population. Two case studies of persons with hemophilia who became homeless will be discussed outlining the strategies utilized to assist the patient during this crisis.
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Affiliation(s)
- A Lambing
- Hematology/Oncology, Henry Ford Health System, Detroit, MI, USA.
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Bonaros N, Heinz A, Plank F, Mueller S, Bartel T, Friedrich G, Feuchtner G, Schachner T, Grimm M, Mueller L. Relative amplitude index: A new tool for prediction of the impact of periprosthetic regurgitation on outcome after transcatheter aortic valve implantation. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332256] [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: 10/27/2022]
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Bonaros N, Plank F, Friedrich G, Bartel T, Mueller S, Heinz A, Schachner T, Mueller L, Grimm M, Feuchtner G. Effective aortic annulus sizing by 3 d-ct is superior to 2 d-ct for reduction of paravalvular leaks after transcatheter aortic valve implantation. Thorac Cardiovasc Surg 2013. [DOI: 10.1055/s-0032-1332516] [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: 10/27/2022]
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Bessudo A, Bendell JC, Gabrail N, Kopp MV, Mueller L, Hart LL, Vladimirov VI, Pande AU, Gorbatchevsky I, Eng C. Phase I results of the randomized, placebo controlled, phase I/II study of the novel oral c-MET inhibitor, ARQ 197, irinotecan (CPT-11), and cetuximab (C) in patients (pts) with wild-type (WT) KRAS metastatic colorectal cancer (mCRC) who have received front-line systemic therapy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.3582] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Wilhelm S, Mueller L, Tessen HW, Schlichting A, Bartels S. The palliative therapy of NSCLC in the medical practice. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.e18069] [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: 11/20/2022] Open
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Hartmann JT, Sturm I, Issels RD, Krause SW, Gruenwald V, Kunitz A, Lindner L, San Nicolo K, Mayer F, Hertenstein B, Mueller L, Kontny U, Topaly J, Trappe RU, Grothe W. Topoisomerase-based chemotherapy in adults with relapsed or refractory pediatric-type sarcoma: A retrospective analysis of the German AIO Sarcoma Group/BMBF SAREZ registry. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10084] [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: 11/20/2022] Open
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Mueller L, Goebell P, Blumenstengel K, Lueck A, Koska M, Marschner N. Real-life treatment of patients with advanced or metastatic renal cell carcinoma in German oncology and urology outpatient centers (RCC-Registry). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.7_suppl.367] [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: 11/20/2022] Open
Abstract
367 Background: Until 2006, advanced or metastatic renal cell carcinoma (mRCC) patients were treated with immunomodulators such as interleukins and interferons. Multiple new targeted therapeutics, mainly signal transduction inhibitors, have been developed resulting in fundamental changes of therapeutic standards for patients with mRCC. In 2007, recruitment into the registry started in order to survey the treatment of mRCC patients, the course of disease and treatment as well as the therapeutic decision-making processes. Methods: It is intended to enroll 1,000 mRCC patients and collect data for each case for a maximum of 3 years. Over 100 oncology and urology outpatient centers in Germany are participating. Inclusion Criteria: (1) patients with metastatic or locally advanced RCC requiring antineoplastic therapy, (2) start of first palliative therapy within 1 year before enrolment, (3) age at least 18 years, and (4) Informed written consent. Results: By May 2010, 509 patients were enrolled. At the start of systemic therapy mean age were 66.2 years for male and 69.0 years for female patients, respectively. Patients have a Charlson Comorbidity Index of 1.0. More than 94% of patients had metastases at inclusion. 62.8% of the patients received sunitinib as first-line treatment, 12.0% received temsirolimus, 9.6% were treated with bevacizumab/interferon alpha, and 9.1% received sorafenib. Median duration determined using Kaplan-Meier analyses of first-line treatment with: sunitinib: 8.5 months (n=319), temsirolimus: 2.6 months (n=60), bevacizumab/interferon alpha: 4.6 months (n=49), and sorafenib: 6.7 months (n=45) whereby the duration of ongoing therapies was censored as the date of last documentation; thus the final duration might exceed the given values. After first-line treatment with sunitinib most of the patients received either sorafenib (12.4%, n=63) or temsirolimus (7.7%, n=39) in the second line. Conclusions: The registry provides an overview of the current treatment of mRCC patients in German outpatient cancer centers and shows how fast the insights of clinical studies concerning treatment of mRCC patients are transferred into current medical practice. [Table: see text]
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Affiliation(s)
- L. Mueller
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - P. Goebell
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - K. Blumenstengel
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - A. Lueck
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - M. Koska
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
| | - N. Marschner
- Onkologische Schwerpunktpraxis Leer-Emden, Leer, Germany; Urologische Universitätsklinik im Waldkrankenhaus St. Marien, Erlangen, Germany; Onkologische Schwerpunktpraxis, Eisenach, Germany; Praxis fuer Onkologie und Proktologie, Rostock, Germany; iOMEDICO AG, Freiburg, Germany; Praxis Onkologie, Freiburg, Germany
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Mueller L. Threshold for toxicological concern (TTC) and impurities. Toxicol Lett 2010. [DOI: 10.1016/j.toxlet.2010.03.075] [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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Krane DE, Bahn V, Balding D, Barlow B, Cash H, Desportes BL, D'Eustachio P, Devlin K, Doom TE, Dror I, Ford S, Funk C, Gilder J, Hampikian G, Inman K, Jamieson A, Kent PE, Koppl R, Kornfield I, Krimsky S, Mnookin J, Mueller L, Murphy E, Paoletti DR, Petrov DA, Raymer M, Risinger DM, Roth A, Rudin N, Shields W, Siegel JA, Slatkin M, Song YS, Speed T, Spiegelman C, Sullivan P, Swienton AR, Tarpey T, Thompson WC, Ungvarsky E, Zabell S. Time for DNA disclosure. Science 2010; 326:1631-2. [PMID: 20019271 DOI: 10.1126/science.326.5960.1631] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Sehouli J, Oskay-Özcelik G, Stengel D, Harter P, Kurzeder C, Belau A, Markmann S, Lorenz R, Mueller L, Lichtenegger W. 8002 What is the best schedule of Topotecan? – weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer – a randomized, multicenter trial of the North-Eastern German Society of Gynaecological Oncology (TOWER). EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)71524-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Hofheinz R, Wenz F, Post S, Matzdorff A, Laechelt S, Mueller L, Link H, Moehler M, Burkholder I, Hochhaus A. Capecitabine (Cape) versus 5-fluorouracil (5-FU)-based (neo-)adjuvant chemoradiotherapy (CRT) for locally advanced rectal cancer (LARC): Safety results of a randomized, phase III trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4014] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4014 Background: 5-FU based CRT is regarded standard perioperative treatment in LARC. Here we report safety data of a non-inferiority phase III trial investigating (neo-)adjuvant CRT with Cape in comparison with 5-FU. Methods: Patients (pts) aged ≥18 years with LARC UICC stages II or III were recruited in this two-arm, two-strata randomized phase-III trial (arm A: Cape, arm B: 5-FU; stratum [S] I: adjuvant, S II: neoadjuvant). Regimens: Arm A: CRT: 50.4 Gy + Cape 1,650 mg/m2 days 1–38 plus five cycles of Cape 2,500 mg/m2 d 1–14, rep. d 22 (S I: 2 x Cape, CRT, 3 x Cape; S II: CRT, TME surgery followed by Cape x 5). Arm B: CRT: 50.4 Gy + 5-FU 225 mg/m2 c.i. daily [S I] or 5-FU 1,000 mg/m2 c.i. d 1–5 and 29–33 [S II] plus 4 cycles of bolus 5-FU 500mg/m2 d 1–5, rep. d 29 (S I: 2 x 5-FU, CRT, 2 x 5-FU; S II: CRT, TME surgery followed by 5-FU x 4). Primary endpoint was survival, secondary endpoints comprised safety and disease-free survival. Results: Of 401 randomized pts a total of 392 are evaluable (Arm A n=197, arm B n=195; S I n=231, S II n=161). Both arms were well balanced with respect to age, sex, WHO status, T- and N- stages. Regarding duration of treatment, 78% (Cape) and 80% (5-FU) completed all scheduled treatment cycles in S I, and 46% (Cape) and 40% (5-FU) in neoadjuvant stratum S II. In S II a total of 38% (Cape) and 43% (5-FU) did not continue chemotherapy after tumour resection. Concerning early efficacy endpoints in S II, pts treated with Cape (evaluable thus far n=121) exhibited a higher rate of T-downstaging (defined as ypT0–2; 52 vs 39%; p=0.16) and N0 (71 vs 56%; p=0.09). Regarding overall safety (NCI-CTC), pts receiving Cape experienced significantly less leukopenia (25 vs 35%; p=0.04), but more hand-foot syndrome (31 vs. 2%; p<0.001). Stomatitis/mucositis, diarrhea, nausea/vomiting, and radiodermatitis were not significantly different between both arms. Conclusions: Given the observed safety profile and the trend in improved downstaging in neoadjuvant stratum, Cape exhibits a potential to replace 5-FU as perioperative treatment of LARC. Efficacy results on the primary endpoint are expected for 2010. [Table: see text]
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Affiliation(s)
- R. Hofheinz
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - F. Wenz
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - S. Post
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - A. Matzdorff
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - S. Laechelt
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - L. Mueller
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - H. Link
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - M. Moehler
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - I. Burkholder
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
| | - A. Hochhaus
- Interdisziplinäres Tumorzentrum, Mannheim, Germany; Klinik für Strahlentherapie und Radioonkologie, Mannheim, Germany; Chirurgische Klinik und Poliklinik, Mannheim, Germany; Caritasklinik St. Theresa, Saarbrücken, Germany; Klinik für Strahlentherapie, Tübingen, Germany; Onkologische Praxis, Leer, Germany; Westpfalz Klinikum, Kaiserslautern, Germany; Medizinische Universitätsklinik, Mainz, Germany; Abteilung Biostatistik, DKFZ, Heidelberg, Germany; III. Medizinische Universitätsklinik, Mannheim, Germany
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Sehouli J, Oskay-Oezcelik G, Stengel D, Harter P, Kurzeder C, Belau A, Belau A, Markmann S, Lorenz R, Mueller L, Lichtenegger W. Topotecan weekly versus routine 5-day schedule in patients with platinum-resistant ovarian cancer (TOWER): A randomized, multicenter trial of the North-Eastern German Society of Gynecological Oncology (NOGGO). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5553] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5553 Background: In women with platinum-resistant recurrent ovarian cancer, weekly administration of topotecan (Tw) may be equally effective, but better tolerated than conventional 5-day dosing (Tc). We conducted a randomized multicenter trial to validate this assumption. Methods: The trial was pre-registered at clinicaltrials.gov ( NCT00170677 ). Women with platinum-resistant ovarian and fallopian tube cancers or primary peritoneal carcinoma, and measurable or assessable disease (GCIG criteria) were randomized to receive either Tw (d1,8,15/q28d, 4 mg/m2) or Tc (d1–5/q21d, 1.25 mg/m2). The predefined stopping rule, based on the primary endpoint of best CA-125 or tumor response, was not reached (presented at ASCO 2007, Abstract 5526). This permitted the accrual of 194 patients, 154 of whom could be assessed for CA-125 or tumor response (SD + CR + PR). We also compared progression-free (PFS) and overall survival (OS), as well as toxicity between trial groups. Results: Mean age was 61.8 (SD 9.8) years, and 59 women were on third-line treatment. Patients received a total of 809 cycles of chemotherapy. Demographic baseline characteristics, tumor stages and grades, and previous lines of chemotherapy were well balanced between treatment groups. There were 35 / 75 (47%) and 45 / 79 (57%) responses in the Tw and Tc groups, respectively (risk ratio [RR] 1.22, 95% CI 0.89–1.66). Median PFS and OS did not differ markedly between both regimens (3.2 versus 4.4 months, hazard ratio [HR] 1.30, 95% CI 0.96–1.77 and 9.8 versus 10.0 months, HR 1.08, 95% CI 0.77–1.52). The risk of grade III/IV hematological toxicity was significantly lower in the Tw group (anemia: RR 0.35, p = 0.007, neutropenia: RR 0.38, p = 0.0001, thrombopenia: RR 0.23, p = 0.0004). Conclusions: Weekly administration of topotecan shows no substantial difference in endpoints of effectiveness compared to conventional dosing, but is associated with a significantly lower likelihood of severe hematological toxicity. Weekly topotecan should be considered as a possible treatment alternative in women with platinum-resistant ovarian cancer because of its favourable benefit-risk-profile. No significant financial relationships to disclose.
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Affiliation(s)
- J. Sehouli
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - G. Oskay-Oezcelik
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - D. Stengel
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - P. Harter
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - C. Kurzeder
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - A. Belau
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - S. Markmann
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - R. Lorenz
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - L. Mueller
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
| | - W. Lichtenegger
- University Hospital Charite, Berlin, Germany; Unfallkrankenhaus Berlin, Berlin, Germany; Horst Schmidt Klinikum, Wiesbaden, Germany; University Hospital, Ulm, Germany; University Hospital, Greifswald, Germany; University Hoospital, Rostock, Germany; Praxis, Braunschweig, Germany; Onkologische Schwerpunktpraxis Leer und Emden, Leer und Emden, Germany
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Boggula R, Lorenz F, Chen H, Gansemer C, Wertz H, Giuliacci A, Brusasco C, Mueller L, Wenz F. Commissioning of a System to Correlate Dose Measurements to Patients Anatomy. Int J Radiat Oncol Biol Phys 2008. [DOI: 10.1016/j.ijrobp.2008.06.354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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