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Livingstone E, Gogas H, Kandolf-Sekulovic L, Meier F, Eigentler TK, Ziemer M, Terheyden PAM, Gesierich AH, Herbst RA, Kähler KC, Ziogas DC, Mijuskovic Z, Garzarolli M, Garbe C, Roesch A, Ugurel S, Gutzmer R, Grob JJ, Kiecker F, Utikal J, Windemuth-Kieselbach C, Eckhardt S, Zimmer L, Schadendorf D. Early switch from run-in treatment with vemurafenib plus cobimetinib to atezolizumab after 3 months leads to rapid loss of tumour control in patients with advanced BRAFV600-positive melanoma: The ImmunoCobiVem phase 2 randomised trial. Eur J Cancer 2023; 190:112941. [PMID: 37482012 DOI: 10.1016/j.ejca.2023.112941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023]
Abstract
AIM ImmunoCobiVem investigated whether a planned switch to atezolizumab after achieving tumour control during run-in with vemurafenib + cobimetinib improves progression-free survival (PFS) and overall survival (OS) compared to continuous targeted therapy (TT) in patients with previously untreated advanced BRAFV600-mutated melanoma. METHODS In this multicenter phase 2 study, patients received vemurafenib plus cobimetinib. After 3months, patients without progressive disease (PD) were randomly assigned (1:1) to continue vemurafenib + cobimetinib (Arm A) or switch to atezolizumab (Arm B) until first documented PD (PD1). Primary outcome was PFS1 (time from start of run-in until PD1 or death). OS and safety were also assessed. RESULTS Of 185 patients enroled between November 2016 and December 2019, 135 were randomly assigned after the run-in period (Arm A, n = 69; Arm B, n = 66). Median PFS1 was significantly longer in Arm A versus Arm B (13.9 versus 5.9months; hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.37-0.84; PStratified=0.001). Median OS was not reached in either arm (HR 1.22; 95%CI, 0.69-2.16; PStratified=0.389); 2-year OS was higher in Arm B versus Arm A (67%; 95%CI, 53-78 versus 58%; 95%CI, 45-70). Grade 3/4 AEs occurred in 55% of patients in Arm A and 64% in Arm B; treatment-related AEs led to discontinuation of any drug in 7% and 9% of patients, respectively. CONCLUSION In patients with BRAFV600-mutated advanced melanoma who achieve tumour control with TT, early switch at 3months to atezolizumab led to rapid loss of tumour control but provided a numerical OS benefit at 2years compared with continued TT.
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Affiliation(s)
- E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - H Gogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - L Kandolf-Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - F Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, Dresden, Germany
| | - T K Eigentler
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - M Ziemer
- Department of Dermatology, University of Leipzig Medical Center, Leipzig, Germany
| | | | - A H Gesierich
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | | | - K C Kähler
- Department of Dermatology, Venerology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D C Ziogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - M Garzarolli
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - R Gutzmer
- Department of Dermatology, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany; Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany
| | - J J Grob
- Aix-Marseille University, Timone Hospital (APHM), Marseille, France
| | - F Kiecker
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | | | | | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany.
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Becker J, Ugurel S, Leiter-Stoppke U, Meier F, Gutzmer R, Haferkamp S, Zimmer L, Livingstone E, Eigentler T, Hauschild A, Kiecker F, Hassel J, Mohr P, Fluck M, Thomas I, Garzarolli M, Grimmelmann I, Drexler K, Eckhardt S, Schadendorf D. 787O Adjuvant immunotherapy with nivolumab (NIVO) versus observation in completely resected Merkel cell carcinoma (MCC): Disease-free survival (DFS) results from ADMEC-O, a randomized, open-label phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.913] [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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3
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Dimitriou F, Namikawa K, Reijers ILM, Buchbinder EI, Soon JA, Zaremba A, Teterycz P, Mooradian MJ, Armstrong E, Nakamura Y, Vitale MG, Tran LE, Bai X, Allayous C, Provent-Roy S, Indini A, Bhave P, Farid M, Kähler KC, Mehmi I, Atkinson V, Klein O, Stonesifer CJ, Zaman F, Haydon A, Carvajal RD, Hamid O, Dummer R, Hauschild A, Carlino MS, Mandala M, Robert C, Lebbe C, Guo J, Johnson DB, Ascierto PA, Shoushtari AN, Sullivan RJ, Cybulska-Stopa B, Rutkowski P, Zimmer L, Sandhu S, Blank CU, Lo SN, Menzies AM, Long GV. Single-agent anti-PD-1 or combined with ipilimumab in patients with mucosal melanoma: an international, retrospective, cohort study. Ann Oncol 2022; 33:968-980. [PMID: 35716907 DOI: 10.1016/j.annonc.2022.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/15/2022] [Accepted: 06/07/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Mucosal melanoma (MM) is a rare melanoma subtype with distinct biology and poor prognosis. Data on the efficacy of immune checkpoint inhibitors (ICIs) is limited. We determined the efficacy of ICIs in MM, analysed by primary site and ethnicity/race. PATIENTS AND METHODS Retrospective cohort study from 25 cancer centres in Australia, Europe, USA and Asia. Patients with histologically confirmed MM were treated with anti-PD1+/-ipilimumab. Primary endpoints were response rate (RR), progression-free survival (PFS), overall survival (OS) by primary site (naso-oral, urogenital, anorectal, other), ethnicity/race (Caucasian, Asian, Other) and treatment. Univariate and multivariate Cox proportional hazard model analyses were conducted. RESULTS In total, 545 patients were included: 331 (63%) Caucasian, 176 (33%) Asian and 20 (4%) Other. Primary sites included 113 (21%) anorectal, 178 (32%) urogenital, 206 (38%) naso-oral and 45 (8%) other. 348 (64%) received anti-PD1 and 197 (36%) anti-PD1/ipilimumab. RR, PFS and OS did not differ by primary site, ethnicity/race or treatment. RR for naso-oral was numerically higher for anti-PD1/ipilimumab (40%, 95% CI 29-54%) compared with anti-PD1 (29%, 95% CI 21-37%). 35% of patients that initially responded progressed. Median duration of response (mDOR) was 26 months (95% CI 18-NR [Not Reached]). Factors associated with short PFS were ECOG PS ≥3 (p<0.01), LDH >ULN (p=0.01), lung metastases (p<0.01) and ≥1 previous treatments (p<0.01). Factors associated with short OS were ECOG PS ≥1 (p<0.01), LDH >ULN (p=0.03), lung metastases (p<0.01) and ≥1 previous treatments (p<0.01). CONCLUSIONS MM has poor prognosis. Treatment efficacy of anti-PD1+/-ipilimumab was similar and did not differ by ethnicity/race. Naso-oral primaries had numerically higher response to anti-PD1/ipilimumab, without difference in survival. The addition of ipilimumab did not show greater benefit over anti-PD1 for other primary sites. In responders, mDOR was short and acquired resistance was common. Other factors, including site and number of metastases were associated with survival.
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Affiliation(s)
- F Dimitriou
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Department of Dermatology, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - K Namikawa
- Department of Dermatologic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - I L M Reijers
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - E I Buchbinder
- Melanoma Disease Center, Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA 02481, USA
| | - J A Soon
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - A Zaremba
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - P Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, 49585Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - M J Mooradian
- Division of Oncology and Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - E Armstrong
- Department of Medicine, Melanoma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Y Nakamura
- Department of Skin Oncology/Dermatology, Saitama Medical University International Medical Center, Saitama, Japan
| | - M G Vitale
- Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Napoli, Italy
| | - L E Tran
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - X Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - C Allayous
- APHP Hôpital Saint-Louis, Dermatology Department, DMU ICARE, Paris, France
| | - S Provent-Roy
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - A Indini
- Unit of Medical Oncology, Ospedale di Circolo e Fondazione Macchi, ASST Sette Laghi, Varese, Italy
| | - P Bhave
- Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia
| | - M Farid
- Division of Medical Oncology, National Cancer Centre Singapore, 11 Hospital Crescent, Singapore, 169610, Singapore
| | - K C Kähler
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - I Mehmi
- Department of Hematology/Oncology, The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, 11800 Wilshire Blvd Suite 300, Los Angeles, CA, 90025, USA
| | - V Atkinson
- Princess Alexandra Hospital, Greenslopes Private Hospital, University of Queensland, Queensland, Australia
| | - O Klein
- Department of Medical Oncology, Austin Health, Melbourne, Australia; Olivia Newton-John Cancer Research Institute, Melbourne, Victoria
| | - C J Stonesifer
- Columbia University Irving Medical Center, New York City, New York, USA
| | - F Zaman
- Alfred Hospital, Melbourne, Victoria, Australia
| | - A Haydon
- Alfred Hospital, Melbourne, Victoria, Australia
| | - R D Carvajal
- Columbia University Irving Medical Center, New York City, New York, USA
| | - O Hamid
- Department of Hematology/Oncology, The Angeles Clinic and Research Institute, a Cedars-Sinai Affiliate, 11800 Wilshire Blvd Suite 300, Los Angeles, CA, 90025, USA
| | - R Dummer
- Department of Dermatology, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Westmead and Blacktown Hospitals, Sydney, New South Wales, Australia
| | - M Mandala
- Unit of Medical Oncology, University of Perugia, Perugia, Italy
| | - C Robert
- Dermatology Service, Department of Medicine, Gustave Roussy and Paris-Saclay University, Villejuif, France
| | - C Lebbe
- Université de Paris, APHP Hôpital Saint-Louis, Dermatology Department, DMU ICARE, INSERM U-976, Paris, France
| | - J Guo
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma and Sarcoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - D B Johnson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P A Ascierto
- Istituto Nazionale Tumori IRCCS Fondazione 'G. Pascale', Napoli, Italy
| | - A N Shoushtari
- Department of Medicine, Melanoma Service, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - R J Sullivan
- Division of Oncology and Hematology, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston MA, USA
| | - B Cybulska-Stopa
- Department of Clinical Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, Cracow Branch, Poland
| | - P Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, 49585Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen, Germany
| | - S Sandhu
- Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - C U Blank
- Department of Medical Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia
| | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia; Department of Medical Oncology, Royal North Shore and Mater Hospitals, Sydney, NSW, Australia.
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4
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Jansen P, Lodde GC, Wetter A, Welt A, Stuschke M, Dührsen U, Stoffels I, Klode J, Livingstone E, Zimmer L, Roesch A, Hadaschik E, Griewank KG, Schadendorf D, Ugurel S. Checkpoint immunotherapy of cutaneous squamous cell carcinoma in patients suffering from chronic lymphocytic leukaemia: divergent outcomes in two men treated with PD-1 inhibitors. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:41-44. [PMID: 34855243 DOI: 10.1111/jdv.17405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 04/21/2021] [Indexed: 11/28/2022]
Abstract
Cutaneous squamous cell carcinoma (cSCC) numbers among the most common types of skin cancer and is known as one of the cancer entities with the highest mutational burden among all solid tumours. Due to the positive correlation between mutational burden and response rate to inhibitors of the programmed cell death 1 (PD-1), those inhibitors are considered promising candidates for the systemic therapy of cSCC. Recently, the PD-1 inhibitors pembrolizumab, nivolumab and cemiplimab demonstrated efficacy in the systemic treatment of locally advanced or metastatic cSCC leading to the approval of cemiplimab by the FDA (U.S. Food and Drug Administration) in 2018 and the EMA (European Medicines Agency) in 2019. Patients with haematological malignancies tend to develop skin cancers of high aggressiveness, enhanced cumulative recurrence rate and higher rates of metastases with subsequent death. Chronic lymphocytic leukaemia (CLL) is the most frequent type of leukaemia in the United States and Europe with the majority of patients older than 50 years of age. This neoplasm predominantly originates from B -cells leading to an impaired immune system of the patient. Although CLL is a B-cell malignancy, studies have also described the involvement of T cells in the pathogenesis and progression of the disease with contradictory findings on the effects of PD-1 inhibitors in CLL. Due to their underlying hematologic malignancy, these patients have commonly no access to PD-1 inhibitor trials for treatment of advanced cSCC. We report on two patients with locally advanced or metastatic cSCC. Both patients had been suffering from a CLL for many years without indication for treatment. Despite a potential immunosuppressive state of the patients due to their CLL, both were treated with the PD-1 inhibitor pembrolizumab resulting in different therapy outcomes.
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Affiliation(s)
- P Jansen
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - G C Lodde
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - A Wetter
- Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - A Welt
- Department of Medical Oncology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - M Stuschke
- Department of Radiotherapy, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - U Dührsen
- Department of Hematology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - I Stoffels
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - J Klode
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - E Hadaschik
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - K G Griewank
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,Dermatopathologie bei Mainz, Nieder-Olm, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
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Jansen P, Lodde GC, Griewank KG, Hadaschik E, Roesch A, Ugurel S, Zimmer L, Livingstone E, Schadendorf D. Management of partial and non-responding cutaneous squamous cell carcinoma. J Eur Acad Dermatol Venereol 2021; 36 Suppl 1:29-34. [PMID: 34855242 DOI: 10.1111/jdv.17404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 05/18/2021] [Indexed: 01/20/2023]
Abstract
Cutaneous squamous cell carcinoma (cSCC) and basal cell carcinoma are the most common types of skin cancer. For patients with locally advanced and metastatic cSCC, the programmed cell death 1 (PD-1) inhibitor cemiplimab is approved for systemic treatment. Despite this revolutionary immunomodulatory therapeutic approach, tumours may fail to respond either completely or partially. In addition to the previously established local treatment with radiotherapy or systemic treatment with chemotherapy and epidermal growth factor receptor inhibitors, ongoing trials are currently focussed on re-stimulating the antitumour immune response in patients with advanced cSCC refractory to PD-1 inhibitors. In this review, ongoing and recently finished trials with different therapeutic approaches will be discussed.
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Affiliation(s)
- P Jansen
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - G C Lodde
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - K G Griewank
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany.,Dermatopathologie bei Mainz, Nieder-Olm, Germany
| | - E Hadaschik
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany.,German Cancer Consortium, Partner Site Essen, Essen, Germany
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Chen FZ, Mauro NA, Bertrand SM, McGrath P, Zimmer L, Kelton KF. Breakdown of the Stokes-Einstein relationship and rapid structural ordering in CuZrAl metallic glass-forming liquids. J Chem Phys 2021; 155:104501. [PMID: 34525827 DOI: 10.1063/5.0062724] [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: 11/14/2022] Open
Abstract
The results of a combined structural and dynamical study of Cu-Zr-Al metallic glass forming liquids are presented. Containerless high-energy x-ray scattering experiments made using electrostatic levitation are combined with molecular dynamics simulations to probe the onset of rapid structural ordering as well as the temperature-dependent diffusivity and viscosity in three liquids: Cu49Zr45Al6, Cu47Zr45Al8, and Cu43Zr45Al12. These compositions were chosen because they are reported to have dramatically different glass forming-ability. Experimental data show that the first peak in the x-ray static structure factor displays evidence for a Curie-Weiss type behavior, but also a peak in the effective Curie temperature. The evidence provided here for the onset of cooperativity, marked by a crossover temperature, TA (which is usually above the liquidus temperature), is accompanied by the onset of development of more spatially extended structural order in the liquids. Based on the molecular dynamics simulations, each of the liquids exhibits a clear breakdown of the Stokes-Einstein relation at a temperature near, but below, the crossover temperature, TA. The breakdown is manifest as a rapid reduction in the relative diffusion coefficients between Cu, Zr, and Al.
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Affiliation(s)
- F Z Chen
- Institute of Materials Science and Engineering, Washington University, St. Louis, Missouri 63130, USA
| | - N A Mauro
- Department of Physics, St. Norbert College, De Pere, Wisconsin 54115, USA
| | - S M Bertrand
- Department of Physics, St. Norbert College, De Pere, Wisconsin 54115, USA
| | - P McGrath
- Department of Physics, St. Norbert College, De Pere, Wisconsin 54115, USA
| | - L Zimmer
- Department of Physics, St. Norbert College, De Pere, Wisconsin 54115, USA
| | - K F Kelton
- Institute of Materials Science and Engineering, Washington University, St. Louis, Missouri 63130, USA
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Pires da Silva I, Zakria D, Ahmed T, Trojaniello C, Dimitriou F, Allayous C, Gerard C, Zimmer L, Lo S, Michielin O, Lebbe C, Mangana J, Ascierto P, Johnson D, Carlino M, Menzies A, Long G. 1042P Anti-PD1 (PD1) monotherapy or in combination with ipilimumab (IPI) after BRAF/MEK inhibitors (BRAF/MEKi) in BRAF mutant metastatic melanoma (MM) patients (pts). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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8
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Dimitriou F, Namikawa K, Teterycz P, Reijers I, Buchbinder E, Soon J, Zimmer L, Mooradian M, Vitale M, Armstrong E, Johnson D, Guo J, Lebbe C, Robert C, Mandala M, Bhave P, Farid M, Kähler K, Lo S, Long G. 1049P Clinical models to predict response in mucosal melanoma (MM) patients (pts) treated with anti-PD-1 (PD1) or combined with ipilimumab (PD1+IPI). Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1434] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Owen CN, Bai X, Quah T, Lo SN, Allayous C, Callaghan S, Martínez-Vila C, Wallace R, Bhave P, Reijers ILM, Thompson N, Vanella V, Gerard CL, Aspeslagh S, Labianca A, Khattak A, Mandala M, Xu W, Neyns B, Michielin O, Blank CU, Welsh SJ, Haydon A, Sandhu S, Mangana J, McQuade JL, Ascierto PA, Zimmer L, Johnson DB, Arance A, Lorigan P, Lebbé C, Carlino MS, Sullivan RJ, Long GV, Menzies AM. Delayed immune-related adverse events with anti-PD-1-based immunotherapy in melanoma. Ann Oncol 2021; 32:917-925. [PMID: 33798657 DOI: 10.1016/j.annonc.2021.03.204] [Citation(s) in RCA: 66] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 03/09/2021] [Accepted: 03/28/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Immune-related adverse events (irAEs) typically occur within 4 months of starting anti-programmed cell death protein 1 (PD-1)-based therapy [anti-PD-1 ± anti-cytotoxic T-lymphocyte-associated protein 4 (CTLA4)], but delayed irAEs (onset >12 months after commencement) can also occur. This study describes the incidence, nature and management of delayed irAEs in patients receiving anti-PD-1-based immunotherapy. PATIENTS AND METHODS Patients with delayed irAEs from 20 centres were studied. The incidence of delayed irAEs was estimated as a proportion of melanoma patients treated with anti-PD-1-based therapy and surviving >1 year. Onset, clinical features, management and outcomes of irAEs were examined. RESULTS One hundred and eighteen patients developed a total of 140 delayed irAEs (20 after initial combination with anti-CTLA4), with an estimated incidence of 5.3% (95% confidence interval 4.0-6.9, 53/999 patients at sites with available data). The median onset of delayed irAE was 16 months (range 12-53 months). Eighty-seven patients (74%) were on anti-PD-1 at irAE onset, 15 patients (12%) were <3 months from the last dose and 16 patients (14%) were >3 months from the last dose of anti-PD-1. The most common delayed irAEs were colitis, rash and pneumonitis; 55 of all irAEs (39%) were ≥grade 3. Steroids were required in 80 patients (68%), as well as an additional immunosuppressive agent in 27 patients (23%). There were two irAE-related deaths: encephalitis with onset during anti-PD-1 and a multiple-organ irAE with onset 11 months after ceasing anti-PD-1. Early irAEs (<12 months) had also occurred in 69 patients (58%), affecting a different organ from the delayed irAE in 59 patients (86%). CONCLUSIONS Delayed irAEs occur in a small but relevant subset of patients. Delayed irAEs are often different from previous irAEs, may be high grade and can lead to death. They mostly occur in patients still receiving anti-PD-1. The risk of delayed irAE should be considered when deciding the duration of treatment in responding patients. However, patients who stop treatment may also rarely develop delayed irAE.
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Affiliation(s)
- C N Owen
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - X Bai
- Massachusetts General Hospital, Boston, USA; Key laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Melanoma, Peking University Cancer Hospital & Institute, Beijing, China
| | - T Quah
- Westmead and Blacktown Hospitals, Sydney, Australia
| | - S N Lo
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia
| | - C Allayous
- Dermatology Department, Université de Paris, AP-HP Saint-Louis Hospital, INSERM, Paris, France
| | - S Callaghan
- The Christie NHS Foundation Trust, Manchester, UK
| | | | - R Wallace
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - P Bhave
- The Alfred Hospital, Melbourne, Australia
| | - I L M Reijers
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - N Thompson
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - V Vanella
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - C L Gerard
- Lausanne University Hospital, Lausanne, Switzerland
| | - S Aspeslagh
- University Hospital Brussels, Brussels, Belgium
| | - A Labianca
- Papa Giovanni XXIII Cancer Center Hospital, Bergamo, Italy
| | - A Khattak
- Fiona Stanley Hospital and Edith Cowan University, Perth, Australia
| | - M Mandala
- University of Perugia, Unit of Medical Oncology, Santa Maria misericordia hospital, Perugia, Italy
| | - W Xu
- Princess Alexandra Hospital and The University of Queensland, Brisbane, Australia
| | - B Neyns
- University Hospital Brussels, Brussels, Belgium
| | - O Michielin
- Lausanne University Hospital, Lausanne, Switzerland
| | - C U Blank
- Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - S J Welsh
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - A Haydon
- The Alfred Hospital, Melbourne, Australia
| | - S Sandhu
- Peter MacCallum Cancer Centre and the University of Melbourne, Melbourne, Australia
| | - J Mangana
- Dermatology, Department of Dermato-Oncology, University Hospital Zurich, Zürich, Switzerland
| | - J L McQuade
- The University of Texas MD Anderson Cancer Center, Houston, USA
| | - P A Ascierto
- Istituto Nazionale Tumori IRCCS Fondazione Pascale, Napoli, Italy
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - D B Johnson
- Vanderbilt University Medical Center, Nashville, USA
| | - A Arance
- Hospital Clinic Barcelona, Barcelona, Spain
| | - P Lorigan
- The Christie NHS Foundation Trust, Manchester, UK; The University of Manchester, Manchester, UK
| | - C Lebbé
- Dermatology Department, Université de Paris, AP-HP Saint-Louis Hospital, INSERM, Paris, France
| | - M S Carlino
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Westmead and Blacktown Hospitals, Sydney, Australia
| | | | - G V Long
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia.
| | - A M Menzies
- Melanoma Institute Australia, The University of Sydney, Sydney, Australia; Royal North Shore Hospital, Sydney, Australia; Mater Hospital, Sydney, Australia
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10
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Albrecht M, Hadaschik E, Zimmer L, Livingstone E, Hamacher R, Bauer S, Schadendorf D, Ugurel S. [Cutaneous angiosarcoma clinically presenting as Quincke's edema]. Hautarzt 2021; 72:801-804. [PMID: 33439269 PMCID: PMC8416850 DOI: 10.1007/s00105-020-04748-3] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 11/28/2022]
Abstract
Es wird über den Fall eines 75-jährigen Patienten mit einer Gesichtsschwellung v. a. periorbital berichtet, der unter der Verdachtsdiagnose eines Quincke-Ödems stationär aufgenommen wurde. Probebiopsien ergaben das Vorliegen eines kutanen Angiosarkoms. Bei nicht resezierbarem Befund und schwieriger Bestrahlungssituation wurde zunächst eine Chemotherapie eingeleitet. Im Verlauf erfolgte bei Befundprogress die Therapieumstellung auf Zweit- und Drittlinientherapie. Der geschilderte Fall verdeutlicht die Komplexität bei der Diagnostik und Therapie bei Patienten mit kutanem Angiosarkom.
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Affiliation(s)
- M Albrecht
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland.
| | - E Hadaschik
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - L Zimmer
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - E Livingstone
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - R Hamacher
- Sarkomzentrum, Westdeutsches Tumorzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - S Bauer
- Sarkomzentrum, Westdeutsches Tumorzentrum Essen, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - D Schadendorf
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
| | - S Ugurel
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
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11
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Ugurel S, Schadendorf D, Horny K, Sucker A, Schramm S, Utikal J, Pföhler C, Herbst R, Schilling B, Blank C, Becker JC, Paschen A, Zimmer L, Livingstone E, Horn PA, Rebmann V. Elevated baseline serum PD-1 or PD-L1 predicts poor outcome of PD-1 inhibition therapy in metastatic melanoma. Ann Oncol 2021; 31:144-152. [PMID: 31912789 DOI: 10.1016/j.annonc.2019.09.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Programmed cell death protein 1 (PD-1) checkpoint inhibition has recently advanced to one of the most effective treatment strategies in melanoma. Nevertheless, a considerable proportion of patients show upfront therapy resistance and baseline predictive biomarkers of treatment outcome are scarce. In this study we quantified PD-1 and programmed death-ligand 1 (PD-L1) in baseline sera from melanoma patients in relation to therapy response and survival. PATIENTS AND METHODS Sera taken at therapy baseline from a total of 222 metastatic melanoma patients (two retrospectively selected monocentric discovery cohorts, n = 130; one prospectively collected multicentric validation cohort, n = 92) and from 38 healthy controls were analyzed for PD-1 and PD-L1 concentration by sandwich enzyme-linked immunosorbent assay. RESULTS Melanoma patients showed higher serum concentrations of PD-1 (P = 0.0054) and PD-L1 (P < 0.0001) than healthy controls. Elevated serum PD-1 and PD-L1 levels at treatment baseline were associated with an impaired best overall response (BOR) to anti-PD-1 (P = 0.014, P = 0.041), but not to BRAF inhibition therapy. Baseline PD-1 and PD-L1 serum levels correlated with progression-free (PFS; P = 0.0081, P = 0.053) and overall survival (OS; P = 0.055, P = 0.0062) in patients who received anti-PD-1 therapy, but not in patients treated with BRAF inhibitors. By combining both markers, we obtained a strong discrimination between favorable and poor outcome of anti-PD-1 therapy, with elevated baseline serum levels of PD-1 and/or PD-L1 associated with an impaired BOR (P = 0.037), PFS (P = 0.048), and OS (P = 0.0098). This PD-1/PD-L1 combination serum biomarker was confirmed in an independent multicenter validation set of serum samples prospectively collected at baseline of PD-1 inhibition (BOR, P = 0.019; PFS, P = 0.038; OS, P = 0.022). Multivariable Cox regression demonstrated serum PD-1/PD-L1 as an independent predictor of PFS (P = 0.010) and OS (P = 0.003) in patients treated with PD-1 inhibitors. CONCLUSION Our findings indicate PD-1 and PD-L1 as useful serum biomarkers to predict the outcome of PD-1 inhibition therapy in melanoma patients and to select patients for PD-1-based versus BRAF-based therapy strategies.
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Affiliation(s)
- S Ugurel
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Horny
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Translational Skin Cancer Research, German Consortium of Translational Cancer Research (DKTK), Essen, Germany
| | - A Sucker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Schramm
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - C Pföhler
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - R Herbst
- Department of Dermatology, Helios Klinikum Erfurt, Erfurt, Germany
| | - B Schilling
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - C Blank
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J C Becker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Translational Skin Cancer Research, German Consortium of Translational Cancer Research (DKTK), Essen, Germany
| | - A Paschen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - V Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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12
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Fourneret P, Zimmer L, Rolland B. How to improve in France ADHD transition support from childhood to adulthood. Encephale 2020; 47:187-188. [PMID: 33293034 DOI: 10.1016/j.encep.2020.08.009] [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] [Received: 05/04/2020] [Revised: 07/28/2020] [Accepted: 08/08/2020] [Indexed: 10/22/2022]
Affiliation(s)
- P Fourneret
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon, France; Institut des Sciences Cognitives Marc Jeannerod - CNRS, Bron, France.
| | - L Zimmer
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon, France; CERMEP Imagerie du Vivant, Lyon, France; Centre de Recherche en Neurosciences de Lyon, INSERM-CNRS, Lyon, France
| | - B Rolland
- Université de Lyon, Université Claude Bernard Lyon 1, Lyon, France; Hospices Civils de Lyon, Lyon, France; Service Universitaire d'Addictologie de Lyon, Centre Hospitalier Le Vinatier, Bron, France
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13
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Michel L, Hendgen-Cotta U, Mincu R, Helfrich I, Korste S, Mrotzek S, Rischpler C, Herrmann K, Ugurel S, Zimmer L, Coman C, Ahrends R, Schadendorf D, Rassaf T, Totzeck M. Preclinical and clinical assessment of immune checkpoint inhibitor-associated left ventricular dysfunction. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Immune checkpoint inhibitor (ICI) therapy has improved treatment of advanced cancers but is associated with yet incompletely characterized cardiotoxic side effects. While inflammatory cardiac complications were initially described as a rare phenomenon, emerging evidence indicates frequent cardiotoxicity, particularly latent left ventricular (LV) dysfunction. Distinct clinical characteristics and potential pathomechanisms are so far unknown.
Purpose
This study aims to investigate incidence and frequency of LV dysfunction in patients receiving ICI therapy for malignant melanoma. Using a suitable melanoma mouse model, ICI-related cardiotoxicity will be reenacted to identify potential underlying pathomechanisms.
Methods
Patients receiving ICI therapy for stage IV melanoma that presented in our cardio-oncology unit were evaluated at baseline and four weeks after initiation of therapy including echocardiography, cardiac biomarkers, and dobutamine stress echocardiography in the absence of contraindications. Patients with decreased LV ejection fraction (LVEF) were further evaluated by 18-fludeoxyglucose PET-MRI to assess manifest myocarditis. To elucidate underlying pathomechanisms, we established a melanoma mouse model that showed profound response to anti-programmed death 1 (PD1) ICI therapy. Immune cell infiltration was assessed by flow cytometry and light sheet fluorescence microscopy. Myocardial biochemical function was analyzed using a multi-omics mass spectrometry-based approach.
Results
Seven patients were included to the analysis. Six patients received a combination ICI therapy with ipilimumab and nivolumab, and one patient received nivolumab monotherapy. Echocardiography revealed significantly decreased 3D-LVEF after 4 weeks of therapy in treated patients (p=0.021). A reduced global longitudinal strain was found in six of seven patients. Remarkably, dobutamine stress echocardiography revealed a more pronounced LVEF-decrease (p=0.009) as a sign for impaired myocardial contractility with a mean decrease of 5 percentage points. Using the melanoma mouse model, we were able to recapitulate the disease phenotype as indicated by decreased LVEF and impaired response to inotropic stress during mouse pressure/volume catheterization. Increased concentrations of intramyocardial CD4+ and CD8+ T cells were found in mice treated with anti-PD1 ICI therapy compared to controls (p=0.01). Mass spectrometry revealed disrupted energy metabolism and calcium homeostasis as a putative underlying pathomechanism for impaired myocardial function.
Conclusions
ICI-related left ventricular dysfunction may affect a large proportion of patients and potentially increase cardiac morbidity and mortality. Preclinical data proposes myocardial lymphocyte infiltration and disruption of cardiomyocyte metabolism as the underlying pathomechanism. Prospective studies are now needed for a further characterization of this novel form of ICI-related cardiotoxicity.
Funding Acknowledgement
Type of funding source: Public hospital(s). Main funding source(s): IFORES research grant, Medical Faculty, University Duisburg-Essen, Germany
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Affiliation(s)
- L Michel
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - U.B Hendgen-Cotta
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - R.I Mincu
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - I Helfrich
- University Hospital Essen, Department of Dermatology, Essen, Germany
| | - S Korste
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - S.M Mrotzek
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - C Rischpler
- University Hospital Essen, Department of Nuclear Medicine, Essen, Germany
| | - K Herrmann
- University Hospital Essen, Department of Nuclear Medicine, Essen, Germany
| | - S Ugurel
- University Hospital Essen, Department of Dermatology, Essen, Germany
| | - L Zimmer
- University Hospital Essen, Department of Dermatology, Essen, Germany
| | - C Coman
- University of Vienna, Institute for Analytical Chemistry, Vienna, Austria
| | - R Ahrends
- University of Vienna, Institute for Analytical Chemistry, Vienna, Austria
| | - D Schadendorf
- University Hospital Essen, Department of Dermatology, Essen, Germany
| | - T Rassaf
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
| | - M Totzeck
- University of Duisburg-Essen - West-German Heart and Vascular Center, Department of Cardiology and Vascular Medicine, Essen, Germany
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14
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Versluis J, Hendriks A, Weppler A, Brown L, de Joode K, Suijkerbuijk K, Zimmer L, Kapiteijn E, Allayous C, Johnson D, Hepner A, Mangana J, Bhave P, Jansen Y, Trojaniello C, Atkinson V, Storey L, de Vries E, Blank C, Jalving M. 1080MO The value of local therapy in treatment of solitary melanoma progression upon immune checkpoint inhibition. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1204] [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: 10/23/2022] Open
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15
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Owen C, Bai X, Quah T, Lo S, Callaghan S, Martínez-Vila C, Bhave P, Reijers I, Gerard C, Aspelagh S, Xu W, Welsh S, Sandhu S, Mangana J, McQuade J, Ascierto P, Zimmer L, Johnson D, Lebbé C, Menzies A. 1138P Delayed immune-related adverse events (irAEs) on anti-PD1-based therapy. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Although cutaneous melanoma accounts for only about 4% of all skin cancers (including nonmelanocytic skin cancer), it is responsible for 80% of all deaths caused by skin cancer. The introduction of immune checkpoint inhibitors led to a significant improvement in long-term survival of patients in an advanced stage regardless of BRAF mutation status. In addition to targeted therapy for patients with BRAF-mutated melanoma, immunotherapies are the therapies of choice in advanced stages and, since 2018, also in the adjuvant setting. The effectiveness of combination therapies and sequences of targeted and immunotherapies are currently being tested.
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Affiliation(s)
- A Zaremba
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - L Zimmer
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - K G Griewank
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - S Ugurel
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - A Roesch
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
| | - D Schadendorf
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland.
- Westdeutsches Tumorzentrum (WTZ), Universitätsklinikum Essen, Essen, Deutschland.
| | - E Livingstone
- Klinik und Poliklinik für Dermatologie, Venerologie und Allergologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Deutschland
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17
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Livingstone E, Zaremba A, Horn S, Ugurel S, Casalini B, Schlaak M, Hassel JC, Herbst R, Utikal JS, Weide B, Gutzmer R, Meier F, Koelsche C, Hadaschik E, Sucker A, Reis H, Merkelbach-Bruse S, Siewert M, Sahm F, von Deimling A, Cosgarea I, Zimmer L, Schadendorf D, Schilling B, Griewank KG. GNAQ and GNA11 mutant nonuveal melanoma: a subtype distinct from both cutaneous and uveal melanoma. Br J Dermatol 2020; 183:928-939. [PMID: 32064597 DOI: 10.1111/bjd.18947] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND GNAQ and GNA11 mutant nonuveal melanoma represent a poorly characterized rare subgroup of melanoma with a gene mutation profile similar to uveal melanoma. OBJECTIVES To characterize these tumours in terms of clinical behaviour and genetic characteristics. METHODS Patients with nonuveal GNAQ/11 mutated melanoma were identified from the prospective multicentre tumour tissue registry ADOREG, Tissue Registry in Melanoma (TRIM) and additional cooperating skin cancer centres. Extensive data on patient, tumour and treatment characteristics were collected retrospectively. Targeted sequencing was used to determine tumour mutational burden. Immunohistochemistry staining was performed for programmed death-ligand 1 and BRCA1-associated protein (BAP)1. Existing whole-exome cutaneous and uveal melanoma data were analysed for mutation type and burden. RESULTS We identified 18 patients with metastatic GNAQ/11 mutant nonuveal melanoma. Tumours had a lower tumour mutational burden and fewer ultraviolet signature mutations than cutaneous melanomas. In addition to GNAQ and GNA11 mutations (nine each), six splicing factor 3b subunit 1 (SF3B1), three eukaryotic translation initiation factor 1A X-linked (EIF1AX) and four BAP1 mutations were detected. In contrast to uveal melanoma, GNAQ/11 mutant nonuveal melanomas frequently metastasized lymphatically and concurrent EIF1AX, SF3B1 and BAP1 mutations showed no apparent association with patient prognosis. Objective response to immunotherapy was poor with only one partial response observed in 10 treated patients (10%). CONCLUSIONS Our findings suggest that GNAQ/11 mutant nonuveal melanomas are a subtype of melanoma that is both clinically and genetically distinct from cutaneous and uveal melanoma. As they respond poorly to available treatment regimens, novel effective therapeutic approaches for affected patients are urgently needed. What is already known about this topic? The rare occurrence of GNAQ/11 mutations in nonuveal melanoma has been documented. GNAQ/11 mutant nonuveal melanomas also harbour genetic alterations in EIF1AX, SF3B1 and BAP1 that are of prognostic relevance in uveal melanoma. What does this study add? GNAQ/11 mutant nonuveal melanomas show metastatic spread reminiscent of cutaneous melanoma, but not uveal melanoma. GNAQ/11 mutant nonuveal melanomas have a low tumour mutational burden that is higher than uveal melanoma, but lower than cutaneous melanoma. What is the translational message? Primary GNAQ/11 mutant nonuveal melanomas are a subtype of melanoma that is clinically and genetically distinct from both cutaneous and uveal melanoma. As metastatic GNAQ/11 mutant nonuveal melanomas respond poorly to available systemic therapies, including immune checkpoint inhibition, novel therapeutic approaches for these tumours are urgently needed. Linked Comment: Rafei-Shamsabadi. Br J Dermatol 2020; 183:806-807.
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Affiliation(s)
- E Livingstone
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - A Zaremba
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - S Horn
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,Medical Faculty of the University Leipzig, Rudolf-Schönheimer-Institute of Biochemistry, Johannisallee 30, 04103, Leipzig, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - B Casalini
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - M Schlaak
- Department of Dermatology, LMU München, Frauenlobstraße 9-11, 80337, Munich, Germany
| | - J C Hassel
- Department of Dermatology and National Center for Tumor Diseases, University Hospital Heidelberg, Im Neuenheimer Feld 460, 69120, Heidelberg, Germany
| | - R Herbst
- Department of Dermatology, Helios Klinikum Erfurt, Nordhäuserstr. 74, 99089, Erfurt, Germany
| | - J S Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - B Weide
- Department of Dermatology, University of Tübingen, Liebermeisterstraße 25, 72076, Tübingen, Germany
| | - R Gutzmer
- Department of Dermatology, Medizinische Hochschule Hannover, Carl-Neuberg-Straße 1, 30625, Hannover, Germany
| | - F Meier
- Department of Dermatology, Carl-Gustav-Carus University Hospital, Fetscherstr. 74, 01307, Dresden, Germany
| | - C Koelsche
- Department of General Pathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany
| | - E Hadaschik
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - A Sucker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - H Reis
- Institute of Pathology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - S Merkelbach-Bruse
- Institute of Pathology, University Hospital Cologne, Kerpener Str. 62, 50924, Cologne, Germany
| | - M Siewert
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - F Sahm
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - A von Deimling
- Department of Neuropathology, University Hospital Heidelberg, Ruprecht-Karls-University Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit Neuropathology and DKTK, DKFZ, Heidelberg, Germany
| | - I Cosgarea
- Dermatological Sciences, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,German Cancer Consortium (DKTK), Heidelberg, Germany
| | - B Schilling
- Deptartment of Dermatology, University of Würzburg, Josef-Schneider-Str. 2, 97080, Würzburg, Germany
| | - K G Griewank
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122, Essen, Germany.,Dermatopathologie bei Mainz, Bahnhofstr. 2B, 55268, Nieder-Olm, Germany
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Mhanni A, Boutin M, Stockl F, Johnston J, Barnes J, Duerksen D, Zimmer L, Auray-Blais C, Rockman-Greenberg C. Mass Spectrometry Evaluation of Biomarkers in the Vitreous Fluid in Gaucher Disease Type 3 with Disease Progression Despite Long-Term Treatment. Diagnostics (Basel) 2020; 10:diagnostics10020069. [PMID: 31991859 PMCID: PMC7168891 DOI: 10.3390/diagnostics10020069] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 01/17/2020] [Accepted: 01/18/2020] [Indexed: 11/23/2022] Open
Abstract
Intraocular lesions have been infrequently reported in patients with Gaucher disease type 3 (GD3). We previously reported siblings with GD3 who responded well to the combination of enzyme replacement therapy (ERT) and substrate reduction therapy (SRT). Here we report progressive bilateral vitreous and preretinal deposits with declining visual acuity requiring bilateral vitrectomies in one of these siblings. These ocular manifestations had progressed despite combined ERT and SRT with improvement in visual acuity after vitrectomies. Vitrectomy fluid analysis performed for the first time by ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS) identified a high concentration of glucosylceramide (GluCer) in the patient (262.842 nM) compared to a sample (0.428 nM from a patient without a lysosomal storage or known hereditary metabolic disorder). The GluCer detected in our patient was resolved into 12 different isoforms including two methylated ones. No evidence of galactosylceramide (GalCer) was detected. The development of these intraocular manifestations and their characterization by UPLC-MS/MS indicate a need for ongoing ophthalmologic evaluation of all GD patients and for new therapies that can cross the blood–retinal and blood–brain barriers for patients with GD and other neuropathic lysosomal storage disorders.
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Affiliation(s)
- Aizeddin Mhanni
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3T2N2, Canada;
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R3T2N2, Canada
| | - Michel Boutin
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.B.); (C.A.-B.)
| | - Frank Stockl
- Department of Ophthalmology, University of Manitoba, Winnipeg, MB R3T2N2, Canada; (F.S.); (J.J.)
| | - Janine Johnston
- Department of Ophthalmology, University of Manitoba, Winnipeg, MB R3T2N2, Canada; (F.S.); (J.J.)
| | - Jeff Barnes
- Department of Medicine, University of Manitoba, Winnipeg, MB R3T2N2, Canada; (J.B.); (D.D.)
| | - Donald Duerksen
- Department of Medicine, University of Manitoba, Winnipeg, MB R3T2N2, Canada; (J.B.); (D.D.)
| | - Leanne Zimmer
- Manitoba Association of Optometrists, Winnipeg, MB R3H0Y4, Canada
| | - Christiane Auray-Blais
- Department of Pediatrics, Université de Sherbrooke, Sherbrooke, QC J1H 5N4, Canada; (M.B.); (C.A.-B.)
| | - Cheryl Rockman-Greenberg
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, MB R3T2N2, Canada;
- Department of Biochemistry and Medical Genetics, University of Manitoba, Winnipeg, MB R3T2N2, Canada
- Correspondence:
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19
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Gensolen F, Ammour L, Bautista M, Heymes J, Fieux S, Kachel M, Lefebvre F, Pangaud P, Pinot L, Lanièce P, Baudot J, Gisquet P, Zimmer L, Verdier MA, Morel C. MAPSSIC, a communicating MAPS-based intracerebral positrons probe for deep brain imaging in awake and freely-moving rats. EPJ Web Conf 2020. [DOI: 10.1051/epjconf/202022509002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Radioisotope imaging is a powerful tool to understand the biological mechanisms in-vivo, especially in the brain of small animals, providing a significant model to study the human brain.
In this context, we have developed and built a pixelated intracerebral positron probe to be embedded on awake and freely moving small animals, typically rats. This pixelated probe will represent a key instrument for neuroscientists to study neural mechanisms and correlate them to behavioral experiments.
We describe in this paper the simulations carried out to design the intracerebral sensor, its architecture, and the detection of positrons in a volume with a couple of sensors assembled back-to-back. We also depict the architecture of the wireless acquisition system. Finally, we present the first measurements performed in real-time by this miniaturized probe with sealed radioactive sources and a 18F solution.
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20
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Picard C, Lalande L, Bertin C, Abel-coindoz C, Mauchauffée A, Giret G, Zimmer L, Cabelguenne D. Sécurisation de la prise en charge médicamenteuse des patients sous antipsychotiques : impact de la collaboration médico-pharmaceutique à la Maison d’Arrêt de Lyon-Corbas. Encephale 2019; 45:482-487. [DOI: 10.1016/j.encep.2019.05.008] [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: 09/27/2018] [Revised: 04/30/2019] [Accepted: 05/15/2019] [Indexed: 10/26/2022]
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21
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Knispel S, Gassenmaier M, Menzies A, Loquai C, Johnson D, Franklin C, Gutzmer R, Hassel J, Weishaupt C, Eigentler T, Schummer P, Kiecker F, Owen C, Schmidgen M, Kähler K, Cann C, Niebel D, Mohr P, Schadendorf D, Zimmer L. Outcome of patients with elevated LDH treated with first-line targeted therapy (TT) or PD-1 based immune checkpoint inhibitors (ICI). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz255.034] [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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22
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Schadendorf D, Hassel J, Fluck M, Eigentler T, Loquai C, Berneburg M, Gutzmer R, Meier F, Mohr P, Hauschild A, Becker J, Menzer C, Kiecker F, Dippel E, Simon JC, Conrad B, Garbe C, Körner S, Livingstone E, Zimmer L. Adjuvant immunotherapy with nivolumab (NIVO) alone or in combination with ipilimumab (IPI) versus placebo in stage IV melanoma patients with no evidence of disease (NED): A randomized, double-blind phase II trial (IMMUNED). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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23
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Khoja L, Atenafu E, Suciu S, Leyvraz S, Sato T, Marshall E, Keilholz U, Zimmer L, Patel S, Piperno-Neumann S, Piulats J, Kivelä T, Pfoehler C, Bhatia S, Huppert P, Van Iersel L, De Vries I, Penel N, Vogl T, Cheng T, Fiorentini G, Mouriaux F, Tarhini A, Patel P, Carvajal R, Joshua A. Meta-analysis in metastatic uveal melanoma to determine progression free and overall survival benchmarks: an international rare cancers initiative (IRCI) ocular melanoma study. Ann Oncol 2019; 30:1370-1380. [DOI: 10.1093/annonc/mdz176] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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24
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Ammour L, Heymes J, Bautista M, Fieux S, Gensolen F, Kachel M, Dubois A, Lefebvre F, Pain F, Pangaud P, Pinot L, Baudot J, Gisquet-Verrier P, Laniece P, Morel C, Zimmer L, Verdier MA. MAPSSIC, a Novel CMOS Intracerebral Positrons Probe for Deep Brain Imaging in Awake and Freely Moving Rats: A Monte Carlo Study. IEEE Trans Radiat Plasma Med Sci 2019. [DOI: 10.1109/trpms.2018.2881301] [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: 12/14/2022]
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Affiliation(s)
- D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Heidelberg, Germany.
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Heidelberg, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK), Heidelberg, Germany
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Shannan B, Matschke J, Chauvistré H, Vogel F, Klein D, Meier F, Westphal D, Bruns J, Rauschenberg R, Utikal J, Forschner A, Berking C, Terheyden P, Dabrowski E, Gutzmer R, Rafei-Shamsabadi D, Meiss F, Heinzerling L, Zimmer L, Livingstone E, Váraljai R, Hoewner A, Horn S, Klode J, Stuschke M, Scheffler B, Marchetto A, Sannino G, Grünewald TGP, Schadendorf D, Jendrossek V, Roesch A. Sequence-dependent cross-resistance of combined radiotherapy plus BRAF V600E inhibition in melanoma. Eur J Cancer 2019; 109:137-153. [PMID: 30721788 DOI: 10.1016/j.ejca.2018.12.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 11/21/2018] [Revised: 12/22/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Treatment of patients with metastatic melanoma is hampered by drug-resistance and often requires combination with radiotherapy as last-resort option. However, also after radiotherapy, clinical relapses are common. METHODS & RESULTS Our preclinical models indicated a higher rate of tumour relapse when melanoma cells were first treated with BRAFV600E inhibition (BRAFi) followed by radiotherapy as compared to the reverse sequence. Accordingly, retrospective follow-up data from 65 stage-IV melanoma patients with irradiated melanoma brain metastases confirmed a shortened duration of local response of mitogen-activated protein kinase (MAPK)-inhibitor-pretreated compared with MAPK-inhibitor-naïve intracranial metastases. On the molecular level, we identified JARID1B/KDM5B as a cellular marker for cross-resistance between BRAFi and radiotherapy. JARID1Bhigh cells appeared more frequently under upfront BRAFi as compared with upfront radiation. JARID1B favours cell survival by transcriptional regulation of genes controlling cell cycle, DNA repair and cell death. CONCLUSION The level of cross-resistance between combined MAPK inhibition and radiotherapy is dependent on the treatment sequence. JARID1B may represent a novel therapy-overarching resistance marker.
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Affiliation(s)
- B Shannan
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Matschke
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - H Chauvistré
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - F Vogel
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - D Klein
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - F Meier
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - D Westphal
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Bruns
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - R Rauschenberg
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Utikal
- Skin Cancer Unit German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - A Forschner
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Germany
| | - C Berking
- Department of Dermatology and Allergy, University Hospital of Munich, Munich, Germany
| | - P Terheyden
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - E Dabrowski
- Department of Dermatology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - R Gutzmer
- Skin Cancer Centre, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D Rafei-Shamsabadi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - L Heinzerling
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Renáta Váraljai
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Hoewner
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - S Horn
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Klode
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - M Stuschke
- Department of Radiotherapy, West German Cancer Center, University Hospital, University of Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Essen, Germany
| | - B Scheffler
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Marchetto
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - G Sannino
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - T G P Grünewald
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - V Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany.
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Urbonas V, Schadendorf D, Zimmer L, Danson S, Marshall E, Corrie P, Wheater M, Plummer E, Mauch C, Scudder C, Goff M, Love SB, Mohammed SB, Middleton MR. Paclitaxel with or without trametinib or pazopanib in advanced wild-type BRAF melanoma (PACMEL): a multicentre, open-label, randomised, controlled phase II trial. Ann Oncol 2019; 30:317-324. [PMID: 30428063 PMCID: PMC6386028 DOI: 10.1093/annonc/mdy500] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Advanced melanoma treatments often rely on immunotherapy or targeting mutations, with few treatment options for wild-type BRAF (BRAF-wt) melanoma. However, the mitogen-activated protein kinase pathway is activated in most melanoma, including BRAF-wt. We assessed whether inhibiting this pathway by adding kinase inhibitors trametinib or pazopanib to paclitaxel chemotherapy improved outcomes in patients with advanced BRAF-wt melanoma in a phase II, randomised and open-label trial. PATIENTS AND METHODS Patients were randomised (1 : 1 : 1) to paclitaxel alone or with trametinib or pazopanib. Paclitaxel was given for a maximum of six cycles, while 2 mg trametinib and 800 mg pazopanib were administered orally once daily until disease progression or unacceptable toxicity. Participants and investigators were unblinded. The primary end point was progression-free survival (PFS). Key secondary end points included overall survival (OS) and objective response rate (ORR). RESULTS Participants were randomised to paclitaxel alone (n = 38), paclitaxel and trametinib (n = 36), or paclitaxel and pazopanib (n = 37). Adding trametinib significantly improved 6-month PFS [time ratio (TR), 1.47; 90% confidence interval (CI) 1.08-2.01, P = 0.04] and ORR (42% versus 13%; P = 0.01) but had no effect on OS (P = 0.25). Adding pazopanib did not benefit 6-month PFS; (TR 1.36; 90% CI 0.96-1.93; P = 0.14), ORR, or OS. Toxicity increased in both combination arms. CONCLUSION In this phase II trial, adding trametinib to paclitaxel chemotherapy for BRAF-wt melanoma improved PFS and substantially increased ORR but did not impact OS.This study was registered with the EU Clinical Trials Register, EudraCT number 2011-002545-35, and with the ISRCTN registry, number 43327231.
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Affiliation(s)
- V Urbonas
- Early Phase Clinical Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; National Cancer Institute, Vilnius, Lithuania
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Centre, University Duisburg-Essen, Essen, Germany; The German Cancer Consortium, Essen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Centre, University Duisburg-Essen, Essen, Germany; The German Cancer Consortium, Essen, Germany
| | - S Danson
- Department of Oncology, Sheffield Experimental Cancer Medicine Centre, Weston Park Hospital, Sheffield, UK
| | - E Marshall
- Department of Oncology, Clatterbridge Cancer Centre, Wirral, UK
| | - P Corrie
- Department of Oncology, Addenbrookes Hospital, Cambridge, UK
| | - M Wheater
- Department of Oncology, Southampton General Hospital, Southampton, UK
| | - E Plummer
- Department of Oncology, Freeman Hospital, Newcastle upon Tyne, UK
| | - C Mauch
- Köln Universitätsklinik, Köln, Germany
| | - C Scudder
- Oncology Clinical Trials Office, University of Oxford, Oxford, UK
| | - M Goff
- Oncology Clinical Trials Office, University of Oxford, Oxford, UK
| | - S B Love
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - S B Mohammed
- Centre for Statistics in Medicine, University of Oxford, Oxford, UK
| | - M R Middleton
- Early Phase Clinical Trials Unit, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Department of Oncology, NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
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Cabelguenne D, Picard C, Lalande L, Jonker J, Sautereau M, Meunier F, Zimmer L. Benzodiazepine dose reduction in prisoner patients: 15 years' teamwork between psychiatrists and pharmacists. J Clin Pharm Ther 2018; 43:807-812. [PMID: 29800494 DOI: 10.1111/jcpt.12709] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Accepted: 04/16/2018] [Indexed: 11/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Benzodiazepines are widely consumed in prisons, despite the iatrogenic risks associated with this therapeutic class. A multidisciplinary pharmacotherapy programme was therefore initiated by pharmacists in 2001. The aim of this study was to demonstrate the efficacy of teamwork between psychiatrists and pharmacists in benzodiazepine dose adjustment, with 15 years of hindsight. METHOD In this retrospective study, daily prescribed benzodiazepine doses were compared between a reference group of patients in prisons in Lyon, France, in 2000, and four groups after psychiatrist-pharmacist teamwork in 2004, 2008, 2012 and 2016. RESULTS AND DISCUSSION A number of 1249 patients were included. Prescribed doses of benzodiazepine decreased in the intervention groups, to a mean of 29-35 mg diazepam equivalent per day, compared to the control group (42 mg/day) (P < .001). The first 4-year period (2000-2004) demonstrated that monthly meetings and systematic pharmaceutical medication review had an impact on prescribed benzodiazepines, limiting consumed doses. The others (2004-2008, 2008-2012 and 2012-2016) confirmed that physicians' adherence to prescription guidelines and the efficacy of pharmacotherapy programme was maintained, particularly in those inmates taking high doses. WHAT IS NEW AND CONCLUSION A continuous quality programme conducted by psychiatrists and pharmacists showed positive impact in reducing doses of benzodiazepine prescribed to prisoner patients and contributing to reduce risk of benzodiazepine-related problems.
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Affiliation(s)
- D Cabelguenne
- Pharmacie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France
| | - C Picard
- Pharmacie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France
| | - L Lalande
- Pharmacie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France
| | - J Jonker
- Pharmacie, Groupement Hospitalier Sud, Hospices Civils de Lyon, Lyon, France
| | - M Sautereau
- Pôle santé mentale des détenus et psychiatrie légale, Centre Hospitalier du Vinatier, Bron, France
| | - F Meunier
- Pôle santé mentale des détenus et psychiatrie légale, Centre Hospitalier du Vinatier, Bron, France
| | - L Zimmer
- Lyon Neuroscience Research Center, Université Claude Bernard Lyon1, INSERM, CNRS, Lyon, France
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Zimmer L, Fourneret P. Tout ce que vous devez connaître sur le méthylphénidate (sans oser le demander…). Arch Pediatr 2018; 25:229-235. [DOI: 10.1016/j.arcped.2018.01.002] [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: 03/16/2017] [Revised: 01/03/2018] [Accepted: 01/28/2018] [Indexed: 11/27/2022]
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Franklin C, Rooms I, Fiedler M, Reis H, Milsch L, Herz S, Livingstone E, Zimmer L, Schmid K, Dittmer U, Schadendorf D, Schilling B. Cytomegalovirus reactivation in patients with refractory checkpoint inhibitor-induced colitis. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.055] [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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Yankam Njiwa J, Costes N, Bouillot C, Bouvard S, Fieux S, Becker G, Levigoureux E, Kocevar G, Stamile C, Langlois JB, Bolbos R, Bonnet C, Bezin L, Zimmer L, Hammers A. Quantitative longitudinal imaging of activated microglia as a marker of inflammation in the pilocarpine rat model of epilepsy using [ 11C]-( R)-PK11195 PET and MRI. J Cereb Blood Flow Metab 2017; 37:1251-1263. [PMID: 27381824 PMCID: PMC5414902 DOI: 10.1177/0271678x16653615] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Inflammation may play a role in the development of epilepsy after brain insults. [11C]-( R)-PK11195 binds to TSPO, expressed by activated microglia. We quantified [11C]-( R)-PK11195 binding during epileptogenesis after pilocarpine-induced status epilepticus (SE), a model of temporal lobe epilepsy. Nine male rats were studied thrice (D0-1, D0 + 6, D0 + 35, D0 = SE induction). In the same session, 7T T2-weighted images and DTI for mean diffusivity (MD) and fractional anisotropy (FA) maps were acquired, followed by dynamic PET/CT. On D0 + 35, femoral arterial blood was sampled for rat-specific metabolite-corrected arterial plasma input functions (AIFs). In multiple MR-derived ROIs, we assessed four kinetic models (two with AIFs; two using a reference region), standard uptake values (SUVs), and a model with a mean AIF. All models showed large (up to two-fold) and significant TSPO binding increases in regions expected to be affected, and comparatively little change in the brainstem, at D0 + 6. Some individuals showed increases at D0 + 35. AIF models yielded more consistent increases at D0 + 6. FA values were decreased at D0 + 6 and had recovered by D0 + 35. MD was increased at D0 + 6 and more so at D0 + 35. [11C]-( R)-PK11195 PET binding and MR biomarker changes could be detected with only nine rats, highlighting the potential of longitudinal imaging studies.
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Affiliation(s)
| | - N Costes
- 2 CERMEP-Imagerie du Vivant, Lyon, France
| | - C Bouillot
- 2 CERMEP-Imagerie du Vivant, Lyon, France
| | - S Bouvard
- 2 CERMEP-Imagerie du Vivant, Lyon, France.,3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
| | - S Fieux
- 2 CERMEP-Imagerie du Vivant, Lyon, France
| | - G Becker
- 2 CERMEP-Imagerie du Vivant, Lyon, France
| | - E Levigoureux
- 3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France.,4 Hospices Civils de Lyon, France
| | | | | | | | - R Bolbos
- 3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
| | - C Bonnet
- 3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
| | - L Bezin
- 3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France
| | - L Zimmer
- 2 CERMEP-Imagerie du Vivant, Lyon, France.,3 Lyon Neuroscience Research Center, University Claude Bernard Lyon 1, Lyon, France.,4 Hospices Civils de Lyon, France
| | - A Hammers
- 1 Neurodis Foundation, Lyon, France.,6 Division of Imaging Sciences and Biomedical Engineering, King's College London & Guy's and St Thomas' PET Centre, King's College London, London, UK
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Zimmer L, Breton P, Durand G, Guilloteau D, Besnard J, Chalon S. Prominent Role ofn—3 Polyunsaturated Fatty Acids in Cortical Dopamine Metabolism. Nutr Neurosci 2016; 2:257-65. [DOI: 10.1080/1028415x.1999.11747282] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Becker G, Bolbos R, Costes N, Redouté J, Newman-Tancredi A, Zimmer L. Selective serotonin 5-HT1A receptor biased agonists elicitdistinct brain activation patterns: a pharmacoMRI study. Sci Rep 2016; 6:26633. [PMID: 27211078 PMCID: PMC4876409 DOI: 10.1038/srep26633] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/06/2016] [Indexed: 11/09/2022] Open
Abstract
Serotonin 1A (5-HT1A) receptors are involved in several physiological and pathological processes and constitute therefore an important therapeutic target. The recent pharmacological concept of biased agonism asserts that highly selective agonists can preferentially direct receptor signaling to specific intracellular responses, opening the possibility of drugs targeting a receptor subtype in specific brain regions. The present study brings additional support to this concept thanks to functional magnetic resonance imaging (7 Tesla-fMRI) in anaesthetized rats. Three 5-HT1A receptor agonists (8-OH-DPAT, F13714 and F15599) and one 5-HT1A receptor antagonist (MPPF) were compared in terms of influence on the brain blood oxygen level-dependent (BOLD) signal. Our study revealed for the first time contrasting BOLD signal patterns of biased agonists in comparison to a classical agonist and a silent antagonist. By providing functional information on the influence of pharmacological activation of 5-HT1A receptors in specific brain regions, this neuroimaging approach, translatable to the clinic, promises to be useful in exploring the new concept of biased agonism in neuropsychopharmacology.
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Affiliation(s)
- G Becker
- Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, CNRS, INSERM, Lyon, France.,Hospices Civils de Lyon, Lyon, France
| | - R Bolbos
- CERMEP - Imagerie du vivant, Lyon, France
| | - N Costes
- CERMEP - Imagerie du vivant, Lyon, France
| | - J Redouté
- CERMEP - Imagerie du vivant, Lyon, France
| | | | - L Zimmer
- Université Claude Bernard Lyon 1, Centre de Recherche en Neurosciences de Lyon, CNRS, INSERM, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,CERMEP - Imagerie du vivant, Lyon, France
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Hecht M, Zimmer L, Loquai C, Weishaupt C, Gutzmer R, Schuster B, Gleisner S, Schulze B, Goldinger SM, Berking C, Forschner A, Clemens P, Grabenbauer G, Müller-Brenne T, Bauch J, Eich HT, Grabbe S, Schadendorf D, Schuler G, Keikavoussi P, Semrau S, Fietkau R, Distel LV, Heinzerling L. Radiosensitization by BRAF inhibitor therapy-mechanism and frequency of toxicity in melanoma patients. Ann Oncol 2015; 26:1238-1244. [PMID: 25762352 DOI: 10.1093/annonc/mdv139] [Citation(s) in RCA: 74] [Impact Index Per Article: 8.2] [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: 01/17/2015] [Accepted: 03/02/2015] [Indexed: 08/08/2023] Open
Abstract
BACKGROUND Recent evidence suggests that ionizing radiation may be associated with unexpected side-effects in melanoma patients treated with concomitant BRAF inhibitors. A large multicenter analysis was carried out to generate reliable safety data and elucidate the mechanism. METHODS A total of 161 melanoma patients from 11 European skin cancer centers were evaluated for acute and late toxicity, of whom 70 consecutive patients received 86 series of radiotherapy with concomitant BRAF inhibitor therapy. To further characterize and quantify a possible radiosensitization by BRAF inhibitors, blood samples of 35 melanoma patients were used for individual radiosensitivity testing by fluorescence in situ hybridization of chromosomal breaks after ex vivo irradiation. RESULTS With radiotherapy and concomitant BRAF inhibitor therapy the rate of acute radiodermatitis ≥2° was 36% and follicular cystic proliferation was seen in 13% of all radiotherapies. Non-skin toxicities included hearing disorders (4%) and dysphagia (2%). Following whole-brain radiotherapy, rates of radiodermatitis ≥2° were 44% and 8% (P < 0.001) for patients with and without BRAF inhibitor therapy, respectively. Concomitant treatment with vemurafenib induced acute radiodermatitis ≥2° more frequently than treatment with dabrafenib (40% versus 26%, P = 0.07). In line with these findings, analysis of chromosomal breaks ex vivo indicated significantly increased radiosensitivity for patients under vemurafenib (P = 0.004) and for patients switched from vemurafenib to dabrafenib (P = 0.002), but not for patients on dabrafenib only. No toxicities were reported after stereotactic treatment. CONCLUSION Radiotherapy with concomitant BRAF inhibitor therapy is feasible with an acceptable increase in toxicity. Vemurafenib is a more potent radiosensitizer than dabrafenib.
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Affiliation(s)
- M Hecht
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen
| | - C Loquai
- Department of Dermatology, University Hospital Mainz, Mainz
| | - C Weishaupt
- Department of Dermatology, University Hospital Münster, Münster
| | - R Gutzmer
- Department of Dermatology, Hannover Medical School, Hannover
| | - B Schuster
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen
| | - S Gleisner
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen
| | - B Schulze
- Department of Radiation Oncology, University Hospital Frankfurt, Frankfurt, Germany
| | - S M Goldinger
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - C Berking
- Department of Dermatology, University Hospital München (LMU), München
| | - A Forschner
- Department of Dermatology, University Hospital Tübingen, Tübingen, Germany
| | - P Clemens
- Department of Radiation Oncology, Hospital Feldkirch, Feldkirch, Austria
| | - G Grabenbauer
- Department of Radiation Oncology, Hospital Coburg, Coburg
| | - T Müller-Brenne
- Department of Radiation Oncology, University Hospital Mainz, Mainz
| | - J Bauch
- Department of Radiation Oncology, University Hospital Münster, Münster
| | - H T Eich
- Department of Radiation Oncology, University Hospital Münster, Münster
| | - S Grabbe
- Department of Dermatology, University Hospital Mainz, Mainz
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, Essen
| | - G Schuler
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - P Keikavoussi
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - S Semrau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen
| | - R Fietkau
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen
| | - L V Distel
- Department of Radiation Oncology, University Hospital Erlangen, Erlangen.
| | - L Heinzerling
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
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Gutzmer R, Hassel JC, Kähler KC, Loquai C, Mössner R, Ugurel S, Zimmer L, der das Ado FKKNA. [Cutaneous side effects of anti-tumor therapy with BRAF and MEK inhibitors]. Hautarzt 2015; 65:582-9. [PMID: 24903029 DOI: 10.1007/s00105-013-2733-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND BRAF and MEK inhibitors are new targeted therapies which are used in the treatment of malignancies, in particular of malignant melanoma. SIDE EFFECTS Cutaneous side effects are common during the treatment with both types of inhibitors. These side effects include inflammatory reactions such as maculopapular and papulopustular exanthema, hand-foot syndrome, panniculitis, paronychia, photo- and radio-sensitization. As a class effect, BRAF-inhibitors induce proliferative disorders of keratinocytes and melanocytes, such as palmoplantar hyperkeratosis (as part of the hand-foot syndrome), verruciform and acanthoma-like lesions, follicular and Grover disease-like hyperkeratoses, keratoacanthomas, squamous cell carcinomas and atypical melanocytic nevi with transition to secondary melanomas. Furthermore, hair alterations and xerosis are possible. CONCLUSIONS Treatment with BRAF and MEK inhibitors requires close dermatologic monitoring of the patient. This manuscript summarizes the most frequent cutaneous side effects and their management.
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Affiliation(s)
- R Gutzmer
- Klinik für Dermatologie, Allergologie und Venerologie, Hauttumorzentrum Hannover (HTZH), Medizinische Hochschule Hannover, Ricklinger Str. 5, 30449, Hannover, Deutschland,
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Mössner R, Zimmer L, Berking C, Hoeller C, Loquai C, Richtig E, Kähler K, Hassel J, Gutzmer R, Ugurel S. Erythema nodosum-like lesions during BRAF inhibitor therapy: Report on 16 new cases and review of the literature. J Eur Acad Dermatol Venereol 2015; 29:1797-806. [DOI: 10.1111/jdv.13039] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 01/19/2015] [Indexed: 01/16/2023]
Affiliation(s)
- R. Mössner
- Department of Dermatology, Venereology and Allergology; University Medical Center Göttingen; Göttingen Germany
| | - L. Zimmer
- Department of Dermatology; University of Duisburg-Essen; Essen Germany
| | - C. Berking
- Department of Dermatology and Allergology; University of Munich (LMU); Munich Germany
| | - C. Hoeller
- Department of Dermatology; Medical University of Vienna; Vienna Austria
| | - C. Loquai
- Department of Dermatology; University Medical Center Mainz; Mainz Germany
| | - E. Richtig
- Department of Dermatology; Medical University of Graz; Graz Austria
| | - K.C. Kähler
- Department of Dermatology and Venerology; Universitätsklinikum Schleswig-Holstein; Campus Kiel Germany
| | - J.C. Hassel
- Department of Dermatology and National Center for Tumor Diseases (NCT); University Hospital Heidelberg; Heidelberg Germany
| | - R. Gutzmer
- Department of Dermatology and Allergy; Skin Cancer Center; Hannover Medical School; Hannover Germany
| | - S. Ugurel
- Department of Dermatology; University of Würzburg; Würzburg Germany
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Ugurel S, Loquai C, Kähler K, Hassel J, Berking C, Zimmer L, Haubitz I, Satzger I, Müller-Brenne T, Mikhaimer N, Becker J, Kilian K, Schadendorf D, Heinzerling L, Kaatz M, Utikal J, Göppner D, Pföhler C, Pflugfelder A, Mössner R, Gutzmer R. A multicenter DeCOG study on predictors of vemurafenib therapy outcome in melanoma: pretreatment impacts survival. Ann Oncol 2015; 26:573-82. [DOI: 10.1093/annonc/mdu573] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [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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Schilling B, Sondermann W, Griewank KG, Livingstone E, Zimmer L, Hillen U, Schadendorf D. Reply to the letters to the editor 'Differential influence of vemurafenib and dabrafenib on patients' lymphocytes despite similar clinical efficacy in melanoma' by Diwakar et al. Ann Oncol 2014; 26:250-251. [PMID: 25355721 DOI: 10.1093/annonc/mdu502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Affiliation(s)
- B Schilling
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany.
| | - W Sondermann
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - K G Griewank
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - U Hillen
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK), Heidelberg, Germany
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Billard T, Le Bars D, Zimmer L. PET radiotracers for molecular imaging of serotonin 5-HT1A receptors. Curr Med Chem 2014; 21:70-81. [PMID: 23992341 DOI: 10.2174/09298673113209990215] [Citation(s) in RCA: 19] [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] [Received: 04/18/2013] [Revised: 05/11/2013] [Accepted: 07/06/2013] [Indexed: 11/22/2022]
Abstract
Serotonin and its various receptors are involved in numerous brain functions and neuropsychiatric disorders. The 5-HT1A family is the best characterized subtype of the fourteen currently known 5-HT receptors. The 5-HT1A receptor is closely involved in the pathogenesis of anxiety, depression, epilepsy and eating disorders and therefore is an important target for drug therapy. The development in the 1980s of molecules specifically targeting this receptor was followed by the rapid development of corresponding PET neuroimaging. Because this receptor represents a crucial target in neuroscience, a large number of radioligands have been developed by academic and industry centers for visualization and quantification, first in living animals and ultimately in humans. After a brief account of some of the structural and functional characteristics of brain 5-HT1A receptors, this review focuses on the main lines of evolution opened up by preclinical and clinical 5-HT1A PET radiopharmaceuticals, illustrating the potential value of PET for clinical research and drug development.
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Affiliation(s)
- T Billard
- CERMEP-Imaging Platform, University Hospital of Lyon (Hospices Civils de Lyon), 59 Boulevard Pinel, F-69003 Lyon, France.
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Karkas A, Keller J, Attye A, Bettega G, Theodosopoulos P, Romanet J, Chiquet C, Zimmer L. Endonasal Endoscopic Approach to the Orbit (EEAO). Skull Base Surg 2014. [DOI: 10.1055/s-0034-1384027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Perret-Liaudet A, Quadrio I, Zimmer L. Place des métabolites du précurseur de la protéine amyloïde (APP) dans le diagnostic biologique de la maladie d’Alzheimer : présent et futur. Rev Neurol (Paris) 2014. [DOI: 10.1016/j.neurol.2014.01.507] [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: 11/30/2022]
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Schilling B, Sondermann W, Zhao F, Griewank KG, Livingstone E, Sucker A, Zelba H, Weide B, Trefzer U, Wilhelm T, Loquai C, Berking C, Hassel J, Kähler KC, Utikal J, Al Ghazal P, Gutzmer R, Goldinger SM, Zimmer L, Paschen A, Hillen U, Schadendorf D. Differential influence of vemurafenib and dabrafenib on patients' lymphocytes despite similar clinical efficacy in melanoma. Ann Oncol 2014; 25:747-753. [PMID: 24504444 PMCID: PMC4433519 DOI: 10.1093/annonc/mdt587] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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: 09/17/2013] [Revised: 10/21/2013] [Accepted: 12/02/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Since the majority of melanomas eventually become resistant and progress, combining selective BRAF inhibitors (BRAFi) with immunotherapies has been proposed to achieve more durable treatment responses. Here, we explored the impact of selective BRAFi on the hosts' immune system. PATIENTS AND METHODS Clinical data, whole blood counts (WBC) and serum lactate dehydrogenase (LDH) of 277 vemurafenib- and 65 dabrafenib-treated melanoma patients were evaluated. The frequency and phenotype of lymphocyte subpopulations were determined by flow cytometry while T cell cytokine secretion was measured by multiplex assays. RESULTS Progression-free survival (PFS) as well as overall survival (OS) were similar in patients treated with either BRAFi. High pretreatment LDH was associated with shorter PFS and OS in both groups. During therapy, peripheral lymphocytes decreased by 24.3% (median, P < 0.0001) in vemurafenib-treated patients but remained unchanged in dabrafenib-treated patients (+1.2%, P = 0.717). Differentiation of peripheral lymphocytes of vemurafenib-treated patients showed a significant decrease in CD4(+) T cells (P < 0.05). Within CD4(+) T cells obtained during treatment, an increase in CCR7(+)CD45RA(+) (naïve) and a decrease in CCR7(+)CD45RA(-) (central memory) populations were found (P < 0.01 for both). Furthermore, secretion of interferon-γ and interleukin-9 by CD4(+) T cells was significantly lower in samples obtained during vemurafenib treatment compared with baseline samples. CONCLUSION While both compounds have comparable clinical efficacy, vemurafenib but not dabrafenib decreases patients peripheral lymphocyte counts and alters CD4(+) T cell phenotype and function. Thus, selective BRAFi can significantly affect patients' peripheral lymphocyte populations. Fully understanding these effects could be critical for successfully implementing combinatorial therapies of BRAFi with immunomodulatory agents.
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Affiliation(s)
- B Schilling
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK).
| | - W Sondermann
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - F Zhao
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - K G Griewank
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - E Livingstone
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - A Sucker
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - H Zelba
- University Medical Center, University of Tübingen, Tübingen
| | - B Weide
- German Cancer Consortium (DKTK); University Medical Center, University of Tübingen, Tübingen
| | - U Trefzer
- German Cancer Consortium (DKTK); Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Humboldt University, Berlin
| | - T Wilhelm
- German Cancer Consortium (DKTK); Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Humboldt University, Berlin
| | - C Loquai
- German Cancer Consortium (DKTK); Department of Dermatology, University of Mainz, Mainz
| | - C Berking
- German Cancer Consortium (DKTK); Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich
| | - J Hassel
- German Cancer Consortium (DKTK); Department of Dermatology, Heidelberg University Hospital, Heidelberg
| | - K C Kähler
- Department of Dermatology, Venerology and Allergology, University of Schleswig-Holstein Hospital, Campus Kiel
| | - J Utikal
- German Cancer Consortium (DKTK); Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg; Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim
| | - P Al Ghazal
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - R Gutzmer
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S M Goldinger
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - L Zimmer
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - A Paschen
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - U Hillen
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - D Schadendorf
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
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Vaubel J, Livingstone E, Schadendorf D, Zimmer L. Retarded low-dose doxycycline for EGFR or MEK inhibitor-induced papulopustular rash. J Eur Acad Dermatol Venereol 2014; 28:1685-9. [DOI: 10.1111/jdv.12365] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2013] [Accepted: 12/11/2013] [Indexed: 12/01/2022]
Affiliation(s)
- J. Vaubel
- Department of Dermatology; University Hospital Essen; Essen Germany
| | - E. Livingstone
- Department of Dermatology; University Hospital Essen; Essen Germany
| | - D. Schadendorf
- Department of Dermatology; University Hospital Essen; Essen Germany
| | - L. Zimmer
- Department of Dermatology; University Hospital Essen; Essen Germany
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Aghi M, Vogelbaum MA, Jolly DJ, Robbins JM, Ostertag D, Ibanez CE, Gruber HE, Kasahara N, Bankiewicz K, Cloughesy TF, Chang SM, Butowski N, Kesari S, Chen C, Mikkelsen T, Landolfi J, Chiocca EA, Elder JB, Foltz G, Pertschuk D, Anaizi A, Taylor C, Kosty J, Zimmer L, Theodosopoulos P, Anaizi A, Gantwerker E, Pensak M, Theodosopoulos P, Anaizi A, Grewal S, Theodosopoulos P, Zimmer L, Anaizi A, Pensak M, Theodosopoulos P, Arakawa Y, Kang Y, Murata D, Fujimoto KI, Miyamoto S, Blagia M, Paulis M, Orunesu G, Serra S, Akers J, Ramakrishnan V, Kim R, Skog J, Nakano I, Pingle S, Kalinina J, Kesari S, Breakfield X, Hochberg F, Van Meir E, Carter B, Chen C, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran F, Calaminus G, Hamer PDW, Hendriks E, Mandonnet E, Barkhof F, Zwinderman K, Duffau H, Esquenazi Y, Johnson J, Tandon N, Esquenazi Y, Friedman E, Lin Y, Zhu JJ, Tandon N, Fujimaki T, Kobayashi M, Wakiya K, Ohta M, Adachi J, Fukuoka K, Suzuki T, Yanagisawa T, Matsutani M, Mishima K, Sasaki J, Nishikawa R, Hoffermann M, Bruckmann L, Ali KM, Asslaber M, Payer F, von Campe G, Jungk C, Beigel B, Abb V, Herold-Mende C, Unterberg A, Kim JH, Cho YH, Kim CJ, Mardor Y, Nissim O, Grober Y, Guez D, Last D, Daniels D, Hoffmann C, Nass D, Talianski A, Spiegelmann R, Cohen Z, Zach L, Marupudi N, Mittal S, Michaud K, Cantin L, Cottin S, Dandurand C, Mohammadi A, Hawasli A, Rodriguez A, Schroeder J, Laxton A, Elson P, Tatter S, Barnett G, Leuthardt E, Moriuchi S, Dehara M, Fukunaga T, Hagiwara Y, Soda H, Imakita M, Nitta M, Maruyama T, Iseki H, Ikuta S, Tamura M, Chernov M, Okamoto S, Okada Y, Muragaki Y, Ohue S, Kohno S, Inoue A, Yamashita D, Kumon Y, Ohnishi T, Oppido P, Villani V, Vidiri A, Pace A, Pompili A, Carapella C, Orringer D, Lau D, Niknafs Y, Piquer J, Llacer JL, Rovira V, Riesgo P, Cremades A, Rotta R, Levine N, Prabhu S, Sawaya R, Weinberg J, Rao G, Tummala S, Tilley C, Rovin R, Kassam A, Schwartz C, Romagna A, Thon N, Tonn JC, Schwarz SB, Kreth FW, Sonoda Y, Shibahara I, Saito R, Kanamori M, Kumabe T, Tominaga T, Steele C, Lawrence J, Rovin R, Winn R, Rachinger W, Simon M, Dutzmann S, Feigl G, Kremenevskaya N, Thon N, Tonn JC, Whelan H, Kelly M, Jogel S, Kaufmann B, Foy A, Lew S, Quirk B, Yong RL, Wu T, Mihatov N, Shen MJ, Brown MA, Zaghloul KA, Park GE, Park JK. SURGICAL THERAPIES. Neuro Oncol 2013; 15:iii217-iii225. [PMCID: PMC3823906 DOI: 10.1093/neuonc/not191] [Citation(s) in RCA: 3] [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: 01/19/2024] Open
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Griewank KG, Murali R, Schilling B, Scholz S, Sucker A, Song M, Süsskind D, Grabellus F, Zimmer L, Hillen U, Steuhl KP, Schadendorf D, Westekemper H, Zeschnigk M. TERT promoter mutations in ocular melanoma distinguish between conjunctival and uveal tumours. Br J Cancer 2013; 109:497-501. [PMID: 23799844 PMCID: PMC3721405 DOI: 10.1038/bjc.2013.312] [Citation(s) in RCA: 90] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2013] [Revised: 05/23/2013] [Accepted: 05/30/2013] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Recently, activating mutations in the TERT promoter were identified in cutaneous melanoma. We tested a cohort of ocular melanoma samples for similar mutations. METHODS The TERT promoter region was analysed by Sanger sequencing in 47 uveal (ciliary body or choroidal) melanomas and 38 conjunctival melanomas. RESULTS Mutations of the TERT promoter were not identified in uveal melanomas, but were detected in 12 (32%) conjunctival melanomas. Mutations had a UV signature and were identical to those found in cutaneous melanoma. CONCLUSION Mutations of TERT promoter with UV signatures are frequent in conjunctival melanomas and favour a pathogenetic kinship with cutaneous melanomas. Absence of these mutations in uveal melanomas emphasises their genetic distinction from cutaneous and conjunctival melanomas.
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Affiliation(s)
- K G Griewank
- Department of Dermatology, University Hospital, University Duisburg-Essen, Hufelandstrasse 55, Essen, Germany.
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Märk J, Benoit D, Balasse L, Benoit M, Clémens JC, Fieux S, Fougeron D, Graber-Bolis J, Janvier B, Jevaud M, Genoux A, Gisquet-Verrier P, Menouni M, Pain F, Pinot L, Tourvielle C, Zimmer L, Morel C, Laniece P. A wireless beta-microprobe based on pixelated silicon for in vivo brain studies in freely moving rats. Phys Med Biol 2013; 58:4483-500. [PMID: 23760022 DOI: 10.1088/0031-9155/58/13/4483] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The investigation of neurophysiological mechanisms underlying the functional specificity of brain regions requires the development of technologies that are well adjusted to in vivo studies in small animals. An exciting challenge remains the combination of brain imaging and behavioural studies, which associates molecular processes of neuronal communications to their related actions. A pixelated intracerebral probe (PIXSIC) presents a novel strategy using a submillimetric probe for beta(+) radiotracer detection based on a pixelated silicon diode that can be stereotaxically implanted in the brain region of interest. This fully autonomous detection system permits time-resolved high sensitivity measurements of radiotracers with additional imaging features in freely moving rats. An application-specific integrated circuit (ASIC) allows for parallel signal processing of each pixel and enables the wireless operation. All components of the detector were tested and characterized. The beta(+) sensitivity of the system was determined with the probe dipped into radiotracer solutions. Monte Carlo simulations served to validate the experimental values and assess the contribution of gamma noise. Preliminary implantation tests on anaesthetized rats proved PIXSIC's functionality in brain tissue. High spatial resolution allows for the visualization of radiotracer concentration in different brain regions with high temporal resolution.
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Affiliation(s)
- J Märk
- CPPM, Aix-Marseille Université, CNRS/IN2P3, Marseille, France.
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Abstract
Immunotherapy using unspecific modulators has a long tradition in the adjuvant treatment of stage II/III melanoma. Interferon has shown a consistent effect on relapse-free survival independent of interferon dosage and duration. The results of the american Joint Committee on Cancer (AJCC) Melanoma Staging Database analysis led to a strict inclusion of additional prognostic risk factors such as ulceration of the primary and microscopic lymph node involvement explored by the sentinel node biopsy in the revised 2009 AJCC classification. These factors are now being increasingly included as stratification factors into clinical trials and yield a new hypothesis that primarily patients with both characteristics benefit from adjuvant interferon treatment. In the metastatic situation, interleukin-2 is the only immunotherapeutic agent approved by the Food and Drug administration. In combination with interferon and/or with various chemotherapeutic agents, IL-2 is associated with substantial toxic effect and poor efficacy that does not improve overall survival (OS). Ipilimumab is a fully human, monoclonal antibody that blocks the cytotoxic T-lymphocyte antigen-4 and has recently been approved for metastatic melanoma based on two independent randomized phase III studies both demonstrating an improved OS rate after 1, 2, and 3 years compared with the control group. Based on this major step in treating metastatic melanoma, novel adjuvant strategies in stage III and combination therapies with targeted agents in stage IV are currently being explored.
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Affiliation(s)
- D Schadendorf
- Department of Dermatology, Skin Cancer Centre, University Hospital Essen, Essen, Germany.
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Taylor CI, Theodosopoulos P, Zimmer L, Keller J. A Comparison of Operative Exposure Between the Le Fort I Osteotomy and the Exclusive Endoscopic Transnasal Approach for Middle and Lower Clival Lesions. Skull Base Surg 2013. [DOI: 10.1055/s-0033-1336225] [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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Tsioga M, Voigtlaender R, Suttorp W, Zimmer L, Schlamann M, Sure U, Lahner H, Moeller LC, Fuehrer D. Immune-related hypophysitis in three patients with metastatic melanoma undergoing Ipilimumab treatment. Exp Clin Endocrinol Diabetes 2013. [DOI: 10.1055/s-0033-1336692] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nagy P, Rabis T, Wang Y, Kleibrink B, Zimmer L, Moraidis I, Werther S, Kamler M, Teschler H, Weinreich G, Sommerwerck U. Einfluss schlafbezogener Atmungsstörungen auf die Belastbarkeit von Patienten nach Lungentransplantation. Pneumologie 2013. [DOI: 10.1055/s-0033-1334789] [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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