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Goessinger EV, Cerminara SE, Mueller AM, Gottfrois P, Huber S, Amaral M, Wenz F, Kostner L, Weiss L, Kunz M, Maul JT, Wespi S, Broman E, Kaufmann S, Patpanathapillai V, Treyer I, Navarini AA, Maul LV. Consistency of convolutional neural networks in dermoscopic melanoma recognition: A prospective real-world study about the pitfalls of augmented intelligence. J Eur Acad Dermatol Venereol 2024; 38:945-953. [PMID: 38158385 DOI: 10.1111/jdv.19777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/23/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Deep-learning convolutional neural networks (CNNs) have outperformed even experienced dermatologists in dermoscopic melanoma detection under controlled conditions. It remains unexplored how real-world dermoscopic image transformations affect CNN robustness. OBJECTIVES To investigate the consistency of melanoma risk assessment by two commercially available CNNs to help formulate recommendations for current clinical use. METHODS A comparative cohort study was conducted from January to July 2022 at the Department of Dermatology, University Hospital Basel. Five dermoscopic images of 116 different lesions on the torso of 66 patients were captured consecutively by the same operator without deliberate rotation. Classification was performed by two CNNs (CNN-1/CNN-2). Lesions were divided into four subgroups based on their initial risk scoring and clinical dignity assessment. Reliability was assessed by variation and intraclass correlation coefficients. Excisions were performed for melanoma suspicion or two consecutively elevated CNN risk scores, and benign lesions were confirmed by expert consensus (n = 3). RESULTS 117 repeated image series of 116 melanocytic lesions (2 melanomas, 16 dysplastic naevi, 29 naevi, 1 solar lentigo, 1 suspicious and 67 benign) were classified. CNN-1 demonstrated superior measurement repeatability for clinically benign lesions with an initial malignant risk score (mean variation coefficient (mvc): CNN-1: 49.5(±34.3)%; CNN-2: 71.4(±22.5)%; p = 0.03), while CNN-2 outperformed for clinically benign lesions with benign scoring (mvc: CNN-1: 49.7(±22.7)%; CNN-2: 23.8(±29.3)%; p = 0.002). Both systems exhibited lowest score consistency for lesions with an initial malignant risk score and benign assessment. In this context, averaging three initial risk scores achieved highest sensitivity of dignity assessment (CNN-1: 94%; CNN-2: 89%). Intraclass correlation coefficients indicated 'moderate'-to-'good' reliability for both systems (CNN-1: 0.80, 95% CI:0.71-0.87, p < 0.001; CNN-2: 0.67, 95% CI:0.55-0.77, p < 0.001). CONCLUSIONS Potential user-induced image changes can significantly influence CNN classification. For clinical application, we recommend using the average of three initial risk scores. Furthermore, we advocate for CNN robustness optimization by cross-validation with repeated image sets. TRIAL REGISTRATION ClinicalTrials.gov (NCT04605822).
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Affiliation(s)
- E V Goessinger
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - S E Cerminara
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - A M Mueller
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - P Gottfrois
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - S Huber
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - M Amaral
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - F Wenz
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - L Kostner
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - L Weiss
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - M Kunz
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - J-T Maul
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - S Wespi
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - E Broman
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - S Kaufmann
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - V Patpanathapillai
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - I Treyer
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - A A Navarini
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
| | - L V Maul
- Department of Dermatology, University Hospital Basel, Basel, Switzerland
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
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2
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Lafarge MW, Domingo E, Sirinukunwattana K, Wood R, Samuel L, Murray G, Richman SD, Blake A, Sebag-Montefiore D, Gollins S, Klieser E, Neureiter D, Huemer F, Greil R, Dunne P, Quirke P, Weiss L, Rittscher J, Maughan T, Koelzer VH. Image-based consensus molecular subtyping in rectal cancer biopsies and response to neoadjuvant chemoradiotherapy. NPJ Precis Oncol 2024; 8:89. [PMID: 38594327 PMCID: PMC11003957 DOI: 10.1038/s41698-024-00580-3] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 03/13/2024] [Indexed: 04/11/2024] Open
Abstract
The development of deep learning (DL) models to predict the consensus molecular subtypes (CMS) from histopathology images (imCMS) is a promising and cost-effective strategy to support patient stratification. Here, we investigate whether imCMS calls generated from whole slide histopathology images (WSIs) of rectal cancer (RC) pre-treatment biopsies are associated with pathological complete response (pCR) to neoadjuvant long course chemoradiotherapy (LCRT) with single agent fluoropyrimidine. DL models were trained to classify WSIs of colorectal cancers stained with hematoxylin and eosin into one of the four CMS classes using a multi-centric dataset of resection and biopsy specimens (n = 1057 WSIs) with paired transcriptional data. Classifiers were tested on a held out RC biopsy cohort (ARISTOTLE) and correlated with pCR to LCRT in an independent dataset merging two RC cohorts (ARISTOTLE, n = 114 and SALZBURG, n = 55 patients). DL models predicted CMS with high classification performance in multiple comparative analyses. In the independent cohorts (ARISTOTLE, SALZBURG), cases with WSIs classified as imCMS1 had a significantly higher likelihood of achieving pCR (OR = 2.69, 95% CI 1.01-7.17, p = 0.048). Conversely, imCMS4 was associated with lack of pCR (OR = 0.25, 95% CI 0.07-0.88, p = 0.031). Classification maps demonstrated pathologist-interpretable associations with high stromal content in imCMS4 cases, associated with poor outcome. No significant association was found in imCMS2 or imCMS3. imCMS classification of pre-treatment biopsies is a fast and inexpensive solution to identify patient groups that could benefit from neoadjuvant LCRT. The significant associations between imCMS1/imCMS4 with pCR suggest the existence of predictive morphological features that could enhance standard pathological assessment.
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Affiliation(s)
- Maxime W Lafarge
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Enric Domingo
- Department of Oncology, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Korsuk Sirinukunwattana
- Ground Truth Labs, Oxford, UK
- Department of Engineering Science, Institute of Biomedical Engineering (IBME), University of Oxford, Oxford, UK
| | - Ruby Wood
- Department of Engineering Science, University of Oxford, Oxford, UK
| | - Leslie Samuel
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Graeme Murray
- School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Susan D Richman
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Andrew Blake
- Department of Oncology, Medical Sciences Division, University of Oxford, Oxford, UK
| | | | - Simon Gollins
- North Wales Cancer Treatment Centre, Besti Cadwaladr University Health Board, Bodelwyddan, UK
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Philip Dunne
- The Patrick G Johnston Centre for Cancer Research, Queens University Belfast, Belfast, UK
| | - Philip Quirke
- Leeds Institute of Medical Research, University of Leeds, Leeds, UK
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Jens Rittscher
- Department of Engineering Science, Institute of Biomedical Engineering (IBME), University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Tim Maughan
- Department of Oncology, Medical Sciences Division, University of Oxford, Oxford, UK
| | - Viktor H Koelzer
- Department of Pathology and Molecular Pathology, University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- Department of Oncology and Nuffield Department of Medicine, University of Oxford, Oxford, UK.
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland.
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3
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Kahl M, Offner T, Trendel A, Weiss L, Manzini I, Hassenklöver T. S100Z is expressed in a lateral subpopulation of olfactory receptor neurons in the main olfactory system of Xenopus laevis. Dev Neurobiol 2024; 84:59-73. [PMID: 38439531 DOI: 10.1002/dneu.22935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024]
Abstract
In contrast to other S100 protein members, the function of S100 calcium-binding protein Z (S100Z) remains largely uncharacterized. It is expressed in the olfactory epithelium of fish, and it is closely associated with the vomeronasal organ (VNO) in mammals. In this study, we analyzed the expression pattern of S100Z in the olfactory system of the anuran amphibian Xenopus laevis. Using immunohistochemistry in whole mount and slice preparations of the larval olfactory system, we found exclusive S100Z expression in a subpopulation of olfactory receptor neurons (ORNs) of the main olfactory epithelium (MOE). S100Z expression was not co-localized with TP63 and cytokeratin type II, ruling out basal cell and supporting cell identity. The distribution of S100Z-expressing ORNs was laterally biased, and their average number was significantly increased in the lateral half of the olfactory epithelium. The axons of S100Z-positive neurons projected exclusively into the lateral and intermediate glomerular clusters of the main olfactory bulb (OB). Even after metamorphic restructuring of the olfactory system, S100Z expression was restricted to a neuronal subpopulation of the MOE, which was then located in the newly formed middle cavity. An axonal projection into the ventro-lateral OB persisted also in postmetamorphic frogs. In summary, S100Z is exclusively associated with the main olfactory system in the amphibian Xenopus and not with the VNO as in mammals, despite the presence of a separate accessory olfactory system in both classes.
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Affiliation(s)
- Melina Kahl
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Thomas Offner
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Alena Trendel
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Lukas Weiss
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Ivan Manzini
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
| | - Thomas Hassenklöver
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Giessen, Germany
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4
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Huemer F, Weiss L, Regitnig P, Winder T, Schmitt CA, Thaler J, Wöll E, Greil R. Comment on: Incidence, clinicopathological features, and clinical outcomes of low HER2 expressed, inoperable, advanced, or recurrent gastric/gastroesophageal junction adenocarcinoma. ESMO Open 2024; 9:102973. [PMID: 38507896 DOI: 10.1016/j.esmoop.2024.102973] [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: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 03/22/2024] Open
Affiliation(s)
- F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria
| | - P Regitnig
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - T Winder
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Department of Internal Medicine II, Hospital Feldkirch, Feldkirch, Austria
| | - C A Schmitt
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Johannes Kepler University, Kepler University Hospital, Department of Hematology and Oncology, Linz, Austria
| | - J Thaler
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Department of Internal Medicine IV, Hematology and Oncology, Klinikum Wels-Grieskirchen, Wels, Austria
| | - E Wöll
- Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; St. Vinzenz Krankenhaus Betriebs GmbH, Zams, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Salzburg, Austria; Austrian Group of Medical Tumor Therapy (AGMT) Study Group, Vienna, Austria; Cancer Cluster Salzburg, Salzburg, Austria.
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5
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Weiss L, Fischer LE, Heinemann V, Gieseler F, Hoehler T, Mayerle J, Quietzsch D, Reinacher-Schick A, Schenk M, Seipelt G, Siveke JT, Stahl M, Kaiser U, Waldschmidt DT, Dorman K, Zhang D, Westphalen CB, Boeck S, Haas M. Changes over time in the course of advanced pancreatic cancer treatment with systemic chemotherapy: a pooled analysis of five clinical trials from two decades of the German AIO study group. ESMO Open 2024; 9:102944. [PMID: 38503144 DOI: 10.1016/j.esmoop.2024.102944] [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: 12/19/2023] [Revised: 02/15/2024] [Accepted: 02/18/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Over the past two decades, our group has conducted five multicenter trials focusing on first-line systemic therapy for patients with advanced pancreatic cancer. The current pooled analysis was designed to evaluate prognosis over time and the impact of clinical characteristics on survival. PATIENTS AND METHODS Individual patient data were derived from five prospective, controlled, multicenter trials conducted by the 'Arbeitsgemeinschaft Internistische Onkologie' (AIO): 'Gem/Cis', 'Ro96', 'RC57', 'ACCEPT' and 'RASH', which recruited patients between December 1997 and January 2017. RESULTS Overall, 912 patients were included. The median overall survival (OS) for all assessable patients was 7.1 months. OS significantly improved over time, with a median OS of 8.6 months for patients treated from 2012 to 2017 compared with 7.0 months from 1997 to 2006 [hazard ratio (HR) 1.06; P < 0.004]. Eastern Cooperative Oncology Group performance status (HR 1.48; P < 0.001), use of second-line treatment (HR 1.51; P < 0.001), and Union for International Cancer Control (UICC) stage (III versus IV) (HR 1.34, P = 0.002) had a significant impact on OS. By contrast, no influence of age and gender on OS was detectable. Comparing combination therapy with single-agent chemotherapy did not demonstrate a survival benefit, nor did regimens containing epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) such as afatinib or erlotinib, compared with chemotherapy-only arms. Patients with early-onset pancreatic cancer (age at study entry of ≤50 years, n = 102) had a similar OS compared with those >50 years (7.1 versus 7.0 months; HR 1.13; P = 0.273). The use of a platinum-containing regimen was not associated with better outcomes in patients with early-onset pancreatic cancer. CONCLUSIONS Within this selected group of patients treated within prospective clinical trials, survival has shown improvement over two decades. This effect is likely attributable to the availability of more effective combination therapies and treatment lines, rather than to any specific regimen, such as those containing EGFR-TKIs. In addition, concerning age and sex subgroups, the dataset did not provide evidence for distinct clinical behavior.
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Affiliation(s)
- L Weiss
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - L E Fischer
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - V Heinemann
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - F Gieseler
- Clinic of Hematology and Oncology, University Hospital Schleswig-Holstein-Campus Lübeck, Lübeck
| | - T Hoehler
- Department of Medicine I, Prosper Hospital, Recklinghausen
| | - J Mayerle
- Comprehensive Cancer Center, LMU Munich, Munich; Department of Medicine II, LMU Munich, Munich
| | - D Quietzsch
- Department of Medical Oncology, Klinikum Chemnitz, Chemnitz
| | - A Reinacher-Schick
- Department of Hematology and Oncology, St. Josef Hospital, Ruhr University Bochum
| | - M Schenk
- Department of Haematology and Oncology, Krankenhaus Barmherzige Brüder, Regensburg
| | | | - J T Siveke
- Bridge Institute of Experimental Tumor Therapy and DKTK Division of Solid Tumor Translational Oncology, University Hospital Essen, University of Duisburg-Essen, Essen
| | - M Stahl
- Department of Medical Oncology, Evang. Kliniken Essen-Mitte, Essen
| | - U Kaiser
- Palliativmedizinisches Netzwerk Landshut, Landshut
| | - D T Waldschmidt
- Department of Gastroenterology and Hepatology, University of Cologne, Cologne
| | - K Dorman
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - D Zhang
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich
| | - C B Westphalen
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich
| | - S Boeck
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; German Cancer Consortium (DKTK), Partner Site Munich, Munich; Department of Hematology and Oncology, München Klinik Neuperlach, Munich, Germany
| | - M Haas
- Department of Medicine III, LMU Munich, Munich; Comprehensive Cancer Center, LMU Munich, Munich; Department of Hematology and Oncology, München Klinik Neuperlach, Munich, Germany.
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6
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Laurette P, Cao C, Ramanujam D, Schwaderer M, Lueneburg T, Kuss S, Weiss L, Dilshat R, Furlong EEM, Rezende F, Engelhardt S, Gilsbach R. In Vivo Silencing of Regulatory Elements Using a Single AAV-CRISPRi Vector. Circ Res 2024; 134:223-225. [PMID: 38131200 DOI: 10.1161/circresaha.123.323854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Affiliation(s)
- P Laurette
- Institute of Experimental Cardiology, Heidelberg University Hospital, Germany (P.L., C.C., T.L., S.K., R.G.)
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Germany (P.L., C.C., R.G., E.E.M.F.)
- DZHK Partner Site Rhein/Main, Germany (P.L., C.C., L.W., F.R., R.G.)
- Institute of Cardiovascular Physiology, Frankfurt University, Germany (P.L., C.C., L.W., F.R., R.G.)
| | - C Cao
- Institute of Experimental Cardiology, Heidelberg University Hospital, Germany (P.L., C.C., T.L., S.K., R.G.)
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Germany (P.L., C.C., R.G., E.E.M.F.)
- DZHK Partner Site Rhein/Main, Germany (P.L., C.C., L.W., F.R., R.G.)
- Institute of Cardiovascular Physiology, Frankfurt University, Germany (P.L., C.C., L.W., F.R., R.G.)
| | - D Ramanujam
- DZHK Partner Site München, Germany (D.R, S.E.)
- Institute of Pharmacology and Toxicology, Technical University of Munich, Germany (D.R., S.E.)
| | - M Schwaderer
- Institute of Clinical and Experimental Pharmacology and Toxicology, University of Freiburg, Germany (M.S.)
| | - T Lueneburg
- Institute of Experimental Cardiology, Heidelberg University Hospital, Germany (P.L., C.C., T.L., S.K., R.G.)
| | - S Kuss
- Institute of Experimental Cardiology, Heidelberg University Hospital, Germany (P.L., C.C., T.L., S.K., R.G.)
| | - L Weiss
- DZHK Partner Site Rhein/Main, Germany (P.L., C.C., L.W., F.R., R.G.)
- Institute of Cardiovascular Physiology, Frankfurt University, Germany (P.L., C.C., L.W., F.R., R.G.)
| | - R Dilshat
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany (R.D., E.E.M.F.)
| | - E E M Furlong
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Germany (P.L., C.C., R.G., E.E.M.F.)
- European Molecular Biology Laboratory, Genome Biology Unit, Heidelberg, Germany (R.D., E.E.M.F.)
| | - F Rezende
- DZHK Partner Site Rhein/Main, Germany (P.L., C.C., L.W., F.R., R.G.)
- Institute of Cardiovascular Physiology, Frankfurt University, Germany (P.L., C.C., L.W., F.R., R.G.)
| | - S Engelhardt
- DZHK Partner Site München, Germany (D.R, S.E.)
- Institute of Pharmacology and Toxicology, Technical University of Munich, Germany (D.R., S.E.)
| | - R Gilsbach
- Institute of Experimental Cardiology, Heidelberg University Hospital, Germany (P.L., C.C., T.L., S.K., R.G.)
- DZHK (German Center for Cardiovascular Research) Partner Site Heidelberg/Mannheim, Germany (P.L., C.C., R.G., E.E.M.F.)
- DZHK Partner Site Rhein/Main, Germany (P.L., C.C., L.W., F.R., R.G.)
- Institute of Cardiovascular Physiology, Frankfurt University, Germany (P.L., C.C., L.W., F.R., R.G.)
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7
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Weiss L, Dorman K, Boukovala M, Schwinghammer F, Jordan P, Fey T, Hasselmann K, Subklewe M, Bücklein V, Bargou R, Goebeler M, Sayehli C, Spoerl S, Lüke F, Heudobler D, Claus R, von Luettichau I, Lorenzen S, Lange S, Westphalen CB, von Bergwelt-Baildon M, Heinemann V, Gießen-Jung C. Early clinical trial unit tumor board: a real-world experience in a national cancer network. J Cancer Res Clin Oncol 2023; 149:13383-13390. [PMID: 37490102 PMCID: PMC10587227 DOI: 10.1007/s00432-023-05196-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 07/17/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE Early clinical trials are the first step into clinical therapies for new drugs. Within the six Bavarian university-based hospitals (Augsburg, Erlangen, Regensburg, Munich (LMU and TU), Würzburg) we have enrolled a virtual network platform for patient discussion. METHODS The virtual Early Clinical Trial Unit Tumor Board (ECTU Tumor Board) is a secured web-based meeting to evaluate early clinical trial options for patients, where representatives from local ECTUs participate. We retrospectively analyzed patient cases discussed between November 2021 and November 2022. RESULTS From November 2021 to November 2022, a total of 43 patients were discussed in the ECTU Tumor Board. Median age at diagnosis was 44.6 years (range 10-76 years). The median number of previous lines of therapies was 3.7 (range 1-9 therapies) including systemic treatment, surgery, and radiation therapy. A total of 27 different tumor entities were presented and 83.7% (36/43) patients received at least one trial recommendation. In total, 21 different active or shortly recruiting clinical trials were recommended: ten antibody trials, four BiTE (bispecific T cell engager) trials, six CAR (chimeric antigen receptor) T-cell trials, and one chemotherapy trial. Only six trials (28.6%) were recommended on the basis of the previously performed comprehensive genetic profiling (CGP). CONCLUSION The ECTU Tumor Board is a feasible and successful network, highlighting the force of virtual patient discussions for improving patient care as well as trial recruitment in advanced diseases. It can provide further treatment options after local MTB presentation, aiming to close the gap to access clinical trials.
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Affiliation(s)
- L Weiss
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - K Dorman
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M Boukovala
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - F Schwinghammer
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - P Jordan
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - T Fey
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
| | - K Hasselmann
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
| | - M Subklewe
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - V Bücklein
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - R Bargou
- Comprehensive Cancer Center Mainfranken, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M Goebeler
- Early Clinical Trials Unit, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C Sayehli
- Early Clinical Trials Unit, Department of Internal Medicine II, University Hospital Würzburg, Würzburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Spoerl
- Department of Internal Medicine 5 (Hematology and Clinical Oncology), Friedrich-Alexander-Universität Erlangen-Nürnberg, University Hospital Erlangen, Erlangen, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - F Lüke
- Department of Internal Medicine III (Hematology and Oncology), University Hospital Regensburg, Regensburg, Germany
- Division of Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and Experimental Medicine, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - D Heudobler
- Department of Internal Medicine III (Hematology and Oncology), University Hospital Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - R Claus
- Department of Hematology and Clinical Oncology, University Medical Center Augsburg, Augsburg, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - I von Luettichau
- Department of Pediatrics and Children's Cancer Research Center, TUM School of Medicine, Kinderklinik München Schwabing, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Lorenzen
- Department of Medicine II (Gastroenterology), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Lange
- Department of Medicine II (Gastroenterology), Klinikum Rechts Der Isar, Technical University of Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C B Westphalen
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - M von Bergwelt-Baildon
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - V Heinemann
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany
- Comprehensive Cancer Center (CCC Munich LMU), LMU University Hospital Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - C Gießen-Jung
- Department Medicine III (Hematology and Oncology), LMU University Hospital Munich, Munich, Germany.
- Bavarian Cancer Research Center (BZKF), Munich, Germany.
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Heregger R, Huemer F, Steiner M, Gonzalez-Martinez A, Greil R, Weiss L. Unraveling Resistance to Immunotherapy in MSI-High Colorectal Cancer. Cancers (Basel) 2023; 15:5090. [PMID: 37894457 PMCID: PMC10605634 DOI: 10.3390/cancers15205090] [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: 09/28/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 10/29/2023] Open
Abstract
Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related deaths. Incidences of early CRC cases are increasing annually in high-income countries, necessitating effective treatment strategies. Immune checkpoint inhibitors (ICIs) have shown significant clinical efficacy in various cancers, including CRC. However, their effectiveness in CRC is limited to patients with mismatch-repair-deficient (dMMR)/microsatellite instability high (MSI-H) disease, which accounts for about 15% of all localized CRC cases and only 3% to 5% of metastatic CRC cases. However, the varied response among patients, with some showing resistance or primary tumor progression, highlights the need for a deeper understanding of the underlying mechanisms. Elements involved in shaping the response to ICIs, such as tumor microenvironment, immune cells, genetic changes, and the influence of gut microbiota, are not fully understood thus far. This review aims to explore potential resistance or immune-evasion mechanisms to ICIs in dMMR/MSI-H CRC and the cell types involved, as well as possible pitfalls in the diagnosis of this particular subtype.
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Affiliation(s)
- Ronald Heregger
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
| | - Florian Huemer
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
| | - Markus Steiner
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Alejandra Gonzalez-Martinez
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Hematology, Medical Oncology, Hemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria (F.H.); (M.S.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
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9
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Offner T, Weiss L, Daume D, Berk A, Inderthal TJ, Manzini I, Hassenklöver T. Functional odor map heterogeneity is based on multifaceted glomerular connectivity in larval Xenopus olfactory bulb. iScience 2023; 26:107518. [PMID: 37636047 PMCID: PMC10448113 DOI: 10.1016/j.isci.2023.107518] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 07/05/2023] [Accepted: 07/31/2023] [Indexed: 08/29/2023] Open
Abstract
Glomeruli are the functional units of the vertebrate olfactory bulb (OB) connecting olfactory receptor neuron (ORN) axons and mitral/tufted cell (MTC) dendrites. In amphibians, these two circuit elements regularly branch and innervate multiple, spatially distinct glomeruli. Using functional multiphoton-microscopy and single-cell tracing, we investigate the impact of this wiring on glomerular module organization and odor representations on multiple levels of the Xenopus laevis OB network. The glomerular odor map to amino acid odorants is neither stereotypic between animals nor chemotopically organized. Among the morphologically heterogeneous group of uni- and multi-glomerular MTCs, MTCs can selectively innervate glomeruli formed by axonal branches of individual ORNs. We conclude that odor map heterogeneity is caused by the coexistence of different intermingled glomerular modules. This demonstrates that organization of the amphibian main olfactory system is not strictly based on uni-glomerular connectivity.
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Affiliation(s)
- Thomas Offner
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Lukas Weiss
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Daniela Daume
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Anna Berk
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Tim Justin Inderthal
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Ivan Manzini
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
| | - Thomas Hassenklöver
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392 Giessen, Germany
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Taghizadeh H, Djanani A, Eisterer W, Gerger A, Gruenberger B, Gruenberger T, Rumpold H, Weiss L, Winder T, Wöll E, Prager GW. Systemic treatment of patients with locally advanced or metastatic cholangiocarcinoma - an Austrian expert consensus statement. Front Oncol 2023; 13:1225154. [PMID: 37711201 PMCID: PMC10499516 DOI: 10.3389/fonc.2023.1225154] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 08/11/2023] [Indexed: 09/16/2023] Open
Abstract
Locally advanced or metastatic cholangiocarcinoma is an aggressive carcinoma with a dismal prognosis. For the first-line treatment of locally advanced or metastatic cholangiocarcinoma, cisplatin/gemcitabine has been the standard of care for more than 10 years. Its combination with the immune checkpoint inhibitor durvalumab resulted in an efficiency improvement in the phase III setting. Regarding the use of chemotherapy in the second line, positive phase III data could only be generated for FOLFOX. The evidence base for nanoliposomal irinotecan (Nal-IRI) plus 5-fluorouracil (5-FU) and leucovorin (LV) is contradictory. After the failure of first-line treatment, targeted therapies can be offered if the molecular targets microsatellite instability-high (MSI-H), IDH1, FGFR2, BRAF V600E, and NTRK are detected. These targeted agents are generally preferable to second-line chemotherapy. Broad molecular testing should be performed, preferably from tumor tissue, at the initiation of first-line therapy to timely identify potential molecular targets.
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Affiliation(s)
- Hossein Taghizadeh
- Department of Internal Medicine I, University Hospital St. Pölten, St. Pölten, Austria
- Karl Landsteiner University of Health Sciences, Krems, Austria
| | - Angela Djanani
- Clinical Division of Gastroenterology, Hepatology and Metabolism, Department of Internal Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine, Klagenfurt Hospital, Klagenfurt am Wörthersee, Austria
| | - Armin Gerger
- Department of Internal Medicine, Clinical Division of Oncology, Medical University of Graz, Graz, Austria
| | - Birgit Gruenberger
- Department of Internal Medicine and Hematology and Internal Oncology, Landesklinikum Wiener Neustadt, Wiener Neustadt, Austria
| | - Thomas Gruenberger
- Department of Surgery, Clinic Favoriten, Hepatopancreatobiliary Center (HPB) Center, Health Network Vienna, and Sigmund Freud Private University, Vienna, Austria
| | - Holger Rumpold
- Visceral Oncology Center, Ordensklinikum Linz, Linz, Austria
| | - Lukas Weiss
- Department of Internal Medicine III, Paracelsus Medical University, Salzburg, Austria
| | - Thomas Winder
- Department of Internal Medicine II, Hospital Feldkirch, Feldkirch, Austria
| | - Ewald Wöll
- Department of Internal Medicine, Saint Vincent Hospital Zams, Zams, Austria
| | - Gerald W. Prager
- Department of Medicine I, Clinical Division of Oncology, Medical University of Vienna, Vienna, Austria
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11
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Schlick K, Gantschnigg A, Seymer A, Huemer F, Greil R, Weiss L. Comparison of gemcitabine plus oxaliplatin versus gemcitabine plus nab-paclitaxel as first-line chemotherapy for advanced pancreatic adenocarcinoma: A single-center retrospective analysis. Cancer Med 2023; 12:16997-17004. [PMID: 37537780 PMCID: PMC10501299 DOI: 10.1002/cam4.6334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/13/2023] [Accepted: 07/02/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND Pancreatic cancer is mostly diagnosed in an advanced stage and treated with systemic therapy with palliative intent. Nowadays, the doublet chemotherapy of Gemcitabine and nab-paclitaxel (Gem-Nab) is one of the most frequently used regimens worldwide, but is not ubiquitarily available or reimbursed. Therefore, we compared the clinical efficacy of Gem-Nab to a historical control of patients treated with gemcitabine and oxaliplatin (Gem-Ox) at our tertiary cancer center, which was the standard treatment prior to the introduction of FOLFIRINOX. METHODS This single-center retrospective real world study includes 121 patients diagnosed with locally advanced or primary metastatic pancreatic adenocarcinoma who were treated with chemotherapy doublet, with either Gem-Nab or Gem-Ox in palliative first-line. Survival rates were analyzed using the Kaplan-Meier method, and comparisons were made with log-rank tests. Gem-Ox was considered as standard first line therapy at our institution for patients who were deemed fit for doublet chemotherapy between the years 2006 to 2012. These patients were compared to a cohort of patients treated with the new standard first-line therapy of Gem-Nab between 2013 and 2020. RESULTS A total of 554 patients with pancreatic cancer of all stages were screened, and 73 patients treated with Gem-Nab and 48 patients treated with Gem-Ox in the palliative first-line setting were identified and included in this analysis. Patients receiving Gem-Ox had a statistically significantly better performance score (ECOG PS) when compared to the Gem-Nab group (Odds ratio (OR) 0.28, 95% CI 0.12-0.65, p = 0.005), more often suffered from locally advanced than metastatic disease (OR 3.10, 95% CI 1.27-7.91, p = 0.019) and were younger in age (OR 0.95, 95% CI 0.91-0.99, p = 0.013). Median overall survival (OS) of the whole study cohort was 10.3 months (95% CI 8.5-11.6). No statistically significant difference in OS could be observed between the Gem-Nab and the Gem-Ox cohort (median OS: 8.9 months (95% CI 6.4-13.5) versus 10.9 months (95% CI 9.5-13.87, p = 0.794, HR 1.27, 95% CI 0.85-1.91)). Median progression-free survival (PFS) was 6.8 months in the entire cohort (95% CI 4.9-8.4). No statistically significant difference in PFS could be observed between the Gem-Nab and the Gem-Ox cohort (median PFS: 5.8 months (95% CI 4.3-8.2) versus 7.9 months (95% CI 5.4-9.5) p = 0.536, HR 1.11, 95% CI 0.74-1.67). Zero-truncated negative binomial regressions on OS and PFS adjusting for gender, age, performance status (ECOG PS), and CA19-9 levels yielded no significant difference between Gem-Nab or Gem-Ox. CONCLUSION From our analysis, we could evidence no difference in outcome parameters in this retrospective analysis despite the worse prognostic pattern for GemOX. Therefore, we suggest Gem-Ox as potential first line treatment option for inoperable locally advanced or metastatic pancreatic cancer, especially if Gem-Nab is not available.
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Affiliation(s)
- Konstantin Schlick
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic CenterParacelsus Medical UniversitySalzburgAustria
- Salzburg Cancer Research Institute, Center for Clinical Cancer and Immunology TrialsSalzburgAustria
| | | | - Alexander Seymer
- Department of Sociology and Human Geography, Division of SociologyParis Lodron University Salzburg (PLUS)SalzburgAustria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic CenterParacelsus Medical UniversitySalzburgAustria
- Salzburg Cancer Research Institute, Center for Clinical Cancer and Immunology TrialsSalzburgAustria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic CenterParacelsus Medical UniversitySalzburgAustria
- Salzburg Cancer Research Institute, Center for Clinical Cancer and Immunology TrialsSalzburgAustria
- Cancer Cluster SalzburgSalzburgAustria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic CenterParacelsus Medical UniversitySalzburgAustria
- Salzburg Cancer Research Institute, Center for Clinical Cancer and Immunology TrialsSalzburgAustria
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12
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Huemer F, Dunkl C, Rinnerthaler G, Schlick K, Heregger R, Emmanuel K, Neureiter D, Klieser E, Deutschmann M, Roeder F, Greil R, Weiss L. Management of metastatic colorectal cancer in patients ≥70 years - a single center experience. Front Oncol 2023; 13:1222951. [PMID: 37560467 PMCID: PMC10407548 DOI: 10.3389/fonc.2023.1222951] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 06/23/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Age-standardized mortality rates for metastatic colorectal cancer (mCRC) are highest among elderly patients. In current clinical guidelines, treatment recommendations for this patient population are based on a limited number of clinical trials. PATIENTS AND METHODS In this monocentric, retrospective analysis we characterized patients aged ≥70 years undergoing systemic therapy for mCRC and overall survival (OS) was investigated. RESULTS We included 117 unselected, consecutive mCRC patients aged ≥70 years undergoing systemic therapy for mCRC between February 2009 and July 2022. Median OS was 25.6 months (95% CI: 21.8-29.4). The median age was 78 years (range: 70-90) and 21%, 48%, 26% and 5% had an ECOG performance score of 0, 1, 2, and 3, respectively. The median number of systemic therapy lines was 2 (range: 1-5). The choice of first-line chemotherapy backbone (doublet/triplet versus mono) did not impact OS (HR: 0.83, p=0.50) or the probability of receiving subsequent therapy (p=0.697). Metastasectomy and/or local ablative treatment in the liver, lung, peritoneum and/or other organs were applied in 26 patients (22%) with curative intent. First-line anti-EGFR-based therapy showed a trend towards longer OS compared to anti-VEGF-based therapy or chemotherapy alone in left-sided mCRC (anti-EGFR: 39.3 months versus anti-VEGF: 27.3 months versus chemotherapy alone: 13.8 months, p=0.105). In multivariable analysis, metastasectomy and/or local ablative treatment with curative intent (yes versus no, HR: 0.22, p<0.001), the ECOG performance score (2 versus 0, HR: 3.07, p=0.007; 3 versus 0, HR: 3.66, p=0.053) and the presence of liver metastases (yes versus no, HR: 1.79, p=0.049) were independently associated with OS. CONCLUSIONS Our findings corroborate front-line monochemotherapy in combination with targeted therapy as the treatment of choice for elderly mCRC patients with palliative treatment intent. Metastasectomy and/or local ablative treatment with curative intent are feasible and may improve OS in selected elderly mCRC patients.
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Affiliation(s)
- Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Celine Dunkl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
| | - Konstantin Schlick
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Ronald Heregger
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Klaus Emmanuel
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Daniel Neureiter
- Cancer Cluster Salzburg, Salzburg, Austria
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Michael Deutschmann
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Falk Roeder
- Department of Radiation Oncology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
- Tumor Registry of the Province of Salzburg, Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
- Tumor Registry of the Province of Salzburg, Salzburg, Austria
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13
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Wöll E, Amann A, Eisterer W, Gerger A, Grünberger B, Rumpold H, Weiss L, Winder T, Greil R, Prager GW. Treatment Algorithm for Patients With Gastric Adenocarcinoma: Austrian Consensus on Systemic Therapy - An Update. Anticancer Res 2023; 43:2889-2897. [PMID: 37351962 DOI: 10.21873/anticanres.16460] [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: 04/05/2023] [Revised: 04/26/2023] [Accepted: 05/09/2023] [Indexed: 06/25/2023]
Abstract
Over the last decade, therapeutic options for patients with gastric cancer have improved significantly. However, despite these recent advances, mortality is still substantial. Surgery and chemotherapy represent the cornerstones of patient management. Immune checkpoint inhibitors as well as targeted treatments such as HER2-directed therapies and antiangiogenic agents contribute to improved patient prognosis. Herein, we present the updated version of an Austrian consensus on the systemic treatment of patients with gastric adenocarcinoma and adenocarcinoma of the lower gastroesophageal junction, including those with human epidermal growth receptor 2 (HER2) overexpression, microsatellite instability, programmed death-ligand 1 (PD-L1)-positive disease, and claudin 18.2 positivity. The consensus considers the curative setting as well as first-line and later-line systemic treatment options in advanced disease. For HER2-positive disease, HER2 testing is discussed in addition to a review of first-line and later-line therapies. Potential future therapies are also listed, with a focus on targeted [e.g., fibroblast growth factor receptor 2 (FGRF2)-directed] treatments that might provide a further step forward in the management of patients with gastric cancer.
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Affiliation(s)
- Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital Zams, Zams, Austria;
| | - Arno Amann
- Department of Internal Medicine V, Medical University of Innsbruck, Innsbruck, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine and Oncology, Klagenfurt Hospital, Klagenfurt am Wörthersee, Austria
| | - Armin Gerger
- Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Birgit Grünberger
- Department of Internal Medicine, Hematology and Oncology, Landesklinikum Wr. Neustadt, Wiener Neustadt, Austria
| | - Holger Rumpold
- Gastrointestincal Cancer Center, Ordensklinikum Linz, Linz, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Thomas Winder
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gerald W Prager
- Department of Medicine I, Medical University of Vienna, Vienna, Austria
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Laverre M, Kerhervé P, Constant M, Weiss L, Charrière B, Stetzler M, González-Fernández D, Ludwig W. Heavy rains control the floating macroplastic inputs into the sea from coastal Mediterranean rivers: A case study on the Têt River (NW Mediterranean Sea). Sci Total Environ 2023; 877:162733. [PMID: 36924956 DOI: 10.1016/j.scitotenv.2023.162733] [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] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 02/28/2023] [Accepted: 03/05/2023] [Indexed: 05/06/2023]
Abstract
This study focuses on the relevance of small watersheds in the macroplastic pollution of coastal environments. It aims to identify and quantify in terms of composition, number and mass, current riverine flows of floating macroplastics (>2.5 cm). Estimates are based on 66 visual monitoring of total litter over a 4-year-period (2016-2019) in a small coastal Mediterranean river, the Têt River (NW Mediterranean Sea). The plastic fraction represented 97 % of the observed litter, mainly cigarette butts (20.5 %), polystyrene fragments (18.8 %) and light packaging (16.3 %). The Tet River is characterized by frequent flash-flood events caused by heavy rain, that can induce a sudden rise of the water discharge. Such hydroclimatic forcing greatly influence macroplastic flows, both in terms of their average compositions and loads. We have estimated that 354,000 macroplastic items, corresponding to 0.65 tons, are discharged annually from the Tet River into the sea, and that 73 % of them are released during rain events (∼6 % of the year). The short observation distance from the water surface allowed to exhibit the great abundance of small litter (80 % of them were < 10 cm) and to evaluate to 1.8 g the average mass of floating plastics. Our results suggest that remediation actions must be taken on rainy days and target small litter in order to significantly limit macroplastic inputs from rivers to the sea. Moreover, the large share of cigarette butts in macrolitter inputs demonstrates that reducing ocean pollution cannot be achieved solely by improving waste management, but that changes in social behavior are also needed to stem waste production at the source.
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Affiliation(s)
- M Laverre
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
| | - P Kerhervé
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France.
| | - M Constant
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
| | - L Weiss
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
| | - B Charrière
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
| | - M Stetzler
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
| | - D González-Fernández
- Department of Biology, University Marine Research Institute INMAR, University of Cádiz and European University of the Seas, Puerto Real, Spain
| | - W Ludwig
- Université de Perpignan Via Domitia, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, 52 Avenue Paul Alduy, F-66860 Perpignan cedex, France; CNRS, Centre de Formation et de Recherche sur les Environnements Méditerranéens, UMR 5110, F-66860 Perpignan, France
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15
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Mirshahvalad SA, Seyedinia SS, Huemer F, Schweighofer-Zwink G, Koch O, Hitzl W, Weiss L, Emannuel K, Greil R, Pirich C, Beheshti M. Prognostic value of [ 18F]FDG PET/CT on treatment response and progression-free survival of gastroesophageal cancer patients undergoing perioperative FLOT chemotherapy. Eur J Radiol 2023; 163:110843. [PMID: 37119707 DOI: 10.1016/j.ejrad.2023.110843] [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: 11/25/2022] [Revised: 03/17/2023] [Accepted: 04/17/2023] [Indexed: 05/01/2023]
Abstract
PURPOSE To evaluate the prognostic role of [18F]FDG PET/CT metabolic parameters in gastric cancer (GC) and gastroesophageal adenocarcinoma (GEJAC) patients receiving neoadjuvant chemotherapy. METHOD In this retrospective study, 31 patients with biopsy-proven GC or GEJAC were included between August 2016 and March 2020. [18F]FDG PET/CT was performed before the neoadjuvant chemotherapy. Primary tumours' semi-quantitative metabolic parameters were extracted. All patients received a perioperative FLOT regimen thereafter. Post-chemotherapy [18F]FDG PET/CT was performed in most patients (17/31). All patients underwent surgical resection. Histopathology response to treatment and progression-free survival (PFS) were evaluated. Two-sided p-values < 0.05 were considered statistically significant. RESULTS Thirty-one patients (mean age = 62 ± 8), including 21 GC and 10 GEJAC patients, were evaluated. 20/31(65%) patients were histopathology responders to neoadjuvant chemotherapy, including twelve complete and eight partial responders. During the median follow-up of 42.0 months, nine patients experienced recurrence. The median PFS was 60(95% CI:32.9-87.1) months. Pre-neoadjuvant chemotherapy SULpeak was significantly correlated with pathological response to treatment (p-value = 0.03;odds ratio = 16.75). In survival analysis, SUVmax (p-value = 0.01;hazard ratio[HR] = 1.55), SUVmean (p-value = 0.04;HR = 2.73), SULpeak (p-value < 0.001;HR = 1.91) and SULmean (p-value = 0.04;HR = 4.22) in the post-neoadjuvant chemotherapy pre-operative [18F]FDG PET/CT showed significant correlation with PFS. Additionally, aspects of staging were significantly correlated with PFS (p-value = 0.01;HR = 2.21). CONCLUSIONS Pre-neoadjuvant chemotherapy [18F]FDG PET/CT parameters, especially SULpeak, could predict the pathological response to treatment in GC and GEJAC patients. Additionally, in survival analysis, post-chemotherapy metabolic parameters significantly correlated with PFS. Thus, performing [18F]FDG PET/CT before chemotherapy may help to identify patients at risk for inadequate response to perioperative FLOT and, after chemotherapy, may predict clinical outcomes.
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Affiliation(s)
- Seyed Ali Mirshahvalad
- Division of Molecular Imaging & Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria; Joint Department of Medical Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Seyedeh Sara Seyedinia
- Division of Molecular Imaging & Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Gregor Schweighofer-Zwink
- Division of Molecular Imaging & Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Oliver Koch
- Department of Surgery, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Wolfgang Hitzl
- Biostatistics and Publication of Clinical Trial Studies, Research and Innovation Management (RIM), Paracelsus Medical University, 5020 Salzburg, Austria; Department of Ophthalmology and Optometry, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; Research Program Experimental Ophthalmology and Glaucoma Research, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Klaus Emannuel
- Department of Surgery, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Christian Pirich
- Division of Molecular Imaging & Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria
| | - Mohsen Beheshti
- Division of Molecular Imaging & Theranostics, Department of Nuclear Medicine, University Hospital Salzburg, Paracelsus Medical University, 5020 Salzburg, Austria.
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16
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Weiss L, Heinrich K, Zhang D, Dorman K, Rühlmann K, Hasselmann K, Klauschen F, Kumbrink J, Jung A, Rudelius M, Mock A, Ormanns S, Kunz WG, Roessler D, Beyer G, Corradini S, Heinzerling L, Haas M, von Bergwelt-Baildon M, Boeck S, Heinemann V, Westphalen CB. Cancer of unknown primary (CUP) through the lens of precision oncology: a single institution perspective. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04741-y. [PMID: 37062035 PMCID: PMC10374717 DOI: 10.1007/s00432-023-04741-y] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/02/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE For patients with cancer of unknown primary (CUP), treatment options are limited. Precision oncology, the interplay of comprehensive genomic profiling (CGP) and targeted therapies, aims to offer additional treatment options to patients with advanced and hard-to-treat cancers. We aimed to highlight the use of a molecular tumor board (MTB) in the therapeutic management of CUP patients. METHODS In this single-center observational study, CUP patients, presented to the MTB of the Comprehensive Cancer Center Munich LMU, a tertiary care center, were analyzed retrospectively. Descriptive statistics were applied to describe relevant findings. RESULTS Between June 2016 and February 2022, 61 patients with unfavorable CUP were presented to the MTB, detected clinically relevant variants in 74% (45/61) of patients, of which 64% (29/45) led to therapeutic recommendation. In four out of 29 patients (14%), the treatment recommendations were implemented, unfortunately without resulting in clinical benefit. Reasons for not following the therapeutic recommendation were mainly caused by the physicians' choice of another therapy (9/25, 36%), especially in the context of worsening of general condition, lost to follow-up (7/25, 28%) and death (6/25, 24%). CONCLUSION CGP and subsequent presentation to a molecular tumor board led to a high rate of therapeutic recommendations in patients with CUP. Recommendations were only implemented at a low rate; however, late GCP diagnostic and, respectively, MTB referral were found more frequent for the patients with implemented treatment. This contrast underscores the need for early implementation of CGP into the management of CUP patients.
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Affiliation(s)
- L Weiss
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - K Heinrich
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - D Zhang
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - K Dorman
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - K Rühlmann
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - K Hasselmann
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - F Klauschen
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - J Kumbrink
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - A Jung
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - M Rudelius
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - A Mock
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - W G Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - D Roessler
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - G Beyer
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - L Heinzerling
- Department of Dermatology, University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - M Haas
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - M von Bergwelt-Baildon
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - S Boeck
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - C B Westphalen
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
- Bavarian Cancer Research Center (BZKF), Munich, Germany.
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17
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Wagner SM, Magnes T, Melchardt T, Kiem D, Weiss L, Neureiter D, Wagner C, Aretin MB, Nemec S, Gamerith G, Pall G, Greil R, Fuereder T. Real-world Data of Palliative First-line Checkpoint Inhibitor Therapy for Head and Neck Cancer. Anticancer Res 2023; 43:1273-1282. [PMID: 36854497 DOI: 10.21873/anticanres.16274] [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: 01/05/2023] [Revised: 01/19/2023] [Accepted: 01/20/2023] [Indexed: 03/02/2023]
Abstract
BACKGROUND/AIM Pembrolizumab alone or combined with chemotherapy is now approved in PD-L1-positive patients with recurrent or metastatic squamous cell carcinoma of the head and neck (SCCHN). Since real-world data are pending, our goal was to evaluate the efficacy and safety of immune checkpoint inhibitor (CPI) therapy in an unselected cohort of patients with SCCHN. PATIENTS AND METHODS We analyzed 78 patients with recurrent or metastatic SCCHN from three Austrian cancer centers that received CPI therapy alone or with chemotherapy as palliative first-line systemic treatment for this retrospective study. Patient characteristics, details on treatment, and survival were analyzed by a chart-based review. RESULTS Of the 78 patients analyzed, 55 patients were treated with CPI alone (45 with Pembrolizumab, 10 with Nivolumab) and 23 patients received chemotherapy with a platinum and 5-FU in addition to CPI. With a median follow-up of twelve months, the median PFS of all patients was 4 months [95% confidence interval (CI)=2.2-5.8] and the median OS was 11 months (95% CI=7.1-14.9). The overall response and disease control rates were 20.5% and 46.1%, respectively. There was no statistically significant difference in clinical outcome between patient groups with a different combined positive score (CPS). The rate of reported immune related adverse events was comparable to existing data. CONCLUSION Our findings confirm the results of the KEYNOTE-048 trial that CPI therapy alone or together with chemotherapy is an effective treatment for patients with recurrent or metastatic CPS-positive SCCHN.
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Affiliation(s)
- Sandro M Wagner
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria.,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Teresa Magnes
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria.,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Thomas Melchardt
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria.,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Dominik Kiem
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria.,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Lukas Weiss
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria.,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - Christina Wagner
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
| | | | - Stefan Nemec
- Department of Biomedical Imaging and Image-guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Gabriele Gamerith
- Department of Internal Medicine V (Hematology and Oncology), Medical University of Innsbruck, Innsbruck, Austria
| | - Georg Pall
- Department of Internal Medicine V (Hematology and Oncology), Medical University of Innsbruck, Innsbruck, Austria
| | - Richard Greil
- III Medical Department at the Paracelsus Medical University, Salzburg, Austria; .,Salzburg Cancer Research Institute, Salzburg, Austria
| | - Thorsten Fuereder
- Division of Oncology, Department of Medicine I, Medical University of Vienna, Vienna, Austria
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18
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Zhao Z, Weiss L, McBride CS. GCaMP Imaging in Mosquitoes: Central Nervous System. Cold Spring Harb Protoc 2023; 2023:107682-pdb.top. [PMID: 36446531 DOI: 10.1101/pdb.top107682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Mosquitoes spread dengue, Zika, malaria, and other pathogens to hundreds of millions of people every year. A better understanding of mosquito behavior and its underlying neural mechanisms may lead to new control strategies, but such an understanding requires the development of tools and approaches for exploring the nervous system of key vector species. For example, we can now image neural activity in mosquito brains using genetically encoded calcium sensors like GCaMP. Compared with other types of neural recording, GCaMP imaging has the advantage of allowing one to record from many neurons simultaneously and/or to record from specific neuronal types. Successful implementation requires careful consideration of many factors, including the choice of microscope and how to make the brains of experimental animals visible and stable while minimizing damage. Here, we elaborate on these points and provide a concise introduction to GCaMP imaging in the mosquito central nervous system.
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Affiliation(s)
- Zhilei Zhao
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
| | - Lukas Weiss
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
| | - Carolyn S McBride
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA .,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
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19
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Zhao Z, Weiss L, McBride CS. Two-Photon Calcium Imaging in the Brain of Aedes aegypti Mosquitoes. Cold Spring Harb Protoc 2023; 2023:108070-pdb.prot. [PMID: 36446529 DOI: 10.1101/pdb.prot108070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Understanding the neural basis of mosquito behavior is critical for designing effective vector control strategies and can potentially shed new light on basic nervous system function. Because mosquitoes are a non-model species, however, functional studies of mosquito nervous systems have long been restricted to electrophysiological recording from peripheral sensory organs such as the antenna. This is now changing with the advent of CRISPR-Cas9 gene editing and the development of other powerful new genetic tools. Transgenic mosquitoes that carry genetically encoded calcium sensors, for example, open the door to optical recording of neural activity with two-photon calcium imaging. Compared with electrophysiology, calcium imaging permits continuous monitoring of neural activity from large populations of neurons, even deep in the brain. When combined with selective neural drivers, it also allows targeted recording from specific neuronal types. Here, we describe a calcium imaging protocol we use in our laboratory to study neural activity in the brain of Aedes aegypti mosquitoes.
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Affiliation(s)
- Zhilei Zhao
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
| | - Lukas Weiss
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA.,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
| | - Carolyn S McBride
- Princeton Neuroscience Institute, Princeton University, Princeton, New Jersey 08544, USA .,Department of Ecology and Evolutionary Biology, Princeton University, Princeton, New Jersey 08544, USA
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20
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Roeder F, Gerum S, Hecht S, Huemer F, Jäger T, Kaufmann R, Klieser E, Koch OO, Neureiter D, Emmanuel K, Sedlmayer F, Greil R, Weiss L. How We Treat Localized Rectal Cancer-An Institutional Paradigm for Total Neoadjuvant Therapy. Cancers (Basel) 2022; 14:cancers14225709. [PMID: 36428801 PMCID: PMC9688120 DOI: 10.3390/cancers14225709] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/15/2022] [Accepted: 11/16/2022] [Indexed: 11/23/2022] Open
Abstract
Total neoadjuvant therapy (TNT)-the neoadjuvant employment of radiotherapy (RT) or chemoradiation (CRT) as well as chemotherapy (CHT) before surgery-may lead to increased pathological complete response (pCR) rates as well as a reduction in the risk of distant metastases in locally advanced rectal cancer. Furthermore, increased response rates may allow organ-sparing strategies in a growing number of patients with low rectal cancer and upfront immunotherapy has shown very promising early results in patients with microsatellite instability (MSI)-high/mismatch-repair-deficient (dMMR) tumors. Despite the lack of a generally accepted treatment standard, we strongly believe that existing data is sufficient to adopt the concept of TNT and immunotherapy in clinical practice. The treatment algorithm presented in the following is based on our interpretation of the current data and should serve as a practical guide for treating physicians-without any claim to general validity.
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Affiliation(s)
- Falk Roeder
- Department of Radiation Oncology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Sabine Gerum
- Department of Radiation Oncology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Stefan Hecht
- Department of Radiology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Tarkan Jäger
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Reinhard Kaufmann
- Department of Radiology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Oliver Owen Koch
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Klaus Emmanuel
- Department of Visceral and Thoracic Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Felix Sedlmayer
- Department of Radiation Oncology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria
- Correspondence: ; Tel.: +43-57255-25801
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21
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Huemer F, Hecht S, Scharinger B, Schlintl V, Rinnerthaler G, Schlick K, Heregger R, Melchardt T, Wimmer A, Mühlbacher I, Koch OO, Neureiter D, Klieser E, Seyedinia S, Beheshti M, Greil R, Weiss L. Body composition dynamics and impact on clinical outcome in gastric and gastro-esophageal junction cancer patients undergoing perioperative chemotherapy with the FLOT protocol. J Cancer Res Clin Oncol 2022:10.1007/s00432-022-04096-w. [PMID: 35864270 DOI: 10.1007/s00432-022-04096-w] [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: 04/03/2022] [Accepted: 05/27/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE Perioperative chemotherapy with FLOT constitutes a standard of care approach for locally advanced, resectable gastric or gastro-esophageal junction (GEJ) cancer. We aimed at investigating anthropometric, CT-based and FDG-PET-based body composition parameters and dynamics during this multidisciplinary approach and the impact on clinical outcomes. METHODS This retrospective, single-center study was based on medical records and (FDG-PET)-CT images among gastric/GEJ cancer patients undergoing perioperative FLOT chemotherapy. RESULTS Between 2016 and 2021, 46 gastric/GEJ cancer patients started perioperative FLOT at our tertiary cancer center (Salzburg, Austria). At a median follow-up of 32 months median PFS was 47.4 months and median OS was not reached. The skeletal muscle index (SMI, cm2/m2) turned out to be the only body composition parameter with a statistically significant decrease during pre-operative FLOT (51.3 versus 48.8 cm2/m2, p = 0.02). Neither pre-FLOT body mass index (BMI), nor SMI had an impact on the duration of pre-operative FLOT, the time interval from pre-operative FLOT initiation to surgery, the necessity of pre-operative or post-operative FLOT de-escalation or the likelihood of the start of postoperative chemotherapy. Pre-FLOT BMI (overweight versus normal, HR: 0.11, 95% CI: 0.02-0.65, p = 0.02) and pre-FLOT SMI (sarcopenia versus no sarcopenia, HR: 5.08, 95% CI: 1.27-20.31, p = 0.02) were statistically significantly associated with PFS in the multivariable analysis. CONCLUSION The statistically significant SMI loss during pre-operative FLOT and the meaningful impact of baseline SMI and BMI on PFS argue for the implementation of a nutritional screening and support program prior to the initiation of pre-operative FLOT in clinical routine.
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Affiliation(s)
- Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Stefan Hecht
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Bernhard Scharinger
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Verena Schlintl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
| | - Konstantin Schlick
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Ronald Heregger
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Thomas Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Angela Wimmer
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Iris Mühlbacher
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Oliver Owen Koch
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Daniel Neureiter
- Cancer Cluster Salzburg, Salzburg, Austria
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Sara Seyedinia
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Mohsen Beheshti
- Division of Molecular Imaging and Theranostics, Department of Nuclear Medicine, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria
- Cancer Cluster Salzburg, Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute , Center for Clinical Cancer and Immunology Trials (SCRI-CCCIT), Paracelsus Medical University Salzburg, Salzburg, Austria.
- Cancer Cluster Salzburg, Salzburg, Austria.
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Sebbag E, Cloarec N, Barthelemy P, Sedmak N, Hamamouche N, Servy H, Desjeux G, Monnet I, Najem A, Porneuf M, Rajpar LS, Meunier J, San T, Chauvenet L, Darut Jouve A, Falkowski S, Rizzo C, Litrowski N, Canellas A, Paitel JF, Pracht M, Cadranel J, Weiss L, Chouaid C, Aparicio T, Nancey S, Arnold C, Sauleau E, Gottenberg JE. POS1412 FIRSTS RESULTS OF THE PRAISE STUDY (PATIENT-REPORTED AUTOIMMUNITY SECONDARY TO CANCER IMMUNOTHERAPY): MULTICENTRIC PROSPECTIVE COHORT STUDY ON AUTOIMMUNE DISEASES SECONDARY TO CANCER IMMUNOTHÉRAPY. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1093] [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: 11/04/2022]
Abstract
BackgroundIn cancer immunotherapy, T-lymphocyte activation can lead to secondary autoimmune diseases named OASI for Opportunistic Autoimmunity Secondary to cancer Immunotherapy [1]. The epidemiology of OASI deserves to be further studied due to the unadapted reporting of clinical trials and the lack of prospective studies. Moreover, literature focuses on the most severe OASI and/or on specific OASI (myocarditis, colitis, arthritis).ObjectivesOur goal was to determine incidence, severity of all grade OASI using a multicentric prospective patient cohort starting treatment with cancer immunotherapy.MethodsWe present a multicentric, prospective, observational, longitudinal, real life, French e-cohort. 900 patients treated with ipilimumumab and/or nivolumab will be included. Data is collected from the patient and the oncologist at inclusion, then patients report directly any symptom that could be suggestive of OASI with the help of monthly digital questionaries. In case an OASI is suspected, further confirmation is made with the practician in charge and by a paired analysis with the Système National De Santé (SNDS), the French health insurance registry.ResultsOn the 19/01/2022, 439 patients were included, 310 males (70.6%) and 129 females (29.4%). Mean age is 66 years old with a median follow up of 192 days. 354 patients (80.6%) are treated with Nivolumab alone, 7 (1.6%) with Ipilimumab alone and 76 (17.8 %) with combined Nivolumab + Ipilimumab. 136 patients (31.6%) are treated for a non-small cell lung carcinoma, 107 patients (24.9%) for a clear cell renal carcinoma, 91 patients (21.2%) for a skin melanoma, 49 patients (11.4%) for a head or neck epidermoid carcinoma, 24 patients (5.6%) for another lung cancer sub-type, and 32 patients (5.3%) for another histological cancer type. The mean follow-up is 294 days (+/- 192). 83 patients (18.9%) died since the beginning of the follow up.47 patients (10.7%) developed 63 OASI. The mean delay between the beginning of cancer immunotherapy and the OASI is 134.7 days (+/- 103.4).Approximately, one third of the OASI were musculoskeletal diseases. The OASI included polymyalgia rheumatica (3 patients), psoriatic arthritis (1 patient), polyarthritis (1 patient) systemic lupus (1 patient), arthralgias and myalgias (8 patients), colitis (11 patients), dysthyroïditis (6 patients), hepatitis (4 patients), nephritis (3 patients), pneumonitis (2 patients), hypophysitis (2 patients), adrenal insufficiency (4 patients), myocarditis (1 patient), hemophagocytic lympho-histiocytosis (1 patient), and other types of OASI (15 patients).26 patients (55% of patients with OASI, 5,9% of all patients) had to stop cancer immunotherapy due to an OASI, one because of a rheumatic disease (systemic lupus). 52 patients were treated with corticosteroids, 1 patient with methotrexate (psoriatic arthritis), 3 patients with infliximab (colitis) and 1 patient with abatacept (myocarditis). 1 patient died after an OASI (colitis).ConclusionThe first results of this prospective study, using an original patient-centered methodology, confirm the expected incidence of autoimmune events secondary to cancer immunotherapy and the role of rheumatologists in their therapeutic management.References[1]Kostine M, Chiche L, Lazaro E, et al. Opportunistic autoimmunity secondary to cancer immunotherapy (OASI): An emerging challenge. Rev Med Interne. 2017;38(8):513-525. doi:10.1016/j.revmed.2017.01.004AcknowledgementsBMS funded the study (unrestricted grant) but had no role in study design, data collection, analysis or decision to publish.Disclosure of InterestsEden Sebbag: None declared, Nicolas Cloarec: None declared, Philippe Barthelemy: None declared, Nathanaël Sedmak: None declared, Naima Hamamouche Consultant of: Work for Sanoia Digital CRO, Hervé Servy Consultant of: Work for Sanoia Digital CRO, Guillaume Desjeux Consultant of: Work for Sanoia Digital CRO, Isabelle Monnet: None declared, Abeer Najem: None declared, Marc Porneuf: None declared, Laetitia-Shanna Rajpar: None declared, Jérôme Meunier: None declared, Tévy San: None declared, Laure Chauvenet: None declared, Ariane DARUT JOUVE: None declared, Sabrina FALKOWSKI: None declared, Claudia Rizzo: None declared, Noémie Litrowski: None declared, Anthony Canellas: None declared, Jean-François Paitel: None declared, Marc Pracht: None declared, Jacques Cadranel: None declared, Laurence Weiss: None declared, Christos Chouaid: None declared, Thomas Aparicio: None declared, Stephane Nancey: None declared, Cécile Arnold: None declared, Erik Sauleau: None declared, Jaqcues-Eric Gottenberg: None declared
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Wyrwicz L, Taieb J, Price T, Bachet J, Karthaus M, Vidot L, Chevallier B, Reisländer T, Weiss L, Heinemann V. SO-18 Reinforcing clinical outcomes with patient-reported QoL outcomes in patients with mCRC receiving FTD/TPI: Pooled analysis of PRECONNECT and TALLISUR studies. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.417] [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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Kelliher S, Macleod H, Weiss L, Szklanna P, Gamba S, Ainle FN, Schieppati F, Marchetti M, Maguire P, Falanga A, Kevane B. PO-08: Characterisation of plasma extracellular vesicles in myeloproliferative neoplasms. Thromb Res 2022. [DOI: 10.1016/s0049-3848(22)00196-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Abstract
This short review reflects on a personal selection of three abstracts on colorectal cancer (CRC) presented at the 2021 ESMO Congress: (1) KRASG12C as a new therapeutic target in metastatic CRC, supported by data from the KRYSTAL‑1 and CodeBreaK101 trials, (2) positive phase 3 data on the possible role of selective internal radiotherapy (SIRT) in the second-line treatment of liver-limited metastatic CRC, and (3) the impact of the coronavirus disease 2019 (COVID-19) pandemic on CRC screening, management and mortality, now and in the upcoming years.
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Affiliation(s)
- Lukas Weiss
- IIIrd Medical Department, Paracelsus Medical University, Muellner Hauptstr. 48, 5020 Salzburg, Austria
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Schlintl V, Huemer F, Rinnerthaler G, Melchardt T, Winder T, Reimann P, Riedl J, Amann A, Eisterer W, Romeder F, Piringer G, Ilhan-Mutlu A, Wöll E, Greil R, Weiss L. Checkpoint inhibitors in metastatic gastric and GEJ cancer: a multi-institutional retrospective analysis of real-world data in a Western cohort. BMC Cancer 2022; 22:51. [PMID: 35012477 PMCID: PMC8744304 DOI: 10.1186/s12885-021-09115-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 12/15/2021] [Indexed: 12/24/2022] Open
Abstract
Background Safety and efficacy of immune checkpoint inhibitors in advanced gastric or gastroesophageal junction (GEJ) cancer could be demonstrated in predominantly Asian cohorts, whereas data in Western patients outside of clinical trials are vastly missing. Methods In this multi-institutional retrospective analysis conducted at nine oncologic centers in Austria, we tried to assess feasibility of checkpoint inhibitors in advanced gastric/GEJ cancer in a real-world Western cohort. Results In total, data from 50 patients with metastatic gastric/GEJ cancer who received nivolumab or pembrolizumab in a palliative setting between November 2015 and April 2020 have been evaluated. The median number of previous palliative therapy lines was two. The median progression-free survival (PFS) and overall survival (OS) were 2.1 (95% CI: 1.4–2.8) and 6.3 (95% CI: 3.3–9.3) months, respectively. There was no statistically significant difference in median OS according to microsatellite or PD-L1 status. However, a trend towards prolonged PFS and OS for the microsatellite instability high subgroup could be observed. Patients with an ECOG Performance Status (PS) ≥ 2 displayed a significantly worse outcome than those with an ECOG PS ≤ 1 (p = .03). Only one patient discontinued immunotherapy due to treatment-related toxicity. Conclusions Our results support feasibility of nivolumab and pembrolizumab in pre-treated patients with metastatic gastric and GEJ cancer in a Western real-world cohort. Further phase II/III studies are needed to confirm clinical efficacy.
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Affiliation(s)
- Verena Schlintl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria
| | - Thomas Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria
| | - Thomas Winder
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Patrick Reimann
- Department of Internal Medicine II, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Jakob Riedl
- Division of Clinical Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Arno Amann
- Department of Internal Medicine V, Medical University Innsbruck, Innsbruck, Austria
| | - Wolfgang Eisterer
- Department of Internal Medicine and Oncology, Klagenfurt Hospital, Klagenfurt, Austria
| | - Franz Romeder
- Internal Medicine I: Department of Medical Oncology and Haematology, Ordensklinikum Linz Barmherzige Schwestern, Linz, Austria
| | - Gudrun Piringer
- Department of Internal Medicine IV, Wels-Grieskirchen Hospital, Wels, Austria and Johannes Kepler University Linz, Linz, Austria
| | - Aysegül Ilhan-Mutlu
- Department of Medicine I, Comprehensive Cancer Center Vienna, Gastroesophageal Tumor Unit, Medical University of Vienna, Vienna, Austria
| | - Ewald Wöll
- Department of Internal Medicine, St. Vinzenz Hospital, Zams, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, Salzburg, Austria.
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Schlick K, Markus S, Huemer F, Ratzinger L, Zaborsky N, Clemens H, Neureiter D, Neumayer B, Beate AS, Florian S, Martin V, Grundbichler M, Weiss L, Melchardt T, Greil R, Egle A. Evaluation of circulating cell-free KRAS mutational status as a molecular monitoring tool in patients with pancreatic cancer. Pancreatology 2021; 21:1466-1471. [PMID: 34511398 DOI: 10.1016/j.pan.2021.09.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 08/06/2021] [Accepted: 09/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND Pancreatic carcinoma carries a devastating prognosis and is the 4th leading cause for cancer related death in the US and most European countries. Apart from imaging and CA 19-9, pancreatic carcinoma is still lacking reliable markers to assess tumor dynamics and to monitor treatment response over time. The aim of this study was to evaluate the feasibility of cell free tumor-DNA (cft-DNA), respectively KRAS mutation in peripheral blood, detection as a prognostic and predictive value for chemotherapy monitoring. METHODS Serial plasma samples from 42 patients with KRAS mutated pancreatic cancer were prospectively collected and the ctKRAS Mutation Assay (Idylla™, Biocartis, Mechelen, Belgium) of cft-DNA was performed on 29 patients that did not receive curative surgery and went on to palliative chemotherapy. To monitor cft-DNA KRAS mutation levels during treatment quantitative assessment of cft-DNA was performed at baseline and during follow up at predetermined times. RESULTS All 29 patients included in our analyses had a detected KRAS mutation in the tumor biopsy. In almost half (48.2%) of patients a KRAS mutation could also be detected in peripheral plasma. Patients with detectable KRAS mutations before treatment start in plasma had a significantly worse survival (16.8 months vs not reached, p < 0.031 and HR 3.303). Looking for a dynamic assessment of tumor response, we found a statistically significant association between the KRAS mutant ratio from first staging CT scan to basal levels with tumor response or progress (p = 0.014). CONCLUSION Performing KRAS testing from peripheral blood for patients, who have no elevated tumor markers, might be a novel option for treatment monitoring complementing routine imaging techniques.
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Affiliation(s)
- Konstantin Schlick
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Steiner Markus
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Florian Huemer
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Lukas Ratzinger
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Nadja Zaborsky
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Hufnagl Clemens
- Department for Neuroinvention, Christian-Doppler-Klinik Universitätsklinik für Neurologie Paracelsus Medical University, Salzburg, Austria
| | - Daniel Neureiter
- Department of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Bettina Neumayer
- Department of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | | | - Steiner Florian
- Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Varga Martin
- Department of Surgery, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Michael Grundbichler
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Lukas Weiss
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Thomas Melchardt
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Richard Greil
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria
| | - Alexander Egle
- 3rd Medical Department with Hematology and Medical Oncology, Hemostaseology, Rheumatology and Infectious Diseases, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute (SCRI), Salzburg, Austria; Laboratory for Immunological and Molecular Cancer Research (LIMCR), Salzburg, Austria; Center for Clinical Cancer and Immunology Trials (CCCIT), Salzburg, Austria.
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Bouillet L, Boccon-Gibod I, Weiss L, Launay D, Lahjibi E, Du-Thanh A, Aubineau M, Pagnier A, Gobert D, Fain O. Efficacité du lanadelumab en vie réelle chez des patients atteints d’angiœdème héréditaire : résultats intermédiaires de l’étude observationnelle française SERENITI. Rev Med Interne 2021. [DOI: 10.1016/j.revmed.2021.10.115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Schlick K, Kiem D, Huemer F, Neureiter D, Weiss L, Greil R. Non-pegylated Liposomal Doxorubicin as Palliative Chemotherapy in pre-Treated Advanced Pancreatic Cancer: A Retrospective Analysis of Twenty-Eight Patients. Technol Cancer Res Treat 2021; 20:15330338211042139. [PMID: 34595977 PMCID: PMC8489749 DOI: 10.1177/15330338211042139] [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] [Indexed: 11/21/2022] Open
Abstract
Background: Pancreatic cancer carries a devastating prognosis and is the fourth leading cause for cancer-related death in the United States and most European countries. Although one-third of patients receive a palliative third line therapy, the benefit of systemic therapy beyond second-line remains unclear. A plethora of clinical trials investigating novel drugs have failed over the past years. Due to the lack of established treatment regimens beyond second line, we offered nonpegylated liposomal doxorubicin, well known in other tumor entities, to pretreated pancreatic cancer patients requesting systemic therapy. Material and Methods: In this retrospective analysis, 28 patients with pancreatic carcinoma treated with nonpegylated liposomal doxorubicin (Myocet®) between 2012 and 2018 at our department were included. Results: For the majority of patients (n = 18, 64%), nonpeglyted liposomal doxorubicin was offered as a third-line therapy. Five patients received it as second line, four patients as fourth line, and one patient as fifth line of therapy. Half of the patients received at least a therapy cycle. The objective response rate to treatment was 7.1%. One patient had a period of radiologically confirmed stable disease with stable tumor markers. Another patient experienced partial remission. Conclusion: According to our findings the benefit of nonpegylated liposomal doxorubicin in pancreatic cancer beyond second line is limited.
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Affiliation(s)
- Konstantin Schlick
- Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Dominik Kiem
- Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Florian Huemer
- Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University, Salzburg, Austria
| | | | - Lukas Weiss
- Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University, Salzburg, Austria
| | - Richard Greil
- Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Cancer Cluster Salzburg, Paracelsus Medical University, Salzburg, Austria
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Osigwe C, Salcido D, Weiss L. 180 Disparities in Distribution of PulsePoint Responders and Potential Impacts on Pandemic Response in Underserved Communities of Allegheny County. Ann Emerg Med 2021. [PMCID: PMC8536308 DOI: 10.1016/j.annemergmed.2021.09.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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Weiss L, Segoviano Arias P, Offner T, Hawkins SJ, Hassenklöver T, Manzini I. Distinct interhemispheric connectivity at the level of the olfactory bulb emerges during Xenopus laevis metamorphosis. Cell Tissue Res 2021; 386:491-511. [PMID: 34580751 PMCID: PMC8595194 DOI: 10.1007/s00441-021-03527-3] [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] [Received: 05/14/2021] [Accepted: 09/15/2021] [Indexed: 11/28/2022]
Abstract
During metamorphosis, the olfactory system of anuran tadpoles undergoes substantial restructuring. The main olfactory epithelium in the principal nasal cavity of Xenopus laevis tadpoles is associated with aquatic olfaction and transformed into the adult air-nose, while a new adult water-nose emerges in the middle cavity. Impacts of this metamorphic remodeling on odor processing, behavior, and network structure are still unexplored. Here, we used neuronal tracings, calcium imaging, and behavioral experiments to examine the functional connectivity between the epithelium and the main olfactory bulb during metamorphosis. In tadpoles, olfactory receptor neurons in the principal cavity project axons to glomeruli in the ventral main olfactory bulb. These projections are gradually replaced by receptor neuron axons from the newly forming middle cavity epithelium. Despite this reorganization in the ventral bulb, two spatially segregated odor processing streams remain undisrupted and behavioral responses to waterborne odorants are unchanged. Contemporaneously, new receptor neurons in the remodeling principal cavity innervate the emerging dorsal part of the bulb, which displays distinct wiring features. Glomeruli around its midline are innervated from the left and right nasal epithelia. Additionally, postsynaptic projection neurons in the dorsal bulb predominantly connect to multiple glomeruli, while half of projection neurons in the ventral bulb are uni-glomerular. Our results show that the “water system” remains functional despite metamorphic reconstruction. The network differences between the dorsal and ventral olfactory bulb imply a higher degree of odor integration in the dorsal main olfactory bulb. This is possibly connected with the processing of different odorants, airborne vs. waterborne.
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Affiliation(s)
- Lukas Weiss
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany.
| | - Paola Segoviano Arias
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany.,Max Planck Research Unit for Neurogenetics, 60438, Frankfurt, Germany
| | - Thomas Offner
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany
| | - Sara Joy Hawkins
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany
| | - Thomas Hassenklöver
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany
| | - Ivan Manzini
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, 35392, Giessen, Germany
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Kasprick L, Weiss L, Götz K. Die GeriNurse - Versorgungsgestaltung durch ein sektorenübergreifendes, assessmentgestütztes Care- und Casemangement. Das Gesundheitswesen 2021. [DOI: 10.1055/s-0041-1732724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- L Kasprick
- Leipziger Gesundheitsnetz Management GmbH
- Gerinet e.V
| | | | - K Götz
- Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Institut für Allgemeinmedizin
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Heregger R, Huemer F, Hutarew G, Hecht S, Cheveresan L, Kotzot D, Schamschula E, Rinnerthaler G, Melchardt T, Weiss L, Greil R. Sustained response to brigatinib in a patient with refractory metastatic pheochromocytoma harboring R1192P anaplastic lymphoma kinase mutation: a case report from the Austrian Group Medical Tumor Therapy next-generation sequencing registry and discussion of the literature. ESMO Open 2021; 6:100233. [PMID: 34371380 PMCID: PMC8358412 DOI: 10.1016/j.esmoop.2021.100233] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 02/02/2021] [Revised: 06/21/2021] [Accepted: 07/12/2021] [Indexed: 11/30/2022] Open
Abstract
Metastatic pheochromocytoma and paraganglioma (PPGL) are rare diseases with dismal prognosis and standard therapies are lacking. We herein report the first case of a germline anaplastic lymphoma kinase (ALK) mutation in a patient with chemorefractory metastatic pheochromocytoma in the absence of mutations of known PPGL-associated predisposing genes. Therapy with the ALK inhibitor (ALKi) brigatinib led to dramatic and durable disease remission, despite previous disease progression on the ALKi alectinib. This case underscores the potential clinical use of molecular profiling in rare diseases with limited treatment options and suggests that the ALK-R1192P point mutation might predict sensitivity to brigatinib. First case of a germline ALK mutation in a patient with metastatic pheochromocytoma. Durable response to the ALKi brigatinib after disease progression on combination chemotherapy and alectinib. A germline ALK mutation in a patient with pheochromocytoma in the absence of mutations of known PPGL-associated genes.
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Affiliation(s)
- R Heregger
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - G Hutarew
- Institute of Pathology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - S Hecht
- Institute of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - L Cheveresan
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - D Kotzot
- Clinical Genetics Unit, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - E Schamschula
- Institute of Human Genetics, Medical University of Innsbruck, Innsbruck, Austria
| | - G Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Austrian Group Medical Tumor Therapy, Vienna, Austria
| | - T Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Austrian Group Medical Tumor Therapy, Vienna, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Austrian Group Medical Tumor Therapy, Vienna, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University Salzburg, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Austrian Group Medical Tumor Therapy, Vienna, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria.
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Riess S, Rezaei J, Weiss L, Peter A, Wensing M. Phase change in fuel sprays at diesel engine ambient conditions: Modeling and experimental validation. J Supercrit Fluids 2021. [DOI: 10.1016/j.supflu.2021.105224] [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: 10/21/2022]
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Lhomme E, Sitta R, Journot V, Chazallon C, Gabillard D, Piroth L, Lefèvre B, Darnaud T, Naccache J, Weiss L, Le Bel J, Binquet C, Markinson A, Dupouy J, Onaisi R, Duvignaud A, Anglaret X, Malvy D, Richert L, Wittkop L. Plateforme COVERAGE France : un essai clinique randomisé multicentrique utilisant un schéma adaptatif multi-bras multi-étape (MAMS) pour évaluer plusieurs traitements expérimentaux de la COVID-19 en ambulatoire. Rev Epidemiol Sante Publique 2021. [DOI: 10.1016/j.respe.2021.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Magnes T, Wagner S, Kiem D, Weiss L, Rinnerthaler G, Greil R, Melchardt T. Prognostic and Predictive Factors in Advanced Head and Neck Squamous Cell Carcinoma. Int J Mol Sci 2021; 22:4981. [PMID: 34067112 PMCID: PMC8125786 DOI: 10.3390/ijms22094981] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 05/03/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease arising from the mucosa of the upper aerodigestive tract. Despite multimodality treatments approximately half of all patients with locally advanced disease relapse and the prognosis of patients with recurrent or metastatic HNSCC is dismal. The introduction of checkpoint inhibitors improved the treatment options for these patients and pembrolizumab alone or in combination with a platinum and fluorouracil is now the standard of care for first-line therapy. However, approximately only one third of unselected patients respond to this combination and the response rate to checkpoint inhibitors alone is even lower. This shows that there is an urgent need to improve prognostication and prediction of treatment benefits in patients with HNSCC. In this review, we summarize the most relevant risk factors in the field and discuss their roles and limitations. The human papilloma virus (HPV) status for patients with oropharyngeal cancer and the combined positive score are the only biomarkers consistently used in clinical routine. Other factors, such as the tumor mutational burden and the immune microenvironment have been highly studied and are promising but need validation in prospective trials.
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Affiliation(s)
- Teresa Magnes
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Sandro Wagner
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Dominik Kiem
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
| | - Lukas Weiss
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Gabriel Rinnerthaler
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Richard Greil
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
| | - Thomas Melchardt
- Oncologic Center, Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Paracelsus Medical University, 5020 Salzburg, Austria; (T.M.); (S.W.); (D.K.); (L.W.); (G.R.); (R.G.)
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), 5020 Salzburg, Austria
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Schlintl V, Huemer F, Greil R, Weiss L. Ramucirumab plus FOLFIRI or irinotecan as second-line therapy in advanced or metastatic gastric or gastroesophageal junction adenocarcinoma. J Gastrointest Oncol 2021; 12:906-909. [PMID: 34012679 PMCID: PMC8107630 DOI: 10.21037/jgo-20-230] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 10/22/2020] [Indexed: 11/06/2022] Open
Affiliation(s)
- Verena Schlintl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute, Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute, Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute, Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology, and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute, Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria
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Trivedi C, Shukla S, Adnan M, Shah K, Weiss L. Impact of “national suicide prevention week” on digital awareness of suicide prevention : an insight from google trends. Eur Psychiatry 2021. [PMCID: PMC9476111 DOI: 10.1192/j.eurpsy.2021.1082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Every year in the month of September, National Suicide Prevention Week is celebrated. The goal of suicide prevention week is to inform the public about suicide prevention, primarily the warning signs of suicide. However, the impact of this month on the general population is unknown. The Google trends show how frequent web searches have been performed for a particular search-term, which provide an approximation of the people’s interest. Objectives To evaluate public interest in suicide prevention by analyzing the google trends of “Suicide Prevention” search-term. Methods We estimated the interest in such topics by running the google trends data of the last decade by using the filter [Search Term:“Suicide Prevention”, Locations: “United States” and Time Ranges “ 2010 to 2020”]. Results During this specific interval, people have searched “Suicide Prevention” most frequently during the month of September (month of National Suicide Prevention week). Conversely, in the other months, interest in “suicide prevention” fluctuated between little to none. The only other time people have shown interest in Suicide prevention, other than the month of September, was with suicide news in the media, such as the death of a celebrity by suicide, or suicide-related TV shows. [Figure]![]() Conclusions Although it is not definitive, it gives some idea that National Suicide Prevention week has a considerable impact on population interest. Since we did not observe sufficient public interest in other months, there should be frequent and systematic efforts to spread suicide prevention awareness among the general population.
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Magnes T, Wagner S, Thorner AR, Neureiter D, Klieser E, Rinnerthaler G, Weiss L, Huemer F, Schlick K, Zaborsky N, Steiner M, Greil R, Egle A, Melchardt T. Spatial Heterogeneity in Large Resected Diffuse Large B-Cell Lymphoma Bulks Analysed by Massively Parallel Sequencing of Multiple Synchronous Biopsies. Cancers (Basel) 2021; 13:650. [PMID: 33561953 PMCID: PMC7914762 DOI: 10.3390/cancers13040650] [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] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 02/03/2021] [Indexed: 11/21/2022] Open
Abstract
Diffuse large B-cell lymphoma (DLBCL) usually needs to be treated immediately after diagnosis from a single lymph node biopsy. However, several reports in other malignancies have shown substantial spatial heterogeneity within large tumours. Therefore, we collected multiple synchronous biopsies of twelve patients that had diagnostic or therapeutic resections of large lymphoma masses and performed next-generation sequencing of 213 genes known to be important for lymphoma biology. Due to the high tumour cell content in the biopsies, we were able to detect several mutations which were present with a stable allelic frequency across all the biopsies of each patient. However, ten out of twelve patients had spatially discordant mutations and similar results were found by the analysis of copy number variants. The median Jaccard similarity coefficient, a measure of the similarity of a sample set was 0.77 (range 0.47-1), and some of the involved genes such as CARD11, CD79B, TP53, and PTEN have a known prognostic or therapeutic relevance in DLBCL. This shows that single biopsies underestimate the complexity of the disease and might overlook possible mechanisms of resistance and therapeutic targets. In the future, the broader application of liquid biopsies will have to overcome these obstacles.
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Affiliation(s)
- Teresa Magnes
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
| | - Sandro Wagner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
| | - Aaron R. Thorner
- Center for Cancer Genomics, Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA;
| | - Daniel Neureiter
- Department of Pathology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (D.N.); (E.K.)
| | - Eckhard Klieser
- Department of Pathology, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (D.N.); (E.K.)
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Cancer Cluster Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Cancer Cluster Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Cancer Cluster Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Konstantin Schlick
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
| | - Nadja Zaborsky
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Markus Steiner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Cancer Cluster Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Alexander Egle
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Cancer Cluster Salzburg, Müllner Hauptstraße 48, 5020 Salzburg, Austria
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Müllner Hauptstraße 48, 5020 Salzburg, Austria
| | - Thomas Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Müllner Hauptstraße 48, 5020 Salzburg, Austria; (T.M.); (S.W.); (G.R.); (L.W.); (F.H.); (K.S.); (R.G.); (A.E.); (N.Z.); (M.S.)
- Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Müllner Hauptstraße 48, 5020 Salzburg, Austria
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Goetz K, Warkentin N, Weiss L, Kasprick L. "We are the patients' advocates": Care and case managers' reasons to participate in a geriatric health care project - A qualitative study. Z Evid Fortbild Qual Gesundhwes 2021; 161:28-32. [PMID: 33454231 DOI: 10.1016/j.zefq.2020.12.004] [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] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/11/2020] [Accepted: 12/12/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Healthcare provision for the multimorbid elderly is complex. Care and Case Managers (CCMs) can help to coordinate and structure outpatient care for these patient groups. This approach will be realized in the project RubiN ("Continuous Care in Regional Networks"), which is funded by the Federal Joint Committee. The aim of the present qualitative study was to explore the motivation to work as a CCM. METHODS As part of the qualitative study framework, semi-structured interviews with CCMs were conducted as part of a joint kick-off event. The interviews were focused on the reasons and motivation for participating in the RubiN project. The transcribed interviews were analyzed using qualitative content analysis. RESULTS Eight of 20 CCMs agreed to take part in the interviews. One of the main motivations for taking part in RubiN was to shift away from working conditions that were perceived as stressful and towards an activity that was experienced as appreciative. The CCMs felt that their professional expertise was recognized by other service providers, and that appreciation of their role increased through their active involvement in the care of geriatric patients. CONCLUSIONS Care and Case Management as a practical application with extensive coordination services for geriatric patients may contribute to an increase in appreciation and recognition through establishing a separate area of responsibility and scope as well as working in an interdisciplinary team.
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Affiliation(s)
- Katja Goetz
- Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany.
| | - Nicole Warkentin
- Institut für Allgemeinmedizin, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Lübeck, Germany
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Magnes T, Wagner S, Thorner AR, Neureiter D, Klieser E, Rinnerthaler G, Weiss L, Huemer F, Zaborsky N, Steiner M, Weis S, Greil R, Egle A, Melchardt T. Clonal evolution in diffuse large B-cell lymphoma with central nervous system recurrence. ESMO Open 2021; 6:100012. [PMID: 33399078 PMCID: PMC7807834 DOI: 10.1016/j.esmoop.2020.100012] [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: 10/06/2020] [Revised: 11/05/2020] [Accepted: 11/10/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The prognosis of patients with secondary central nervous system lymphoma (SCNSL) is poor and despite massive advances in understanding the mutational landscape of primary diffuse large B-cell lymphoma (DLBCL), the genetic comparison to SCNSL is still lacking. We therefore collected paired samples from six patients with DLBCL with available biopsies from a lymph node (LN) at primary diagnosis and the central nervous system (CNS) at recurrence. PATIENTS AND METHODS A targeted, massively parallel sequencing approach was used to analyze 216 genes recurrently mutated in DLBCL. Healthy tissue from each patient was also sequenced in order to exclude germline mutations. The results of the primary biopsies were compared with those of the CNS recurrences to depict the genetic background of SCNSL and evaluate clonal evolution. RESULTS Sequencing was successful in five patients, all of whom had at least one discordant mutation that was not detected in one of their samples. Four patients had mutations that were found in the CNS but not in the primary LN. Discordant mutations were found in genes known to be important in lymphoma biology such as MYC, CARD11, EP300 and CCND3. Two patients had a Jaccard similarity coefficient below 0.5 indicating substantial genetic differences between the primary LN and the CNS recurrence. CONCLUSIONS This analysis gives an insight into the genetic landscape of SCNSL and confirms the results of our previous study on patients with systemic recurrence of DLBCL with evidence of substantial clonal diversification at relapse in some patients, which might be one of the mechanisms of treatment resistance.
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Affiliation(s)
- T Magnes
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - S Wagner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria
| | - A R Thorner
- Center for Cancer Genomics, Dana-Farber Cancer Institute, Boston, USA
| | - D Neureiter
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - E Klieser
- Department of Pathology, Paracelsus Medical University, Salzburg, Austria
| | - G Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - L Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - F Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria
| | - N Zaborsky
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - M Steiner
- Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - S Weis
- Division of Neuropathology, Department of Pathology and Neuropathology, Kepler University Hospital and School of Medicine, Johannes Kepler University, Linz, Austria
| | - R Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - A Egle
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Cancer Cluster Salzburg, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria
| | - T Melchardt
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Paracelsus Medical University, Salzburg, Austria; Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Salzburg, Austria.
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Fusconi M, Candelori F, Weiss L, Riccio A, Priori R, Businaro R, Mastromanno L, Musy I, de Vincentiis M, Greco A. Qualitative mucin disorders in patients with primary Sjögren's syndrome: a literature review. Med Oral Patol Oral Cir Bucal 2021; 26:e71-e77. [PMID: 33247578 PMCID: PMC7806352 DOI: 10.4317/medoral.23996] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 11/09/2020] [Indexed: 11/05/2022] Open
Abstract
Background It is a common opinion that Primary Sjögren Syndrome (pSS) damages the exocrine glands and determines the reduction of secreted saliva, some studies show that there are qualitative anomalies of the mucins produced in saliva, including MUC7, MUC5B, MUC1. The purpose of this study is to trace all the information useful to establish whether there is a qualitative or quantitative defect of the mucins in the pSS.
Material and Methods We reviewed the literature by looking for publications relevant to the topic in electronic databases. Sixteen articles met the search criteria. The studies were divided into two categories, those that studied the rheological characteristics of the saliva and those that studied the structural and / or metabolism modifications of the muciparous cells in the salivary glands.
Results in Patients with pSS, xerostomia and the reduction of salivary spinnbarkeit are only partially related to the reduction of the unstimulated salivary flow. In pSS, pathological alterations of mucins’ chemical-physical properties prevail as a cause of the clinical characteristics. Moreover, in pSS there are structural and metabolism changes in salivary glands’ muciparous cells.
Conclusions There is much evidence that supports the presence of qualitative alterations in the saliva’s rheological properties in Patients with pSS, and these are the main cause, more than the reduction of the unstimulated salivary flow, of the disease clinical characteristics - dry mouth and complications in the oral cavity. Therefore we propose to add to the classification criteria of pSS also a qualitative test of salivary glycoproteins. Key words:Primary Sjögren's syndrome, mucin, MUC7, MUC5B, MUC1, sulphate oligosaccharides.
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Abstract
Extant anuran amphibians originate from an evolutionary intersection eventually leading to fully terrestrial tetrapods. In many ways, they have to deal with exposure to both terrestrial and aquatic environments: (i) phylogenetically, as derivatives of the first tetrapod group that conquered the terrestrial environment in evolution; (ii) ontogenetically, with a development that includes aquatic and terrestrial stages connected via metamorphic remodeling; and (iii) individually, with common changes in habitat during the life cycle. Our knowledge about the structural organization and function of the amphibian olfactory system and its relevance still lags behind findings on mammals. It is a formidable challenge to reveal underlying general principles of circuity-related, cellular, and molecular properties that are beneficial for an optimized sense of smell in water and air. Recent findings in structural organization coupled with behavioral observations could help to understand the importance of the sense of smell in this evolutionarily important animal group. We describe the structure of the peripheral olfactory organ, the olfactory bulb, and higher olfactory centers on a tissue, cellular, and molecular levels. Differences and similarities between the olfactory systems of anurans and other vertebrates are reviewed. Special emphasis lies on adaptations that are connected to the distinct demands of olfaction in water and air environment. These particular adaptations are discussed in light of evolutionary trends, ontogenetic development, and ecological demands.
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Affiliation(s)
- Lukas Weiss
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 38, 35392, Giessen, Germany
| | - Ivan Manzini
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 38, 35392, Giessen, Germany
| | - Thomas Hassenklöver
- Institute of Animal Physiology, Department of Animal Physiology and Molecular Biomedicine, Justus-Liebig-University Giessen, Heinrich-Buff-Ring 38, 35392, Giessen, Germany.
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Abstract
Sensory systems detect environmental stimuli and transform them into electrical activity patterns interpretable by the central nervous system. En route to higher brain centers, the initial sensory input is successively transformed by interposed secondary processing centers. Mapping the neuronal activity patterns at all of those stages is essential to understand sensory information processing. Larval Xenopus laevis is very well-suited for whole-brain imaging of neuronal activity. This is mainly due to its small size, transparency, and the accessibility of both peripheral and central parts of sensory systems. Here we describe a protocol for calcium imaging at several levels of the olfactory system using focal injection of chemical calcium indicator dyes or a Xenopus transgenic line with neuronal GCaMP6s expression. In combination with fast volumetric multiphoton microscopy, the calcium imaging methods described can provide detailed insight into spatiotemporal activity of entire brain regions at different stages of sensory information processing. Although the methods are broadly applicable to the central nervous system, in this work we focus on protocols for calcium imaging of glomeruli in the olfactory bulb and odor-responsive neurons in the olfactory amygdala.
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Affiliation(s)
- Thomas Offner
- Department of Animal Physiology and Molecular Biomedicine, University of Giessen, 35392 Giessen, Germany
| | - Daniela Daume
- Department of Animal Physiology and Molecular Biomedicine, University of Giessen, 35392 Giessen, Germany
| | - Lukas Weiss
- Department of Animal Physiology and Molecular Biomedicine, University of Giessen, 35392 Giessen, Germany
| | - Thomas Hassenklöver
- Department of Animal Physiology and Molecular Biomedicine, University of Giessen, 35392 Giessen, Germany
| | - Ivan Manzini
- Department of Animal Physiology and Molecular Biomedicine, University of Giessen, 35392 Giessen, Germany
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Offner T, Daume D, Weiss L, Hassenklöver T, Manzini I. Erratum: Whole-Brain Calcium Imaging in Larval Xenopus. Cold Spring Harb Protoc 2020; 2020:pdb.err107425. [PMID: 33139504 DOI: 10.1101/pdb.err107425] [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: 06/11/2023]
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Schernthaner C, Kopp M, Dagn K, Rettenbacher L, Weiss L, Meyersburg D, Brandt MC, Hoppe UC, Strohmer B. Safe application of extensive radiotherapy to a cardiac resynchronization device. ESC Heart Fail 2020; 7:4293-4296. [PMID: 33040476 PMCID: PMC7754946 DOI: 10.1002/ehf2.12869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2020] [Revised: 03/09/2020] [Accepted: 06/10/2020] [Indexed: 11/25/2022] Open
Abstract
Patients with cardiac implantable electronic devices undergoing radiotherapy (RT) are prone to the risk of device failure. Guidelines and manufacturer's instructions are lacking practical recommendations for cumulative radiation doses to pacemakers or implantable cardioverter defibrillators. The present case demonstrates the effect of RT of a Merkel cell carcinoma near the location of a cardiac resynchronization therapy pacemaker. Despite guideline recommendations, surgical relocation or de novo implantation of the device on the contralateral side was avoided to prevent the dissemination of tumour cells, inflammation, and wound healing complications. A total dose of 47.25 Gy applied in very close proximity to the cardiac resynchronization therapy pacemaker was carried out safely without jeopardizing the patient and any device malfunction during and after treatment within >1.5 years of follow‐up period. The present case demonstrates that high‐dose RT near to a cardiac resynchronization therapy device can be carried out safely. Special precautions during RT as well as close device follow‐up interrogations are mandatory. Large‐scale studies are needed for the true frequency of adverse events.
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Affiliation(s)
- Christiana Schernthaner
- Department of Cardiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, A-5020, Austria
| | - Michael Kopp
- Department of Radiotherapy and Radio-oncology, Paracelsus Medical University, Salzburg, Austria
| | - Karin Dagn
- Department of Radiotherapy and Radio-oncology, Paracelsus Medical University, Salzburg, Austria
| | - Lukas Rettenbacher
- Department of Nuclear Medicine, Paracelsus Medical University, Salzburg, Austria
| | - Lukas Weiss
- Department of Oncology, Salzburg Cancer Research Institute, Paracelsus Medical University, Salzburg, Austria
| | - Damian Meyersburg
- Department of Dermatology, Paracelsus Medical University, Salzburg, Austria
| | - Mathias-Christoph Brandt
- Department of Cardiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, A-5020, Austria
| | - Uta C Hoppe
- Department of Cardiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, A-5020, Austria
| | - Bernhard Strohmer
- Department of Cardiology, Paracelsus Medical University, Muellner Hauptstrasse 48, Salzburg, A-5020, Austria
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McCollum C, Engelhardt S, Weiss L, Hückelhoven R. ROP INTERACTIVE PARTNER b Interacts with RACB and Supports Fungal Penetration into Barley Epidermal Cells. Plant Physiol 2020; 184:823-836. [PMID: 32665335 PMCID: PMC7536699 DOI: 10.1104/pp.20.00742] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 06/29/2020] [Indexed: 06/11/2023]
Abstract
Rho of Plants (ROP) G-proteins are key components of cell polarization processes in plant development. The barley (Hordeum vulgare) ROP protein RACB is a susceptibility factor in the interaction of barley with the barley powdery mildew fungus Blumeria graminis f. sp. hordei (Bgh). RACB also drives polar cell development, and this function might be coopted during the formation of fungal haustoria in barley epidermal cells. To understand RACB signaling during the interaction of barley with Bgh, we searched for potential downstream interactors of RACB. Here, we show that ROP INTERACTIVE PARTNER b (RIPb; synonym: INTERACTOR OF CONSTITUTIVE ACTIVE ROP b) directly interacts with RACB in yeast and in planta. Overexpression of RIPb supports the susceptibility of barley to Bgh RIPb further interacts with itself at microtubules. However, the interaction with activated RACB largely takes place at the plasma membrane. Both RIPb and RACB are recruited to the site of fungal attack around the neck of developing haustoria, suggesting locally enhanced ROP activity. We further assigned different functions to different domains of the RIPb protein. The N-terminal coiled-coil CC1 domain is required for microtubule localization, while the C-terminal coiled-coil CC2 domain is sufficient to interact with RACB and to fulfill a function in susceptibility at the plasma membrane. Hence, RIPb appears to be localized at microtubules and is then recruited by activated RACB for a function at the plasma membrane during formation of the haustorial complex.
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Affiliation(s)
- Christopher McCollum
- Phytopathology, School of Life Science Weihenstephan, Technical University of Munich, 85354 Freising, Germany
| | - Stefan Engelhardt
- Phytopathology, School of Life Science Weihenstephan, Technical University of Munich, 85354 Freising, Germany
| | - Lukas Weiss
- Phytopathology, School of Life Science Weihenstephan, Technical University of Munich, 85354 Freising, Germany
| | - Ralph Hückelhoven
- Phytopathology, School of Life Science Weihenstephan, Technical University of Munich, 85354 Freising, Germany
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Huemer F, Piringer G, Schlintl V, Hackl H, Rinnerthaler G, Thaler J, Greil R, Weiss L. Hospitalizations and Clinical Outcome in Metastatic Colorectal Cancer During Regorafenib or TAS-102 Therapy. Cancers (Basel) 2020; 12:cancers12102812. [PMID: 33007814 PMCID: PMC7599669 DOI: 10.3390/cancers12102812] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 09/16/2020] [Accepted: 09/29/2020] [Indexed: 01/05/2023] Open
Abstract
Simple Summary Regorafenib and TAS-102 showed a survival benefit against placebo, and both drugs are approved for the treatment of metastatic colorectal cancer (mCRC) beyond second-line. The highly differential toxicity profile of both substances has led to a potentially biased perception of drug tolerability and complications—such as hospitalization—in the oncologic community. The aim of this retrospective analysis was to investigate hospitalization frequency during regorafenib and TAS-102 treatment and the impact of hospitalizations on survival. Treatment with regorafenib as well as a low Eastern Cooperative Oncology Group (ECOG) performance status turned out to be independent risk factors for hospitalization. Hospitalizations due to gastrointestinal toxicity were only seen with regorafenib. However, hospitalizations during regorafenib or TAS-102 treatment did not impact survival. In light of increased gastrointestinal toxicity leading to hospitalization during regorafenib treatment, we call for increased awareness to drug-specific toxicities, in order to prevent unnecessary complications by the early detection of adverse events and prompt counteraction. Abstract Current National Comprehensive Cancer Network (NCCN) and European Society of Medical Oncology (ESMO) guidelines recommend regorafenib or trifluridine/tipiracil (TAS-102) for the third-line therapy of metastatic colorectal cancer (mCRC). In this analysis, we evaluated hospitalizations during regorafenib or TAS-102 treatment and the impact of hospitalizations on overall survival (OS). This retrospective analysis was based on unselected, consecutive mCRC patients treated with regorafenib and/or TAS-102 at the tertiary cancer centers in Salzburg and Wels-Grieskirchen, Austria. Between January 2013 and May 2019, 93 patients started third- or fourth-line therapy with regorafenib or TAS-102. Tumor therapy (regorafenib versus TAS-102, HR: 1.95 [95% CI: 1.07–3.54], p = 0.03) and the Eastern Cooperative Oncology Group (ECOG) performance status (2–3 versus 0–1, HR: 4.04 [95% CI: 2.11–7.71], p < 0.001) showed a statistically significant association with hospitalization risk in multivariate analysis. The corresponding hospitalization probability from initiation of third- or fourth-line was 30% with regorafenib versus 18% with TAS-102 at five weeks and 41% versus 28% at ten weeks, respectively. Hospitalizations irrespective of cause during regorafenib or TAS-102 therapy did neither impact median survival in patients undergoing only third-line therapy (never-hospitalized: 5.7 months [95% CI: 3.9–10.5] versus hospitalized: 5.4 months [95% CI: 2.8–9.6], p = 0.45), nor in patients receiving third- and fourth-line therapy (12.2 months [95% CI: 10.6–28.8] versus 18.6 months [95% CI: 6.3-not reached], p = 0.90). In conclusion, apart from poor ECOG performance status, regorafenib therapy was associated with an increased hospitalization probability during palliative systemic third- and fourth-line therapy in mCRC. However, hospitalizations during regorafenib or TAS-102 therapy did not impact OS beyond second-line therapy.
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Affiliation(s)
- Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (R.G.)
| | - Gudrun Piringer
- Department of Internal Medicine IV, Hematology and Oncology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria; (G.P.); (J.T.)
- Johannes Kepler University Linz, 4040 Linz, Austria
| | - Verena Schlintl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (R.G.)
| | - Hubert Hackl
- Division of Bioinformatics, Biocenter, Medical University of Innsbruck, 6020 Innsbruck, Austria;
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Josef Thaler
- Department of Internal Medicine IV, Hematology and Oncology, Klinikum Wels-Grieskirchen, 4600 Wels, Austria; (G.P.); (J.T.)
- Johannes Kepler University Linz, 4040 Linz, Austria
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute—Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Center for Clinical Cancer and Immunology Trials (CCCIT), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
- Correspondence: ; Tel.: +43-57255-57892
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Weiss L, Jungblut LD, Pozzi AG, Zielinski BS, O'Connell LA, Hassenklöver T, Manzini I. Cover Image, Volume 528, Issue 13. J Comp Neurol 2020. [DOI: 10.1002/cne.24991] [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: 11/10/2022]
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Huemer F, Klieser E, Neureiter D, Schlintl V, Rinnerthaler G, Pagès F, Kirilovsky A, El Sissy C, Iglseder W, Singhartinger F, Jäger T, Dinnewitzer A, Zaborsky N, Steiner M, Greil R, Weiss L. Impact of PD-L1 Scores and Changes on Clinical Outcome in Rectal Cancer Patients Undergoing Neoadjuvant Chemoradiotherapy. J Clin Med 2020; 9:E2775. [PMID: 32867256 PMCID: PMC7563312 DOI: 10.3390/jcm9092775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/16/2020] [Accepted: 08/24/2020] [Indexed: 12/24/2022] Open
Abstract
Reports on the prognostic role of programmed death-ligand 1 (PD-L1) expression in rectal cancer are controversial. We investigated expression patterns and changes of PD-L1 in rectal cancer patients undergoing neoadjuvant chemoradiotherapy (CRT). Seventy-two patients diagnosed with rectal cancer and/or treated with fluorouracil-based neoadjuvant CRT at the Department of Internal Medicine III of the Paracelsus Medical University Salzburg (Austria) between January 2003 and October 2012 were included. PD-L1 scoring was performed according to the tumor proportion score (TPS), combined positive score (CPS), and immune cell score (IC). PD-L1 TPS prior to neoadjuvant CRT had a statistically significant impact on survival (median: ≤1%: 95.4 months (95% CI: 51.8-not reached) vs. >1%: not reached, p = 0.03, log-rank). Patients with a PD-L1 TPS ≤1% prior to and after CRT showed an inferior survival compared to all other patients (median: 56.7 months (95% CI: 51.4-not reached) vs. not reached, p = 0.005, log-rank). In multivariate analysis, PD-L1 TPS prior to neoadjuvant CRT (>1% vs. ≤1%, hazard ratio: 0.29 (95% CI: 0.11-0.76), p = 0.01) remained independently associated with survival. In conclusion, low PD-L1 TPS was associated with inferior survival in rectal cancer patients undergoing neoadjuvant CRT. A prospective validation of the prognostic value of PD-L1 expression in rectal cancer patients within a clinical trial is necessitated.
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Affiliation(s)
- Florian Huemer
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
| | - Eckhard Klieser
- Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (E.K.); (D.N.)
| | - Daniel Neureiter
- Institute of Pathology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (E.K.); (D.N.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Verena Schlintl
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
| | - Gabriel Rinnerthaler
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Franck Pagès
- Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Immunology and Cancer Department, Cordeliers Research Center, 75006 Paris, France; (F.P.); (A.K.); (C.E.S.)
- Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, Faculté de santé, 75015 Paris, France
| | - Amos Kirilovsky
- Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Immunology and Cancer Department, Cordeliers Research Center, 75006 Paris, France; (F.P.); (A.K.); (C.E.S.)
- Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, Faculté de santé, 75015 Paris, France
| | - Carine El Sissy
- Laboratory of Integrative Cancer Immunology, INSERM UMRS1138, Immunology and Cancer Department, Cordeliers Research Center, 75006 Paris, France; (F.P.); (A.K.); (C.E.S.)
- Hôpital Européen Georges Pompidou, Assistance Publique-Hôpitaux de Paris, Université de Paris, Faculté de santé, 75015 Paris, France
| | - Wolfgang Iglseder
- Department of Radiation Oncology, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria;
| | - Franz Singhartinger
- Department of Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (F.S.); (T.J.); (A.D.)
| | - Tarkan Jäger
- Department of Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (F.S.); (T.J.); (A.D.)
| | - Adam Dinnewitzer
- Department of Surgery, Paracelsus Medical University Salzburg, 5020 Salzburg, Austria; (F.S.); (T.J.); (A.D.)
| | - Nadja Zaborsky
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
| | - Markus Steiner
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
| | - Richard Greil
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
| | - Lukas Weiss
- Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute-Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University, 5020 Salzburg, Austria; (F.H.); (V.S.); (G.R.); (N.Z.); (M.S.); (R.G.)
- Cancer Cluster Salzburg, 5020 Salzburg, Austria
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