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Cabrit N, Faron M, Tierney J, Cheugoua-Zanetsie M, Thirion P, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, Paoletti X, Ducreux M, Michiels S. SO-5 Disease-free survival as surrogate for overall survival in neoadjuvant chemo(radio)therapy treatment of esophageal or gastro-esophageal junction carcinoma: An analysis of 4518 individual patients and 22 trials. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.404] [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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Faron M, Cheugoua-Zanetsie M, Thirion P, Tierney J, Cunningham D, Winter K, Fu J, Mauer M, Shapiro J, Burmeister B, Walsh T, Piessen G, Klevebro F, Ychou M, Van Der Gaast A, Law S, Stahl M, van Sandick J, Pignon J, Ducreux M, Michiels S. SO-4 Individual participant data network meta-analysis (IPD-NMA) of neoadjuvant chemotherapy or chemoradiotherapy in esophageal or gastro-esophageal junction carcinoma. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.403] [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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Paz-Ares L, O'Brien M, Mauer M, Dafni U, Oselin K, Havel L, Esteban Gonzalez E, Isla D, Martinez-Marti A, Faehling M, Tsuboi M, Lee JS, Nakagawa K, Yang J, Keller S, Jha N, Marreaud S, Stahel R, Peters S, Besse B. VP3-2022: Pembrolizumab (pembro) versus placebo for early-stage non-small cell lung cancer (NSCLC) following complete resection and adjuvant chemotherapy (chemo) when indicated: Randomized, triple-blind, phase III EORTC-1416-LCG/ETOP 8-15 – PEARLS/KEYNOTE-091 study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.224] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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Moreno-Martinez D, Aguiar P, Auray-Blais C, Beck M, Bichet DG, Burlina A, Cole D, Elliott P, Feldt-Rasmussen U, Feriozzi S, Fletcher J, Giugliani R, Jovanovic A, Kampmann C, Langeveld M, Lidove O, Linhart A, Mauer M, Moon JC, Muir A, Nowak A, Oliveira JP, Ortiz A, Pintos-Morell G, Politei J, Rozenfeld P, Schiffmann R, Svarstad E, Talbot AS, Thomas M, Tøndel C, Warnock D, West ML, Hughes DA. Standardising clinical outcomes measures for adult clinical trials in Fabry disease: A global Delphi consensus. Mol Genet Metab 2021; 132:234-243. [PMID: 33642210 DOI: 10.1016/j.ymgme.2021.02.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/14/2020] [Revised: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Recent years have witnessed a considerable increase in clinical trials of new investigational agents for Fabry disease (FD). Several trials investigating different agents are currently in progress; however, lack of standardisation results in challenges to interpretation and comparison. To facilitate the standardisation of investigational programs, we have developed a common framework for future clinical trials in FD. METHODS AND FINDINGS A broad consensus regarding clinical outcomes and ways to measure them was obtained via the Delphi methodology. 35 FD clinical experts from 4 continents, representing 3389 FD patients, participated in 3 rounds of Delphi procedure. The aim was to reach a consensus regarding clinical trial design, best treatment comparator, clinical outcomes, measurement of those clinical outcomes and inclusion and exclusion criteria. Consensus results of this initiative included: the selection of the adaptative clinical trial as the ideal study design and agalsidase beta as ideal comparator treatment due to its longstanding use in FD. Renal and cardiac outcomes, such as glomerular filtration rate, proteinuria and left ventricular mass index, were prioritised, whereas neurological outcomes including cerebrovascular and white matter lesions were dismissed as a primary or secondary outcome measure. Besides, there was a consensus regarding the importance of patient-related outcomes such as general quality of life, pain, and gastrointestinal symptoms. Also, unity about lysoGb3 and Gb3 tissue deposits as useful surrogate markers of the disease was obtained. The group recognised that cardiac T1 mapping still has potential but requires further development before its widespread introduction in clinical trials. Finally, patients with end-stage renal disease or renal transplant should be excluded unless a particular group for them is created inside the clinical trial. CONCLUSION This consensus will help to shape the future of clinical trials in FD. We note that the FDA has, coincidentally, recently published draft guidelines on clinical trials in FD and welcome this contribution.
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Affiliation(s)
- D Moreno-Martinez
- Lysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation Trust and University College London, London, UK
| | - P Aguiar
- Inborn Errors of Metabolism Reference Centre, North Lisbon Hospital Centre, Lisbon, Portugal
| | - C Auray-Blais
- Division of Medical Genetics, Department of Pediatrics, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Canada
| | - M Beck
- Institute of Human Genetics, University Medical Centre, University of Mainz, Mainz, Germany
| | - D G Bichet
- Unité de Recherche Clinique, Centre de Recherche et Service de Néphrologie, Hôpital du Sacré-Coeur de Montreal, Montreal, Quebec, Canada
| | - A Burlina
- Neurological Unit, St. Bassiano Hospital, Bassano del Grappa, Italy
| | - D Cole
- Department of Medical Biochemistry and Immunology, University Hospital of Wales, Cardiff, Wales, UK
| | - P Elliott
- Barts Cardiac Centre, University College London, London, UK
| | - U Feldt-Rasmussen
- Medical Endocrinology and Metabolism, Rigshospitalet, Copenhagen, Denmark
| | - S Feriozzi
- Division of Nephrology, Belcolle Hospital, Viterbo, Italy
| | - J Fletcher
- Genetics and Molecular Pathology, SA Pathology Women's and Children's Hospital, North Adelaide, Australia
| | - R Giugliani
- Medical Genetics Service, HCPA, Department of Genetics, UFRGS, Porto Alegre, Rio Grande do Sul, Brazil
| | - A Jovanovic
- Department of Endocrinology and Metabolic Medicine, Salford Royal NHS Foundation Trust, Salford, UK
| | - C Kampmann
- Centre for Paediatric and Adolescent Medicine, University Medical Centre, University of Mainz, Mainz, Germany
| | - M Langeveld
- Department of Endocrinology and Metabolism, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - O Lidove
- Department of Internal Medicine, Université Paris 7, Hôpital Bichat Claude-Bernard, Paris, France
| | - A Linhart
- Department of Cardiovascular Medicine, First Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic
| | - M Mauer
- Department of Paediatrics, University of Minnesota, Minneapolis, MN, United States
| | - J C Moon
- Cardiac Imaging Department, Barts Heart Centre, London, UK
| | - A Muir
- Belfast Heart Centre, Royal Victoria Hospital, Belfast, UK
| | - A Nowak
- Department of Endocrinology and Clinical Nutrition, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - J P Oliveira
- Service of Medical Genetics, São João University Hospital Centre, Alameda Hernãni Monteiro, Porto, Portugal
| | - A Ortiz
- Fundación Jiménez Díaz (IIS-FJD) Área de Patología Cardiovascular, Renal e Hipertensión, Madrid, Spain
| | - G Pintos-Morell
- Rare and Metabolic Diseases Unit, Vall Hebron University Hospital, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Politei
- Fundation for the Study of Neurometabolic Diseases, FESEN, Argentina
| | - P Rozenfeld
- Departamento de Ciencias Biológicas, CONICET, Facultad de Ciencias Exactas, IIFP, Universidad Nacional de La Plata, La Plata, Argentina
| | - R Schiffmann
- Institute of Metabolic Disease, Baylor Research Institute, Dallas, TX, USA
| | - E Svarstad
- Department of Clinical Medicine, University of Bergen and Haukeland University Hospital, Bergen, Norway
| | - A S Talbot
- Department of Nephrology, Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - M Thomas
- Department of Nephrology, Royal Perth Hospital, Perth, Western Australia, Australia
| | - C Tøndel
- Clinical Trials Unit, Haukeland University Hospital, Bergen, Norway
| | - D Warnock
- Division of Nephrology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - M L West
- Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
| | - D A Hughes
- Lysosomal Storage Disorders Unit, Royal Free Hospital NHS Foundation Trust and University College London, London, UK.
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Menis J, Bironzo P, Radj G, Greillier L, Monnet I, Livi L, Young R, Decroisette C, Cloarec N, Robinet G, Schott R, Califano R, De Marinis F, Mauer M, Pochesci A, Silva M, Caramella C, Dingemans AM, Dive C, Besse B. 9P Circulating tumour cells (CTCs) count and PD-L1 expression in untreated extensive small cell lung cancer patients treated in the REACTION trial, a phase II study of etoposide and cis/carboplatin with or without pembrolizumab (NCT02580994). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.10.494] [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: 11/27/2022] Open
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Besse B, Menis J, Bironzo P, Gervais R, Greillier L, Monnet I, Livi L, Young R, Decroisette C, Cloarec N, Robinet G, Schott R, Califano R, De Marinis F, Banna G, Mauer M, Pochesci A, Hasan B, Berghmans T, Dingemans AM. LBA85 REACTION: A phase II study of etoposide and cis/carboplatin with or without pembrolizumab in untreated extensive small cell lung cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2327] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Wagner AD, Oertelt-Prigione S, Adjei A, Buclin T, Cristina V, Csajka C, Coukos G, Dafni U, Dotto GP, Ducreux M, Fellay J, Haanen J, Hocquelet A, Klinge I, Lemmens V, Letsch A, Mauer M, Moehler M, Peters S, Özdemir BC. Gender medicine and oncology: report and consensus of an ESMO workshop. Ann Oncol 2019; 30:1914-1924. [PMID: 31613312 DOI: 10.1093/annonc/mdz414] [Citation(s) in RCA: 104] [Impact Index Per Article: 20.8] [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] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The importance of sex and gender as modulators of disease biology and treatment outcomes is well known in other disciplines of medicine, such as cardiology, but remains an undervalued issue in oncology. Considering the increasing evidence for their relevance, European Society for Medical Oncology decided to address this topic and organized a multidisciplinary workshop in Lausanne, Switzerland, on 30 November and 1 December 2018. DESIGN Twenty invited faculty members and 40 selected physicians/scientists participated. Relevant content was presented by faculty members on the basis of a literature review conducted by each speaker. Following a moderated consensus session, the final consensus statements are reported here. RESULTS Clinically relevant sex differences include tumour biology, immune system activity, body composition and drug disposition and effects. The main differences between male and female cells are sex chromosomes and the level of sexual hormones they are exposed to. They influence both local and systemic determinants of carcinogenesis. Their effect on carcinogenesis in non-reproductive organs is largely unknown. Recent evidence also suggests differences in tumour biology and molecular markers. Regarding body composition, the difference in metabolically active, fat-free body mass is one of the most prominent: in a man and a woman of equal weight and height, it accounts for 80% of the man's and 65% of the woman's body mass, and is not taken into account in body-surface area based dosing of chemotherapy. CONCLUSION Sex differences in cancer biology and treatment deserve more attention and systematic investigation. Interventional clinical trials evaluating sex-specific dosing regimens are necessary to improve the balance between efficacy and toxicity for drugs with significant pharmacokinetic differences. Especially in diseases or disease subgroups with significant differences in epidemiology or outcomes, men and women with non-sex-related cancers should be considered as biologically distinct groups of patients, for whom specific treatment approaches merit consideration.
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Affiliation(s)
- A D Wagner
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - S Oertelt-Prigione
- Department of Primary and Community Care, Radboud Institute of Health Sciences (RIHS), Radboud University Medical Center, Nijmegen, The Netherlands
| | - A Adjei
- Department of Oncology, Mayo Clinic, Rochester, USA
| | - T Buclin
- Service of Clinical Pharmacology, Lausanne University, Lausanne
| | - V Cristina
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - C Csajka
- Service of Clinical Pharmacology, Lausanne University, Lausanne; Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, Lausanne
| | - G Coukos
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Ludwig Lausanne Branch and Swiss Cancer Center, Lausanne, Switzerland
| | - U Dafni
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; National and Kapodistrian University of Athens, Athens, Greece
| | - G-P Dotto
- Department of Biochemistry, Lausanne University, Lausanne, Switzerland; Massachusetts General Hospital, Boston, USA; International Cancer Prevention Institute, Epalinges, Switzerland
| | - M Ducreux
- Gastrointestinal Cancer Unit, Gustave Roussy, Paris Saclay University, Villejuif, France
| | - J Fellay
- Precision Medicine Unit, Lausanne University Hospital and University of Lausanne, Lausanne; EPFL School of Life Sciences, Lausanne, Switzerland
| | - J Haanen
- Division of Medical Oncology and Immunology, Department of Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - A Hocquelet
- Department of Radiodiagnostic and Interventional Radiology, Lausanne University Hospital, Lausanne, Switzerland
| | - I Klinge
- Dutch Society for Gender and Health
| | - V Lemmens
- Department of Research and Development, Comprehensive Cancer Organisation the Netherlands, Utrecht; Department of Public Health, Erasmus Medical Centre University, Rotterdam, The Netherlands
| | - A Letsch
- Department of Hematology and Oncology, Charity CBF, Berlin; Charity Comprehensive Cancer Center CCCC, Berlin; Palliative Care Unit, Campus Benjamin Franklin, Berlin, Germany
| | | | - M Moehler
- Department of Internal Medicine 1/Gastrointestinal Oncology, Johannes-Gutenberg-University Clinic, Mainz, Germany
| | - S Peters
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - B C Özdemir
- Department of Oncology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; International Cancer Prevention Institute, Epalinges, Switzerland
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Cella D, Escudier B, Ivanescu C, Mauer M, Lord-Bessen J, Gooden K. Quality of life in previously untreated patients with advanced renal cell carcinoma (aRCC) in CheckMate 214: Updated results. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz249.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Caballero C, Alvarez LC, Nilsson H, Ruers T, Senellart P, Rivoire M, Staettner S, Primavesi F, Troisi R, Gruenberger T, Heil J, Schnitzbauer A, Rahbari N, Swijnenburg R, Malik H, Protic M, Neven A, Mauer M, Poston G, Evrard S. EORTC 1409 GITCG / ESSO 01 - A prospective colorectal liver metastasis database with an integrated quality assurance program (CLIMB): Primary analysis of variations in European clinical practices and surgical complications after complex liver metastasis surgeries. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Fosbol E, Rorth R, Leicht BP, Schou M, Mauer M, Kober L, Gustafsson F. 4378Carpal tunnel syndrome is associated with an increased risk of heart failure carrying a poor prognosis. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4378] [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] [Indexed: 11/13/2022] Open
Affiliation(s)
- E Fosbol
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - R Rorth
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - B P Leicht
- Rigshospitalet - Copenhagen University Hospital, Orthopedic surgery, Copenhagen, Denmark
| | - M Schou
- Herlev Hospital, Department of Cardiology, Herlev, Denmark
| | - M Mauer
- Columbia University Medical Center, New York, United States of America
| | - L Kober
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
| | - F Gustafsson
- Rigshospitalet - Copenhagen University Hospital, Department of Cardiology, Copenhagen, Denmark
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Schmoll H, Haustermans K, Price T, Nordlinger B, Hofheinz R, Daisne J, Janssens J, Brenner B, Schmidt P, Reinel H, Hollerbach S, Caca K, Fauth F, Hannig C, Zalcberg J, Tebbutt N, Mauer M, Marreaud S, Lutz M, Van Cutsem E. PETACC-6: Preop chemoradiation and postop chemotherapy (capecitabine +/- oxaliplatin) in locally advanced rectal cancer: Overall survival after long term follow-up. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy149.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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12
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Cristina V, Mahachie J, Mauer M, Csajka C, Cunningham D, Van Cutsem E, Roth A, Wagner A. Gender and chemotherapy-related toxicity in colon cancer: an analysis of the PETACC-3 trial conducted by the EORTC GI-group. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.97] [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: 11/12/2022] Open
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13
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Schmoll H, Stein A, Hofheinz R, Price T, Nordlinger B, Daisne JF, Daisne JF, Janssens J, Brenner B, Schmidt P, Reinel H, Hollerbach S, Caca K, Fauth F, Zalcberg J, Marreaud S, Mauer M, Lutz M, Van Cutsem E, Haustermans K. Preoperative chemoradiotherapy and postoperative chemotherapy with capecitabine and oxaliplatin vs. capecitabine alone in locally advanced rectal cancer: final analyses. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Caballero C, Carrion Alvarez L, Rivoire M, Nilsson H, Staettner S, Gruenberger T, Malik H, Rahbari N, Mauer M, Kataoka K, Atasoy A, Ducreux M, Audisio R, Poston G, Evrard S. 80. EORTC-1409: An EORTC-ESSO prospective colorectal liver metastasis database with an integrated quality assurance program (CLIMB) NCT02218801. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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15
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Wagner A, Kang Y, Van Dieren J, Mauer M, Grabsch H, Caballero C, Kataoka K, Atasoy A, Cho J, Mohler M, Roth A, Salto-Tellez M, Langer R, Schuhmacher C, Van Sandick J, Van Grieken N, Lordick F. 64. EORTC-1203: Integration of trastuzumab, with or without pertuzumab, into perioperative chemotherapy of HER-2 positive stomach cancer: INNOVATION EudraCT number 2014-000722-38; NCT02205047. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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16
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Abulaban KM, Song H, Zhang X, Kimmel PL, Kusek JW, Nelson RG, Feldman HI, Vasan RS, Ying J, Mauer M, Nelsestuen GL, Bennett M, Brunner HI, Rovin BH. Predicting decline of kidney function in lupus nephritis using urine biomarkers. Lupus 2016; 25:1012-8. [PMID: 26873651 DOI: 10.1177/0961203316631629] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Accepted: 01/14/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To evaluate candidate biomarkers to predict future renal function decline (RFD) in children and adults with lupus nephritis (LN). METHODS At the time of enrollment into prospective observational LN cohort studies liver-type fatty acid binding protein (LFABP), albumin, monocyte chemoattractant protein-1 (MCP-1), uromodulin, transferrin, and hepcidin were measured in urine samples of two cohorts of patients with LN, one followed at a pediatric (cohort-1; n = 28) and one at an adult institution (cohort-2; n = 69). The primary outcome was RFD, defined in cohort-1 as a decrease in estimated glomerular filtration rate (eGFR) of ≥20% and in cohort-2 as a sustained increase of ≥25% in serum creatinine concentration (SCr), both from baseline. RESULTS All patients (n = 97) had normal eGFR or SCr at the time of urine collection at baseline. RFD occurred in 29% (8/28) of patients in cohort-1 during a mean follow-up of 6.1 months, and in 30% (21/69) of those in cohort-2 during a mean follow-up of 60 months. Individually, in cohort-1, levels of MCP-1, transferrin, LFABP, and albumin were higher in the RFD group than those who maintained renal function, with statistical significance for LFABP and albumin. In cohort-2 the RFD group also had higher levels of urine MCP-1 and albumin than others. The combination of LFABP, MCP-1, albumin, and transferrin had good predictive accuracy for RFD in both cohorts (area under the ROC curve = 0.77-0.82). CONCLUSION The combinatorial urine biomarker LFABP, MCP-1, albumin, and transferrin shows promise as a predictor of renal functional decline in LN, and warrants further investigation.
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Affiliation(s)
- K M Abulaban
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA Department of Pediatrics, Helen DeVos Childrens Hospital, Michigan State University, Grand Rapids, USA
| | - H Song
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, USA
| | - X Zhang
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, USA
| | - P L Kimmel
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - J W Kusek
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD
| | - R G Nelson
- National Institute of Diabetes and Digestive and Kidney Diseases, Phoenix, USA
| | - H I Feldman
- Department of Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, USA
| | - R S Vasan
- Preventive Medicine and Cardiology Sections, and Department of Medicine, Boston University School of Medicine, Boston, USA
| | - J Ying
- Department of Environmental Health, University of Cincinnati, Cincinnati, USA
| | - M Mauer
- Department of Pediatrics, University of Minnesota, Minneapolis, USA
| | - G L Nelsestuen
- Department of Pediatrics, University of Minnesota, Minneapolis, USA
| | - M Bennett
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - H I Brunner
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, USA
| | - B H Rovin
- Department of Internal Medicine, Ohio State University Wexner Medical Center, Columbus, USA
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Donneau AF, Mauer M, Lambert P, Molenberghs G, Albert A. Simulation-based study comparing multiple imputation methods for non-monotone missing ordinal data in longitudinal settings. J Biopharm Stat 2016; 25:570-601. [PMID: 24905056 DOI: 10.1080/10543406.2014.920864] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The application of multiple imputation (MI) techniques as a preliminary step to handle missing values in data analysis is well established. The MI method can be classified into two broad classes, the joint modeling and the fully conditional specification approaches. Their relative performance for the longitudinal ordinal data setting under the missing at random (MAR) assumption is not well documented. This article intends to fill this gap by conducting a large simulation study on the estimation of the parameters of a longitudinal proportional odds model. The two MI methods are also illustrated in quality of life data from a cancer clinical trial.
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Affiliation(s)
- A F Donneau
- a Medical Informatics and Biostatistics, Department of Public Health , University of Liège , Liège , Belgium
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Ruers T, Punt C, van Coevorden F, Pierie JP, Borel Rinkes I, Ledermann J, Poston G, Bechstein W, Lentz MA, Mauer M, Van Cutsem E, Lutz M, Nordlinger B. O-018 Radiofrequency ablation (RFA) combined with chemotherapy for unresectable colorectal liver metastases (CRC LM): Long-term survival results of a randomised phase II study of the EORTC-NCRI CCSG-ALM Intergroup 40004 (CLOCC). Ann Oncol 2015. [DOI: 10.1093/annonc/mdv235.17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Donneau A, Mauer M, Lambert P, Lesaffre E, Albert A. Testing the proportional odds assumption in multiply imputed ordinal longitudinal data. J Appl Stat 2015. [DOI: 10.1080/02664763.2015.1023704] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Donneau AF, Mauer M, Molenberghs G, Albert A. A Simulation Study Comparing Multiple Imputation Methods for Incomplete Longitudinal Ordinal Data. COMMUN STAT-SIMUL C 2014. [DOI: 10.1080/03610918.2013.818690] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Tanis E, Julie C, Emile J, Nordlinger B, Mauer M, Aust D, Roth A, Lutz M, Ruers T. Prognostic Impact of Immune Response in Resectable Colorectal Liver Metastases Treated with and Without Perioperative Folfox Chemotherapy. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu342.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Schmoll H, Haustermans K, Price T, Nordlinger B, Hofheinz R, Daisne J, Janssens J, Brenner B, Schmidt P, Reinel H, Hollerbach S, Caca K, Fauth F, Hannig C, Zalcberg J, Tebbutt N, Mauer M, Messina C, Lutz M, Van Cutsem E. Preoperative Chemoradiotherapy and Postoperative Chemotherapy with Capecitabine +/- Oxaliplatin in Locally Advanced Rectal Cancer: Interim Analysis for Disease-Free Survival of Petacc 6. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Donneau AF, Mauer M, Coens C, Bottomley A, Albert A. Longitudinal quality of life data: a comparison of continuous and ordinal approaches. Qual Life Res 2014; 23:2873-81. [DOI: 10.1007/s11136-014-0730-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2014] [Indexed: 11/24/2022]
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Sarswat N, Niehaus E, Tabtabai S, Stone J, Gilstrap L, Mauer M, Witteles R, Estep J, Baran D, Zucker M, Guiseppe F, Seldin D, Semigran M. Pre-transplant Chemotherapy Does Not Affect Cardiac Transplant Survival in Light-Chain Amyloid Patients. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.171] [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: 11/29/2022] Open
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Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Schlag PM, Punt CJA, Ledermann J, Ruers TJM. Local recurrence rates after radiofrequency ablation or resection of colorectal liver metastases. Analysis of the European Organisation for Research and Treatment of Cancer #40004 and #40983. Eur J Cancer 2014; 50:912-9. [PMID: 24411080 DOI: 10.1016/j.ejca.2013.12.008] [Citation(s) in RCA: 136] [Impact Index Per Article: 13.6] [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: 10/03/2013] [Revised: 12/07/2013] [Accepted: 12/10/2013] [Indexed: 01/03/2023]
Abstract
AIM The aim of this study is to describe local tumour control after radiofrequency ablation (RFA) and surgical resection (RES) of colorectal liver metastases (CLM) in two independent European Organisations for Research and Treatment of Cancer (EORTC) studies. BACKGROUND Only 10-20% of patients with newly diagnosed CLM are eligible for curative RES. RFA has found a place in daily practice for unresectable CLM. There are no prospective trials comparing RFA to RES for resectable CLM. METHODS The CLOCC trial randomised 119 patients with unresectable CLM between RFA (±RES)+adjuvant FOLFOX (±bevacizumab) versus FOLFOX (±bevacizumab) alone. The EPOC trial randomised 364 patients with resectable CLM between RES±perioperative FOLFOX. We describe the local control of resected patients with lesions ≤4 cm in the perioperative chemotherapy arm of the EPOC trial (N=81) and the RFA arm of the CLOCC trial (N=55). RESULTS Local recurrence (LR) rate for RES was 7.4% per patient and 5.5% per lesion. LR rate for RFA was 14.5% per patient and 6.0% per lesion. When lesion size was limited to 30 mm, LR rate for RFA lesions was 2.9% per lesion. Non-local hepatic recurrences were more often observed in RFA patients than in RES patients, 30.9% and 22.3% respectively. Patients receiving RFA had a more advanced disease. CONCLUSIONS LR rate after RFA for lesions with a limited size is low. The local control per lesion does not appear to differ greatly between RFA and surgical resection. This study supports the local control of RFA in patients with limited liver metastases. Future studies should evaluate in which patients RFA could be an equal alternative to liver resection.
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Affiliation(s)
- E Tanis
- EORTC Headquarters, Brussels, Belgium.
| | - B Nordlinger
- Department of Surgery, Centre Hospitalier Universitaire Ambroise Pare, Assistance Publique Hopitaux de Paris, Boulogne-Billancourt, France
| | - M Mauer
- Department of Statistics, EORTC Headquarters, Brussels, Belgium
| | - H Sorbye
- Department of Oncology, Haukeland University Hospital, Bergen, Norway
| | - F van Coevorden
- Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
| | - T Gruenberger
- Department of Surgery, Medical University Vienna, Vienna, Austria
| | - P M Schlag
- Department of Surgery, Robert-Roessle-Klinik, Humboldt-Universitat Berlin, Berlin, Germany
| | - C J A Punt
- Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - J Ledermann
- UCL and UCL Hospitals Comprehensive Biomedical Research Centre, University College London, London, United Kingdom
| | - T J M Ruers
- Department of Surgery, The Netherlands Cancer Institute (NKI), Amsterdam, The Netherlands
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Ruers T, Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Schlag P, Punt C, Ledermann J. PG 8.2 Surgery versus radiofrequency ablation (Lessons from the CLOCC trial). Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70029-2] [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: 10/25/2022]
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Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston G, Rougier P, Schlag P, Bechstein W, Primrose J, Walpole E, Nordlinger B. PG 8.3 Recurrence patterns after resection of liver metastases. Eur J Cancer 2014. [DOI: 10.1016/s0959-8049(14)70030-9] [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: 10/25/2022]
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Tanis E, Nordlinger B, Mauer M, Sorbye H, van Coevorden F, Gruenberger T, Punt C, Schlag P, Lederman J, Ruers T. 189. Local recurrence rates after RFA and resection of colorectal liver metastases – A descriptive analysis of EORTC CLOCC and EPOC databases. Eur J Surg Oncol 2012. [DOI: 10.1016/j.ejso.2012.06.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Wanner C, Oliveira J, Ortiz A, Mauer M, Germain D, Linthorst G, Serra A, Maródi L, Mignani R, Cianciaruso B, Vujkovac B, Lemay R, Beitner-Johnson D, Waldek S, Warnock D. P24—Prognostic Indicators of Renal Disease Progression: Natural History Data From the Fabry Registry. Clin Ther 2012. [DOI: 10.1016/j.clinthera.2012.03.053] [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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Ruers T, Punt C, Van Coevorden F, Pierie JPEN, Borel-Rinkes I, Ledermann JA, Poston G, Bechstein W, Lentz MA, Mauer M, Van Cutsem E, Lutz MP, Nordlinger B. Radiofrequency ablation combined with systemic treatment versus systemic treatment alone in patients with non-resectable colorectal liver metastases: a randomized EORTC Intergroup phase II study (EORTC 40004). Ann Oncol 2012; 23:2619-2626. [PMID: 22431703 DOI: 10.1093/annonc/mds053] [Citation(s) in RCA: 287] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study investigates the possible benefits of radiofrequency ablation (RFA) in patients with non-resectable colorectal liver metastases. METHODS This phase II study, originally started as a phase III design, randomly assigned 119 patients with non-resectable colorectal liver metastases between systemic treatment (n = 59) or systemic treatment plus RFA ( ± resection) (n = 60). Primary objective was a 30-month overall survival (OS) rate >38% for the combined treatment group. RESULTS The primary end point was met, 30-month OS rate was 61.7% [95% confidence interval (CI) 48.2-73.9] for combined treatment. However, 30-month OS for systemic treatment was 57.6% (95% CI 44.1-70.4), higher than anticipated. Median OS was 45.3 for combined treatment and 40.5 months for systemic treatment (P = 0.22). PFS rate at 3 years for combined treatment was 27.6% compared with 10.6% for systemic treatment only (hazard ratio = 0.63, 95% CI 0.42-0.95, P = 0.025). Median progression-free survival (PFS) was 16.8 months (95% CI 11.7-22.1) and 9.9 months (95% CI 9.3-13.7), respectively. CONCLUSIONS This is the first randomized study on the efficacy of RFA. The study met the primary end point on 30-month OS; however, the results in the control arm were in the same range. RFA plus systemic treatment resulted in significant longer PFS. At present, the ultimate effect of RFA on OS remains uncertain.
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Affiliation(s)
- T Ruers
- Department of Surgery, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek ziekenhuis, Amsterdam.
| | - C Punt
- Department of Medical Oncology, Academic Medical Centre, University of Amsterdam, Amsterdam
| | - F Van Coevorden
- Department of Surgery, The Netherlands Cancer Institute-Antoni Van Leeuwenhoek ziekenhuis, Amsterdam
| | - J P E N Pierie
- Department of Surgery, Leeuwarden Medical Center, Leeuwarden
| | - I Borel-Rinkes
- Department of Surgery, Universitair Medisch Centrum, Utrecht, The Netherlands
| | - J A Ledermann
- UCL and UCL Hospitals Comprehensive Biomedical Research Centre, University College London, London
| | - G Poston
- Department of Surgery, Aintree University Hospital, Liverpool, UK
| | - W Bechstein
- Department of Surgery, Klinikum Der J.W. Goethe Universitaet, Frankfurt, Germany
| | - M A Lentz
- Data Management Unit, EORTC Headquarters, Brussels
| | - M Mauer
- Statistics Department, EORTC Headquarters, Brussels
| | - E Van Cutsem
- Department of Medical Oncology, University Hospital Gasthuisberg, Leuven, Belgium
| | - M P Lutz
- Department of Medical Oncology, Caritasklinik St. Theresia, Saarbrücken, Germany
| | - B Nordlinger
- Department of Surgery, Centre Hospitalier Universitaire Ambroise Paré, Assistance Publique Hôpitaux de Paris, Boulogne-Billancourt, France
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Collette L, Bogaerts J, Suciu S, Fortpied C, Gorlia T, Coens C, Mauer M, Hasan B, Collette S, Ouali M, Litière S, Rapion J, Sylvester R. Statistical methodology for personalized medicine: New developments at EORTC Headquarters since the turn of the 21st Century. EJC Suppl 2012. [DOI: 10.1016/s1359-6349(12)70005-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Van Laethem JL, Verslype C, Iovanna JL, Michl P, Conroy T, Louvet C, Hammel P, Mitry E, Ducreux M, Maraculla T, Uhl W, Van Tienhoven G, Bachet JB, Maréchal R, Hendlisz A, Bali M, Demetter P, Ulrich F, Aust D, Luttges J, Peeters M, Mauer M, Roth A, Neoptolemos JP, Lutz M. New strategies and designs in pancreatic cancer research: consensus guidelines report from a European expert panel. Ann Oncol 2012; 23:570-576. [PMID: 21810728 DOI: 10.1093/annonc/mdr351] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Although the treatment of pancreatic ductal adenocarcinoma (PDAC) remains a huge challenge, it is entering a new era with the development of new strategies and trial designs. Because there is an increasing number of novel therapeutic agents and potential combinations available to test in patients with PDAC, the identification of robust prognostic and predictive markers and of new targets and relevant pathways is a top priority as well as the design of adequate trials incorporating molecular-driven hypothesis. We presently report a consensus strategy for research in pancreatic cancer that was developed by a multidisciplinary panel of experts from different European institutions and collaborative groups involved in pancreatic cancer. The expert panel embraces the concept of exploratory early proof of concept studies, based on the prediction of response to novel agents and combinations, and randomised phase II studies permitting the selection of the best therapeutic approach to go forward into phase III, where the recommended primary end point remains overall survival. Trials should contain as many translational components as possible, relying on standardised tissue and blood processing and robust biobanking, and including dynamic imaging. Attention should not only be paid to the pancreatic cancer cells but also to microenvironmental factors and stem/stellate cells.
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Affiliation(s)
- J-L Van Laethem
- Gastrointestinal Cancer Unit, Hôpital Erasme, Université Libre de Bruxelles, Brussels.
| | - C Verslype
- Department of Hepatology, Universitair Ziekenhuis Gasthuisberg, Leuven, Belgium
| | - J L Iovanna
- Institut National de la Santé et de la Recherche Médicale, Marseille, France
| | - P Michl
- Department of Gastroenterology and Endocrinology, University of Marburg, Marburg, Germany
| | - T Conroy
- Nancy University and Department of Medical Oncology, Centre Alexis Vautrin, Nancy
| | - C Louvet
- Digestive Surgery Department, Institut Mutualiste Montsouris, Paris
| | - P Hammel
- Gastroenterology Department, Hôpital Beaujon, Clichy
| | - E Mitry
- Medical Oncology Department, Institut Curie, Hôpital René-Huguenin, Saint-Cloud
| | - M Ducreux
- Digestive Oncology Department, Institut G. Roussy, Villejuif, France
| | - T Maraculla
- Medical Oncology Department, Hospital Vall d'Hebron, Barcelona, Spain
| | - W Uhl
- Department of Surgery, St Josef-Hospital, Ruhr-University, Bochum, Germany
| | - G Van Tienhoven
- Department of Radiation Oncology, Academic Medical Centre, Amsterdam, The Netherlands
| | - J B Bachet
- Department of Gastroenterology, Hôpital Pitié Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - R Maréchal
- Department of Gastroenterology and Hepato-Pancreatology, Gastrointestinal Cancer Unit, Hôpital Universitaire Erasme, Brussels
| | - A Hendlisz
- Department of Gastroenterology, Institut J. Bordet, Brussels
| | - M Bali
- Department of Medical Imaging, Hôpital Erasme, Brussels, Belgium
| | - P Demetter
- Gastrointestinal Cancer Unit, Hôpital Erasme, Université Libre de Bruxelles, Brussels
| | - F Ulrich
- Department of General and Visceral Surgery, J. W. Goethe University Medical Center, Frankfurt
| | - D Aust
- Institute of Pathology, University Hospital Carl Gustav Carus, Dresden
| | - J Luttges
- Caritasklinik St Theresia, Saarbrücken, Germany
| | - M Peeters
- Department of Oncology, Universitair Ziekenhuis Antwerpen, Edegem
| | - M Mauer
- European Organisation for Research and Treatment of Cancer Headquarters, Brussels, Belgium
| | - A Roth
- Department of Surgery, Clinic for Visceral and Transplantation Surgery, Hôpital Universitaire de Genève, Geneva, Switzerland
| | - J P Neoptolemos
- Department of Surgery, University of Liverpool, Liverpool, UK
| | - M Lutz
- Caritasklinik St Theresia, Saarbrücken, Germany
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Mauer M, Collette L, Bogaerts J. Adaptive designs at European Organisation for Research and Treatment of Cancer (EORTC) with a focus on adaptive sample size re-estimation based on interim-effect size. Eur J Cancer 2012; 48:1386-91. [PMID: 22281098 DOI: 10.1016/j.ejca.2011.12.024] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2011] [Accepted: 12/20/2011] [Indexed: 11/17/2022]
Abstract
Given the high failure rates and the increased costs of Phase III trials in oncology and the recent explosion of targeted agents, researchers are looking for better design strategies to try and optimise the use of available patients and financial resources. In this context, adaptive designs are seen as promising tools. We reviewed the different possible adaptations in the design of a clinical trial on the basis of the FDA guidance and summarized these. The pro and cons of adaptive designs are highlighted with a focus on one of the more 'controversial' adaptive designs, the sample size reassessment based on interim-effect size as proposed by Mehta and Pocock. While group sequential designs are preferable to such adaptive designs, both are difficult to implement in the case of rapid accrual and long time to event. Adaptive designs may have some potential in less favourable situations. However, the increase in overall power should be carefully weighted as well as the risk of a large negative trial. Adaptive designs need good, sometimes extensive, logistics. Some adaptive designs (e.g. group sequential designs) proved to be very useful and are already a part of the standard repertoire of trial designs used at European Organisation for Research and Treatment of Cancer (EORTC). Adaptive designs need strong measures to prevent bias that could otherwise become uncontrollable, particularly if interim results are leaked. This includes a prospective planning of adaptations. Finally, these studies currently have the potential to induce a heavy workload and cost linked to their regulatory management.
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Affiliation(s)
- M Mauer
- EORTC Statistics Department, Av E Mounier 83/11, 1200 Brussels, Belgium.
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Wanner C, Germain DP, Linthorst G, Marodi L, Mauer M, Mignani R, Oliveira J, Ortiz A, Serra AL, Svarstad E, Vujkovac B, Waldek S, Warnock DG, West M, Schiffmann R, Mehta A, Amato D, Nair N, Zahrieh D, Huertas P, Bonatti F, Maritati F, Alberici F, Oliva E, Sinico RA, Moroni G, Leoni A, Gregorini G, Jeannin G, Possenti S, Tumiati B, Grasselli C, Brugnano R, Salvarani C, Fraticelli P, Pavone L, Pesci A, Guida G, Neri TM, Buzio C, Malerba G, Martorana D, Vaglio A, Oda A, Kitamura K, Mizumoto T, Eguchi K, Anzai N, Tomita K, Arsali M, Athanasiou Y, Demosthenous P, Voskarides K, Deltas C, Pierides A. Genetic diseases / Molecular mechanisms. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.5] [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: 11/15/2022] Open
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Stoehlmacher J, Kohne C, Mauer M, Goekkurt E, Lutz MP, Aust DE, Carrato A, Bedenne L, Popov I, Ladner RD. Expression of dUTP nucleotidohydrolase (dUTPase) and thymidylate synthase (TS) in stage III colon cancer patients treated with either bolus 5-FU or infusional 5-FU in the adjuvant setting: Results of a translational study of the PETACC-2 trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
417 Background: Pts with stage III colon cancer have been treated with either infusional 5-FU or bolus 5- FU in the adjuvant setting (PETACC-2 trial). DUTPase and TS demonstrated potential as predictive markers for 5-FU efficacy in pts with advanced colorectal cancer. Here we aimed to explore whether TS or dUTPase protein levels may predict recurrence of disease for stage III colon pts treated with 5-FU. Methods: Tumor (T) blocks of 324 pts were analyzed for protein expression of dUTPase and TS. For analysis monoclonal antibodies DUT415 and TS106 were used. T were evaluated by two investigators as follows. Only nuclear staining for both, TS and dUTPase, was analyzed. If tumor cells (TC) showed a nuclear dUTPase expression in >10% of cells, the sample was scored positive. Positive nuclear staining for >20% of TC, when using the TS antibody, determined a positive sample. Results: Analysis for dUTPase was successful in 308 samples (95.1%, 308/324). 263 out of those 308 pts showed a positive dUTPase expression (85.3%). 297/324 samples (91.7%) could be evaluated for TS. In the TS group 62.3% (185/297) showed a positive expression for TS protein. In 281 cases analyses were successful for both TS and dUTPase. We observed a significant association between dUTPase and TS expression with a majotity of 71.4% (172/241) dUTPase positive T also being positive for TS as compared to 32.5% (13/40) of dUTPase negative T that showed positivity for TS protein expression (p< 0.0001). Of pts with dUTPase positive T 64.7% showed no recurrence of disease as compared to 44.7% of those with dUTPase negative T 5 years after completion of therapy (HR 0.61 [95% CI 0.36, 1.03], p=0.06). No associations between TS and DFS were observed. Both TS and dUTPase expression did not correlate with OS in this patient cohort. Conclusions: High TS protein levels appeared to be significantly correlated with high protein levels of dUTPase in stage III colon cancer pts. Neither dUTPase nor TS protein levels appeared to be significantly associated with DFS or OS of stage III colon cancer pts that received adjuvant chemotherapy with 5-FU. No significant financial relationships to disclose.
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Affiliation(s)
- J. Stoehlmacher
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - C. Kohne
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - M. Mauer
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - E. Goekkurt
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - M. P. Lutz
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - D. E. Aust
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - A. Carrato
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - L. Bedenne
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - I. Popov
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
| | - R. D. Ladner
- University Hospital Carl Gustav Carus, Dresden, Germany; Onkologie Klinikum Oldenburg, Oldenburg, Germany; EORTC Headquarters, Brussels, Belgium; University Hospital Aachen, Aachen, Germany; Caritasklinik St. Theresia, Saarbruecken, Germany; Ramon y Cajal University Hospital, IRYCIS, Madrid, Spain; University Hospital, Dijon, France; Institute for Oncology and Radiology of Serbia, Belgrade, Serbia and Montenegro; University of Southern California Norris Comprehensive Cancer Center, Los Angeles, CA
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Klein R, Knudtson MD, Klein BEK, Zinman B, Gardiner R, Suissa S, Sinaiko AR, Donnelly SM, Goodyer P, Strand T, Mauer M. The relationship of retinal vessel diameter to changes in diabetic nephropathy structural variables in patients with type 1 diabetes. Diabetologia 2010; 53:1638-46. [PMID: 20437026 PMCID: PMC2892559 DOI: 10.1007/s00125-010-1763-3] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2010] [Accepted: 03/22/2010] [Indexed: 12/22/2022]
Abstract
AIMS/HYPOTHESIS We examined whether retinal vessel diameter in persons with type 1 diabetes mellitus is associated with changes in subclinical anatomical and functional indicators of diabetic nephropathy. METHODS Persons with type 1 diabetes mellitus had gradable fundus photographs and renal biopsy data at baseline and 5-year follow-up (n = 234). Retinal arteriolar and venular diameters were measured at baseline and follow-up. Central retinal arteriole equivalent (CRAE) and central retinal venule equivalent (CRVE) were computed. Baseline and 5-year follow-up renal structural variables were assessed by masked electron microscopic morphometric analyses from percutaneous renal biopsy specimens. Variables assessed included: mesangial fractional volume, glomerular basement membrane width, mesangial matrix fractional volume and glomerular basement membrane width composite glomerulopathy index. RESULTS While controlling for other covariates, baseline CRAE was positively associated with change in the glomerulopathy index over the 5-year period. Change in CRAE was inversely related to a change in mesangial matrix fractional volume and abnormal mesangial matrix fractional volume, while change in CRVE was directly related to change in the volume fraction of cortex that was interstitium [Vv((Int/cortex))] over the 5-year period. Baseline CRAE or CRVE or changes in these diameters were not related to changes in other anatomical or functional renal endpoints. CONCLUSIONS/INTERPRETATION Independently of other factors, baseline CRAE correlated with changes in glomerulopathy index, a composite measure of extracellular matrix accumulation in the mesangium and glomerular basement membrane. A narrowing of the CRAE was related to mesangial matrix accumulation. Changes in CRVE were related to changes in Vv((Int/cortex),) a measure of interstitial expansion in persons with type 1 diabetes mellitus.
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Affiliation(s)
- R Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, 610 North Walnut Street, Fourth Floor WARF, Madison, WI 53726-2397, USA.
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37
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Aust DE, Lutz MP, Mauer M, Popov I, Baretton GB, Bedenne L, Carrato A, Kohne C. Lessons from PETACC 2: No prognostic impact of KRAS-/BRAF-status in stage III colon cancer treated with adjuvant 5-FU monotherapy. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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38
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Ruers T, Punt CJ, van Coevorden F, Borel Rinkes I, Ledermann JA, Poston GJ, Bechstein W, Lentz M, Mauer M, Nordlinger B. Final results of the EORTC intergroup randomized study 40004 (CLOCC) evaluating the benefit of radiofrequency ablation (RFA) combined with chemotherapy for unresectable colorectal liver metastases (CRC LM). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3526] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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39
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Roth A, Moehler MH, Mauer M, Schad A, Karrasch M, Praet M, Lim ML, Das-Gupta A, Lutz MP. Lapatinib in combination with ECF/x in EGFR1 or HER2-overexpressing first-line metastatic gastric cancer (GC): A phase II randomized placebo controlled trial (EORTC 40071). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.tps205] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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40
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Sorbye H, Mauer M, Gruenberger T, Glimelius B, Poston GJ, Schlag PM, Rougier P, Primrose JN, Walpole ET, Nordlinger B. Predictive factors for the effect of perioperative FOLFOX for resectable liver metastasis in colorectal cancer patients (EORTC phase III study 40983). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.3544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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41
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Van Laethem JL, Mornex F, Azria D, van Tienhoven G, Mauer M, Praet M, Budach V, Hammel P, Van Cutsem E, Haustermans K. Adjuvant gemcitabine alone versus gemcitabine-based chemoradiation after curative resection for pancreatic cancer: Updated results of a randomized EORTC/FFCD/GERCOR phase II study (40013–22012/9203). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4527] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
4527 Background: The role of adjuvant chemoradiotherapy (CRT) in resectable pancreatic cancer is debated. This randomized phase II intergroup study demonstrated the feasibility and tolerability of a gemcitabine-based CRT regimen after R0 resection of pancreatic head cancer (Proc ASCO 2008, 4514). Long term and survival data are now reported. Methods: Patients were randomized within 8 weeks after surgery to receive either 4 cycles of gemcitabine 1000 mg/m2 given over 30 minutes every 3 weeks (control arm) or gemcitabine 1000 mg/m2 for 2 cycles followed by weekly gemcitabine 300 mg/m2 with concurrent radiation of 50.4 Gy given in 28 fractions of 1.8 Gy (experimental arm). The co-primary endpoints were completion of treatment and tolerability. Secondary endpoints were late toxicity, DFS and OS. Results: Between 9/04 and 1/07, 90 patients were randomized by 29 centers (45:45). Treatment arms were balanced in terms of patient/tumour characteristics. Follow-up was equal for both arms with an overall median follow-up of 27.1 months. In the control arm, 5 patients were ineligible, including 2 not treated. In the experimental arm, CRT was delivered to 36 of 45 patients (80%). Treatment was completed per protocol by 86.7% and 73.3% (80% CI 63.1–81.9%) of randomized patients in the control and experimental arms, respectively. Grade 4 toxicity was 0% and 4.4%, respectively. In the CRT arm, 2 patients experienced grade 3 late toxicity (anorexia 1 and epigastric pain 1). In the CRT experimental arm, 33 DFS events were noted and 23 deaths versus 34 and 24, respectively, in the control arm. Median DFS was 12 months in the experimental arm vs. 11 months in the control arm (p=0.6). Median overall survival was 24 months both in the experimental arm and the control arm. Distant progression was similar in both arms while the rate of first local recurrence was lower in the chemoradiation arm (11 vs 24 %, p=0.16). Conclusions: Post-op modern gemcitabine-based CRT is feasible and well- tolerated after long-term follow-up, and a larger trial should assess its true benefit to that of standard gemcitabine alone. [Table: see text]
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Affiliation(s)
- J. L. Van Laethem
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - F. Mornex
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - D. Azria
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - G. van Tienhoven
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - M. Mauer
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - M. Praet
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - V. Budach
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - P. Hammel
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - E. Van Cutsem
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
| | - K. Haustermans
- Erasme University Hospital, Brussels, Belgium; CHU Lyon, Lyon, France; CHU Val d’Aurel, Montpellier, France; AMC, Amsterdam, Netherlands; EORTC, Brussels, Belgium; Charité Campus, Berlin, Germany; Hopital Beaujon, Paris, France; Gasthuisberg UZ, Leuven, Belgium
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Fioretto P, Caramori ML, Mauer M. The kidney in diabetes: dynamic pathways of injury and repair. The Camillo Golgi Lecture 2007. Diabetologia 2008; 51:1347-55. [PMID: 18528679 DOI: 10.1007/s00125-008-1051-7] [Citation(s) in RCA: 103] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2008] [Accepted: 04/17/2008] [Indexed: 11/29/2022]
Abstract
Diabetic nephropathy is the most common cause of end-stage renal disease (ESRD). The natural history of diabetic nephropathy has changed over the last decades, as a consequence of better metabolic and blood pressure management. Thus, it may now be possible to delay or halt the progression towards ESRD in patients with overt diabetic nephropathy, and the decline of renal function is not always inexorable and unavoidable. Also, the rate of progression from microalbuminuria to overt nephropathy is much lower than originally estimated in the early 80s. Furthermore, there is now evidence that it is possible, in humans, to obtain reversal of the established lesions of diabetic nephropathy. This review focuses on the contribution of kidney biopsy studies to the understanding of the pathogenesis and natural history of diabetic nephropathy and the identification of patients at high risk of progression to ESRD. The classic lesions of diabetic nephropathy and the well-established structural-functional relationships in type 1 diabetes will be briefly summarised and the renal lesions leading to renal dysfunction in type 2 diabetes will be described. The relevance of these biopsy studies to diabetic nephropathy pathogenesis will be outlined. Finally, the evidence and the possible significance of reversibility of diabetic renal lesions will be discussed, as well as future directions for research in this field.
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Affiliation(s)
- P Fioretto
- Department of Medical and Surgical Sciences, University of Padua, Via Giustininiani n.2, 35128, Padua, Italy.
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43
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Quinten C, Coens C, Mauer M, Comte S, Sprangers M, Cleeland CS, Osoba D, Bjordal K, Bottomley A. An examination into quality of life as a prognostic survival indicator. Results of a meta-analysis of over 10,000 patients covering 30 EORTC clinical trials. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.9516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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44
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Taphoorn MJ, Claassens L, Aaronson NK, Coens C, Mauer M, Osoba D, Stupp R, Mirimanoff R, Van den Bent MJ, Bottomley A. The EORTC QLQ-BN20 questionnaire for assessing the health-related quality of life (HRQoL) in brain cancer patients: A phase IV validation study on behalf of the EORTC QLG, BCG, ROG, NCIC-CTG. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.2041] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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45
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Slotman B, Faivre-Finn C, Kramer G, Rankin E, Snee M, Hatton M, Postmus P, Collette L, Mauer M, Senan S. Prophylactic Cranial Irradiation (PCI) in Extensive Stage Small Cell Lung Cancer (ES-SCLC) (EORTC 22993-08993). Int J Radiat Oncol Biol Phys 2007. [DOI: 10.1016/j.ijrobp.2007.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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46
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Mauer M, Stupp R, Taphoorn MJB, Coens C, Osoba D, Marosi C, Wong R, de Witte O, Cairncross JG, Efficace F, Mirimanoff RO, Forsyth P, van den Bent MJ, Weller M, Bottomley A. The prognostic value of health-related quality-of-life data in predicting survival in glioblastoma cancer patients: results from an international randomised phase III EORTC Brain Tumour and Radiation Oncology Groups, and NCIC Clinical Trials Group study. Br J Cancer 2007; 97:302-7. [PMID: 17609661 PMCID: PMC2360328 DOI: 10.1038/sj.bjc.6603876] [Citation(s) in RCA: 86] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
This is one of the few studies that have explored the value of baseline symptoms and health-related quality of life (HRQOL) in predicting survival in brain cancer patients. Baseline HRQOL scores (from the EORTC QLQ-C30 and the Brain Cancer Module (BN 20)) were examined in 490 newly diagnosed glioblastoma cancer patients for the relationship with overall survival by using Cox proportional hazards regression models. Refined techniques as the bootstrap re-sampling procedure and the computation of C-indexes and R2-coefficients were used to try and validate the model. Classical analysis controlled for major clinical prognostic factors selected cognitive functioning (P=0.0001), global health status (P=0.0055) and social functioning (P<0.0001) as statistically significant prognostic factors of survival. However, several issues question the validity of these findings. C-indexes and R2-coefficients, which are measures of the predictive ability of the models, did not exhibit major improvements when adding selected or all HRQOL scores to clinical factors. While classical techniques lead to positive results, more refined analyses suggest that baseline HRQOL scores add relatively little to clinical factors to predict survival. These results may have implications for future use of HRQOL as a prognostic factor in cancer patients.
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Affiliation(s)
- M Mauer
- European Organisation for Research and Treatment of Cancer, Quality of Life Unit, Data Center, Avenue Mounier 83/11, 1200 Brussels, Belgium.
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47
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Hoffmann JN, Fertmann JM, Schick K, Mauer M, Wirsching KC, Vollmar B, Menger MD, Jauch KW. [Failure of microcirculation: diagnosis and therapeutic consequences]. Dtsch Med Wochenschr 2006; 131:2489-92. [PMID: 17066363 DOI: 10.1055/s-2006-955038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Johannes N Hoffmann
- Chirurgische Klinik und Poliklinik, Klinikum der Universität München Grosshadern.
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48
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Fine RL, Fogelman DR, Sherman W, Schreibman S, Siegel A, Mauer M, Chen J, Chu K. Gemcitabine, docetaxel, and capecitabine (GTX) in the treatment of metastatic pancreatic cancer (PC): A prospective phase II study. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.14024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
14024 Background: We have found that the combination of gemcitabine, docetaxel, and capecitabine (GTX), when administered in a specific sequence, will induce a p53 independent pathway of cell death through the MAP kinase pathway. The sequence overcomes drug resistance in PC cells in vitro. We have begun a prospective, phase II trial of GTX in patients with metastatic PC as first-line therapy. Methods: 23 patients with metastatic PC, ECOG 0–2 were enrolled at either Columbia or a community practice. Each cycle was administered over a 21 days. Capecitabine was administered at 750 mg/m2 twice daily for 14 days. Gemcitabine (750 mg/m2 over 75 minutes) and docetaxel (30 mg/m2) were administered on days 4 and 11. Responses were measured by CT (RECIST) and PET after every three cycles. A response by PET was defined as a 50% reduction in SUV while a CR was an absence of uptake. Results: Median age was 61, including 8 men and 15 women. Metastatic sites included liver (87%), abdomen (65%), and lung (17%). 70% of liver positive patients had at least five metastases. 22% had malignant ascites. 16 patients remain alive and 7 have progressive disease. Median survival has not yet been reached. Progression occurred at a median of 5.1 months. By CT, the response rate at metastatic sites was 39% (17% CR / 22% PR). Stable disease was observed in 48% at metastatic sites. PET showed a 53% response rate at metastatic sites. At the primary site, CT showed a 30% response rate including 17% complete responses. By PET criteria, there was a 31% response rate and a 26% CR rate at the primary site. In three patients, a PET response heralded a CT response by three cycles. In one patient, progressive disease on PET preceded progression on CT by two months. Toxicity: Grade 3 leukopenia and thrombocytopenia were 13% and 9%, respectively. There was no grade four hematologic toxicity. One patient experienced lung disease related to gemcitabine and withdrew from the study. A second patient experienced grade 4 mucositis, thrush, and sepsis which was presumed due to DPD deficiency. Grade 3–4 toxicities: HFS: 9%. There was no grade 3–4 diarrhea. Conclusions: GTX, elicits a promising response rate when used in metastatic P.C. PET detects a response and failure of chemotherapy earlier than CT scans. [Table: see text]
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Affiliation(s)
- R. L. Fine
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - D. R. Fogelman
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - W. Sherman
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - S. Schreibman
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - A. Siegel
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - M. Mauer
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - J. Chen
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
| | - K. Chu
- Columbia Presbyterian Medical Center, New York, NY; Montefiore Medical Center, Bronx, NY; Morristown Memorial Hospital, Morristown, NJ
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Abstract
Tubular atrophy and interstitial fibrosis, important in progression of renal diseases, including diabetic (D) and cyclosporine-induced (CSA) nephropathy, have been considered irreversible. Normoglycemia for 10 years following pancreas transplantation alone (PTA) reversed D glomerulopathy lesions. This study quantified tubular, interstitial, and arteriolar parameters in PTA recipients. Kidney function studies and biopsies were performed in eight non-uremic type I D patients (pts) at 5 and 10 years after PTA. Renal biopsies were analyzed by morphometric analysis. All pts were normoglycemic and insulin independent and received CSA during the study. Cortical interstitial volume fraction was increased at 5 years (0.31+/-0.07 vs normal 0.15+/-0.02, P<0.01) and decreased at 10 years post-PTA (0.23+/-0.03, P<0.02 vs 5 years). There was a reduction in the volume fraction of interstitial collagen and cells per cortical tissue, measured using electron microscopy, from 5 (0.126+/-0.061 and 0.103+/-0.026, respectively) to 10 years (0.079+/-0.031, P<0.05, and 0.074+/-0.018, P<0.05, respectively). The volume fraction of tubules which were atrophic (AT) was abnormal at 5 years (0.160+/-0.090) and decreased from 5 to 10 years (0.044+/-0.034, P<0.02), apparently due to AT reabsorption. The index of arteriolar hyalinosis did not change during the study (1.30+/-0.22 and 1.34+/-0.33 at 5 and 10 years, respectively, nonsignificant). This study demonstrates, for the first time in humans, that interstitial expansion is reversible and that atrophic tubules can be reabsorbed. In contrast, there was no improvement in the arteriolar lesions. Whether this is due to long-term normoglycemia, reduction of CSA dose or other mechanisms is unclear.
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Affiliation(s)
- P Fioretto
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy.
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Nicholas S, Basgen J, Mauer M, Ren Y, Kim J, Liu J, Wong J. Cyclic Arg-Gly-Asp (Crgd) Peptide Prevents Diabetic Nephropathy in Db/Db Mice. J Investig Med 2006. [DOI: 10.1177/108155890605401s225] [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: 01/09/2023]
Affiliation(s)
- S.B. Nicholas
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J. Basgen
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - M. Mauer
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - Y. Ren
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J. Kim
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J. Liu
- David Geffen School of Medicine at UCLA, Los Angeles, CA
| | - J. Wong
- David Geffen School of Medicine at UCLA, Los Angeles, CA
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