1
|
Paganetti C, Heigl A, Rosenberg R, Vetter M, Haslbauer J, Steuerwald M. Case report: 65-year-old man with metachronous left sided adrenal metastasis of hepatocellular carcinoma. Int J Surg Case Rep 2024; 119:109683. [PMID: 38688153 PMCID: PMC11067464 DOI: 10.1016/j.ijscr.2024.109683] [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: 02/13/2024] [Revised: 04/18/2024] [Accepted: 04/20/2024] [Indexed: 05/02/2024] Open
Abstract
INTRODUCTION AND IMPORTANCE Due to therapeutic advances and improvements in follow-up care, the diagnosis and treatment of extrahepatic metastases of hepatocellular carcinoma [HCC] have gained clinical significance. However, adrenal gland metastases of HCC remain a rare clinical encounter. Several systemic and local treatment options are discussed in current literature. Adrenalectomy in cases of isolated adrenal metastases with well-controlled intrahepatic lesions has been shown to benefit patients in case series. PRESENTATION OF THE CASE This 65-year-old patient presented with suspected metachronous left sided adrenal metastasis seven years after bisegmentectomy for HCC and after undergoing trans-arterial chemoembolization [TACE] for multifocal intrahepatic recurrences while being listed for liver transplantation "beyond Milan criteria". Adrenalectomy was suggested for histopathological confirmation of the suspected metastasis and re-consideration for liver transplant. The resection was performed laparoscopically and metastasis of HCC was confirmed in histopathological analysis. Postoperatively, the patient recovered quickly. However, the patient decided against re-listing for liver transplantation. CLINICAL DISCUSSION Current literature suggests, that minimally-invasive adrenalectomy should be considered in patients with no more than two extrahepatic lesions, a Child-Pugh-Score of less than A5, low alpha-fetoprotein [AFP] levels <100 ng/ml and size <3 cm. The oncological goal should be to achieve a tumor free extrahepatic situation with a potential oncological benefit. CONCLUSION Our patient presented as an ideal candidate for resection of the adrenal gland metastasis and could have been re-assessed postoperatively for liver transplantation. Still, more research is needed to improve patient-selection for metastasectomy in HCC.
Collapse
Affiliation(s)
- Ch Paganetti
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland.
| | - A Heigl
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland
| | - R Rosenberg
- Department of Surgery, Cantonal Hospital Baselland, Liestal, Switzerland
| | - M Vetter
- Department of Oncology, Cancer Center, Medical University Clinic, Cantonal Hospital Baselland, Liestal, Switzerland
| | - J Haslbauer
- Department of Pathology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - M Steuerwald
- Praxis für Gastroenterologie und Hepatologie, Liestal, Switzerland
| |
Collapse
|
2
|
Meitner-Schellhaas B, Schüler S, Vogl T, Jesper D, Vetter M, Waldner M, Strobel D. Determination and prospective validation of cut-off values for the diagnosis of liver cirrhosis for point shear-wave elastography/acoustic radiation force impulse imaging using the ACUSON Sequoia ultrasound system. Eur J Gastroenterol Hepatol 2024; 36:135-140. [PMID: 37994620 DOI: 10.1097/meg.0000000000002683] [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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
OBJECTIVES Point shear-wave elastography (pSWE) alias acoustic radiation force impulse (ARFI) imaging is a well-established ultrasound-based technique for the non-invasive assessment of liver tissue stiffness. As cut-off values for liver cirrhosis cannot be transferred from one ultrasound system to another, this study aimed at determining cut-off values for the newly developed Siemens ACUSON Sequoia ultrasound system. METHODS In a pilot study phase, two independent examiners conducted 10 pSWE measurements in an elasticity phantom and 32 healthy individuals for the determination of inter-examiner agreement. Afterwards, 22 cirrhotic patients and 57 patients with chronic liver disease undergoing liver biopsy underwent pSWE. Patient characteristics and stiffness values were compared for individuals with and without liver cirrhosis. Diagnostic accuracies of cut-off values for the diagnosis of liver cirrhosis were calculated using areas under the receiver operating characteristics analysis and Youden's index. In a subsequent validation study phase, these cut-off values were validated prospectively in 107 cirrhotic and 68 non-cirrhotic patients. RESULTS Inter-examiner agreement was excellent for measurements in the elasticity phantom (intra-class correlation coefficient [ICC] = 0.998; P < 0.001), and good for measurements in patients (ICC = 0.844; P < 0.001). The best cut-off value for the diagnosis of liver cirrhosis was 1.405 m/s with an AUC of 0.872, a sensitivity of 88.2% and a specificity of 88.2% ( P < 0.001). CONCLUSION ARFI elastography using the Siemens ACUSON Sequoia showed a good inter-examiner agreement. The optimal cut-off value was lower than the cut-off values described for former generations of ultrasound devices. These preliminary results should be confirmed in larger patient collectives with histology as the reference standard.
Collapse
Affiliation(s)
- B Meitner-Schellhaas
- Department of Internal Medicine 1, Erlangen University Hospital, FAU University of Erlangen-Nürnberg, Erlangen, Germany
| | | | | | | | | | | | | |
Collapse
|
3
|
Feagan BG, Sandborn WJ, Sands BE, Liu Y, Vetter M, Mathias SD, Huang KHG, Johanns J, Germinaro M, Han C. Qualitative and psychometric evaluation of the PROMIS®-Fatigue SF-7a scale to assess fatigue in patients with moderately to severely active inflammatory bowel disease. J Patient Rep Outcomes 2023; 7:115. [PMID: 37962770 PMCID: PMC10645698 DOI: 10.1186/s41687-023-00645-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/09/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND This study evaluated the content validity and psychometric properties of the Patient-Reported Outcomes Measurement Information System® (PROMIS)-Fatigue Short Form 7a (SF-7a) v1.0 scale to determine its suitability in clinical trials to assess fatigue in patients with moderately to severely active Crohn's disease (CD) and ulcerative colitis (UC). METHODS A qualitative interview assessed patients' experience living with CD (N = 20) and UC (N = 19). The contents of the SF-7a scale were cognitively debriefed to evaluate content validity. A psychometric evaluation was performed using data from clinical trials of patients with CD (N = 360) and UC (N = 214). Correlations with Inflammatory Bowel Disease Questionnaire (IBDQ), Crohn's Disease Activity Index (CDAI; CD only), and Mayo score (UC only) determined validity. The Patient Global Impression of Change (PGIC) was used to evaluate reliability and responsiveness to change. Using PGIC as an anchor, a preliminary threshold for clinically meaningful change was identified to define fatigue response in both CD and UC patients. RESULTS All patients reported fatigue as a common symptom. Patients confirmed SF-7a items were relevant to assessing fatigue, instructions and response options were clear, and its 7-day recall period was appropriate. Higher SF-7a scores were associated with higher disease activity (CDAI and Mayo score) and lower health-related quality of life (IBDQ), confirming known groups validity. The correlation of the SF-7a scale was higher with fatigue-related items. (rs ≥ -0.70) than with items not directly associated with fatigue. Test-retest reliability was moderate to good (0.54-0.89) among patients with stable disease, and responsiveness to change in disease severity was demonstrated from baseline to Week 12. A ≥7point decrease was identified as a reasonable threshold to define clinically meaningful improvement. CONCLUSION The SF-7a scale is a valid, reliable, and sensitive measure of fatigue in patients with moderately to severely active IBD and can be used to evaluate treatment response.
Collapse
Affiliation(s)
- Brian G Feagan
- Western University and Alimentiv Inc, London, ON, Canada
| | | | - Bruce E Sands
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yan Liu
- Janssen Research & Development, LLC, Spring House, PA, USA
| | - Marion Vetter
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | | | - Jewel Johanns
- Janssen Research & Development, LLC, Spring House, PA, USA
| | | | - Chenglong Han
- Janssen Research & Development, LLC, Spring House, PA, USA.
| |
Collapse
|
4
|
Chiru ED, Grasic Kuhar C, Oseledchyk A, Schötzau A, Gonzalez MJ, Kurzeder C, Vetter M. Clinical application of the 21-gene oncotype recurrence score in an older cohort: A single center experience. Transl Oncol 2023; 36:101724. [PMID: 37480708 PMCID: PMC10375846 DOI: 10.1016/j.tranon.2023.101724] [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: 01/11/2023] [Revised: 06/06/2023] [Accepted: 06/15/2023] [Indexed: 07/24/2023] Open
Abstract
BACKGROUND In early luminal breast cancer, the Oncotype DX® Recurrence Score (RS) prognostic and predictive value with regards to chemotherapy (CHT) application benefit has been broadly validated. In older patients its value has not been deeply addressed. This study aimed to evaluate the benefits of RS testing and to look at differences in treatment allocation for these patients when compared with younger ones. METHODS We included data from consecutive patients with early luminal HER2-negative breast cancer, treated between 2010 and 2022 at the University Hospital Basel and Cantonal Hospital Baselland, Switzerland. The older cohort included 63 (19%) patients aged ≥70, and the younger cohort 263 (81%) patients aged <70. RESULTS Older breast cancer patients had more co-morbidities (N = 36, 57% vs. N = 92, 35%, p = 0.002) and a higher clinical risk status (N = 49, 78% vs. N = 155, 59%; p = 0.01) when compared to younger patients. Histopathologic characteristics were significantly different between the two cohorts. Although older patients had a higher clinical risk status (78% vs. 59%) (p = 0.01), most of them (74%) received no CHT. Specifically, adjuvant CHT was administered less frequently in older than in younger patients (13% vs. 22%; p = 0.01). Moreover, older patients were less likely to complete CHT (>4 cycles: 78% vs. 97%). CONCLUSION Breast cancer patients aged ≥70 have higher clinical risk status, more co-morbidities, higher clinical stage (driven by larger tumor size), and more often RS ≥26. However, they receive fewer adjuvant RT and CHT than those aged <70. RS maintains its independent prognostic value in older patients. However, assessing the predictive value of additional CHT benefit remains challenging due to significant differences in CHT administration. Although therapy decision-making in older patients with breast cancer still follows RS-based guidelines, clinical practice indicates an individualized treatment approach.
Collapse
Affiliation(s)
- E D Chiru
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland
| | - C Grasic Kuhar
- Medical Oncology Department, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Oseledchyk
- Medical Oncology, Basel University Hospital, Basel, Switzerland
| | - A Schötzau
- Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M J Gonzalez
- Adullam Hospital and care centers, Basel, Switzerland
| | - C Kurzeder
- Breast Center, Basel University Hospital, Basel, Switzerland; Department of Gynecologic Oncology, Basel University Hospital, Basel, Switzerland
| | - M Vetter
- Medical Oncology, Basel University Hospital, Basel, Switzerland; Center of Oncology and Hematology, Cantonal Hospital Baselland, Liestal, Switzerland; Breast Center, Basel University Hospital, Basel, Switzerland.
| |
Collapse
|
5
|
Wallrabenstein T, Daetwyler E, Oseledchyk A, Rochlitz C, Vetter M. Pegylated liposomal doxorubicin (PLD) in daily practice-A single center experience of treatment with PLD in patients with comorbidities and older patients with metastatic breast cancer. Cancer Med 2023. [PMID: 37148541 DOI: 10.1002/cam4.6041] [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: 12/08/2022] [Revised: 04/16/2023] [Accepted: 04/23/2023] [Indexed: 05/08/2023] Open
Abstract
PURPOSE Real-world data about pegylated liposomal doxorubicin (PLD) in patients with metastatic breast cancer (MBC) are limited. We have aimed to highlight the role of PLD in daily practice focusing on older patients and patients with comorbidities with MBC. METHODS We analyzed electronic records of all patients with advanced/metastatic breast cancer treated with single-agent PLD at the University Hospital Basel between 2003 and 2021. Primary endpoint was time to next chemotherapy or death (TTNC). Secondary endpoints were overall survival (OS), progression-free survival (PFS), and overall response rate (ORR). We performed univariate and multivariate analysis for clinical variables. RESULTS 112 patients with MBC having received single-agent PLD in any treatment line were analyzed, including 34 patient who were older than 70 years and 61 patients with relevant comorbidities. Median TTNC, OS, and PFS for treatment with PLD were 4.6, 11.9, and 4.4 months, respectively. ORR was 13.6%. Age >70 years predicted shorter OS (median 11.2 months) in multivariate analysis (hazard ratio [HR] 1.83, 95% CI 1.07-3.11, p = 0.026). Age and comorbidities did not significantly affect other endpoints. Unexpectedly, hypertension predicted longer TTNC (8.3 months, p = 0.04) in univariate analysis, maintained in multivariate analysis as a trend for both TTNC (HR 0.62, p = 0.07) and OS (HR 0.63, p = 0.1). CONCLUSION Age predicted shorter OS significantly but median OS was not relevantly shorter in older patients. PLD remains a treatment option in patients with comorbidities and older patients with MBC. However, our real-world results of PLD appear underwhelming compared to relevant phase II trials through all age groups, pointing to an efficacy-effectiveness gap, possibly due to sampling bias.
Collapse
Affiliation(s)
- T Wallrabenstein
- Medical Oncology, University Hospital Basel, Basel, Switzerland
- Hematology/Oncology, University Medical Center Freiburg, Freiburg, Germany
| | - E Daetwyler
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - A Oseledchyk
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - C Rochlitz
- Medical Oncology, University Hospital Basel, Basel, Switzerland
| | - M Vetter
- Medical Oncology, University Hospital Basel, Basel, Switzerland
- Medical Oncology, Kantonsspital Baselland, Liestal, Switzerland
| |
Collapse
|
6
|
Feagan BG, Sands BE, Sandborn WJ, Germinaro M, Vetter M, Shao J, Sheng S, Johanns J, Panés J. Guselkumab plus golimumab combination therapy versus guselkumab or golimumab monotherapy in patients with ulcerative colitis (VEGA): a randomised, double-blind, controlled, phase 2, proof-of-concept trial. Lancet Gastroenterol Hepatol 2023; 8:307-320. [PMID: 36738762 DOI: 10.1016/s2468-1253(22)00427-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Despite the introduction of new monoclonal antibodies and oral therapies for the treatment of ulcerative colitis, clinical remission rates remain low, underscoring the need for innovative treatment approaches. We assessed whether guselkumab plus golimumab combination therapy was more effective for ulcerative colitis than either monotherapy. METHODS We did a randomised, double-blind, controlled, proof-of-concept trial at 54 hospitals, academic medical centres, or private practices in nine countries. Eligible adults (aged ≥18 to 65 years) had a confirmed diagnosis of ulcerative colitis at least 3 months before screening and moderately-to-severely active ulcerative colitis (Mayo score 6-12) with a centrally-read baseline endoscopy subscore of 2 or higher. Patients were randomly assigned (1:1:1) using a computer-generated randomisation schedule to combination therapy (subcutaneous golimumab 200 mg at week 0, subcutaneous golimumab 100 mg at weeks 2, 6, and 10, and intravenous guselkumab 200 mg at weeks 0, 4, and 8, followed by subcutaneous guselkumab monotherapy 100 mg every 8 weeks for 32 weeks), golimumab monotherapy (subcutaneous golimumab 200 mg at week 0 followed by subcutaneous golimumab 100 mg at week 2 and every 4 weeks thereafter for 34 weeks), or guselkumab monotherapy (intravenous guselkumab 200 mg at weeks 0, 4, and 8, followed by subcutaneous guselkumab 100 mg every 8 weeks thereafter for 32 weeks). The primary endpoint was clinical response at week 12 (defined as a ≥30% decrease from baseline in the full Mayo score and a ≥3 points absolute reduction with either a decrease in rectal bleeding score of ≥1 point or a rectal bleeding score of 0 or 1). Efficacy was analysed in the modified intention-to-treat population up to week 38, which included all randomly assigned patients who received at least one (partial or complete) study intervention dose. Safety was analysed up to week 50, according to study intervention received among all patients who received at least one (partial or complete) dose of study intervention. This trial is complete and is registered with ClinicalTrials.gov, NCT03662542. FINDINGS Between Nov 20, 2018, and Nov 15, 2021, 358 patients were screened for eligibility, of whom 214 patients were randomly assigned to combination therapy (n=71), golimumab monotherapy (n=72), or guselkumab monotherapy (n=71). Of the 214 patients included, 98 (46%) were women and 116 (54%) were men and the mean age was 38·4 years (SD 12·0). At week 12, 59 (83%) of 71 patients in the combination therapy group had achieved clinical response compared with 44 (61%) of 72 patients in the golimumab monotherapy group (adjusted treatment difference 22·1% [80% CI 12·9 to 31·3]; nominal p=0·0032) and 53 (75%) of 71 patients in the guselkumab monotherapy group (adjusted treatment difference 8·5% [-0·2 to 17·1; nominal p=0·2155). At week 50, 45 (63%) of 71 patients in the combination therapy group, 55 (76%) of 72 patients in the golimumab monotherapy group, and 46 (65%) of 71 patients in the guselkumab monotherapy group had reported at least one adverse event. The most common adverse events were ulcerative colitis, upper respiratory tract infection, headache, anaemia, nasopharyngitis, neutropenia, and pyrexia. No deaths, malignancies, or cases of tuberculosis were reported during the combination induction period. One case of tuberculosis was reported in the combination therapy group and one case of colon adenocarcinoma was reported in the guselkumab monotherapy group; both occurred after week 12. Two deaths were reported after the final dose of study intervention (poisoning in the combination therapy group and COVID-19 in the guselkumab monotherapy group). INTERPRETATION Data from this proof-of-concept study suggest that combination therapy with guselkumab and golimumab might be more effective for ulcerative colitis than therapy with either drug alone. These findings require confirmation in larger trials. FUNDING Janssen Research and Development.
Collapse
Affiliation(s)
| | - Bruce E Sands
- Dr Henry D. Janowitz Division of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | - Marion Vetter
- Janssen Research and Development, Spring House, PA, USA
| | - Jie Shao
- Janssen Research and Development, Spring House, PA, USA
| | - Shihong Sheng
- Janssen Research and Development, Spring House, PA, USA
| | - Jewel Johanns
- Janssen Research and Development, Spring House, PA, USA
| | - Julián Panés
- Department of Gastroenterology, Hospital Clinic of Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain
| | | |
Collapse
|
7
|
Hu C, Vetter M, Vermeulen A, Ouellet D. Latent variable indirect response modeling of clinical efficacy endpoints with combination therapy: application to guselkumab and golimumab in patients with ulcerative colitis. J Pharmacokinet Pharmacodyn 2023; 50:133-144. [PMID: 36648595 DOI: 10.1007/s10928-022-09841-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/30/2022] [Indexed: 01/18/2023]
Abstract
Accurate characterization of longitudinal exposure-response of clinical trial endpoints is important in optimizing dose and dosing regimens in drug development. Clinical endpoints are often categorical, for which much progress has been made recently in latent variable indirect response (IDR) modeling with single drugs. However, such applications have not yet been used for trials employing multiple drugs administered concurrently. This study aims to demonstrate that the latent variable IDR approach provides a convenient longitudinal exposure-response modeling framework to assess potential interaction effects of combination therapies. This is illustrated by an application to the exposure-response modeling of guselkumab, a monoclonal antibody in clinical development that blocks the interleukin-23p19 subunit, and golimumab, a monoclonal antibody that binds with high affinity to tumor necrosis factor-alpha. A Phase 2a study was conducted in 214 patients with moderate-to severe active ulcerative colitis for which longitudinal assessments of disease severity based on patient-reported measures of rectal bleeding, stool frequency, and symptomatic remission were evaluated as categorical endpoints, and fecal calprotectin as a continuous endpoint. The modeling results suggested independent pharmacodynamic guselkumab and golimumab effects on fecal calprotectin as a continuous endpoint, as well as interaction effects on the categorical endpoints that may be explained by an additional pathway of competitive interaction.
Collapse
Affiliation(s)
- Chuanpu Hu
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, LLC, Spring House, PA, USA.
- Janssen Research & Development, LLC, PO Box 776, 1400 McKean Road, Spring House, PA, 19477, USA.
| | - Marion Vetter
- Clinical Immunology, Janssen Research & Development, LLC, Spring House, PA, USA
| | - An Vermeulen
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, A Division of Janssen Pharmaceutica NV, Beerse, Belgium
| | - Daniele Ouellet
- Clinical Pharmacology and Pharmacometrics, Janssen Research & Development, LLC, Spring House, PA, USA
| |
Collapse
|
8
|
Chiru E, Grasic Kuhar C, Oseledchyk A, Kurzeder C, Vetter M. 21-Gene Oncotype DX® Recurrence-Score benefits and application in elderly breast cancer patients. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00291-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
9
|
Häuptle P, Mertz K, Voegeli M, Robert R, Burri E, Subotic S, Romanens A, Leuppi-Taegtmeyer A, Christian R, Wedeken L, Vetter M. Tailored Anti-Cancer treatment in elderly cancer patients A registry study in Progress. J Geriatr Oncol 2022. [DOI: 10.1016/s1879-4068(22)00262-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
10
|
Vetter M, Pinto C, Bailey V, Gilbert B, Oberhaus E. 147 Meiotic competence of oocytes obtained from seasonally anovulatory mares treated with estradiol and sulpiride. Reprod Fertil Dev 2021; 34:311-312. [PMID: 35231354 DOI: 10.1071/rdv34n2ab147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- M Vetter
- Louisiana State University Agricultural Experiment Station, Baton Rouge, LA, USA
| | - C Pinto
- Louisiana State University School of Veterinary Medicine, Baton Rouge, LA, USA
| | - V Bailey
- Louisiana State University Agricultural Experiment Station, Baton Rouge, LA, USA
| | - B Gilbert
- Louisiana State University Agricultural Experiment Station, Baton Rouge, LA, USA
| | - E Oberhaus
- Louisiana State University Agricultural Experiment Station, Baton Rouge, LA, USA
| |
Collapse
|
11
|
Voss M, Wenger KJ, von Mettenheim N, Bojunga J, Vetter M, Diehl B, Gerlach R, Ronellenfitsch MW, Franz K, Harter PN, Hattingen E, Steinbach JP, Rödel C, Rieger J. OS05.9.A Short-term fasting in glioma patients - Analysis of diet diaries and metabolic parameters of the ERGO2 trial. Neuro Oncol 2021. [DOI: 10.1093/neuonc/noab180.025] [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: 11/13/2022] Open
Abstract
Abstract
BACKGROUND
The prospective, randomized ERGO2 trial investigated the effect of fasting / calorie restricted ketogenic diet (KD-IF) on re-irradiation for recurrent brain tumors (Clinicaltrials.gov number: NCT01754350). The study did not meet its primary endpoint of improved progression-free survival in comparison to a standard diet (SD). We here report the results of the quality of life questionnaire, neurocognition testing, detailed analysis of the diet diaries and the alterations of metabolic parameters.
MATERIAL AND METHODS
50 Patients were randomized 1:1 to re-irradiation combined with either SD or KD-IF. The KD-IF schedule included 3 days of ketogenic diet (KD: 21–23 kcal/kg/d, carbohydrate intake limited to 50 g/d), followed by 3 days of fasting and again 3 days of KD. Follow-up included examination of cognition, quality of life and serum samples.
RESULTS
The 20 patients who completed KD-IF met the prespecified goals for calorie and carbohydrate restriction. In these, a decrease in leptin and insulin and an increase in uric acid was observed. The SD group had a lower calorie intake of 21 kcal/kg/d than the expected 30 kcal/kg/d. Neither quality of life nor cognition were affected by the diet. Low glucose emerged as a significant prognostic parameter in a best responder analysis.
CONCLUSION
The strict caloric goals of the ERGO2 trial could be achieved by patients with recurrent brain tumor. The unexpected lower calorie intake of the SD group might have hampered the interpretation of the trial. However, the short diet schedule already led to significant metabolic alterations, suggesting that short-term dietary interventions might be therapeutically useful, possibly combined with other modalities.
Collapse
Affiliation(s)
- M Voss
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - K J Wenger
- Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - N von Mettenheim
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - J Bojunga
- Department of Medicine 1, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - M Vetter
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - B Diehl
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - R Gerlach
- Department of Neurosurgery, Helios Hospital Erfurt, Erfurt, Germany
| | - M W Ronellenfitsch
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - K Franz
- Department of Neurosurgery, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - P N Harter
- Institute of Neurology (Edinger-Institute), University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - E Hattingen
- Institute of Neuroradiology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - J P Steinbach
- Dr. Senckenberg Institute of Neurooncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - C Rödel
- Department of Radiotherapy and Oncology, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - J Rieger
- Interdisciplinary Division of Neuro-Oncology, University Hospital Tübingen, Tübingen, Germany
| |
Collapse
|
12
|
Vetter M, Kremer AE, Agaimy A, Konturek PC, Pfeifer L, Neurath MF, Siebler J, Zopf S. The amount of liver tissue is essential for accurate histological staging in patients with autoimmune hepatitis. J Physiol Pharmacol 2021; 72. [PMID: 34272349 DOI: 10.26402/jpp.2021.1.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/26/2021] [Indexed: 11/03/2022]
Abstract
The gold standard for the evaluation of liver fibrosis is histology. However, the heterogenous distribution of fibrosis limits the sensitivity of histology. The collection of two samples with a 16G needle is therefore recommended to reduce the risk of sampling error. The aim of this study was to investigate whether this standard is also applicable to patients with autoimmune hepatitis (AIH). This retrospective study included patients with AIH, who underwent mini-laparoscopic biopsy at our center between 2011 and 2020 (n = 32). Diagnosis was verified by usage of the simplified AIH score (≥ 6). Patients were categorized into three groups, based on the number of portal fields (PF) in the collected liver tissue (< 10 PF, 10 - 19 PF, ≥ 20 PF). We correlated the histological staging for these groups with the mini-laparoscopic fibrosis score (MLFS). Furthermore, non-invasive methods for the assessment of fibrosis were correlated with the histological staging (acoustic radiation force impulse (ARFI) and FIB-4 score). MLFS correlated well with histological staging (r = 0.649, p = 0.0001). The correlation between MLFS and histology improved with higher numbers of histologically analyzed portal fields (< 10 PF: r = 0.400, p = 0.378; 10 - 19 PF: r = 0.5467, p = 0.023; ≥ 20 PF: r = 0.956, p = 0.0002). The probability of collecting at least 10 or 20 portal fields was dependent on the number and diameter of the samples. For all patients with at least two 16G biopsies, 10 or more PF were available. With three 16G biopsies, at least 20 PF were obtained for all patients. ARFI correlated with MLFS and histological staging only in patients with low/moderate-grade inflammation as defined by ALT < 10xULN (upper limit of normal) (MLFS: r = 0.723; p = 0.004; histology: r = 0.619, p = 0.018). FIB-4 did not correlate with histological staging. The amount of liver tissue obtained by liver biopsy is crucial to minimalize the risk of sampling error and thus underestimation of fibrosis. This study was the first to investigate the amount of liver tissue required for histological staging in AIH. Our data suggest that diagnostic accuracy is likely to be higher with 20 PF compared to the generally recommended 10 PF. We therefore recommend to perform three biopsies with a 16G needle in (suspected) AIH patients. ARFI correlated well with histological staging unless inflammatory activity is high.
Collapse
Affiliation(s)
- M Vetter
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany. .,Deutsches Zentrum Immuntherapie, DZI Erlangen, Germany
| | - A E Kremer
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, DZI Erlangen, Germany
| | - A Agaimy
- Institute of Pathology, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany
| | - P C Konturek
- Department of Internal Medicine II, Thueringen-Klinik, Saalfeld, Germany
| | - L Pfeifer
- Department of Gastroenterology and Interventional Endoscopy, Krankenhaus Barmherzige Brueder, Regensburg, Germany
| | - M F Neurath
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, DZI Erlangen, Germany
| | - J Siebler
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, DZI Erlangen, Germany
| | - S Zopf
- Department of Medicine 1, Friedrich-Alexander-University Erlangen-Nuernberg and Universitaetsklinikum, Erlangen, Germany.,Deutsches Zentrum Immuntherapie, DZI Erlangen, Germany
| |
Collapse
|
13
|
Bauer M, Fathke C, Stückrath K, Voigtländer S, Vetter M, Wickenhauser C, Kantelhardt E. Untersuchung tumorinfiltrierender Lymphozyten des Tumorstromas (sTILs) in triple negativen Mammakarzinomen (TNBC) aus Subsahara-Afrika (SAA). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717837] [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: 10/23/2022] Open
Affiliation(s)
- M Bauer
- Institut für Pathologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - C Fathke
- Institut für Pathologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - K Stückrath
- Universitätsklinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - S Voigtländer
- Institut für Pathologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - M Vetter
- Universitätsklinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - C Wickenhauser
- Institut für Pathologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| | - E Kantelhardt
- Universitätsklinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
- Institut für Epidemiologie, Universitätsklinikum Halle (Saale), Martin-Luther-Universität Halle-Wittenberg
| |
Collapse
|
14
|
Ungurs O, Vetter M, Pazaitis N, Beer J, Bley N, Thomssen C, Wickenhauser C. Expression von IGF2BP1 in Karzinomen des Ovars (work in progress). Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718193] [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: 10/23/2022] Open
Affiliation(s)
- O Ungurs
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie
| | - M Vetter
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie
| | - N Pazaitis
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie
| | - J Beer
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie
| | - N Bley
- Martin-Luther-Universität Halle-Wittenberg, Institut für Molekulare Medizin
| | - C Thomssen
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie
| | - C Wickenhauser
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie
| |
Collapse
|
15
|
Geissler F, Vetter M, Schoetzau A, Montavon C, Kurzeder C, Heinzelmann V, Schwab FD. Review of treatment strategies for HER2 positive breast cancer and their implementation in a major Swiss hospital. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714550] [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: 03/22/2023] Open
Affiliation(s)
- F Geissler
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
| | - M Vetter
- Gynecological Cancer Center, University Hospital Basel
- Breast Cancer Center, University Hospital Basel
- Department of Medical Oncology, University Hospital Basel
| | - A Schoetzau
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
| | - C Montavon
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
| | - C Kurzeder
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
- Breast cancer Center, University Hospital Basel
| | - V Heinzelmann
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Gynecological Cancer Center, University Hospital Basel
| | - FD Schwab
- Department of Gynecology and Gynecological Oncology, University Women`s Hospital of Basel, University of Basel
- Breast cancer Center, University Hospital Basel
- Gynaecological Cancer Center, University Hospital Basel
| |
Collapse
|
16
|
Kam K, Vetter M, Berryman N, Varga A. 0418 Effect of Acute Administration of DORA-12 on Sleep Impairment in the Aged PS19 Mouse Model of Tauopathy. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.415] [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: 11/12/2022] Open
Abstract
Abstract
Introduction
Aged PS19 mice (MAPT P301S), a mouse model of tauopathy and neurodegeneration, display reduced NREM and REM sleep starting around 8-9 months before death around 12 months. Here, we tested the acute effect of a dual orexin receptor antagonist (DORA-12) on sleep in 11 mice (5 male, 6 female) at 10.3±1.8 months.
Methods
Two consecutive 24-hour recordings (12/12hr L:D cycle) were scored semi-automatically for non-REM sleep, REM sleep, and wake in mice implanted with EEG/EMG. Mice were treated with either vehicle (day 1) or 100mg/kg of DORA-12 (day 2) by oral gavage at both ZT0 and ZT9.
Results
After the first dose at ZT0, both latency to the first NREM sleep episode (paired t-test p=0.002) and to the first REM sleep episode (paired t-test p=0.005) was significantly shorter with DORA-12 (NREM: 20.8±17.8 min.; REM: 23.5±21.2 min.) compared to vehicle (NREM: 49.2±22.3 min.; REM: 127.0±93.3 min.). There was no difference in NREM or REM sleep latency observed after the second dose at ZT9. DORA-12 treatment increased NREM duration across the 24hr period (DORA-12: 664±52 min.; Veh: 601±54 min., paired t-test p=0.007) and also after the 2nd dose (DORA-12: 311±65 min.; Veh: 263±84 min., paired t-test p=0.009). DORA-12 treatment also increased REM duration across 24hrs (DORA-12: 61±30 min.; Veh: 48±29 min., paired t-test p=0.014) but not after the 2nd dose alone (DORA-12: 22±14 min.; Veh: 20±15 min., paired t-test p=0.388). Notably in both vehicle and DORA-12 conditions, we observed apparent dream enactment behavior including mastication, paw grasp, and fore limb extension during REM in 3 of 11 PS19 mice (all male), not typically observed in younger PS19 or age-matched non-transgenic mice, suggestive of a possible REM behavior disorder (RBD) phenotype. Wake-like behaviors occurred during theta-dominant EEG but with an EMG amplitude >4SD the preceding NREM sleep baseline for at least > 1sec.
Conclusion
In aged PS19 mice, DORA-12 was found to decrease the latency to NREM and REM after the first dose while also increasing NREM and REM duration across the entire 24hr recording period. We also capture a heretofore undescribed RBD-like phenotype in aged PS19 tauopathy mice.
Support
Merck MISP
Collapse
Affiliation(s)
- K Kam
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Vetter
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - N Berryman
- Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Varga
- Icahn School of Medicine at Mount Sinai, New York, NY
| |
Collapse
|
17
|
Bixel K, Vetter M, Davidson B, Berchuck A, Cohn D, Copeland L, Fowler JM, Havrilesky L, Lee PS, O'Malley DM, Salani R, Valea F, Alvarez Secord A, Backes F. Intraperitoneal chemotherapy following neoadjuvant chemotherapy and optimal interval tumor reductive surgery for advanced ovarian cancer. Gynecol Oncol 2020; 156:530-534. [PMID: 31937450 DOI: 10.1016/j.ygyno.2019.12.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 09/30/2019] [Revised: 12/10/2019] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Intraperitoneal (IP) chemotherapy following neoadjuvant chemotherapy (NACT) and interval tumor reductive surgery (TRS) for advanced ovarian cancer is feasible, however, the impact on disease outcomes remains unclear. We compare outcomes of patients treated with IP chemotherapy versus intravenous (IV) chemotherapy following NACT and interval TRS. METHODS In this retrospective review, patients with advanced ovarian cancer were included if they received NACT followed by optimal interval TRS between 1/2004 and 4/2017. Patients were excluded if they had an ECOG PS >1, received >6 cycles of NACT or postoperative chemotherapy, and/or received bevacizumab during primary therapy. Primary outcomes were progression free survival (PFS) and overall survival (OS). RESULTS There were 134 patients included in this study, 37 (28%) received IP and 97 (72%) received IV chemotherapy postoperatively. Patients in the IV group were older (median 66.3 vs 59.7 years, p = 0.0039) though there were no differences in BMI, race, BRCA status, stage, or histology. Median PFS was 3 months longer in the IP group (14.5 versus 11.5 months, p = 0.028) however there was no significant difference in OS. On univariate analysis, increasing number of NACT cycles (HR 1.914, 95% CI 1.024-3.497) and residual disease at completion of TRS (HR 1.541, 95% CI 1.042-2.248) were associated with decreased PFS; IP chemotherapy was associated with increased PFS (HR 0.633, 95% CI 0.414-0.944). These associations remained on multivariate analysis. Toxicity was comparable between the groups. CONCLUSIONS IP after NACT and optimal interval TRS was associated with in improved PFS compared to IV chemotherapy without significant differences in toxicity.
Collapse
Affiliation(s)
- K Bixel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America.
| | - M Vetter
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - B Davidson
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - A Berchuck
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - D Cohn
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - L Copeland
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - J M Fowler
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - L Havrilesky
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - P S Lee
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - D M O'Malley
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - R Salani
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| | - F Valea
- Division of Gynecologic Oncology, Virginia Tech Carilion School of Medicine, Roanoke, VA, United States of America
| | - A Alvarez Secord
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC, United States of America; Duke Cancer Institute, Duke University Medical Center, Durham, NC, United States of America
| | - F Backes
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, The Ohio State University Wexner Medical Center, Columbus, OH, United States of America; The Ohio State University Comprehensive Cancer Center, Arthur G James Cancer Hospital and Richard J Solove Research institute, Columbus, OH, United States of America
| |
Collapse
|
18
|
Vetter M, O'Connor HT, O'Dwyer N, Chau J, Orr R. 'Maths on the move': Effectiveness of physically-active lessons for learning maths and increasing physical activity in primary school students. J Sci Med Sport 2019; 23:735-739. [PMID: 31926869 DOI: 10.1016/j.jsams.2019.12.019] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 12/03/2019] [Accepted: 12/17/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES This study evaluated the benefit of physically-active lessons for learning maths multiplication-tables. The impact of the intervention on general numeracy, physical activity (PA), aerobic fitness, body mass index (BMI) and school-day moderate to vigorous PA (MVPA) was also assessed. DESIGN Randomised controlled cross-over trial. METHOD Year 3 students (n=172, mean age 8.4±0.3 years, 48% male) were recruited from 10 classes across two urban primary schools. Participants were randomly assigned to a seated classroom (Classroom) group or physically-active lessons in the playground (Playground) and crossed over to the alternative condition in the subsequent school term. The 6-week intervention comprised 3×30min sessions/week. Multiplication-tables (teacher-designed test) and general maths (standardised test) were assessed pre- and post-intervention. Aerobic fitness was assessed via the shuttle-run. Pre- to post-intervention change scores were compared for analysis and effect sizes (ES) calculated. Total PA and MVPA were assessed with accelerometers in a subset of participants. RESULTS Multiplication scores improved significantly more in Playground than Classroom groups (ES=0.23; p=0.045), while no significant differences were observed in general numeracy (ES=0.05; p=0.66). Total PA and MVPA were substantially higher during Playground than Classroom lessons (ES: total PA=7.4, MVPA=6.5; p<0.001) but there were no differences in PA/MVPA between the groups throughout the rest of the school day. Aerobic fitness improved more in Playground than Classroom groups (ES=0.3; p<0.001) while the change in BMI was not different between groups (p=0.39). CONCLUSIONS Physically-active lessons may benefit the learning of maths multiplication-tables while favourably contributing to school-day PA/MVPA.
Collapse
Affiliation(s)
- M Vetter
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown NSW 2006, Australia.
| | - H T O'Connor
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown NSW 2006, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - N O'Dwyer
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown NSW 2006, Australia.
| | - J Chau
- Department of Health Systems and Populations, Macquarie University, Level 3, 75 Talavera Road, NSW 2109, Australia.
| | - R Orr
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health Sciences, The University of Sydney, Camperdown NSW 2006, Australia; Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia.
| |
Collapse
|
19
|
Vetter M, Kremer AE. [Primary biliary cholangitis-established and novel therapies]. Internist (Berl) 2019; 59:544-550. [PMID: 29691599 DOI: 10.1007/s00108-018-0427-0] [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] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with primary biliary cholangitis (PBC, formerly primary biliary cirrhosis) and insufficient treatment response or risk factors exhibit a remarkably increased risk for disease progression and associated complications. Furthermore, extrahepatic manifestations may considerably reduce quality of life in affected patients. OBJECTIVES This article presents an overview on standard therapy with ursodeoxycholic acid (UDCA) and further therapeutic options in patients with insufficient treatment response. In addition, symptom-orientated therapies will be presented in a practical and compact way. METHODS The current European and German guidelines from 2017 in addition to several research papers and expert opinions are the basis for this review. RESULTS Every PBC patient should be treated with UDCA life-long. In case of insufficient response to UDCA, obeticholic acid (OCA) has been approved as second line therapy since 2016. Fibrates and budesonide present off-label options for certain patient subpopulations. Pruritus should initially be treated with colestyramine. In case of insufficient efficacy or intolerance, rifampicin represents the most effective off-label option. If fatigue is present, differential diagnoses shall be excluded and coping strategies combined with regular physical activity can have a positive effect. CONCLUSION UDCA and OCA are effective and approved drugs for treating PBC. Patients with insufficient treatment response or risk factors have to be treated consequently. Due to the improved anti-cholestatic treatment options, therapies to reduce fatigue and pruritus are increasingly important.
Collapse
Affiliation(s)
- M Vetter
- Medizinische Klinik 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland
| | - A E Kremer
- Medizinische Klinik 1, Friedrich-Alexander-Universität Erlangen-Nürnberg, Ulmenweg 18, 91054, Erlangen, Deutschland.
| |
Collapse
|
20
|
Essel K, Vetter M, Doo D, Greenwade M, Vesely S, Evans E, Strope B, Opara G, Powell M, Arend R, Salani R, Moore K. Prognostic factors associated with survival following platinum based therapy in advanced/recurrent endometrial cancer. Gynecol Oncol 2019. [DOI: 10.1016/j.ygyno.2019.03.212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
21
|
Hartung C, Stückrath K, Porsch M, Vetter M. Finale Auswertung der molekulare Subtypisierung tripel negativer Tumoren aus einer prospektiven Gesamtkohorte von Mammakarzinomen (n = 1270). Geburtshilfe Frauenheilkd 2019. [DOI: 10.1055/s-0039-1692096] [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: 10/26/2022] Open
Affiliation(s)
- C Hartung
- Universitätsklinik und Poliklinik für Gynäkologie, MLU Halle-Wittenberg
| | - K Stückrath
- Universitätsklinik und Poliklinik für Gynäkologie, MLU Halle-Wittenberg
| | - M Porsch
- Institut für Bioinformatik, MLU-Halle-Wittenberg
| | - M Vetter
- Universitätsklinik und Poliklinik für Gynäkologie, MLU Halle-Wittenberg
| |
Collapse
|
22
|
Biskup E, Montavon Sartorius C, Müller A, Leo C, Uhlmann Nussbaum C, Koychev D, Schreiber A, Taverna C, Thorn D, Vetter M. Pertuzumab (P) as ≥ second-line therapy for HER2-positive metastatic breast cancer (mBC): Swiss clinical experience. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz100.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
23
|
Woldesonbet Z, Nigussie M, Zeleke T, Bekuretsion Y, Assefa M, Anberbir E, Vetter M, Bukhor J, Barbara S, Kantelhardt E. NanoString nCounter based gene expression assay for the evaluation of breast cancer molecular subtypes in Ethiopian patients. Breast 2019. [DOI: 10.1016/s0960-9776(19)30127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
|
24
|
Wimberger P, Bachmann HS, Kuhlmann JD, Link T, Kröber E, Thomssen C, Malle B, Vetter M, Kantelhardt EJ. Abstract P6-09-03: Association of Caspase 8 polymorphisms with TILs and disease-free survival in primary breast cancer patients. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-09-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
BACKGROUND: The minor allele of two caspase-8 polymorphisms, namely CASP8 -652 6N InsDel and CASP8 Asp302His, were shown to promote survival of T-lymphocytes and were repeatedly associated with reduced breast cancer susceptibility. However, besides some preliminary findings, clinical relevance of these polymorphisms in patients with already existing primary breast cancer has not yet been established. Considering an immunomodulatory and potentially tumor-protective role of these caspase-8 variants, we genotyped 785 primary breast cancer patients and correlated caspase-8 variants with i) disease-free survival (DFS) and ii) the presence of tumor infiltrating lymphocytes (TILs).
METHODS: Primary breast cancer samples were collected at the Martin-Luther University, Halle-Wittenberg between 2009 and 2011 as part of the multicenter prospective PiA trial (NCT 01592825). The majority of patients had luminal-like tumors (75.9%), followed by triple negative (10.1%), luminal-Her2-like (9.6%) and Her2-enriched tumors (4.5%). Genotyping was performed by pyrosequencing, TILs status was assessed by hematoxylin and eosin staining.
RESULTS: The CASP8 -652 deletion was significantly associated with improved DFS in an allele-dose dependent manner (p=0.027). Homozygosity for the -652 6N Del variant was an independent predictor for improved DFS (p=0.005). In patients with a 302His/His genotype, there was no event of recurrence during the entire observation time. Combined analysis of diplotypes revealed that both polymorphisms had an influence on DFS (p=0.029). Interestingly, patients with the 302His/His variant among the unstratified patient cohort and among the luminal-like subtype alone had tumors with very low lymphocyte infiltration (0-10% TILs in 65% of cases compared to 31% of cases for other genotypes, p=0.025).
CONCLUSION: In line with previous epidemiological findings, we propose a prognostically favorable role of the CASP8 -652 6N Del and the Asp302His variant in primary breast cancer patients. Moreover, we suggest for the first time a role of the Asp302His variant in immunosurveillance and lymphocyte infiltration of breast cancer. Our findings strongly encourage further analyze of these genetic variants as a biomarker for prognostic and immunotherapeutic considerations.
Citation Format: Wimberger P, Bachmann HS, Kuhlmann JD, Link T, Kröber E, Thomssen C, Malle B, Vetter M, Kantelhardt EJ. Association of Caspase 8 polymorphisms with TILs and disease-free survival in primary breast cancer patients [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-09-03.
Collapse
Affiliation(s)
- P Wimberger
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - HS Bachmann
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - JD Kuhlmann
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - T Link
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - E Kröber
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - C Thomssen
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - B Malle
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - M Vetter
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - EJ Kantelhardt
- Technische Universität Dresden, Dresden, Germany; Centre for Biomedical Education and Research (ZBAF), Witten/Herdecke University, Witten, Witten, Germany; Institute of Pathology, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| |
Collapse
|
25
|
Paepke S, Wilhelm OG, Schmitt M, Noske A, Schricker G, Napieralski R, Vetter M, Thomssen C, Perkins J, Lauber J, Ulm K, Martens JWM, Weichert W, Kiechle M. PITX2 DNA-Methylierung: Erster klinisch validierter prädiktiver Marker zur Vorhersage des Ansprechens auf anthrazyklin-basierte Chemotherapie bei Brustkrebspatientinnen mit hohem Rezidivrisiko. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1655534] [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: 10/28/2022] Open
Affiliation(s)
- S Paepke
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - OG Wilhelm
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - M Schmitt
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - A Noske
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - G Schricker
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - R Napieralski
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - M Vetter
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - C Thomssen
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - J Perkins
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - J Lauber
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - K Ulm
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - JWM Martens
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - W Weichert
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| | - M Kiechle
- Klinik und Poliklinik für Frauenheilkunde/Institut für Pathologie, Klinikum rechts der Isar, Technische Universität München, Comprehensive Cancer Center; Qiagen GmbH, Hilden und Therawis Diagnostics GmbH München, Deutschland
| |
Collapse
|
26
|
Ungurs O, Vetter M, Pazaitis N, Beer J, Thomssen C, Wickenhauser C. Expression von IGF2BP1 in Ovarialkarzinomen. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- O Ungurs
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie, Halle (Saale), Deutschland
| | - M Vetter
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie, Halle (Saale), Deutschland
| | - N Pazaitis
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie, Halle (Saale), Deutschland
| | - J Beer
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie, Halle (Saale), Deutschland
| | - C Thomssen
- Martin-Luther-Universität Halle-Wittenberg, Klinik und Poliklinik für Gynäkologie, Halle (Saale), Deutschland
| | - C Wickenhauser
- Martin-Luther-Universität Halle-Wittenberg, Institut für Pathologie, Halle (Saale), Deutschland
| |
Collapse
|
27
|
Hartung C, Stückrath K, Porsch M, Vetter M. Molekularbiologische Subtypisierung von tripel-negativen Mammakarzinomen (in progress). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1645907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Affiliation(s)
- C Hartung
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| | - K Stückrath
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| | - M Porsch
- Institut für Informatik, Martin-Luther-Universität Halle-Wittenberg
| | - M Vetter
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| |
Collapse
|
28
|
Heinzelmann-Schwarz V, Knipprath Mészaros A, Stadlmann S, Jacob F, Schoetzau A, Russell K, Friedlander M, Singer G, Vetter M. Letrozole may be a valuable maintenance treatment in high-grade serous ovarian cancer patients. Gynecol Oncol 2018; 148:79-85. [DOI: 10.1016/j.ygyno.2017.10.036] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/24/2017] [Accepted: 10/26/2017] [Indexed: 10/18/2022]
|
29
|
Heinzelmann-Schwarz V, Knipprath Mészaros A, Stadlmann S, Jacob F, Schoetzau A, Russell K, Friedlander M, Singer G, Vetter M. Letrozole may be a valuable maintenance treatment in high-grade serous ovarian cancer patients. Gynecol Oncol 2017. [PMID: 29157627 DOI: 10.1016/j.ygyno.2017.10.036] [] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Endocrine therapy is used as maintenance in estrogen receptor (ER) positive breast cancers and has been proposed in low-grade serous ovarian cancers (LGSOC). Here we examine a rationale for its use as maintenance in high-grade serous ovarian cancers (HGSOC). METHODS We accessed the TCGA PANCAN dataset to evaluate the expression of ESR1. ESR1 expression data on all cancers (n=8901) and HGSOC (n=527) were followed by investigation of ER expression via immunohistochemistry (IHC) (n=4071). The same was performed in an independent cohort for matched primary and recurrent HGSOC (n=80). Finally, newly diagnosed ER+ HGSOC patients were offered a maintenance therapy with Letrozole. RESULTS ESR1 was strongly expressed in similar levels in HGSOC as in breast cancer. We found a strong ER expression via IHC in both the primary and matched recurrent HGSOC, particularly in the Platinum-resistant subgroup. The additional use of Letrozole as maintenance treatment was associated with a significantly prolonged recurrence free interval (after 24months 60% when taking Letrozole versus 38.5% in the control group; p=0.035; RFS: IC50 reached by one subject versus 13.2months). This effect was also present in patients treated additionally with Bevacizumab; 20.8% of patients had no recurrence after 12months compared to 87.5% when taking Letrozole in addition to Bevacizumab (p=0.026). CONCLUSIONS Primary HGSOC have a slightly higher ESR1 than and a similar ER expression breast cancer where aromatase inhibitor maintenance is routine for decades. Here we demonstrate evidence for the usefulness of Letrozole in HGSOC, particularly in patients with chemotherapy resistance or residual disease.
Collapse
Affiliation(s)
- V Heinzelmann-Schwarz
- Gynecological Cancer Center, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland; Ovarian Cancer Research, Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland.
| | - A Knipprath Mészaros
- Gynecological Cancer Center, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
| | - S Stadlmann
- Institute of Pathology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
| | - F Jacob
- Glyco-Oncology Group, Ovarian Cancer Research, Department of Biomedicine, University Hospital Basel and University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland; Ovarian Cancer Research, Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland
| | - A Schoetzau
- Ovarian Cancer Research, Department of Biomedicine, University of Basel, Hebelstrasse 20, 4056 Basel, Switzerland
| | - K Russell
- Caris Life Sciences, Jakobsstrasse 199, 4052 Basel, Switzerland
| | - M Friedlander
- Department of Medical Oncology, Prince of Wales Hospital, Prince of Wales Clinical School, University of New South Wales, Barker St, Randwick NSW 2031, Sydney, Australia
| | - G Singer
- Institute of Pathology, Cantonal Hospital Baden, Im Ergel 1, 5404 Baden, Switzerland
| | - M Vetter
- Gynecological Cancer Center, University Hospital Basel, University of Basel, Spitalstrasse 21, 4031 Basel, Switzerland
| |
Collapse
|
30
|
Vetter M, Bosco A, Anderson S, Breen K, Romero C, Steele M, Chiodo V, Boye S, Hauswirth W, Tomlinson S. Contribution of microglia and complement activation to glaucoma progression. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03621] [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: 12/01/2022]
Affiliation(s)
- M. Vetter
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - A. Bosco
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - S. Anderson
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - K. Breen
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - C. Romero
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - M. Steele
- Department of Neurobiology and Anatomy; University of Utah; Salt Lake City UT United States
| | - V. Chiodo
- Department of Ophthalmology; University of Florida; Gainesville FL United States
| | - S. Boye
- Department of Ophthalmology; University of Florida; Gainesville FL United States
| | - W. Hauswirth
- Department of Ophthalmology; University of Florida; Gainesville FL United States
| | - S. Tomlinson
- Department of Microbiology& Immunology; Medical University of South Carolina; Charleston SC United States
| |
Collapse
|
31
|
Harung C, Stückrath K, Porsch M, Kantelhardt E, Thomssen C, Vetter M. Molekularbiologische Subtypisierung von tripel-negativen Mammakarzinomen (in progress). Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1606149] [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: 10/18/2022] Open
Affiliation(s)
- C Harung
- Universitätsklinik für Gynäkologie, Halle (Saale)
| | - K Stückrath
- Universitätsklinik für Gynäkologie, Halle (Saale)
| | - M Porsch
- Institut für Informatik, Martin-Luther-Universität, Halle (Saale)
| | | | - C Thomssen
- Universitätsklinik für Gynäkologie, Halle (Saale)
| | - M Vetter
- Universitätsklinik für Gynäkologie, Halle (Saale)
| |
Collapse
|
32
|
Hartung C, Stückrath K, Porsch M, Vetter M. Molekularbiologische Subtypisierung von tripel-negativen Mammakarzinomen (in progress). Geburtshilfe Frauenheilkd 2017. [DOI: 10.1055/s-0037-1601550] [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: 10/19/2022] Open
Affiliation(s)
- C Hartung
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| | - K Stückrath
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| | - M Porsch
- Institut für Informatik, Martin-Luther-Universität Halle-Wittenberg
| | - M Vetter
- Klinik und Poliklinik für Gynäkologie, Universitätsklinikum Halle (Saale)
| |
Collapse
|
33
|
Vetter M, Hartung C, Hanf V, Lantzsch T, Uleer C, Peschel S, John J, Buchmann J, Bürrig KF, Weigert E, Thomssen C, Kantelhardt EJ. Abstract P2-05-12: The ASCO-recommended prognostic factors uPA/PAI-1 in a multicenter cohort study (PiA). Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p2-05-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
The PiA-study (Prognostic assessment in routine Application, NCT 01592825) was designed as a representative cohort of breast cancer patients to estimate the proportions of traditional and modern prognostic factors. The ASCO-recommended biomarkers uPA (urokinase-type plasminogen activator) and its inhibitor PAI-1 were used for biological risk assessment particularly for intermediate risk breast cancer patients and disease-free survival of the patients after 5 yrs of follow-up (F/U) was calculated.
Material & Methods
Between 2009 and 2011, 1,074 non-metastasized, primarily operated breast cancer patients from six centers in Germany were included. From 815 patients, fresh frozen tissue was obtained and processed for central testing uPA/PAI-1 by ELISA (FEMTELLE®, Sekisui Diagnostics GmbH). Low uPA/PAI-1 status is defined by uPA and PAI-1 concentrations below the published cut-offs, high status means one or both were higher than the corresponding cut-offs. Tumor characteristics were based on local pathology. The centers had to follow the national guidelines. In low-risk patients, adjuvant chemotherapy was spared. The median F/U is 56 months (range 0-78).
Results
In the total cohort of 1,074 patients, 166 had G1- and 237 had G3-tumors. Of the 671 patients with a G2-tumor, the following were allocated to the high-risk group: node-positive (n=371), younger than 35 yrs (n=17), and triple-negative (TN) or HER2-positive (n=118). For 253 tumors of the remaining 355 patients with an intermediate risk of recurrence (pN0, G2, HR positive, HER2-negative, ≥35 yrs), uPA/PAI-1 status was available. 126 (49.8%) were allocated to the low-risk group, one patient had a recurrence. At 5 yrs, in the total cohort 90.6% (95% CI, 89.5-91.7) of the patients were free of invasive disease. Of 114 HER2-positive tumors, 94 (82.4 %) had a high uPA/PAI-1 status, only one of the 38 HR negative/HER2 positive tumors had a low uPA/PAI-1 status. In the TN group, the majority of tumors had a high uPA/PAI-1 status (66 of 81; 81.5 %). In 30 patients lymph nodes were involved, 18.5% (n=15) had a low uPA/PAI-1 status, one event was detected. In N pos. patients with an high uPA/PAI-1 6 events were observed.
Conclusion
Testing for uPA/PAI-1 in the daily routine is feasible, fresh frozen tissue has been prepared from 76% of the tumors of the recruited patients, 37% of them had a low risk status. Using uPA/PAI-1, about half of the node-negative patients with an intermediate risk of recurrence were allocated to a group with an extremely low risk of recurrence and thus chemotherapy could be spared. Also in node-positive disease, uPA/PAI-1 has a prognostic impact.
Tab 1: Proportion of the subgroups according to IHC, grading and uPA/PAI-1-statusTumor typetotallow uPA/PAI-1 statushigh uPA/PAI-1 statusn=815 (100%)n=304 (37%)n=511 (63%)Luminal A-like tumors:HRpos., HER2neg., G1, G2515 (63.2%)240 (78.9%)275 (53.9%)Luminal B/HER2-negative-like tumors:HRpos., HER2neg., G3104 (12.8%)29 (9.5%)75 (14.7%)Luminal B/HER2-positive-like tumors:HR pos., HER2 pos., all grades77 (9.4%)19 (6.2%)58 (11.4%)HER2-positive (nonluminal) - like tumors:HRneg., HER2pos., all grades38 (4.7%)1 (0.3%)37 (7.3%)TN tumors:HRneg., HER2neg., all grades81 (9.9%)15 (4.9%)66 (12.9%)
Citation Format: Vetter M, Hartung C, Hanf V, Lantzsch T, Uleer C, Peschel S, John J, Buchmann J, Bürrig K-F, Weigert E, Thomssen C, Kantelhardt EJ. The ASCO-recommended prognostic factors uPA/PAI-1 in a multicenter cohort study (PiA) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-05-12.
Collapse
Affiliation(s)
- M Vetter
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - C Hartung
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - V Hanf
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - T Lantzsch
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - C Uleer
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - S Peschel
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - J John
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - J Buchmann
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - K-F Bürrig
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - E Weigert
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - C Thomssen
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| | - EJ Kantelhardt
- Martin-Luther-University, Halle (Saale), Germany; Klinikum Fürth, Fürth, Germany; St. Elisabeth St. Barbara, Halle (Saale), Germany; Praxis Uleer, Hildesheim, Germany; Klinikum St. Bernward, Hildesheim, Germany; Klinikum Hildesheim, Hildesheim, Germany; Institut of Pathology, Krankenhaus Martha-Maria, Halle (Saale), Germany; Institut of Pathology Hildesheim, Hildesheim, Germany; Institut of Pathology, Klinikum Fürth, Fürth, Germany
| |
Collapse
|
34
|
Vetter M, Stadelmann S, Steffens D, Singer G, Heinzelmann-Schwarz V. Higher expression of estrogen receptor in primary platinum-resistant high grade serous ovarian cancers. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
35
|
Kurtschinski A, Stückrath K, Hüttelmaier S, Thomssen C, Kantelhardt EJ, Vetter M. Genexpressionsanalysen von IGF2BP1, 2, 3 im primären Mammakarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
|
36
|
Hartung C, Stückrath K, Porsch M, Vetter M. Molekularbiologische Subtypisierung von tripel-negativen Mammakarzinomen (in progress). Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583577] [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
|
37
|
Pesavento A, Kaufhold S, Thomssen C, Vetter M. Deskriptive Analyse einer prospektiven Kohorte von nodal-negative Mammakarzinom-Patientinnen, in progress. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1583583] [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
|
38
|
Thomssen C, Kantelhardt EJ, Grosse R, Papendick N, Steer S, Buchmann J, Wickenhauser C, Vetter M. Abstract P2-08-22: The ASCO-recommended biomarkers urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 define a subgroup of patients with very low risk of recurrence under routine conditions. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p2-08-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
ASCO Tumor Marker Guidelines 2007 recommended clinical routine use of the invasion markers uPA and PAI-1 for risk assessment in node-negative breast cancer patients (Harris et al. JCO 2007; 25:5287), and in some countries, e.g. Germany and France, risk assessment using these markers is broadly used. We wanted to evaluate the impact of uPA/PAI-1 on identifying patients with low risk of recurrence also in the daily routine in order to demonstrate that >25 years since their first description, these markers are still valuable.
Material and Methods:
We identified a cohort of 227 patients who were tested for uPA and PAI-1 in the clinical routine before 2012. Fresh frozen tissue of the primary tumor was obtained at biopsy or operation and processed for testing by a commercially available ELISA (FEMTELLE®, Sekisui Diagnostics GmbH) as previously described (Thomssen et al. JNCI 2009;101:1028). Tumor and patient characteristics were documented and all patients were regularly followed. Tumor concentrations below 3 ng/mg protein for uPA and below 14 ng/mg protein for PAI-1 were considered indicating low risk of recurrence (Harbeck et al. EJC 2013; 49:1825). Disease-free survival was defined as survival free from metastasis and loco-regional recurrence.
Results:
In our cohort, 86 patients had low tumor levels of uPA/PAI-1 (37.9 %). The median follow-up was 38.9 months (0.4 – 113.5 months). Adjuvant chemotherapy was delivered to 25 of 86 patients (29.1%) in the low risk group and to 85 of 141 patients (60.3%) in the high risk group; if steroid hormone receptor status was positive, generally adjuvant endocrine therapy for five years was advised. Using immunohistochemical subtyping, 73 of 86 patients with low uPA/PAI-1 values were luminal-like, 9 patients had a HER2-positive tumor and 3 patients had a triple negative breast cancer (TNBC). In patients with uPA or PAI-1 or both elevated, 105 of 141 patients had a luminal-like cancer, 12 patients were HER2 positive and 22 had TNBC; 1 case unknown. At 60 months of follow-up, patients with low uPA and/or PAI-1 tumor values had not experienced any recurrence, while in the high risk group 7 recurrences were observed although adequate adjuvant therapy was delivered (log-rank p=0.07). In node-negative pts with low uPA/PAI-1 values (n=72; pN0 70, cN0 2), no recurrences were observed, in 104 high risk patients 5 recurrences were observed (p=0.057).
Conclusions:
This observation confirms that also in daily routine, patients with a very low risk of recurrence can be identified by testing for uPA/PAI1. This group of pts comprises nearly 40% of pts and in these patients further evaluation with expensive predictive tests can be avoided and - above all - potentially toxic adjuvant chemotherapy can be spared.
Citation Format: Thomssen C, Kantelhardt E-J, Grosse R, Papendick N, Steer S, Buchmann J, Wickenhauser C, Vetter M. The ASCO-recommended biomarkers urokinase-type plasminogen activator (uPA) and its inhibitor PAI-1 define a subgroup of patients with very low risk of recurrence under routine conditions. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P2-08-22.
Collapse
Affiliation(s)
- C Thomssen
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - E-J Kantelhardt
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - R Grosse
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - N Papendick
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - S Steer
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - J Buchmann
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - C Wickenhauser
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| | - M Vetter
- Martin-Luther-University, Halle (Saale), Germany; Institute of Pathology, Martha-Maria, Halle (Saale), Halle (Saale), Germany; Institute of Pathology, Martin-Luther-University, Halle (Saale), Germany
| |
Collapse
|
39
|
Vetter M. Prävalenz von PIK3CA-Genmutationen beim Mammakarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0035-1570061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
|
40
|
Alonso A, Bahnson JL, Gaussoin SA, Bertoni AG, Johnson KC, Lewis CE, Vetter M, Mantzoros CS, Jeffery RW, Soliman EZ. Effect of an intensive lifestyle intervention on atrial fibrillation risk in individuals with type 2 diabetes: the Look AHEAD randomized trial. Am Heart J 2015; 170:770-777.e5. [PMID: 26386801 DOI: 10.1016/j.ahj.2015.07.026] [Citation(s) in RCA: 82] [Impact Index Per Article: 9.1] [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: 04/21/2015] [Accepted: 07/21/2015] [Indexed: 11/17/2022]
Abstract
BACKGROUND Obesity is associated with higher risk of atrial fibrillation (AF), but the impact of behavioral weight loss interventions on atrial fibrillation (AF) risk in persons with diabetes is unknown. We addressed this question in the Look AHEAD randomized trial. METHODS AND RESULTS A total of 5,067 overweight or obese individuals 45 to 76 years old with type 2 diabetes without prevalent AF were randomized to either an intensive lifestyle intervention (ILI) designed to achieve and maintain weight loss through caloric reduction and increased physical activity or a diabetes support and education usual care group. Atrial fibrillation was ascertained from electrocardiograms at study examinations and hospitalization discharge summaries. Multivariable Cox models were used to estimate the intention-to-treat effect of the intervention adjusting for baseline covariates. During a mean follow-up of 9.0 years, 294 incident AF cases were identified. Rates of AF were comparable in the ILI and diabetes support and education groups (6.1 and 6.7 cases per 1,000 person-years, respectively, P = .42). The intervention did not affect AF incidence (multivariable hazard ratio [HR] 0.99, 95% CI 0.77-1.28). Similarly, neither weight loss nor improvement in physical fitness during the first year of the intervention was significantly associated with AF incidence: multivariable hazard ratio (95% CI) comparing top versus bottom quartile was 0.70 (0.41-1.18) for weight loss and 0.88 (0.55-1.43) for physical fitness improvement. CONCLUSION In a large randomized trial of overweight and obese individuals with type 2 diabetes, an ILI that induced modest weight loss did not reduce the risk of developing AF.
Collapse
Affiliation(s)
- Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN.
| | - Judy L Bahnson
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Sarah A Gaussoin
- Department of Biostatistical Sciences, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Alain G Bertoni
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Sciences Center, Memphis, TN
| | - Cora E Lewis
- Division of Preventive Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Marion Vetter
- Center for Weight and Eating Disorders, Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA; Bristol-Myers Squib, Inc, Philadelphia, PA
| | - Christos S Mantzoros
- Section of Endocrinology, Boston VA Healthcare System, Harvard Medical School, Boston, MA
| | - Robert W Jeffery
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Elsayed Z Soliman
- Department of Epidemiology and Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| |
Collapse
|
41
|
Zivich S, Cauterucci M, Allen S, Vetter M, Vinnard C. Long-term virologic outcomes following bariatric surgery in patients with HIV. Obes Res Clin Pract 2015; 9:633-5. [PMID: 26411387 DOI: 10.1016/j.orcp.2015.09.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [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: 09/02/2015] [Accepted: 09/05/2015] [Indexed: 11/19/2022]
Abstract
The management of morbid obesity and its metabolic complications among HIV-infected patients requires a multi-disciplinary approach, with surgical interventions as one option. We sought to assess the long-term durability of ART among HIV-infected patients undergoing bariatric procedures for the management of morbid obesity. During the study period, 7 patients underwent a bariatric surgery procedure for the management of morbid obesity: 3 patients underwent sleeve gastrectomy, 2 patients underwent laparoscopic banding, and 2 patients underwent Roux-en-Y gastric bypass surgery. Overall, the proportion of undetectable HIV viral load levels did not change after the bariatric procedures, although 2 patients did require temporary cessation of medications due to procedure-related complications. Sleeve gastrectomy and Roux-en-Y gastric bypass were safe and effective among morbidly obese HIV-infected patients in our clinic population.
Collapse
Affiliation(s)
- Steven Zivich
- Department of Family Medicine, Drexel University College of Medicine, Philadelphia, USA.
| | - Margaret Cauterucci
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, USA.
| | - Sara Allen
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, USA.
| | | | - Christopher Vinnard
- Division of Infectious Diseases & HIV Medicine, Department of Medicine, Drexel University College of Medicine, Philadelphia, USA.
| |
Collapse
|
42
|
Müller A, Thomssen C, Scheumann N, Vetter M. Klinische Anwendung des Detektor CANCER01 zur in vivo Isolierung von CTCs bei Patienten mit Mammakarzinom und vergleichende Charakterisierung der CTCs mit dem Primärtumorgewebe – Projektvorstellung. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
43
|
Stückrath K, Porsch M, Thomssen C, Vetter M. Molekulares Subtyping mit dem nCounter-System – ein Vergleich der Subgruppen (Pilotprojekt). Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
44
|
Focke C, Kantelhardt EJ, Thomssen C, Vetter M. Die HER2-Bestimmung an Tumoren der Brust mittels unterschiedlicher Testverfahren. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
45
|
Steer S, Papendick N, Müller A, Vetter M, Thomssen C, Große R, Kantelhardt EJ. Das Mammakarzinom am Brustzentrum der Universität Halle (Saale) in den letzten 15 Jahren: Was hat sich geändert? Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1551606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
|
46
|
Wysham CH, Rosenstock J, Malloy J, Vetter M, He Y, Öhman P, Iqbal N, Hollstein K. DURATION-NEO-1: Größere HbA1c-Wertreduktion mit wöchentlicher Depot-Exenatide-Suspension zur Autoinjektion im Vergleich zu Exenatide 2x tgl. bei unzureichend kontrolliertem Typ 2 Diabetes. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
47
|
Vetter M, O’Connor H, O’Dwyer N, Orr R. Learning ‘on the move’: A combined numeracy and physical activity program for primary school children. J Sci Med Sport 2014. [DOI: 10.1016/j.jsams.2014.11.288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
48
|
Vetter M, Reinhardt K, Stückrath K, Ditttmer J, Thomssen C, Kantelhardt EJ. Prävalenz von PIK3CA-Genmutationen beim Mammakarzinom. Geburtshilfe Frauenheilkd 2014. [DOI: 10.1055/s-0034-1388387] [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: 10/24/2022] Open
|
49
|
|
50
|
Vetter G, Zimmermann F, Bruder E, Schulzke S, Hösli I, Vetter M. Aggressive Breast Cancer during Pregnancy with a Rare Form of Metastasis in the Maternal Placenta. Geburtshilfe Frauenheilkd 2014; 74:579-582. [PMID: 24976641 DOI: 10.1055/s-0034-1368181] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 10/23/2013] [Revised: 12/22/2013] [Accepted: 01/10/2014] [Indexed: 10/25/2022] Open
Abstract
Breast cancer is the second most common cancer diagnosed during pregnancy. Here we describe a 29-year-old patient with a recurrence of breast cancer with simultaneous brain, pulmonary and placenta metastasis. An overview of the literature on placenta metastases is provided together with a report on the interdisciplinary medical management.
Collapse
Affiliation(s)
- G Vetter
- Klinik für Geburtshilfe und Perinatalmedizin, Universitätsspital Basel, Schweiz
| | - F Zimmermann
- Klinik für Radioonkologie, Universitätsspital Basel, Schweiz
| | - E Bruder
- Institut für Pathologie, Universitätsspital Basel, Schweiz
| | - S Schulzke
- Universitäts-Kinderspital beider Basel (UKBB), Universitätsspital Basel, Schweiz
| | - I Hösli
- Klinik für Geburtshilfe und Perinatalmedizin, Universitätsspital Basel, Schweiz
| | - M Vetter
- Klinik für Medizinische Onkologie, Universitätsspital Basel, Schweiz
| |
Collapse
|