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Lewis KD, Peris K, Sekulic A, Stratigos AJ, Dunn L, Eroglu Z, Chang ALS, Migden MR, Yoo SY, Mohan K, Coates E, Okoye E, Bowler T, Baurain JF, Bechter O, Hauschild A, Butler MO, Hernandez-Aya L, Licitra L, Neves RI, Ruiz ES, Seebach F, Lowy I, Goncalves P, Fury MG. Final analysis of phase II results with cemiplimab in metastatic basal cell carcinoma after hedgehog pathway inhibitors. Ann Oncol 2024; 35:221-228. [PMID: 38072158 DOI: 10.1016/j.annonc.2023.10.123] [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: 04/03/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Metastatic basal cell carcinoma (mBCC) is a rare condition with no effective second-line treatment options. Cemiplimab is an immune checkpoint inhibitor that blocks the binding of programmed cell death-1 (PD-1) to its ligands, programmed death-ligand 1 (PD-L1) and programmed death-ligand 2 (PD-L2). Here, we present the final analysis of cemiplimab in patients with mBCC after first-line hedgehog pathway inhibitor (HHI) treatment (NCT03132636). PATIENTS AND METHODS In this open-label, single-arm, phase II study, adults with mBCC and Eastern Cooperative Oncology Group performance status ≤1, post-HHI treatment, received cemiplimab 350 mg intravenously every 3 weeks for ≤93 weeks or until disease progression or unacceptable toxicity. The primary endpoint was objective response rate (ORR) by independent central review (ICR). Duration of response (DOR) was a key secondary endpoint. Other secondary endpoints were ORR per investigator assessment, progression-free survival (PFS), overall survival (OS), complete response rate, safety, and tolerability. RESULTS Fifty-four patients were enrolled: 70% were male and the median age of patients was 64 [interquartile range (IQR) 57.0-73.0] years. The median duration of follow-up was 8 months (IQR 4-21 months). The ORR per ICR was 22% [95% confidence interval (CI) 12% to 36%], with 2 complete responses and 10 partial responses. Among responders, the median time to response per ICR was 3 months (IQR 2-7 months). The estimated median DOR per ICR was not reached [95% CI 10 months-not evaluable (NE)]. The disease control rate was 63% (95% CI 49% to 76%) per ICR and 70% (95% CI 56% to 82%) per investigator assessment. The median PFS per ICR was 10 months (95% CI 4-16 months); the median OS was 50 months (95% CI 28 months-NE). The most common treatment-emergent adverse events were fatigue [23 (43%)] and diarrhoea [20 (37%)]. There were no treatment-related deaths. CONCLUSIONS Cemiplimab demonstrated clinically meaningful antitumour activity, including durable responses, and an acceptable safety profile in patients with mBCC who had disease progression on or intolerance to HHI therapy.
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Affiliation(s)
- K D Lewis
- Department of Medicine-Medical Oncology, University of Colorado School of Medicine, Aurora, USA.
| | - K Peris
- Department of Medicine and Translational Surgery, Dermatology, Università Cattolica del Sacro Cuore, Rome; Department of Medical and Surgical Sciences, Dermatology, Fondazione Policlinico Universitario A. Gemelli-IRCCS, Rome, Italy
| | - A Sekulic
- Department of Dermatology, Mayo Clinic, Scottsdale, USA
| | - A J Stratigos
- First Department of Dermatology-Venereology, National and Kapodistrian University of Athens, Andreas Sygros Hospital, Athens, Greece
| | - L Dunn
- Department of Medicine, Head and Neck Medical Oncology, Memorial Sloan Kettering Cancer Center, New York
| | - Z Eroglu
- Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa
| | - A L S Chang
- Dermatology Department, Stanford University School of Medicine, Redwood City
| | - M R Migden
- Department of Dermatology and Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston; Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston
| | - S-Y Yoo
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - K Mohan
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - E Coates
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - E Okoye
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - T Bowler
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - J-F Baurain
- Department of Medical Oncology, Cliniques Universitaires Saint-Luc and Université Catholique de Louvain, Brussels
| | - O Bechter
- Department of General Medical Oncology, University Hospitals, Leuven, Belgium
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Kiel, Germany
| | - M O Butler
- Division of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Ontario, Canada
| | - L Hernandez-Aya
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St Louis, USA
| | - L Licitra
- Department of Medical Oncology Head and Neck Cancer, Istituto Nazionale dei Tumori, Milan; Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
| | - R I Neves
- Division of Plastic Surgery, Penn State Milton S. Hershey Medical Center, Hershey
| | - E S Ruiz
- Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - F Seebach
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - I Lowy
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - P Goncalves
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
| | - M G Fury
- Regeneron Pharmaceuticals, Inc., Tarrytown, USA
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2
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Van Meerhaeghe T, Baurain J, Bechter O, Orte Cano C, Del Marmol V, Devresse A, Doubel P, Hanssens M, Hellemans R, Lienard D, Rutten A, Sprangers B, Le Moine A, Aspeslagh S. Cemiplimab for advanced cutaneous squamous cell carcinoma in kidney transplant recipients. Front Nephrol 2022; 2:1041819. [PMID: 37675002 PMCID: PMC10479765 DOI: 10.3389/fneph.2022.1041819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/06/2022] [Indexed: 09/08/2023]
Abstract
Background Kidney transplant recipients (KTR) are at increased risk of cancer due to chronic immunosuppression. Non-melanoma skin cancer has an excess risk of approximately 250 times higher than the general population. Moreover, in solid organ transplant recipients (SOTR) these cancers have a more aggressive behavior, with an increased risk of metastasis and death. Cemiplimab, a human monoclonal IgG4 antibody against programmed cell death (PD-1) has shown considerable clinical activity in metastatic and locally advanced cutaneous squamous cell carcinoma (cSCC) in patients for whom no widely accepted standard of care exists. Cemiplimab has therefore been approved since 2018 for the treatment of advanced cSCC. However, data regarding the use of cemiplimab in SOTR and particularly in KTR are scarce and based on published case reports and small case series. In this study, we report on the real-life outcome of cemiplimab use in a Belgian cohort of seven KTR suffering from advanced cSCC. Objective To report on the overall response rate (ORR) and safety of cemiplimab in KTR in Belgium. Results Seven patients suffering from advanced cSCC, treated with cemiplimab, between 2018 and 2022, in Belgium were identified. Three patients were on corticosteroid monotherapy, one patient on tacrolimus monotherapy and three patients were on at least 2 immunosuppressants at start of cemiplimab. The ORR was 42.8%, stable disease was seen in 14.3% and progressive disease was found in 42.8% of the patients, respectively. The median administered number of cycles was 12, interquartile range (IQR) 25-75 [3.5 - 13.5]. All patients were treated with surgery before administration of cemiplimab, 71.4% received additional radiotherapy and only 1 patient was treated with chemotherapy prior to receiving cemiplimab. Biopsy-proven acute renal allograft rejection was observed in one patient, who eventually lost his graft function but showed a complete tumor response to treatment. Low grade skin toxicity was seen in one patient of the cohort. Conclusion The present case series shows that the use of cemiplimab in KTR with advanced cSCC who failed to respond to previous surgery, chemo - and/or radiotherapy treatment is associated with an ORR of 42.8% with minimal risk of graft rejection (14.3%) and good tolerance.
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Affiliation(s)
- T. Van Meerhaeghe
- Department of Nephrology, Hôpital Erasme – Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - J.F. Baurain
- Department of Oncology, Clinique Universitaire Saint-Luc – Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - O. Bechter
- Department of Oncology, Universitair Ziekenhuis (UZ) Leuven – Katholieke Universiteit Leuven (KUL), Leuven, Belgium
| | - C. Orte Cano
- Department of Dermatology, Hôpital Erasme – Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - V. Del Marmol
- Department of Dermatology, Hôpital Erasme – Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - A. Devresse
- Department of Nephrology, Clinique Universitaire Saint-Luc – Université Catholique de Louvain (UCLouvain), Brussels, Belgium
| | - P. Doubel
- Department of Nephrology, Academisch Ziekenhuis (AZ) Groeninge, Kortrijk, Belgium
| | - M. Hanssens
- Department of Oncology, Academisch Ziekenhuis (AZ) Groeninge, Kortrijk, Belgium
| | - R. Hellemans
- Departement of Nephrology, Universitair Ziekenhuis (UZ) Antwerpen, Antwerpen, Belgium
| | - D. Lienard
- Department of Dermatology, Hôpital Erasme – Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - A. Rutten
- Department of Oncology, GasthuisZuster, Antwerpen, Belgium
| | - B. Sprangers
- Department of Nephrology, Universitair Ziekenhuis (UZ) Leuven – Katholieke Universiteit Leuven (KUL), Leuven, Belgium
| | - A. Le Moine
- Department of Nephrology, Hôpital Erasme – Université Libre de Bruxelles (ULB), Brussels, Belgium
| | - S. Aspeslagh
- Department of Oncology, Universitair Ziekenhuis (UZ) Brussel – Vrije Universiteit Brussel (VUB), Brussels, Belgium
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Laenens D, Yu Y, Santens B, Jacobs J, Beuselinck B, Bechter O, Wauters E, Staessen J, Janssens S, Van Aelst L. Incidence of cardiovascular events in patients treated with immune checkpoint inhibitors. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2565] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
In rare cases, immune checkpoint inhibitors (ICIs) cause immune-mediated myocarditis. However, the true incidence of other major adverse cardiovascular events (MACE) following ICI treatment remains unknown, mainly because late occurring side effects are rarely reported in prospective clinical trials.
Purpose
To identify the incidence and risk factors of MACE in a real-life ICI-treated cancer cohort and to compare the incidence with non-ICI-treated cancer patients and population controls.
Methods
In total, 672 ICI-treated patients were included. The primary endpoint was MACE, a composite of acute coronary syndrome, heart failure, stroke and transient ischemic attack. Secondary outcomes were acute coronary syndrome and heart failure separately. Incidence rates were compared between groups after matching according to age, sex, cardiovascular history and cancer type.
Results
Incidence of MACE was 10.3% during a median time of follow-up of 13 months (IQR 6 to 22). In multivariable analysis, a history of heart failure (hazard ratio (HR): 2.27; 95% confidence interval (CI): 1.03 to 5.04; p=0.043) and valvular heart disease (HR 3.01; 95% CI: 1.05 to 8.66; p=0.041) remained significantly associated with MACE.
Cumulative incidence rates were significantly higher in the matched ICI group (rate at full range of follow-up (rate): 8.51; 95% CI: 6.18 to 11.4) compared with the cancer cohort not exposed to ICI (rate: 5.20; 95% CI: 3.56 to 7.35; p=0.032) and the population controls (rate: 2.55; 95% CI: 2.16 to 2.99; p<0.001) mainly driven by a higher risk of heart failure events (Figure 1).
Conclusions
Cardiovascular events during and after ICI treatment are more common than currently appreciated. Patients at risk are those with a history of cardiovascular disease. Compared with matched cancer and population controls, MACE incidence rates are significantly higher, suggesting a potential harmful effect of ICI treatment besides the underlying risk.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Laenens
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - Y Yu
- University of Leuven, Public Health and Primary Care , Leuven , Belgium
| | - B Santens
- University of Leuven, Cardiovascular Sciences , Leuven , Belgium
| | - J Jacobs
- University of Leuven, Cardiovascular Sciences , Leuven , Belgium
| | - B Beuselinck
- University Hospitals (UZ) Leuven, Medical Oncology , Leuven , Belgium
| | - O Bechter
- University Hospitals (UZ) Leuven, Medical Oncology , Leuven , Belgium
| | - E Wauters
- University Hospitals (UZ) Leuven, Pneumology , Leuven , Belgium
| | - J Staessen
- University of Leuven, Biomedical Sciences Group , Leuven , Belgium
| | - S Janssens
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
| | - L Van Aelst
- University Hospitals (UZ) Leuven, Cardiology , Leuven , Belgium
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Stratigos A, Sekulic A, Peris K, Bechter O, Dutriaux C, Kaatz M, Lewis K, Basset-Seguin N, Chang A, Dalle S, Fernandez-Orland A, Licitra L, Robert C, Ulrich C, Hauschild A, Migden M, Dummer R, Li S, Bowler T, Fury M. LBA47 Primary analysis of phase II results for cemiplimab in patients (pts) with locally advanced basal cell carcinoma (laBCC) who progress on or are intolerant to hedgehog inhibitors (HHIs). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2277] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Horwitz S, Scarisbrick J, Prince H, Whittaker S, Duvic M, Kim Y, Quaglino P, Zinzani P, Bechter O, Eradat H, Pinter-Brown L, Akilov O, Geskin L, Sanches J, Ortiz-Romero P, Lisano J, Brown L, Palanca-Wessels M, Gautam A, Bunn V, Little M, Dummer R. FINAL DATA FROM THE PHASE 3 ALCANZA STUDY: BRENTUXIMAB VEDOTIN (BV) VS PHYSICIAN'S CHOICE (PC) IN PATIENTS (PTS) WITH CD30-POSITIVE (CD30+) CUTANEOUS T-CELL LYMPHOMA (CTCL). Hematol Oncol 2019. [DOI: 10.1002/hon.96_2630] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- S.M. Horwitz
- Department of Medicine; Memorial Sloan Kettering Cancer Center; New York United States
| | - J. Scarisbrick
- Department of Dermatology; University Hospital Birmingham; Birmingham United Kingdom
| | - H.M. Prince
- Division of Cancer Medicine; Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology, The University of Melbourne; Melbourne Australia
| | - S. Whittaker
- St John's Institute of Dermatology; Guys and St Thomas NHS Foundation Trust; London United Kingdom
| | - M. Duvic
- Department of Dermatology; Division of Internal Medicine, The University of Texas MD Anderson Cancer Center; Houston United States
| | - Y.H. Kim
- Department of Dermatology; Stanford University School of Medicine and Stanford Cancer Institute; Stanford United States
| | - P. Quaglino
- Department of Medical Sciences; Dermatologic Clinic, University of Turin; Turin Italy
| | - P.L. Zinzani
- Institute of Haematology; University of Bologna; Bologna Italy
| | - O. Bechter
- Department of General Medical Oncology; University Hospitals Leuven; Leuven KU Belgium
| | - H. Eradat
- Division of Hematology-Oncology; David Geffen School of Medicine at UCLA; Los Angeles United States
| | - L. Pinter-Brown
- Division of Hematology Oncology; Chao Family Comprehensive Cancer Center, University of California; Irvine United States
| | - O. Akilov
- Department of Dermatology; University of Pittsburgh; Pittsburgh United States
| | - L. Geskin
- Department of Dermatology; Columbia University; New York United States
| | - J. Sanches
- Department of Dermatology; University of São Paulo Medical School; São Paulo Brazil
| | - P. Ortiz-Romero
- Department of Dermatology; University Hospital 12 de Octubre, Institute i+12 Medical School, University Complutense; Madrid Spain
| | - J. Lisano
- Medical Affairs; Seattle Genetics, Inc.; Bothell United States
| | - L. Brown
- Biostatistics; Seattle Genetics, Inc.; Bothell United States
| | | | - A. Gautam
- Global Medical Affairs; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - V. Bunn
- Oncology Statistics; Millennium Pharmaceuticals, Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - M. Little
- Oncology Clinical Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge United States
| | - R. Dummer
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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6
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Rogiers A, Thomas D, Vander Borght S, Oord J, Bechter O, Dewaele M, Rambow F, Marine J, Wolter P. Dabrafenib plus trametinib in
BRAF
K601E‐mutant melanoma. Br J Dermatol 2018; 180:421-422. [DOI: 10.1111/bjd.17250] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- A. Rogiers
- Laboratory for Molecular Cancer Biology Center for Cancer Biology VIB LeuvenBelgium
- Laboratory for Molecular Cancer Biology Department of Oncology KU Leuven LeuvenBelgium
| | - D. Thomas
- Laboratory for Therapeutic and Diagnostic Antibodies/PharmAbs KU Leuven LeuvenBelgium
| | - S. Vander Borght
- Department of Human Genetics Center for Human Genetics KU Leuven LeuvenBelgium
- Department of Pathology University Hospitals KU Leuven Leuven Belgium
| | - J.J. Oord
- Department of Pathology University Hospitals KU Leuven Leuven Belgium
| | - O. Bechter
- Department of General Medical Oncology KU Leuven Leuven Belgium
| | - M. Dewaele
- Laboratory for Molecular Cancer Biology Center for Cancer Biology VIB LeuvenBelgium
- Laboratory for Molecular Cancer Biology Department of Oncology KU Leuven LeuvenBelgium
| | - F. Rambow
- Laboratory for Molecular Cancer Biology Center for Cancer Biology VIB LeuvenBelgium
- Laboratory for Molecular Cancer Biology Department of Oncology KU Leuven LeuvenBelgium
| | - J.‐C. Marine
- Laboratory for Molecular Cancer Biology Center for Cancer Biology VIB LeuvenBelgium
- Laboratory for Molecular Cancer Biology Department of Oncology KU Leuven LeuvenBelgium
| | - P. Wolter
- Department of Hematology and Medical Oncology CHR East Belgium Verviers Belgium
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7
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Robert C, Larkin J, Ascierto P, Long G, Hassel J, Schadendorf D, Hodi F, Lebbé C, Grob JJ, Grossmann K, Wagstaff J, Chesney J, Hogg D, Bechter O, Márquez-Rodas I, Pavlick A, Walker D, Bhore R, Postow M, Wolchok J. Characterization of complete responses (CRs) in patients with advanced melanoma (MEL) who received the combination of nivolumab (NIVO) and ipilimumab (IPI), NIVO or IPI alone. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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8
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De Smedt J, Van Kelst S, Boecxstaens V, Stas M, Bogaerts K, Vanderschueren D, Aura C, Vandenberghe K, Lambrechts D, Wolter P, Bechter O, Nikkels A, Strobbe T, Emri G, Marasigan V, Garmyn M. Vitamin D supplementation in cutaneous malignant melanoma outcome (ViDMe): a randomized controlled trial. BMC Cancer 2017; 17:562. [PMID: 28835228 PMCID: PMC5569491 DOI: 10.1186/s12885-017-3538-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 08/09/2017] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Previous studies have investigated the protective effect of vitamin D serum levels, at diagnosis and during the follow-up period after treatment, on melanoma outcome. In the present study we assess whether vitamin D supplementation, in the follow-up period after diagnosis and surgical resection of the primary tumor, has a protective effect on relapse of cutaneous malignant melanoma and whether this protective effect correlates with vitamin D levels in serum and Vitamin D Receptor immunoreactivity in the primary tumor. METHODS/DESIGN This study is a multicenter randomized double blind placebo- controlled phase III trial. Patients between the age of 18 and 80 years diagnosed and treated surgically for a melanoma stage IB-III are eligible for randomization in a 1:1 ratio to active treatment or placebo. The study drug is taken each month and consists of either 100,000 International Unit cholecalciferol or arachidis oleum raffinatum used as a placebo. The primary endpoint is relapse free survival. The secondary endpoints are 25 hydroxyvitamin D3 serum levels at diagnosis and at 6 month intervals, melanoma subtype, melanoma site and stage of melanoma at diagnosis according to the 2009 American Joint Committee on Cancer melanoma staging and classification. At randomization a bloodsample is taken for DNA analysis. The study is approved by the local Ethics Committees. DISCUSSION If we can confirm our hypothesis that vitamin D supplementation after removal of the tumor has a protective effect on relapse of cutaneous malignant melanoma we may reduce the burden of CMM at several levels. Patients, diagnosed with melanoma may have a better clinical outcome and improved quality of life. There will be a decrease in health care costs related to treatment of metastatic disease and there will be a decrease in loss of professional years, which will markedly reduce the economic burden of the disease. TRIAL REGISTRATION Clinical Trial.gov, NCT01748448 , 05/12/2012.
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Affiliation(s)
- J. De Smedt
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - S. Van Kelst
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - V. Boecxstaens
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - M. Stas
- Oncological and vascular access surgery, Department of surgical oncology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of oncology, KU Leuven, 3000 Leuven, Belgium
| | - K. Bogaerts
- KU Leuven, Faculty of Medicine, I-BioStat, 3000 Leuven, Belgium
- Hasselt University, I-BioStat, 3590 Diepenbeek, Belgium
| | - D. Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
- Department of Endocrinology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - C. Aura
- Translational Cell & Tissue Research, Department of Imaging & Pathology, KU Leuven, 3000 Leuven, Belgium
- Department of Pathology, University Hospitals of Leuven, 3000 Leuven, Belgium
| | - K. Vandenberghe
- Department of Cardiovascular Sciences, KU Leuven, 3000 Leuven, Belgium
| | - D. Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Vesalius Research Center, VIB, 3000 Leuven, Belgium
| | - P. Wolter
- Department of Hematology and Oncology, CHR Verviers East Belgium, 4800 Verviers, Belgium
| | - O. Bechter
- Laboratory of Experimental Oncology (LEO), Department of Oncology, KU Leuven, 3000 Leuven, Belgium
- Department of General Medical Oncology, University Hospitals Leuven, Leuven Cancer Institute, 3000 Leuven, Belgium
| | - A. Nikkels
- Department of Dermatology, CHU Sart Tilman, University of Liège, 4000 Liège, Belgium
| | - T. Strobbe
- Department of Dermatology, University Hospital Antwerp, 2650 Edegem, Belgium
| | - G. Emri
- Department of Dermatology, Faculty of Medicine, University of Debrecen, Debrecen, 4012 Hungary
| | - V. Marasigan
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
| | - M. Garmyn
- Laboratory of Dermatology, Department of oncology, KU Leuven, 3000 Leuven, Belgium
- Department of Dermatology, University Hospitals Leuven, 3000 Leuven, Belgium
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9
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Kim Y, Prince H, Whittaker S, Horwitz S, Duvic M, Scarisbrick J, Quaglino P, Zinzani P, Wolter P, Bechter O, Wang Y, Palanca-Wessels M, Wood K, Li M, Liu Y, Lin H, Little M, Danaee H, Trepicchio W, Dummer R. BRENTUXIMAB VEDOTIN VS PHYSICIAN'S CHOICE IN CTCL PATIENTS FROM THE PHASE 3 ALCANZA STUDY: ANALYSIS OF OUTCOMES BY CD30 EXPRESSION. Hematol Oncol 2017. [DOI: 10.1002/hon.2437_65] [Citation(s) in RCA: 2] [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: 11/11/2022]
Affiliation(s)
- Y.H. Kim
- Department of Dermatology; Stanford University School of Medicine and Stanford Cancer Institute; Stanford USA
| | - H.M. Prince
- Division of Cancer Medicine, Peter MacCallum Cancer Centre and Sir Peter MacCallum Department of Oncology; The University of Melbourne; Melbourne Australia
| | - S. Whittaker
- St John's Institute of Dermatology; Guys and St Thomas NHS Foundation Trust; London UK
| | - S.M. Horwitz
- Department of Medicine; Memorial Sloan Kettering Cancer Center; New York USA
| | - M. Duvic
- Department of Dermatology; The University of Texas MD Anderson Cancer Center; Houston USA
| | - J. Scarisbrick
- Department of Dermatology; University Hospital Birmingham; Birmingham UK
| | - P. Quaglino
- Department of Medical Sciences, Dermatologic Clinic; University of Turin; Turin Italy
| | - P.L. Zinzani
- Institute of Haematology; University of Bologna; Bologna Italy
| | - P. Wolter
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
| | - O. Bechter
- Department of General Medical Oncology; University Hospitals Leuven; Leuven Belgium
| | - Y. Wang
- Biometrics; Seattle Genetics, Inc.; Bothwell USA
| | | | - K.W. Wood
- Translational Medicine; Seattle Genetics, Inc.; Bothell USA
| | - M. Li
- Translational Medicine; Seattle Genetics, Inc.; Bothell USA
| | - Y. Liu
- Biostatistics; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge USA
| | - H. Lin
- Biostatistics; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge USA
| | - M. Little
- Oncology Clinical Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge USA
| | - H. Danaee
- Translational and Biomarker Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge USA
| | - W. Trepicchio
- Translational and Biomarker Research; Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited; Cambridge USA
| | - R. Dummer
- Department of Dermatology; University Hospital Zürich; Zürich Switzerland
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10
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Melis C, Rogiers A, Bechter O, van den Oord JJ. Molecular genetic and immunotherapeutic targets in metastatic melanoma. Virchows Arch 2017; 471:281-293. [DOI: 10.1007/s00428-017-2113-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Revised: 03/14/2017] [Accepted: 03/20/2017] [Indexed: 01/08/2023]
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11
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Bonatti H, Bodner G, Obrist P, Bechter O, Wetscher G, Oefner D. Skin Implant Metastasis after Percutaneous Radio-Frequency Therapy of Liver Metastasis of a Colorectal Carcinoma. Am Surg 2003. [DOI: 10.1177/000313480306900906] [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: 11/29/2022]
Abstract
Percutaneous radio-frequency ablation (RFA) of liver tumors has been reported to be an effective approach. Skin implant metastases have been described after RFA of hepatocellular carcinoma. A 56-year-old man underwent resection of the transverse colon for an adenocarcinoma (pT3N2M0) following by adjuvant chemotherapy. He developed multiple liver metastases and underwent RFA. Six weeks after RFA, the patient noticed a painful skin lesion at the entrance side of the probe in the right upper abdominal quadrant. Ultrasound examination and computed tomography scan revealed an intracutaneous tumor of 2-cm diameter. The tumor was excised and revealed a metastasis of the previously described adenocarcinoma. CPT-11 monotherapy was started; however, due to tumor progression, the patient died 35 months after colonic resection and 10 months after RFA. This is the first case of an implant skin metastasis after RFA of secondary liver tumors. Although RFA is a promising option in the palliation of such tumors, such rare complications have to be considered.
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Affiliation(s)
- H. Bonatti
- From the Clinical Department of General Surgery, University Hospital Innsbruck, Innsbruck, Austria
| | - G. Bodner
- Division of Radiology, University Hospital Innsbruck, Innsbruck, Austria
| | - P. Obrist
- Institute for Pathology, University Hospital Innsbruck, Innsbruck, Austria
| | - O. Bechter
- Division of Internal Medicine, University Hospital Innsbruck, Innsbruck, Austria
| | - G. Wetscher
- From the Clinical Department of General Surgery, University Hospital Innsbruck, Innsbruck, Austria
| | - D. Oefner
- From the Clinical Department of General Surgery, University Hospital Innsbruck, Innsbruck, Austria
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12
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Bonatti H, Bodner G, Obrist P, Bechter O, Wetscher G, Oefner D. Skin implant metastasis after percutaneous radio-frequency therapy of liver metastasis of a colorectal carcinoma. Am Surg 2003; 69:763-5. [PMID: 14509323] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023]
Abstract
Percutaneous radio-frequency ablation (RFA) of liver tumors has been reported to be an effective approach. Skin implant metastases have been described after RFA of hepatocellular carcinoma. A 56-year-old man underwent resection of the transverse colon for an adenocarcinoma (pT3N2M0) following by adjuvant chemotherapy. He developed multiple liver metastases and underwent RFA. Six weeks after RFA, the patient noticed a painful skin lesion at the entrance side of the probe in the right upper abdominal quadrant. Ultrasound examination and computed tomography scan revealed an intracutaneous tumor of 2-cm diameter. The tumor was excised and revealed a metastasis of the previously described adenocarcinoma. CPT-11 monotherapy was started; however, due to tumor progression, the patient died 35 months after colonic resection and 10 months after RFA. This is the first case of an implant skin metastasis after RFA of secondary liver tumors. Although RFA is a promising option in the palliation of such tumors, such rare complications have to be considered.
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Affiliation(s)
- H Bonatti
- Clinical Department of General Surgery, University Hospital Innsbruck, Innsbruck, Austria
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13
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Eisterer W, Bechter O, Hilbe W, van Driel M, Lokhorst HM, Thaler J, Bloem AC, Günthert U, Stauder R. CD44 isoforms are differentially regulated in plasma cell dyscrasias and CD44v9 represents a new independent prognostic parameter in multiple myeloma. Leuk Res 2001; 25:1051-7. [PMID: 11684276 DOI: 10.1016/s0145-2126(01)00075-3] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
To evaluate the role of CD44 variant isoforms (CD44v) in plasma cell dyscrasias, CD44v expression was analysed in bone marrow (BM) biopsies of multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS) patients, in biopsies of soft tissue infiltration by MM and in extramedullary plasmacytoma samples. Expression of CD44 isoforms containing the 3v, 4v, 6v or 10v domain was observed in 15, 7, 13 and 5% of 87 samples from 49 consecutive MM cases, but could not be detected in ten normal persons or 11 MGUS patients. In contrast, CD44v9 revealed a broader pattern of expression and was observed in plasma cells in three out of ten normal persons and in three out of 11 MGUS cases. In MM, CD44v9 was detected in 32 out of 87 samples (37%) of BM infiltrates and was associated with an advanced Durie and Salmon stage (P<0.03), a progressive disease (P<0.01) and an IgA subtype (P<0.01). Furthermore, CD44v9 expression was observed in three out of five cases of MM soft tissue infiltrates, was often upregulated during disease progression, was significantly correlated with a shorter overall survival (P<0.03) and emerged as an independent prognostic factor in multivariate analysis (stage: relative risk 1.36, P<0.02; CD44v9 expression: relative risk 1.45, P<0.04). These results substantiate the clinical relevance of CD44v domains in plasma cell disorders and establish CD44v9 as a new independent prognostic parameter in MM.
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Affiliation(s)
- W Eisterer
- Department of Internal Medicine, Division of Haematology and Oncology, University Hospital, Anichstr. 35, 6020 Innsbruck, Austria
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14
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Hilbe W, Sill H, Eisterer W, Lin F, Bechter O, Grünewald K, Thaler J. Long-lasting haematological remission despite persistence of the Philadelphia-positive clone in an untreated chronic myeloid leukaemia patient. Acta Haematol 2000; 100:101-3. [PMID: 9792944 DOI: 10.1159/000040877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
MESH Headings
- Adult
- Clone Cells
- Follow-Up Studies
- Humans
- Interferon-alpha/therapeutic use
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/blood
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Male
- Remission, Spontaneous
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Affiliation(s)
- W Hilbe
- Department of Internal Medicine, University Hospital, Innsbruck, Austria
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15
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Kühr T, Bechter O, Dirnhofer S, Geley S, Gächter A, Pall G, Url M, Dietrich H, Oberaigner P, Klima G, Eisterer W, Hilbe W, Lukas P, Thaler J. Transplantation of IL-2-transduced murine bone marrow is associated with dose-dependent toxicity. Exp Hematol 2000; 28:895-906. [PMID: 10989190 DOI: 10.1016/s0301-472x(00)00487-2] [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] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of interleukin-2 (IL-2) gene-transduced hematopoietic progenitor cells or cytotoxic function and systemic toxicity following syngeneic bone marrow transplantation. MATERIAL AND METHODS Marrow of 5-fluorouracil pretreated donor mice were transfected with a retroviral vector containing the murine IL-2 gene and transplanted into lethally irradiated syngeneic hosts. RESULTS Productive insertion of the IL-2 gene could be demonstrated at various intervals post-transplant without impairment of hematopoietic engraftment. Endogenously augmented IL-2 release resulted in a selective increase in CD4(+), CD8(+), and NK1.1(+) population in spleen and bone marrow, as well as significant cytolytic activity against syngeneic leukemia cells in vitro. Our results also illustrate the interdependence among the magnitude of systemic IL-2 levels, the number of IL-2-transduced cells in the transplant inoculum, and the appearance of systemic toxicity. Infusion of marrow transduced with high-titer, high-expressing IL-2 retrovirus resulted in significant morbidity and mortality in the recipients. Our studies demonstrate that mortality was secondary to severe lymphocytic infiltration of liver and lung, which was associated with increased expression of intercellular adhesion molecule-1 and vascular adhesion molecule-1. Reducing the number of IL-2-transduced cells in the bone marrow inoculum, however, resulted in significantly improved survival with no adverse events being evident during the post-transplant period. CONCLUSION Delivery of IL-2 to the bone marrow can be achieved by transplantation of genetically modified hematopoietic cells, however, the overall feasibility is strongly influenced by the number of transduced cells in the bone marrow inocolum and/or the expression pattern of IL-2 in vivo.
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Affiliation(s)
- T Kühr
- Department of Internal Medicine, University of Innsbruck, Innsbruck, Austria.
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16
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Kühr T, Eisterer W, Apfelbeck U, Linkesch W, Bechter O, Zabernigg A, Geissler K, Barbieri G, Duba C, Gastl G, Thaler J. Treatment of patients with advanced chronic myelogenous leukemia with interferon-alpha-2b and continuous oral cytarabine ocfosfate (YNK01): a pilot study. Leuk Res 2000; 24:583-7. [PMID: 10867132 DOI: 10.1016/s0145-2126(00)00036-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The efficacy of continuous oral cytarabine ocfosfate (YNK01) (300 mg/day) in combination with interferon alpha (IFNalpha, 5x10(6) IU/day) was evaluated in patients with advanced chronic myelogenous leukemia, who previously failed to respond to IFNalpha-based therapies. Dose escalations up to 900 mg YNK01 were allowed in patients who failed to respond. In view of our results, four patients developed a complete hematological response after YNK01 was started. Among those who initially responded to YNK01, one complete cytogenetic response was achieved 18 months later. Although the data are preliminary, this is the first study showing that continuous administration of YNK01 along with IFNalpha is effective in patients with advanced chronic myelogenous leukemia.
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Affiliation(s)
- T Kühr
- Department of Internal Medicine, University Hospital, Anichstrasse 35, 6020, Innsbruck, Austria.
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17
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Kühr T, Bechter O, Geley S, Eisterer W, Lukas P, Url M, Dietrich H, Hilbe W, Kofler R, Thaler J. Detection and quantitation of genetically marked acute myeloid leukemia by competitive polymerase chain reaction after autologous bone marrow transplantation: a preclinical model for minimal residual disease. Exp Hematol 1999; 27:266-71. [PMID: 10029166 DOI: 10.1016/s0301-472x(98)00006-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Preclinical models and methods aimed at detecting and quantitating minimal residual disease (MRD) after autologous bone marrow transplantation (BMT) for acute myeloid leukemia (AML) could facilitate assessment of innovative therapeutic strategies for their antileukemic potential. Among the various techniques exploited to identify MRD, polymerase chain reaction (PCR) proved to be a valuable tool in instances in which clonogeneic markers are involved during the evolution of disease. In human AML, however, detection of MRD by PCR is limited to a minority of subgroups, as clonospecific markers are absent or presently unknown. Although gene labeling has proved to be efficient in detecting marker-devoid leukemia cells in preclinical models, detection and quantitation by PCR have not yet been considered. We therefore developed an experimental model in which detection and quantitation of genetically marked murine AML cells are based on a highly sensitive two-step nested PCR and competitive PCR protocol, respectively. We further demonstrated its applicability to a murine syngeneic BMT model that was designed to monitor minimal numbers of gene-tagged AML cells at various time intervals after transplantation. Our results showed that detection and quantitation could reproducibly be achieved at levels as low as one in 10(6) and 10(5) cells, respectively.
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MESH Headings
- Acute Disease
- Animals
- Bone Marrow Transplantation
- DNA, Neoplasm/analysis
- Genetic Markers
- Humans
- Leukemia, Experimental/genetics
- Leukemia, Experimental/pathology
- Leukemia, Experimental/therapy
- Leukemia, Myeloid/genetics
- Leukemia, Myeloid/pathology
- Leukemia, Myeloid/therapy
- Male
- Mice
- Mice, Inbred C57BL
- Neoplasm, Residual/diagnosis
- Neoplasm, Residual/genetics
- Polymerase Chain Reaction/methods
- Transplantation, Autologous
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Affiliation(s)
- T Kühr
- Department of Internal Medicine, University Hospital of Innsbruck, Austria
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18
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Mühlmann J, Thaler J, Hilbe W, Bechter O, Erdel M, Utermann G, Duba HC. Fluorescence in situ hybridization (FISH) on peripheral blood smears for monitoring Philadelphia chromosome-positive chronic myeloid leukemia (CML) during interferon treatment: a new strategy for remission assessment. Genes Chromosomes Cancer 1998; 21:90-100. [PMID: 9491319 DOI: 10.1002/(sici)1098-2264(199802)21:2<90::aid-gcc3>3.0.co;2-2] [Citation(s) in RCA: 43] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Interferon-alpha (IFN-alpha) alone or in combination with cytostatic drugs can induce major and durable cytogenetic responses in about 20 to 25% of chronic myeloid leukemia (CML) patients. Since these patients have a significant survival benefit, more frequent follow-up investigations have become clinically important but require bone marrow (BM) aspirates. The aim of our study was to evaluate interphase fluorescence in situ hybridization (IPF) on peripheral blood (PB) smears as a rapid and reliable method to quantify Ph-positive myeloid cells. IPF analysis was performed on 49 PB samples from 36 patients in the chronic phase of CML and at different stages of cytogenetic remission. IPF results of 30 PB samples were compared with those from BM aspirates simultaneously obtained from the same patients to evaluate the correlation of Ph-positive cells. Further, the hypermetaphase FISH (HMF) technique was performed on cultured BM preparations of 31 patients for comparison with IPF results on PB. An excellent correlation was observed between the IPF results obtained on PB and BM samples (r = 0.98, y = x - 0.6, p < 0.0001). The mean difference between HMF from BM, on the one hand, and IPF from PB, on the other hand, was 3.2% (SD = +/- 8.4%). Seventy percent of samples were identically classified in one of the four subgroups of cytogenetic response. Thirty percent were classified in neighbouring response groups. We conclude that FISH performed on PB is a rapid and reliable method for assessing the cytogenetic response of CML patients on IFN-alpha based therapies, allowing more frequent and less invasive follow-up investigations although it is not able entirely to replace routine analysis of BM.
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MESH Headings
- Adult
- Aged
- Blood Cells/pathology
- Bone Marrow Cells/pathology
- Cell Nucleus/genetics
- Cell Nucleus/pathology
- Female
- Humans
- In Situ Hybridization, Fluorescence
- Interferon-alpha/therapeutic use
- Interphase/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myeloid, Chronic-Phase/drug therapy
- Leukemia, Myeloid, Chronic-Phase/genetics
- Leukemia, Myeloid, Chronic-Phase/pathology
- Male
- Middle Aged
- Reproducibility of Results
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Affiliation(s)
- J Mühlmann
- Institut für Medizinische Biologie und Humangenetik, Universität Innsbruck, Austria
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Abstract
In a retrospective study based on 107 B-CLL patients, the expression of the adhesion molecules CD44, CD11a, CD11b, CD11c, CD18, CD25 and CD54 was analysed in bone marrow cryostat sections by immunohistochemistry. CD44 expression clearly identified two subgroups of B-CLL patients with different clinical course. In particular, CD44-positive patients presented with advanced disease, more often displayed a diffuse pattern of bone marrow infiltration, and had a worse prognosis. 33/61 patients positive for CD44 died within the observation period compared to 7/46 patients negative for CD44 (P = 0.0012). Multivariate analysis emphasized the independent prognostic value of CD44 expression for overall survival (P = 0.022). In contrast, patients positive for CD11c showed a longer survival, with 9/40 patients dying within the observation period compared to 31/67 negative for CD11c (P = 0.0013). Patients lacking CD11c were in advanced Rai and Binet stage. Multivariate analysis confirmed CD11c as a relevant independent prognostic marker (P = 0.033). Moreover, CD11c was able to separate patients with significantly different prognosis in the subgroup of CD44-positive cases. 4/18 patients positive for CD44 and CD11c died before median survival time was reached. Patients positive for CD44 but negative for CD11c had an adverse prognosis: 29/43 patients died, median survival time was 33.4 months. Our results indicate that CD44 positivity and CD11c negativity are associated with more advanced disease and worse prognosis in B-CLL and suggest CD44-positive/CD11c-negative cases represent a more aggressive form of the disease.
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Affiliation(s)
- W Eistere
- Department of Internal Medicine, University Hospital, Innsbruck, Austria
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