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Michels S, Massutí B, Vasyliv I, Stratmann J, Frank J, Adams A, Felip E, Grohé C, Rodriguez-Abreu D, Bischoff H, Carcereny I Costa E, Corral J, Pereira E, Fassunke J, Fischer RN, Insa A, Koleczko S, Nogova L, Reck M, Reutter T, Riedel R, Schaufler D, Scheffler M, Weisthoff M, Provencio M, Merkelbach-Bruse S, Hellmich M, Sebastian M, Büttner R, Persigehl T, Rosell R, Wolf J. Overall survival and central nervous system activity of crizotinib in ROS1-rearranged lung cancer-final results of the EUCROSS trial. ESMO Open 2024; 9:102237. [PMID: 38350336 PMCID: PMC10937203 DOI: 10.1016/j.esmoop.2024.102237] [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: 08/15/2023] [Revised: 12/12/2023] [Accepted: 01/07/2024] [Indexed: 02/15/2024] Open
Abstract
BACKGROUND In 2019, we reported the first efficacy and safety analysis of EUCROSS, a phase II trial investigating crizotinib in ROS1 fusion-positive lung cancer. At that time, overall survival (OS) was immature and the effect of crizotinib on intracranial disease control remained unclear. Here, we present the final analysis of OS, systemic and intracranial activity, and the impact of co-occurring aberrations. MATERIALS AND METHODS EUCROSS was a prospective, single-arm, phase II trial. The primary endpoint was best overall response rate (ORR) using RECIST 1.1. Secondary and exploratory endpoints were progression-free survival (PFS), OS, and efficacy in pre-defined subgroups. RESULTS Median OS of the intention-to-treat population (N = 34) was 54.8 months [95% confidence interval (CI) 20.3 months-not reached (NR); median follow-up 81.4 months] and median all-cause PFS of the response-evaluable population (N = 30) was 19.4 months (95% CI 10.1-32.2 months). Time on treatment was significantly correlated with OS (R = 0.82; P < 0.0001). Patients with co-occurring TP53 aberrations (28%) had a significantly shorter OS [hazard ratio (HR) 11; 95% CI 2.0-56.0; P = 0.006] and all-cause PFS (HR 4.2; 95% CI 1.2-15; P = 0.025). Patients with central nervous system (CNS) involvement at baseline (N = 6; 20%) had a numerically shorter median OS and all-cause PFS. Median intracranial PFS was 32.2 months (95% CI 23.7 months-NR) and the rate of isolated CNS progression was 24%. CONCLUSIONS Our final analysis proves the efficacy of crizotinib in ROS1-positive lung cancer, but also highlights the devastating impact of TP53 mutations on survival and treatment efficacy. Additionally, our data show that CNS disease control is durable and the risk of CNS progression while on crizotinib treatment is low.
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Affiliation(s)
- S Michels
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany.
| | - B Massutí
- Department for Oncology, Alicante University Hospital-ISABIAL, Alicante, Spain
| | - I Vasyliv
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - J Stratmann
- Department of Hematology and Oncology, University Hospital of Frankfurt, Frankfurt am Main
| | - J Frank
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - A Adams
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - E Felip
- Vall d'Hebron Institute of Oncology, Vall d'Hebron University Hospital, Barcelona, Spain
| | - C Grohé
- Department of Respiratory Medicine, ELK Berlin, Berlin, Germany
| | - D Rodriguez-Abreu
- Universidad de Las Palmas de Gran Canaria, Complejo Hospitalario Universitario Insular Materno-Infantil de Gran Canaria, Gran Canaria, Spain
| | - H Bischoff
- Thoraxonkologie, Thoraxklinik, Heidelberg, Germany
| | - E Carcereny I Costa
- Medical Oncology Department, Catalan Institute of Oncology (ICO)-Badalona and Badalona-Applied Research Group in Oncology (B-ARGO), Badalona
| | - J Corral
- Department for Medical Oncology, Clínica Universidad de Navarra, Madrid
| | - E Pereira
- Spanish Lung Cancer Group, Barcelona, Spain
| | - J Fassunke
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - R N Fischer
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - A Insa
- Hospital Clínico Universitario de Valencia, València, Spain
| | - S Koleczko
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - L Nogova
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Reck
- Department for Thoracic Oncology, LungenClinic Grosshansdorf, Airway Research Center North (ARCN), German Center for Lung Research, Großhansdorf
| | - T Reutter
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany; Department of Oncology, Asklepios Clinic Altona, Hematology, Palliative Care and Rheumatology, Asklepios Tumorzentrum Hamburg, Hamburg, Germany
| | - R Riedel
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - D Schaufler
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Scheffler
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
| | - M Weisthoff
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - M Provencio
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro de Majadahonda, Madrid
| | - S Merkelbach-Bruse
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - M Hellmich
- Faculty of Medicine and University Hospital of Cologne, Institute of Medical Statistics and Computational Biology, University of Cologne, Cologne, Germany
| | - M Sebastian
- Department of Hematology and Oncology, University Hospital of Frankfurt, Frankfurt am Main
| | - R Büttner
- University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Institute of Pathology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - T Persigehl
- University of Cologne, Faculty of Medicine and University Hospital of Colone, Department of Radiology and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, Cologne, Germany
| | - R Rosell
- Germans Trias i Pujol Research Institute (IGTP), Badalona; Quiron Dexeus University Hospital, Institute of Oncology Rosell (IOR), Barcelona, Spain
| | - J Wolf
- Department I for Internal Medicine and Center for Integrated Oncology Aachen Bonn Cologne Dusseldorf, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Lung Cancer Group Cologne, Cologne, Germany
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Thomalla D, Beckmann L, Grimm C, Oliverio M, Meder L, Herling C, Nieper P, Feldmann T, Merkel O, Lorsy E, da Palma Guerreiro A, von Jan J, Kisis I, Wasserburger E, Claasen J, Faitschuk-Meyer E, Altmüller J, Nürnberg P, Yang TP, Lienhard M, Herwig R, Kreuzer KA, Pallasch C, Büttner R, Schäfer S, Hartley J, Abken H, Peifer M, Kashkar H, Knittel G, Eichhorst B, Ullrich R, Herling M, Reinhardt H, Hallek M, Schweiger M, Frenzel L. Deregulation and epigenetic modification of BCL2-family genes cause resistance to venetoclax in hematologic malignancies. Blood 2022; 140:2113-2126. [PMID: 35704690 PMCID: PMC10653032 DOI: 10.1182/blood.2021014304] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 06/01/2022] [Indexed: 11/20/2022] Open
Abstract
The BCL2 inhibitor venetoclax has been approved to treat different hematological malignancies. Because there is no common genetic alteration causing resistance to venetoclax in chronic lymphocytic leukemia (CLL) and B-cell lymphoma, we asked if epigenetic events might be involved in venetoclax resistance. Therefore, we employed whole-exome sequencing, methylated DNA immunoprecipitation sequencing, and genome-wide clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9 screening to investigate venetoclax resistance in aggressive lymphoma and high-risk CLL patients. We identified a regulatory CpG island within the PUMA promoter that is methylated upon venetoclax treatment, mediating PUMA downregulation on transcript and protein level. PUMA expression and sensitivity toward venetoclax can be restored by inhibition of methyltransferases. We can demonstrate that loss of PUMA results in metabolic reprogramming with higher oxidative phosphorylation and adenosine triphosphate production, resembling the metabolic phenotype that is seen upon venetoclax resistance. Although PUMA loss is specific for acquired venetoclax resistance but not for acquired MCL1 resistance and is not seen in CLL patients after chemotherapy-resistance, BAX is essential for sensitivity toward both venetoclax and MCL1 inhibition. As we found loss of BAX in Richter's syndrome patients after venetoclax failure, we defined BAX-mediated apoptosis to be critical for drug resistance but not for disease progression of CLL into aggressive diffuse large B-cell lymphoma in vivo. A compound screen revealed TRAIL-mediated apoptosis as a target to overcome BAX deficiency. Furthermore, antibody or CAR T cells eliminated venetoclax resistant lymphoma cells, paving a clinically applicable way to overcome venetoclax resistance.
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MESH Headings
- Humans
- Leukemia, Lymphocytic, Chronic, B-Cell/drug therapy
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Myeloid Cell Leukemia Sequence 1 Protein/genetics
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-bcl-2/metabolism
- bcl-2-Associated X Protein/metabolism
- Drug Resistance, Neoplasm/genetics
- Apoptosis Regulatory Proteins/genetics
- Bridged Bicyclo Compounds, Heterocyclic/pharmacology
- Bridged Bicyclo Compounds, Heterocyclic/therapeutic use
- Lymphoma, Large B-Cell, Diffuse/pathology
- Hematologic Neoplasms/drug therapy
- Hematologic Neoplasms/genetics
- Epigenesis, Genetic
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Affiliation(s)
- D. Thomalla
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - L. Beckmann
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - C. Grimm
- Institute for Translational Epigenetics, Medical Faculty, University of Cologne, Cologne, Germany
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - M. Oliverio
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - L. Meder
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Mildred Scheel School of Oncology Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - C.D. Herling
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Clinic of Hematology, Cellular Therapy and Hemostaseology, University of Leipzig, Leipzig, Germany
| | - P. Nieper
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - T. Feldmann
- Institute for Translational Epigenetics, Medical Faculty, University of Cologne, Cologne, Germany
| | - O. Merkel
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - E. Lorsy
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - A. da Palma Guerreiro
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - J. von Jan
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - I. Kisis
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - E. Wasserburger
- Institute for Translational Epigenetics, Medical Faculty, University of Cologne, Cologne, Germany
| | - J. Claasen
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | | | - J. Altmüller
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - P. Nürnberg
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - T.-P. Yang
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center of Integrated Oncology Cologne-Bonn, Medical Faculty, Department of Translational Genomics, University of Cologne, Cologne, Germany
| | - M. Lienhard
- Department of Computational Molecular Biology, Max-Planck-Institute for Molecular Genetics, Berlin, Germany
| | - R. Herwig
- Department of Computational Molecular Biology, Max-Planck-Institute for Molecular Genetics, Berlin, Germany
| | - K.-A. Kreuzer
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - C.P. Pallasch
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - R. Büttner
- Department of Pathology, University of Cologne, Cologne, Germany
| | - S.C. Schäfer
- Department of Pathology, University of Cologne, Cologne, Germany
- Institut für Pathologie im Medizin Campus Bodensee, Friedrichshafen, Germany
| | - J. Hartley
- RCI, Regensburg Center for Interventional Immunology, University Hospital of Regensburg, Regensburg, Germany
| | - H. Abken
- RCI, Regensburg Center for Interventional Immunology, University Hospital of Regensburg, Regensburg, Germany
| | - M. Peifer
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Center of Integrated Oncology Cologne-Bonn, Medical Faculty, Department of Translational Genomics, University of Cologne, Cologne, Germany
| | - H. Kashkar
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
- Institute for Molecular Immunologie, University of Cologne, Cologne, Germany
| | - G. Knittel
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, German Cancer Consortium (DKTK Partner Site Essen), Essen, Germany
| | - B. Eichhorst
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
| | - R.T. Ullrich
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - M. Herling
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
- Clinic of Hematology, Cellular Therapy and Hemostaseology, University of Leipzig, Leipzig, Germany
| | - H.C. Reinhardt
- Department of Hematology and Stem Cell Transplantation, University Hospital Essen, University Duisburg-Essen, German Cancer Consortium (DKTK Partner Site Essen), Essen, Germany
| | - M. Hallek
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - M.R. Schweiger
- Institute for Translational Epigenetics, Medical Faculty, University of Cologne, Cologne, Germany
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
- Center for Molecular Medicine Cologne (CMMC), University of Cologne, Cologne, Germany
| | - L.P. Frenzel
- Faculty of Medicine and Cologne University Hospital, Department I of Internal Medicine, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf, University of Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
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Glaser M, von Levetzow C, Michels S, Nogova L, Katzenmeier M, Wömpner C, Schmitz J, Bitter E, Terjung I, Passmann E, Schaufler D, Eisert A, Fischer R, Riedel R, Hahne S, Merkelbach-Bruse S, Büttner R, Wolf J, Scheffler M. 9P Small-scale ROS1 aberrations: Functional impact and therapeutic potential. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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4
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Ceccon GS, Werner J, Ruge MI, Goldbrunner R, Celik E, Baues C, Deckert M, Brunn A, Büttner R, Golla H, Nogova L, Schlamann M, Kabbasch C, Rueß D, Hampl J, Wollring M, Bauer EK, Tscherpel C, Fink GR, Langen K, Galldiks N. KS02.7.A Impact of FET PET on multidisciplinary neurooncological tumor board decisions in patients with brain tumors. Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac174.012] [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
Following neurooncological treatment of brain tumors, neurooncologists are often confronted with equivocal MRI findings (e.g., treatment-related changes such as pseudoprogression, non-measurable contrast-enhancing lesions, T2/FLAIR signal alterations, pseudoresponse). Especially in Europe, amino-acid PET is increasingly integrated into multidisciplinary neurooncological tumor boards (MNTB) to overcome these diagnostic uncertainties. We evaluated the correctness of MNTB decisions, in which amino acid PET findings were taken into account.
Material and Methods
In a single-university center study, we retrospectively evaluated 182 MNTB decisions of 154 patients with histomolecularly defined WHO grade 3 or 4 gliomas (n=123), including glioblastoma (n=80), anaplastic glioma (n=42), and gliosarcoma (n=1), or brain metastases (n=31) secondary to lung cancer, melanoma, breast cancer, or colorectal cancer presenting equivocal MRI findings following anticancer treatment. All patients underwent O-(2-[18F]-fluoroethyl)-L-tyrosine (FET) PET imaging as an adjunct for decision-making. Additionally, the patients’ clinical status, pretreatment, and conventional MRI findings were considered for decision-making. The presence of neoplastic tissue was considered if the mean FET uptake as assessed by tumor-to-brain ratios was > 2.0. MNTB decisions were validated using the neuropathological result in 42% (n=77) or clinicoradiologically in 58% (n=105). The diagnostic performance of MTNB decisions was evaluated using 2x2 contingency tables.
Results
The validation of all 182 MNTB recommendations, which integrated FET PET in the decision-making process, were correct in 95% (sensitivity, 97%; specificity, 75%; positive predictive value, 96%). Due to tumor progression, MNTB recommendations prompted a treatment change in 88% (n=160 of 182 decisions). When FET PET findings suggested progressive disease (n=157), MNTB decisions were correct in 96% (positive predictive value, 97%). In 22 MNTB decisions with the recommendation to continue the current treatment regimen, 82% were correctly identified as treatment-related changes.
Conclusion
FET PET seems to have a significant impact on MNTB decisions. A prospective evaluation of MNTB decisions with and without the integration of FET PET is warranted to define the added value of FET PET.
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Affiliation(s)
- G S Ceccon
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - J Werner
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - M I Ruge
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - R Goldbrunner
- Department of Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - E Celik
- Department of Radiation Oncology and Cyberknife Center, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - C Baues
- Department of Radiation Oncology and Cyberknife Center, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - M Deckert
- Institute of Neuropathology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - A Brunn
- Institute of Neuropathology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - R Büttner
- Institute of Pathology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - H Golla
- Department of Palliative Medicine, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - L Nogova
- Department of Internal Medicine, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - M Schlamann
- Institute of Radiology, Division of Neuroradiology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - C Kabbasch
- Institute of Radiology, Division of Neuroradiology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - D Rueß
- Department of Stereotactic and Functional Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - J Hampl
- Department of Neurosurgery, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - M Wollring
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich , Juelich , Germany
| | - E K Bauer
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
| | - C Tscherpel
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich , Juelich , Germany
| | - G R Fink
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich , Juelich , Germany
| | - K Langen
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich , Juelich , Germany
- Department of Nuclear Medicine, University Hospital RWTH Aachen , Aachen , Germany
| | - N Galldiks
- Department of Neurology, Faculty of Medicine and University Hospital Cologne , Cologne , Germany
- Institute of Neuroscience and Medicine (INM-3, -4), Research Center Juelich , Juelich , Germany
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Fischer R, George J, Scheel A, Schloesser H, Brossart P, Engel-Riedel W, Griesinger F, Grohé C, Kern J, Panse J, Sebastian M, Serke M, Wiewrodt R, Michels S, Nogova L, Riedel R, Weber JP, Büttner R, Thomas R, Wolf J. 1028P BIOLUMA: A phase II trial of nivolumab in combination with ipilimumab to evaluate efficacy and safety in lung cancer and to evaluate biomarkers predictive for response – results from the NSCLC cohort. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Jackisch C, Pronin D, Dimpfl T, Büttner R, Kunz G, Langwieder C, Rees M, Anzeneder T. 162P MammaPrint 10-year follow up results from a German breast cancer cohort study. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Scheffler M, Dugan M, Saleh M, Koleczko S, Brägelmann J, Arolt C, Nogova L, Riedel R, Michels S, Eisert A, Fischer R, Scharpenseel H, Weber JP, Scheel A, Merkelbach-Bruse S, Büttner R, Lafleur F, Wild R, Catanzariti L, Hillmer A, Wolf J. EP08.02-106 KEAP1/NFE2L2 Transcriptomic Signature Predicts Survival in Advanced Stage NSCLC Patients Without Actionable Driver Mutations. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.789] [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: 10/14/2022]
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Arolt C, Dugan M, Wild R, Richartz V, Holz B, Scheel A, Brägelmann J, Merkelbach-Bruse S, Wolf J, Büttner R, Lafleur F, Scheffler M, Catanzariti L, Hillmer A. EP08.02-031 NRF2 Pathway Signature Predicts KEAP1/NFE2L2 Mutations and Reveals Alternative Pathway-Activating Mutations in NSCLC. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.713] [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: 10/14/2022]
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Glaser M, von Levetzow C, Michels S, Nogova L, Katzenmeier M, Wömpner C, Schmitz J, Bitter E, Terjung I, Passmann E, Schaufler D, Eisert A, Fischer R, Riedel R, Weber JP, Hahne S, Merkelbach-Bruse S, Büttner R, Wolf J, Scheffler M. EP08.02-114 Comprehensive Analysis of ROS1 Aberrations without Rearrangements in Non-small cell Lung Cancer Patients. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.797] [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: 11/28/2022]
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Kron A, Scheffler M, Ihle M, Michels S, Süptitz J, Prang D, Jakobs F, Nogova L, Fischer R, Eisert A, Riedel R, Kron F, Hillmer A, Loges S, Merkelbach-Bruse S, Büttner R, Wolf J. 991P EGFR exon 20 insertions in non-small cell lung cancer (NSCLC): Impact of TP53 mutation status and value of immune checkpoint blockade (ICB). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Vergote I, González-Martín A, Ray-Coquard I, Harter P, Colombo N, Pujol P, Lorusso D, Mirza MR, Brasiuniene B, Madry R, Brenton JD, Ausems MGEM, Büttner R, Lambrechts D. European experts consensus: BRCA/homologous recombination deficiency testing in first-line ovarian cancer. Ann Oncol 2022; 33:276-287. [PMID: 34861371 DOI: 10.1016/j.annonc.2021.11.013] [Citation(s) in RCA: 54] [Impact Index Per Article: 27.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/18/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Homologous recombination repair (HRR) enables fault-free repair of double-stranded DNA breaks. HRR deficiency is predicted to occur in around half of high-grade serous ovarian carcinomas. Ovarian cancers harbouring HRR deficiency typically exhibit sensitivity to poly-ADP ribose polymerase inhibitors (PARPi). Current guidelines recommend a range of approaches for genetic testing to identify predictors of sensitivity to PARPi in ovarian cancer and to identify genetic predisposition. DESIGN To establish a European-wide consensus for genetic testing (including the genetic care pathway), decision making and clinical management of patients with recently diagnosed advanced ovarian cancer, and the validity of biomarkers to predict the effectiveness of PARPi in the first-line setting. The collaborative European experts' consensus group consisted of a steering committee (n = 14) and contributors (n = 84). A (modified) Delphi process was used to establish consensus statements based on a systematic literature search, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. RESULTS A consensus was reached on 34 statements amongst 98 caregivers (including oncologists, pathologists, clinical geneticists, genetic researchers, and patient advocates). The statements concentrated on (i) the value of testing for BRCA1/2 mutations and HRR deficiency testing, including when and whom to test; (ii) the importance of developing new and better HRR deficiency tests; (iii) the importance of germline non-BRCA HRR and mismatch repair gene mutations for predicting familial risk, but not for predicting sensitivity to PARPi, in the first-line setting; (iv) who should be able to inform patients about genetic testing, and what training and education should these caregivers receive. CONCLUSION These consensus recommendations, from a multidisciplinary panel of experts from across Europe, provide clear guidance on the use of BRCA and HRR deficiency testing for recently diagnosed patients with advanced ovarian cancer.
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Affiliation(s)
- I Vergote
- Division of Gynaecological Oncology, Department of Gynaecology and Obstetrics and Leuven Cancer Institute, University Hospitals Leuven, Leuven, Belgium.
| | - A González-Martín
- Clinica Universidad de Navarra, Madrid, Spain; Program for Solid Tumors at Centro de Investigación Médica Aplicada (CIMA), Pamplona, Spain
| | - I Ray-Coquard
- Medical Oncology, Centre Leon Bérard and Université Claude Bernard Lyon, Lyon, France
| | - P Harter
- Department of Gynaecology & Gynaecologic Oncology, Ev. Kliniken Essen-Mitte, Essen, Germany
| | - N Colombo
- University of Milan-Bicocca and European Institute of Oncology IRCCS, Milan, Italy
| | - P Pujol
- Montpellier Faculty of Medicine, University Hospital of Montpellier, Montpellier, France
| | - D Lorusso
- Department of Women and Child Science and Public Health, Catholic University of Rome, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - M R Mirza
- Department of Oncology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - B Brasiuniene
- Department of Medical Oncology, National Cancer Institute of Lithuania, Faculty of Medicine of Vilnius University, Vilnius, Lithuania
| | - R Madry
- Oncological Gynaecology Department, Poznan University of Medical Sciences, Poznan, Poland
| | - J D Brenton
- Cancer Research UK Cambridge Institute, University of Cambridge, Cambridge, UK
| | - M G E M Ausems
- Division Laboratories, Pharmacy and Biomedical Genetics, Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - R Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - D Lambrechts
- Department of Human Genetics, VIB and KU Leuven, Leuven, Belgium
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12
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Riedel R, Heydt C, Scheel A, Tumbrink H, Brägelmann J, Fassunke J, Nogova L, Michels S, Scheffler M, Fischer R, Koleczko S, Weber J, Westphal T, Abdulla D, Merkelbach-Bruse S, Sos M, Büttner R, Wolf J. FP14.04 Resistance to MET Inhibition in MET Driven NSCLC and Response after Switching from Type I to Type II MET Inhibitors. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.147] [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]
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13
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Kron A, Alidousty C, Scheffler M, Merkelbach-Bruse S, Seidel D, Riedel R, Ihle MA, Michels S, Nogova L, Fassunke J, Heydt C, Kron F, Ueckeroth F, Serke M, Krüger S, Grohe C, Koschel D, Benedikter J, Kaminsky B, Schaaf B, Braess J, Sebastian M, Kambartel KO, Thomas R, Zander T, Schultheis AM, Büttner R, Wolf J. Impact of TP53 mutation status on systemic treatment outcome in ALK-rearranged non-small-cell lung cancer. Ann Oncol 2019; 29:2068-2075. [PMID: 30165392 PMCID: PMC6225899 DOI: 10.1093/annonc/mdy333] [Citation(s) in RCA: 116] [Impact Index Per Article: 23.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background We analyzed whether co-occurring mutations influence the outcome of systemic therapy in ALK-rearranged non-small-cell lung cancer (NSCLC). Patients and methods ALK-rearranged stage IIIB/IV NSCLC patients were analyzed with next-generation sequencing and fluorescence in situ hybridization analyses on a centralized diagnostic platform. Median progression-free survival (PFS) and overall survival (OS) were determined in the total cohort and in treatment-related sub-cohorts. Cox regression analyses were carried out to exclude confounders. Results Among 216 patients with ALK-rearranged NSCLC, the frequency of pathogenic TP53 mutations was 23.8%, while other co-occurring mutations were rare events. In ALK/TP53 co-mutated patients, median PFS and OS were significantly lower compared with TP53 wildtype patients [PFS 3.9 months (95% CI: 2.4–5.6) versus 10.3 months (95% CI: 8.6–12.0), P < 0.001; OS 15.0 months (95% CI: 5.0–24.9) versus 50.0 months (95% CI: 22.9–77.1), P = 0.002]. This difference was confirmed in all treatment-related subgroups including chemotherapy only [PFS first-line chemotherapy 2.6 months (95% CI: 1.3–4.1) versus 6.2 months (95% CI: 1.8–10.5), P = 0.021; OS 2.0 months (95% CI: 0.0–4.6) versus 9.0 months (95% CI: 6.1–11.9), P = 0.035], crizotinib plus chemotherapy [PFS crizotinib 5.0 months (95% CI: 2.9–7.2) versus 14.0 months (95% CI: 8.0–20.1), P < 0.001; OS 17.0 months (95% CI: 6.7–27.3) versus not reached, P = 0.049] and crizotinib followed by next-generation ALK-inhibitor [PFS next-generation inhibitor 5.4 months (95% CI: 0.1–10.7) versus 9.9 months (95% CI: 6.4–13.5), P = 0.039; OS 7.0 months versus 50.0 months (95% CI: not reached), P = 0.001). Conclusions In ALK-rearranged NSCLC co-occurring TP53 mutations predict an unfavorable outcome of systemic therapy. Our observations encourage future research to understand the underlying molecular mechanisms and to improve treatment outcome of the ALK/TP53 co-mutated subgroup.
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Affiliation(s)
- A Kron
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - C Alidousty
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - M Scheffler
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - S Merkelbach-Bruse
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - D Seidel
- Center for Integrated Oncology Köln Bonn, Cologne, Germany; CECAD Cluster of Excellence, University of Cologne, Cologne, Germany
| | - R Riedel
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - M A Ihle
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - S Michels
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - L Nogova
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - J Fassunke
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - C Heydt
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - F Kron
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - F Ueckeroth
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - M Serke
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Lungenklinik Hemer des Deutschen Gemeinschafts-Diakonieverbandes GmbH, Hemer, Germany
| | - S Krüger
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Florence Nightingale Hospital, Düsseldorf, Germany
| | - C Grohe
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Evangelische Lungenklinik Berlin (Paul Gerhardt Diakonie), Berlin, Germany
| | - D Koschel
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Fachkrankenhaus Coswig, Coswig, Germany
| | - J Benedikter
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Klinikum Bogenhausen, Munich, Germany
| | - B Kaminsky
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Krankenhaus Bethanien, Solingen, Germany
| | - B Schaaf
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Center, Klinikum Dortmund GmbH, Dortmund, Germany
| | - J Braess
- Network Genomic Medicine, Cologne, Germany; Department of Oncology and Hematology, Krankenhaus Barmherzige Brueder, Regensburg, Germany
| | - M Sebastian
- Network Genomic Medicine, Cologne, Germany; Department of Oncology and Hematology, University Hospital Frankfurt (Johannes-Wolfgang Goethe Institute), Frankfurt am Main, Germany
| | - K-O Kambartel
- Network Genomic Medicine, Cologne, Germany; Department of Pneumology, Bethanien Hospital Moers-Lungenzentrum, Moers, Germany
| | - R Thomas
- Network Genomic Medicine, Cologne, Germany; Cologne Center for Genomics, University Hospital of Cologne, Cologne, Germany
| | - T Zander
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany
| | - A M Schultheis
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - R Büttner
- Network Genomic Medicine, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany; Institute of Pathology, University Hospital of Cologne, Cologne, Germany
| | - J Wolf
- Network Genomic Medicine, Cologne, Germany; Lung Cancer Group Cologne, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany; Center for Integrated Oncology Köln Bonn, Cologne, Germany.
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Abstract
BACKGROUND Hereditary nonpolyposis colorectal cancer (Lynch/HNPCC syndrome) is based on a germline mutation inducing increased occurrence of colorectal cancer and extracolonic carcinomas in young age. The German HNPCC consortium aims to increase awareness for detection of hereditary colon cancer among patients and physicians. OBJECTIVES Reliable detection of HNPCC patients is based on a thorough documentation of patients' medical history and on further diagnostics delivered by human genetics and surgical pathology. This manuscript presents a standardized diagnostic concept. METHODS Relevant literature is reviewed and discussed and diagnostic parameters are outlined. In addition, operating figures of the German HNPCC consortium are presented. RESULTS The German HNPCC consortium is based on an efficient cooperation between clinical physicians, human geneticists, and surgical pathologists. After a funding period from the Deutsche Krebshilfe, HNPCC diagnostics and preventive medical examinations were transferred into standard care in Germany. In total, 5770 families (8873 patients) were included in HNPCC diagnostics. To date, in 1296 families, mutations of the MLH1-, MSH2-, MSH6-, PMS2-, or EPCAM-gene have been detected. Furthermore, 612 pathogenic variants and 325 variants of unknown significance were found. CONCLUSIONS Reliable detection of HNPCC patients is based on a standardized diagnostic concept, which has been established within the German HNPCC consortium.
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Affiliation(s)
- R Büttner
- Institut für Pathologie, Medizinische Fakultät und Uniklinik Köln, Universität Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - N Friedrichs
- Institut für Pathologie, Medizinische Fakultät und Uniklinik Köln, Universität Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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15
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Michels S, Massuti Sureda B, Schildhaus HU, Franklin J, Sebastian M, Felip E, Grohe C, Rodríguez-Abreu D, Bischoff H, Carcereny Costa E, Corral Jaime J, Insa A, Reck M, Scheffler M, Karachaliou N, Merkelbach-Bruse S, Nogova L, Büttner R, Rosell R, Wolf J. Crizotinib in patients with advanced or metastatic ROS1-rearranged lung cancer (EUCROSS): A European phase II clinical trial – Updated progression-free survival, overall survival and mechanisms of resistance. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.070] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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16
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Scheffler M, Chanra T, Kron A, Koleczko S, Abdulla D, Ihle M, Holzem A, Riedel R, Michels S, Fischer R, Merkelbach-Bruse S, Büttner R, Nogova L, Wolf J. Genomic and clinical characterization of non-small cell lung cancer (NSCLC) patients harboring mutations in FGFR2 and FGFR3. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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17
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Büttner R, Wolf J, Kron A. [The national Network Genomic Medicine (nNGM) : Model for innovative diagnostics and therapy of lung cancer within a public healthcare system]. Pathologe 2019; 40:276-280. [PMID: 31101971 DOI: 10.1007/s00292-019-0605-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND Since 2012, the Network Genomic Medicine (NGM) has been providing a large number of lung cancer patients from referring partner sites with comprehensive molecular-pathological diagnostics on the single diagnostic platform at the University Hospital Cologne. In addition, the network headquarters in Cologne interprets the findings in close interdisciplinary coordination between pathologists and oncologists, provides information on innovative treatment options, and evaluates the personalized therapies using the central database. As part of one of its largest single grants in 2018, the German Cancer Aid (DKH) rolled out this interdisciplinary and intersectoral care model to all existing DKH-funded German comprehensive cancer centers at the time of the initial application. GOAL Presentation of the treatment reality within the national Network Genomic Medicine (nNGM) with its core elements and actors (network centers and intersectoral clinical partners sites). METHODS This article is based on our own experience in NGM and nNGM and includes a summary of the currently applicable guidelines for reimbursement and an overview of the treatment landscape in the field of molecular-pathological diagnostics in Germany. RESULTS The focus of nNGM is on the implementation of innovative molecular diagnostics and personalized therapy in broad clinical routine in Germany. This is enabled by developing molecular-pathological diagnostics within the network centers on an ongoing basic, interdisciplinary counseling of referring partner sites, offering innovative clinical trials, and performing central evaluation. In particular, a focus of nNGM is the development of regional networks to treat the affected lung cancer patients close to home at the partner sites whenever possible. DISCUSSION Interdisciplinary teams are essential for the success of a broad implementation of molecular-pathological diagnostics. nNGM addresses a severe deficit in German lung cancer care and in the future will be expanded to further network centers while meeting the defined quality criteria.
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Affiliation(s)
- R Büttner
- Institut für Pathologie, Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universität zu Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
| | - J Wolf
- Klinik I für Innere Medizin, Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universität zu Köln, Köln, Deutschland
| | - A Kron
- Klinik I für Innere Medizin, Centrum für Integrierte Onkologie Aachen Bonn Köln Düsseldorf, Universität zu Köln, Köln, Deutschland
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Knittel G, Flümann R, Nieper P, Rehkämper T, Pfeiffer P, Holzem A, Fritz C, Klatt A, Kashkar H, Persigehl T, Peifer M, Büttner R, Reinhardt C. AN AUTOCHTHONOUS MOUSE MODEL OF MyD88 p.L265P- AND BCL2-DRIVEN DIFFUSE LARGE B CELL LYMPHOMA. Hematol Oncol 2019. [DOI: 10.1002/hon.41_2629] [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: 11/09/2022]
Affiliation(s)
- G. Knittel
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - R. Flümann
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - P. Nieper
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - T. Rehkämper
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - P. Pfeiffer
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - A. Holzem
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - C. Fritz
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
| | - A. Klatt
- Institute for Clinical Chemistry; University Hospital of Cologne; Cologne Germany
| | - H. Kashkar
- Institute for Microbiology and Hygiene; University Hospital of Cologne; Cologne Germany
| | - T. Persigehl
- Department of Radiology; University Hospital Cologne; Cologne Germany
| | - M. Peifer
- Department of Translational Genomics; University of Cologne; Cologne Germany
| | - R. Büttner
- Institute of Pathology; University Hospital of Cologne; Cologne Germany
| | - C. Reinhardt
- Dept. I of Internal Medicine; University Hospital Cologne; Cologne Germany
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19
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Surowy HM, Giesen AK, Otte J, Büttner R, Falkenstein D, Friedl H, Meier F, Petzsch P, Wachtmeister T, Westphal D, Wieczorek D, Wruck W, Adjaye J, Rütten A, Redler S. Gene expression profiling in aggressive digital papillary adenocarcinoma sheds light on the architecture of a rare sweat gland carcinoma. Br J Dermatol 2019; 180:1150-1160. [PMID: 30472730 DOI: 10.1111/bjd.17446] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Sweat gland carcinomas are rare cutaneous adnexal malignancies. Aggressive digital papillary adenocarcinoma (ADPA) represents a very rare subentity, thought to arise almost exclusively from the sweat glands of the fingers and toes. The aetiology of sweat gland carcinomas and ADPA is largely unknown. ADPAs are most likely driven by somatic mutations. However, somatic mutation patterns are largely unexplored, creating barriers to the development of effective therapeutic approaches to the treatment of ADPA. OBJECTIVES To investigate the transcriptome profile of ADPA using a sample of eight formalin-fixed, paraffin-embedded tissue samples of ADPA and healthy control tissue. METHODS Transcriptome profiling was performed using the Affymetrix PrimeView Human Gene Expression Microarray and findings were validated via reverse transcription of RNA and real-time quantitative polymerase chain reaction. RESULTS Transcriptome analyses showed increased tumour expression of 2266 genes, with significant involvement of cell cycle, ribosomal and crucial cancer pathways. Our results point to tumour overexpression of FGFR2 (P = 0·001). CONCLUSIONS The results indicate the involvement of crucial oncogenic driver pathways, highlighting cell cycle and ribosomal pathways in the aetiology of ADPA. Suggested tumour overexpression of FGFR2 raises the hope that targeting the fibroblast growth factor (FGF)/FGF receptor axis might be a promising treatment for ADPA and probably for the overall group of sweat gland carcinomas.
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Affiliation(s)
- H M Surowy
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
| | - A K Giesen
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
| | - J Otte
- Institute for Stem Cell Research and Regenerative Medicine, Düsseldorf, Germany
| | - R Büttner
- Pathology, Institute for Pathology, University Hospital Cologne, Cologne, Germany
| | - D Falkenstein
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
| | - H Friedl
- Klinikum Darmstadt, Department of Dermatology, Darmstadt, Germany
| | - F Meier
- Department of Dermatology, Carl Gustav Carus Medical Center, TU Dresden, Dresden, Germany.,National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - P Petzsch
- Biological and Medical Research Center (BMFZ), Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - T Wachtmeister
- Biological and Medical Research Center (BMFZ), Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - D Westphal
- Department of Dermatology, Carl Gustav Carus Medical Center, TU Dresden, Dresden, Germany.,National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - D Wieczorek
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
| | - W Wruck
- Institute for Stem Cell Research and Regenerative Medicine, Düsseldorf, Germany
| | - J Adjaye
- Institute for Stem Cell Research and Regenerative Medicine, Düsseldorf, Germany
| | - A Rütten
- Dermatopathology, Bodensee, Siemensstrasse 6/1, 88048, Friedrichshafen, Germany
| | - S Redler
- Heinrich-Heine-University, Medical Faculty, Institute of Human Genetics, Düsseldorf, Germany
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Ozretić L, Schwindowski A, Dienes HP, Büttner R, Drebber U, Fries JWU. [Consequences of autopsies for the living : Causes of death in the clinical diagnosis "septic and toxic shock"]. Pathologe 2019. [PMID: 28638939 DOI: 10.1007/s00292-017-0305-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND There is reason to believe that the diagnosis of septic and toxic shock, as indicated on the death certificate, cannot be confirmed as the cause of death without autopsy and subsequent histological analysis. The external examination of the corpse can therefore not represent the sole basis for a reliable statement about the infection status of a corpse, e. g. as a prerequisite for embalming. MATERIAL AND METHODS The validity of autopsy in determining septic and toxic shock as the cause of death is demonstrated in 7 exemplary cases. RESULTS Decades of experience in a university pathology institute have shown that an external examination of the corpse alone is not suitable for certifying the cause of death if an infectious disease is suspected. Consequently, only autopsy with subsequent histological analysis provides reliable statements on the etiopathogenesis of the underlying process. Possible problems and discrepancies between clinical and pathological diagnoses are discussed on the basis of several cases with or without autoptic confirmation of the septic shock. The case of a missionary from Africa infected with Lassa virus serves to point out the seriousness of the threat an undiagnosed infection may represent to the attending staff. CONCLUSION During the treatment of patients suspected to have an infectious cause of fever of unknown origin, compliance with the usual safety regulations, including adequate disinfecting measures, is essential. In cases with fatal outcome, not infrequently under the clinical picture of a septic and toxic shock, autopsy should be regularly performed to confirm the type of infection and the infectious cause of death. Rapid and open communication between the professional groups involved plays a crucial role in this process.
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Affiliation(s)
- L Ozretić
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland
| | - A Schwindowski
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland
| | - H-P Dienes
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland
| | - R Büttner
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland
| | - U Drebber
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland
| | - J W U Fries
- Institut für Pathologie, Universitätsklinikum Köln, Kerpenerstr. 62, 50931, Köln, Deutschland.
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21
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Hanlon Newell A, Liu W, Bubendorf L, Büttner R, Kerr K, Kockx M, Kossai M, Lopez-Rios F, Marchetti A, Marondel I, Nicholson A, Oz B, Pauwels P, Penault-Llorca F, Rossi G, Rüsseler V, Thunnissen E, Pate G, Portier B, Faure C, Le C, Smith D, Menzl I, Huang R. MA26.07 ROS1 (SP384) Immunohistochemistry Inter-Reader Precision Between 12 Pathologists. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.543] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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22
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Tischler V, Ihle M, Stenzinger A, Weichert W, Jochum W, Büttner R, Wolf J, Peifer M, Thomas R. 22P Clonal and subclonal occurrence of oncogenic mutations in lung adenocarcinoma. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30302-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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23
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Hagmeyer L, Treml M, Richter K, Hekmat K, Heldwein M, Schäfer S, Büttner R, Randerath WJ. Sensitivität einer PD-L1-Analyse bei nicht-kleinzelligem Lungenkarzinom (NSCLC) mit Pleuraerguss. Pneumologie 2018. [DOI: 10.1055/s-0037-1619253] [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]
Affiliation(s)
- L Hagmeyer
- Klinik für Pneumologie und Allergologie, Krankenhaus Bethanien gGmbH, Köln
| | - M Treml
- Institut für Pneumologie an der Universität zu Köln
| | - K Richter
- Institut für Pneumologie an der Universität zu Köln
| | - K Hekmat
- Klinik für Herz- und Thoraxchirurgie, Universitätsklinik Köln
| | - M Heldwein
- Klinik für Herz- und Thoraxchirurgie, Universitätsklinik Köln
| | - S Schäfer
- Institut für Pathologie, Universität Köln
| | - R Büttner
- Zentrum für Pathologie, Universitätsklinik Köln
| | - WJ Randerath
- Klinik für Pneumologie und Allergologie; Zentrum für Schlaf- und Beatmungsmedizin, Krankenhaus Bethanien GmbH, Köln
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24
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Kron A, Riedel R, Michels S, Fassunke J, Merkelbach-Bruse S, Scheffler M, Nogova L, Fischer R, Ueckeroth F, Abdulla D, Kron F, Pauli B, Kaminsky B, Braess J, Graeven U, Grohe C, Krueger S, Büttner R, Wolf J. Impact of co-occurring genomic alterations on overall survival of BRAF V600E and non-V600E mutated NSCLC patients: Results of the Network Genomic Medicine. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Riedel R, Kron A, Michels S, Fassunke J, Scheffler M, Fischer R, Nogova L, Abdulla D, Heydt C, Ueckeroth F, Pauli B, Serke M, Krueger S, Grohe C, Sebastian M, Koschel D, Kambartel KO, Zander T, Büttner R, Wolf J. Impact of next generation TKI and co-occurring mutations in ALK-positive NSCLC patients: Results of the Network Genomic Medicine. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx380.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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26
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Meyer M, Meinrath J, Seehawer J, Lechner A, Odenthal M, Quaas A, Semrau R, Huebbers C, Marnitz S, Büttner R, Beutner D. The relevance of the lymph node ratio as predictor of prognosis is higher in HPV-negative than in HPV-positive oropharyngeal squamous cell carcinoma. Clin Otolaryngol 2017; 43:192-198. [DOI: 10.1111/coa.12938] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/12/2017] [Indexed: 01/03/2023]
Affiliation(s)
- M.F. Meyer
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
| | - J. Meinrath
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Institute for Pathology; University of Cologne; Cologne Germany
| | - J. Seehawer
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
| | - A. Lechner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
| | - M. Odenthal
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Institute for Pathology; University of Cologne; Cologne Germany
- Center for Molecular Medicine Cologne; University of Cologne; Cologne Germany
| | - A. Quaas
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Institute for Pathology; University of Cologne; Cologne Germany
| | - R. Semrau
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Department of Radiation Oncology; University of Cologne; Cologne Germany
| | - C.U. Huebbers
- Jean-Uhrmacher Institute; University of Cologne; Cologne Germany
| | - S. Marnitz
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Department of Radiation Oncology; University of Cologne; Cologne Germany
| | - R. Büttner
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
- Institute for Pathology; University of Cologne; Cologne Germany
- Center for Molecular Medicine Cologne; University of Cologne; Cologne Germany
| | - D. Beutner
- Department of Otorhinolaryngology; Head and Neck Surgery; University of Cologne; Cologne Germany
- Center for Integrated Oncology Köln Bonn; University of Cologne; Cologne Germany
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27
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Hagmeyer L, Tharun L, Schäfer SC, Hekmat K, Büttner R, Randerath W. First case report of a curative wedge resection in epithelial-myoepithelial carcinoma of the lung. Gen Thorac Cardiovasc Surg 2017; 65:535-538. [PMID: 28653299 DOI: 10.1007/s11748-017-0796-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 06/19/2017] [Indexed: 10/19/2022]
Abstract
Epithelial-myoepithelial carcinoma is a well differentiated malignant neoplasm, which originates from the salivary glands. The primary pulmonary manifestation is rare-about 30 cases have been reported worldwide. In the literature, anatomical resection has been described as the standard surgical approach. In the presented case, a wedge resection was performed, with no evidence for tumor relapse in the follow-up reevaluation after 24 months. This is the first case report of a primary pulmonary epithelial-myoepithelial carcinoma that has been treated with a non-anatomical wedge resection and lymph node dissection as a curative approach.
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Affiliation(s)
- Lars Hagmeyer
- Clinic for Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Hospital Bethanien Solingen, Aufderhöher Straße 169-175, 42699, Solingen, Germany.
| | - L Tharun
- Institute for Pathology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - S C Schäfer
- Institute for Pathology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - K Hekmat
- Clinic for Cardiac and Thoracic Surgery, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - R Büttner
- Institute for Pathology, University Hospital Cologne, Kerpener Straße 62, 50937, Cologne, Germany
| | - W Randerath
- Clinic for Pneumology and Allergology, Center for Sleep Medicine and Respiratory Care, Hospital Bethanien Solingen, Aufderhöher Straße 169-175, 42699, Solingen, Germany
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Thewes V, Simon R, Hlevnjak M, Schlotter M, Schroeter P, Schmidt K, Wu Y, Anzeneder T, Wang W, Windisch P, Kirchgäßner M, Melling N, Kneisel N, Büttner R, Deuschle U, Sinn HP, Schneeweiss A, Heck S, Kaulfuss S, Hess-Stumpp H, Okun JG, Sauter G, Lykkesfeldt AE, Zapatka M, Radlwimmer B, Lichter P, Tönjes M. The branched-chain amino acid transaminase 1 sustains growth of antiestrogen-resistant and ERα-negative breast cancer. Oncogene 2017; 36:4124-4134. [PMID: 28319069 DOI: 10.1038/onc.2017.32] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 12/16/2016] [Accepted: 01/24/2017] [Indexed: 12/24/2022]
Abstract
Antiestrogen-resistant and triple-negative breast tumors pose a serious clinical challenge because of limited treatment options. We assessed global gene expression changes in antiestrogen-sensitive compared with antiestrogen-resistant (two tamoxifen resistant and two fulvestrant resistant) MCF-7 breast cancer cell lines. The branched-chain amino acid transaminase 1 (BCAT1), which catalyzes the first step in the breakdown of branched-chain amino acids, was among the most upregulated transcripts in antiestrogen-resistant cells. Elevated BCAT1 expression was confirmed in relapsed tamoxifen-resistant breast tumor specimens. High intratumoral BCAT1 levels were associated with a reduced relapse-free survival in adjuvant tamoxifen-treated patients and overall survival in unselected patients. On a tissue microarray (n=1421), BCAT1 expression was detectable in 58% of unselected primary breast carcinomas and linked to a higher Ki-67 proliferation index, as well as histological grade. Interestingly, BCAT1 was predominantly expressed in estrogen receptor-α-negative/human epidermal growth factor receptor-2-positive (ERα-negative/HER-2-positive) and triple-negative breast cancers in independent patient cohorts. The inverse relationship between BCAT1 and ERα was corroborated in various breast cancer cell lines and pharmacological long-term depletion of ERα induced BCAT1 expression in vitro. Mechanistically, BCAT1 indirectly controlled expression of the cell cycle inhibitor p27Kip1 thereby affecting pRB. Correspondingly, phenotypic analyses using a lentiviral-mediated BCAT1 short hairpin RNA knockdown revealed that BCAT1 sustains proliferation in addition to migration and invasion and that its overexpression enhanced the capacity of antiestrogen-sensitive cells to grow in the presence of antiestrogens. Importantly, silencing of BCAT1 in an orthotopic triple-negative xenograft model resulted in a massive reduction of tumor volume in vivo, supporting our findings that BCAT1 is necessary for the growth of hormone-independent breast tumors.
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Affiliation(s)
- V Thewes
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Hlevnjak
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Schlotter
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Schroeter
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Schmidt
- Division of Inherited Metabolic Diseases, University Children's Hospital, Heidelberg, Germany
| | - Y Wu
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - T Anzeneder
- PATH Foundation Biobank-Patients' Tumor Bank of Hope, Munich, Germany
| | - W Wang
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Windisch
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Kirchgäßner
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - N Melling
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Kneisel
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - R Büttner
- Institute of Pathology, University Hospital Cologne, Cologne, Germany
| | - U Deuschle
- Phenex Pharmaceuticals AG, Heidelberg, Germany
| | - H P Sinn
- Institute of Pathology, University of Heidelberg, Heidelberg, Germany
| | - A Schneeweiss
- Gynecologic Oncology, National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - S Heck
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - J G Okun
- Division of Inherited Metabolic Diseases, University Children's Hospital, Heidelberg, Germany
| | - G Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A E Lykkesfeldt
- Breast Cancer Group, Danish Cancer Society Research Center, Copenhagen, Denmark
| | - M Zapatka
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - B Radlwimmer
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Lichter
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - M Tönjes
- Division of Molecular Genetics, German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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Löser H, Heydt C, Büttner R, Markiefka B. [BRCA diagnostics of ovarian cancer : Molecular tumor testing since the introduction of PARP inhibitor therapy]. Pathologe 2017; 38:117-126. [PMID: 28258387 DOI: 10.1007/s00292-017-0274-0] [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] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Approximately 9000 women are diagnosed with ovarian cancer in Germany each year. The most common subtype is high-grade serous ovarian cancer. A relevant proportion of these tumors are associated with mutations in the breast and ovarian cancer susceptibility genes (BRCA1 and BRCA2) representing highly penetrant tumor suppressor genes with autosomal inheritance and play a crucial role in DNA repair mechanisms. These patients have predominantly germline mutations and less frequently have somatic BRCA mutations. Tumors harboring BRCA mutations show a significant improvement in progression-free survival under therapy with poly(adenosine diphosphate ribose) polymerase (PARP) inhibitors. In 2015 the first PARP inhibitor was approved for the therapy of high-grade serous ovarian cancer with BRCA mutations. Mutation analysis can be performed on formalin-fixed paraffin-embedded (FFPE) tumor tissue within a few days.
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Affiliation(s)
- H Löser
- Institut für Pathologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - C Heydt
- Institut für Pathologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - R Büttner
- Institut für Pathologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland
| | - B Markiefka
- Institut für Pathologie, Uniklinik Köln, Kerpener Str. 62, 50937, Köln, Deutschland.
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Kambartel K, Eggert J, Kopeika U, Liebisch P, Mlynek-Kersjes ML, Rösel C, Scheffler M, Yildirim A, Krbek T, Wolf J, Büttner R, Voshaar T. Erfolgreiche Therapie mit Afatinib und Crizotinib bei einer cMET-Amplifikation als Ursache einer sekundären EGFR-Resistenz. Pneumologie 2017. [DOI: 10.1055/s-0037-1598336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- K Kambartel
- Lungenzentrum, Pneumologie, Krankenhaus Bethanien Moers
| | | | - U Kopeika
- Lungenzentrum, Pneumologie, Krankenhaus Bethanien Moers
| | | | | | - C Rösel
- Thoraxchirurgie, Krankenhaus Bethanien Moers
| | - M Scheffler
- Klinik I für Innere Medizin I, Centrum für Integrierte Onkologie (Cio), Universitätsklinikum Köln
| | - A Yildirim
- Lungenzentrum, Pneumologie, Krankenhaus Bethanien Moers
| | - T Krbek
- Thoraxchirurgie, Krankenhaus Bethanien Moers
| | - J Wolf
- Klinik I für Innere Medizin I, Centrum für Integrierte Onkologie (Cio), Universitätsklinikum Köln
| | - R Büttner
- Zentrum für Pathologie, Universitätsklinik Köln
| | - T Voshaar
- Lungenzentrum, Pneumologie, Krankenhaus Bethanien Moers
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von Laffert M, Schirmacher P, Warth A, Weichert W, Büttner R, Huber RM, Wolf J, Griesinger F, Dietel M, Grohé C. [Statement of the German Society for Pathology and the working group thoracic oncology of the working group oncology/German Cancer Society on ALK testing in NSCLC: Immunohistochemistry and/or FISH?]. Pathologe 2017; 37:187-91. [PMID: 26984297 DOI: 10.1007/s00292-016-0152-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Affiliation(s)
- M von Laffert
- Institut für Pathologie, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland
| | - P Schirmacher
- Institut für Pathologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - A Warth
- Institut für Pathologie, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - W Weichert
- Institut für Allgemeine Pathologie und Pathologische Anatomie, Technische Universität München, München, Deutschland
| | - R Büttner
- Institut für Pathologie, Uniklinik Köln, Köln, Deutschland
| | - R M Huber
- Sektion Pneumologie Innenstadt und Thorakale Onkologie, Klinikum der Universität München und Lungentumorzentrum München, München, Deutschland
| | - J Wolf
- Klinik I für Innere Medizin, Uniklinik Köln, Köln, Deutschland
| | - F Griesinger
- Klinik für Hämatologie und Onkologie, Universitätsklinik Innere Medizin-Onkologie, Pius-Hospital Oldenburg, Oldenburg, Deutschland
| | - M Dietel
- Institut für Pathologie, Charité Universitätsmedizin, Campus Mitte, Charitéplatz 1, 10117, Berlin, Deutschland.
| | - C Grohé
- Klinik für Pneumologie, Evangelische Lungenklinik Berlin, Berlin, Deutschland
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von Laffert M, Schirmacher P, Warth A, Weichert W, Büttner R, Huber R, Wolf J, Griesinger F, Dietel M, Grohé C. ALK-Testing in non-small cell lung cancer (NSCLC): Immunohistochemistry (IHC) and/or fluorescence in-situ Hybridisation (FISH)? Lung Cancer 2017; 103:1-5. [DOI: 10.1016/j.lungcan.2016.11.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
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Strake L, Eischeid H, Koitzsch U, Mallmann P, Büttner R, Fries J, Odenthal M, Kirn V. ESR1-Promotor-Methylierung und ER-Rezeptorexpression beim metastasierenden Mammakarzinom. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Rhiem K, Markiefka B, Giesecke J, Hahnen E, Büttner R, Schmutzler R. Entwicklung eines integrierten Versorgungsmoduls „BRCA-Diagnostik“ zur Feststellung einer Therapierelevanz mit dem PARP-Inhibitor Olaparib beim rezidivierten platin-sensitiven HSOC. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Thangarajah F, Mallmann P, Frommke L, Morgenstern B, Fridrich C, Puppe J, Krempel K, Markiefka B, Büttner R, Scheel AH, Schultheis AM. PD-1 und PD-L1 Expression in Plattenepithelkarzinomen der Vulva. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592688] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Koleczko S, Schäpers C, Scheffler M, Ihle M, Kostenko A, Michels S, Fischer R, Nogova L, Brandes V, Abdulla D, Ueckeroth F, Thurat M, Frank R, Eisert A, Bitter E, Wömpner C, Gogl L, Merkelbach-Bruse S, Büttner R, Wolf J. A comprehensive analysis of potentially targetable genetic aberrations and clinical findings in 821 patients with squamous-cell NSCLC – a comparison of NGM and TCGA LUSC data. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw383.13] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Heydt C, Kostenko A, Merkelbach-Bruse S, Wolf J, Büttner R. ALK evaluation in the world of multiplex testing: Network Genomic Medicine (NGM): the Cologne model for implementing personalised oncology. Ann Oncol 2016; 27 Suppl 3:iii25-iii34. [DOI: 10.1093/annonc/mdw303] [Citation(s) in RCA: 22] [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] [Indexed: 12/11/2022] Open
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von Laffert M, Schirmacher P, Warth A, Weichert W, Büttner R, Huber RM, Wolf J, Griesinger F, Dietel M, Grohé C. [ALK-Diagnostics in NSCLC - Immunohistochemistry (IHC) and/or Fluorescence-in-situ Hybridisation (FISH)]. Pneumologie 2016; 70:277-81. [PMID: 26984109 DOI: 10.1055/s-0042-102626] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The EML4-ALK pathway plays an important role in a significant subset of non-small cell lung cancer patients. Treatment options such as tyrosine kinase inhibitors directed against the EML4-ALK signalling pathway lead to improved progression free and overall survival. These therapeutic options are chosen on the basis of the identification of the underlying genetic signature of the EML-ALK translocation. Efficient and easily accessible testing tools are required to identify the patients in time. While FISH techniques have been implemented to characterize this translocation for some time, the implementation of this testing is hampered by its broad use of resources. Immunohistochemical techniques to identify and screen for EML4-ALK translocations may play an important role in the near future. This consensus paper offers recommendations of the sequence and quality of the respective test approaches which are validated on the basis of the current literature.
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Affiliation(s)
- M von Laffert
- Institut für Pathologie, Charité Universitätsmedizin, Berlin
| | - P Schirmacher
- Institut für Pathologie, Universitätsklinikum Heidelberg
| | - A Warth
- Institut für Pathologie, Universitätsklinikum Heidelberg
| | - W Weichert
- Institut für Allgemeine Pathologie und Pathologische Anatomie der Technischen Universität München
| | - R Büttner
- Institut für Pathologie, Uniklinik Köln
| | - R M Huber
- Sektion Pneumologie Innenstadt und Thorakale Onkologie, Klinikum der Universität München und Lungentumorzentrum München
| | - J Wolf
- Klinik I für Innere Medizin, Uniklinik Köln
| | - F Griesinger
- Klinik für Hämatologie und Onkologie, Universitätsklinik Innere Medizin-Onkologie, Pius-Hospital Oldenburg
| | - M Dietel
- Institut für Pathologie, Charité Universitätsmedizin, Berlin
| | - Ch Grohé
- Klinik für Pneumologie, Evangelische Lungenklinik Berlin
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39
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Goltz D, Huss S, Ramadori E, Büttner R, Diehl L, Meyer R. Immunomodulation by splenectomy or by FTY720 protects the heart against ischemia reperfusion injury. Clin Exp Pharmacol Physiol 2015. [DOI: 10.1111/1440-1681.12465] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- D Goltz
- Institute of Pathology; University of Bonn; Bonn Germany
| | - S Huss
- Institute of Pathology; University of Cologne; Cologne Germany
| | - E Ramadori
- Institute of Pathology; University of Bonn; Bonn Germany
| | - R Büttner
- Institute of Pathology; University of Cologne; Cologne Germany
| | - L Diehl
- Experimental Immunology and Hepatology; Centre for Experimental Medicine; University Medical Centre Hamburg-Eppendorf; Hamburg Germany
| | - R Meyer
- Institute of Physiology II; University of Bonn; Bonn Germany
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40
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Gogl L, Scheffler M, Ihle M, Michels S, Fischer R, Serke M, Gerigk U, Wömpner C, Krüger S, Kaminsky B, Schulte W, Höffken G, Merkelbach-Bruse S, Büttner R, Wolf J. 3131 Clinical and molecular characteristics of non-small cell lung cancer in patients harboring CTNNB1 mutations. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)31772-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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41
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Huang J, Amer W, Dienes HP, Büttner R, Odenthal M. Promoter regulation of the miR-29a/b1 gene by transforming growth factor-β in hepatic stellate cells and in hepatoma cells. Z Gastroenterol 2015. [DOI: 10.1055/s-0034-1397082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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42
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Schneider R, Schneider C, Büttner R, Reinacher-Schick A, Tannapfel A, Fürst A, Rüschoff J, Jakobeit C, Royer-Pokora B, Möslein G. [Colorectal Carcinoma with Suspected Lynch Syndrome: A Multidisciplinary Algorithm]. Zentralbl Chir 2014; 140:591-9. [PMID: 25372301 DOI: 10.1055/s-0034-1368480] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Lynch syndrome is the most frequent hereditary cancer syndrome, accounting for approximately 3-5 % of all colorectal cancers. In addition, it is the most frequent predisposing hereditary cause of endometrial cancer and is also associated with gastric cancer, ovarian cancer, cancer of the urinary tract as well as several other cancers. In clinical practise Lynch syndrome is frequently not detected and many clinicians admit uncertainties regarding diagnostic procedures. Also, counselling of patients is considered difficult regarding therapeutic - especially prophylactic surgical and chemopreventive options and recommendations. Based on a review of available literature we discuss optimized strategies for improved detection of suspected Lynch syndrome patients. The aim of this review is to establish a clinical algorithm of how to proceed on a diagnostic level and to discuss surgical options at the time of a colorectal cancer. In order to identify patients with Lynch syndrome, family history should be ascertained and evaluated in regards to fulfilment of the Amsterdam-II- and/or the revised Bethesda criteria. Subsequently immunohistochemical staining for the mismatch-repair-genes, BRAF testing for MLH1 loss of expression, as well as testing for microsatellite instability in some, followed by genetic counselling and mutation analysis when indicated, is recommended. Pathological identification of suspected Lynch syndrome is readily feasible and straightforward. However, the need of performing these analyses in the tumor biopsy at the time of (gastroenterological) diagnosis of CRC neoplasia is essential, in order to offer patients the option of a prophylactically extended surgery and - as recommended in the German S3 guidelines - to discuss the option of a merely prophylactical hysterectomy and oophorectomy (if postmenopausal) in women. Close cooperation between gastroenterologists, pathologists and surgeons is warranted, so that patients may benefit from options of extended or prophylactically extended surgery at the time of diagnosis of a colorectal primary. Patients nowadays must be involved in informed decision-making regarding prophylactic or extended prophylactic surgery at the time of a colorectal primary. To date, however, limitations in daily clinical practise, the failure to assess family history and the lack of awareness of this important hereditary syndrome is the major asset leading to severe underdiagnosis and putting to risk the indexpatients themselves and their families to (metachronous) CRC and the associated extracolonic cancers. If at all tumors of patients fulfilling Bethesda criteria will be analysed for MSI in the surgical specimen and therefore Lynch syndrome patients are not given the opportunity to opt for extended surgery. In clinical experience the postoperative MSI-analysis is inconsistently performed - even if the Bethesda criteria are fulfilled - and in case of suspected Lynch syndrome genetically counselling is not consistently recommended. Therefore affected cancer patients are left unaware of their increased genetic risk and in average 3 high-risk gene carriers per family miss the opportunity to actively engage in the recommended screening program.
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Affiliation(s)
- R Schneider
- Klinik für Visceral-, Thorax- und Gefäßchirurgie, Philipps-Universität Marburg, Deutschland
| | - C Schneider
- Klinik für Allgemein- und Viszeralchirurgie, HELIOS St. Josefs-Hospital, Bochum-Linden, Deutschland
| | - R Büttner
- Institut für Pathologie, Universitätsklinikum Köln, Deutschland
| | - A Reinacher-Schick
- Abteilung für Hämatologie und Onkologie, St. Josef-Hospital der Ruhr-Universität Bochum, Deutschland
| | - A Tannapfel
- Institut für Pathologie, Universitätsklinikum Bochum, Deutschland
| | - A Fürst
- Klinik für Chirurgie, Caritas-Krankenhaus St. Josef, Regensburg, Deutschland
| | - J Rüschoff
- Institut für Pathologie Nordhessen, Kassel, Deutschland
| | - C Jakobeit
- Klinik für Innere Medizin, Gastroenterologie, HELIOS St. Josefs-Hospital, Bochum-Linden, Deutschland
| | - B Royer-Pokora
- Institut für Humangenetik, Heinrich-Heine-Universität Düsseldorf, Deutschland
| | - G Möslein
- Klinik für Allgemein- und Viszeralchirurgie, HELIOS St. Josefs-Hospital, Bochum-Linden, Deutschland
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Frank R, Scheffler M, Michels S, König K, Merkelbach-Bruse S, Serke M, Ko Y, Gerigk U, Geist T, Heukamp L, Büttner R, Wolf J. Occurrence and Characteristics of Keap1-Mutations in Patients with Non-Small Cell Lung Cancer (Nsclc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Michels S, Schultheis A, Scheffler M, Rosner T, Merkelbach-Bruse S, Heukamp L, Engel-Riedel W, Serke M, Krüger S, Benedikter J, Gerigk U, Schulte W, Draube A, Ko Y, Büttner R, Wolf J. Ret Translocation in Adenocarcinoma of the Lung. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Eisert A, Scheffler M, Michels S, Schultheis A, König K, Merkelbach-Bruse S, Serke M, Ko Y, Gerigk U, Geist T, Heukamp L, Büttner R, Wolf J. Genetic Variability and Clinical Presentation of Patients with Non-Small Cell Lung Cancer (Nsclc) Harboring Met-Amplifications. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.95] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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46
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Nogova L, Mattonet C, Scheffler M, Michels S, Bos M, Heukamp L, Schildhaus H, Fuhr U, Eberhardt W, Reis H, Wiesweg M, Schmid K, Schoch G, Serke M, Ko Y, Schuler M, Büttner R, Wolf J. Try - a Phase Ii Study to Evaluate Safety and Efficacy of Combined Trastuzumab and the Hsp90 Inhibitor Auy922 in Advanced Non-Small-Cell Lung Cancer (Nsclc) with Her2 Overexpression or Amplification or Mutation. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu349.17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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47
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Vogel Y, Wolff I, Zienkiewicz T, Büttner R, Schulte W. [A very rare cause of haemoptysis - coexistence of primary oncocytic adenoma of trachea with bronchial carcinoma]. Dtsch Med Wochenschr 2014; 139:1295-8. [PMID: 24892466 DOI: 10.1055/s-0034-1370103] [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: 10/25/2022]
Abstract
HISTORY AND ADMISSION FINDINGS A 70-year-old man with a past history of COPD stage GOLD D with home oxygen therapy and tracheotomy due to long-term ventilation (898 hours) 6 years ago was admitted for investigation of haemoptysis during oral anticoagulation. He suffered from peripheral arterial disease (PAD) with bypass and repeated thrombectomy due to recurrent bypass caps, despite effective warfarin therapy. He had all cardiovascular risk factors. INVESTIGATIONS The suspicion of a bronchial carcinoma was confirmed by CT. Bronchoscopically a 2 cm lesion in the left upper lobe was biopsied. Additionally, bronchoscopy revealed an approximately erythematous, bloody discolored lesion (diameter 7 mm) at a tracheotomy scar. DIAGNOSIS, TREATMENT AND COURSE The biopsies revealed an adenocarcinoma in the left upper lobe and an oncocytic adenoma of the trachea - an extremely rare adenoma. The staging result was cT1b cN0 cM0 G2 IASLC Ia. Because of his severe multiple diseases the patient was in an inoperable condition. An interdisciplinary tumor conference recommended an individualized approach with a definitive radiotherapy of the adenocarcinoma. Endoscopic control of the macroscopically completely removed oncocytic adenoma of the trachea shall be performed one year later. CONCLUSIONS Oncocytoma is an extremely rare adenoma (of the trachea), which in this case, has caused haemoptysis in addition to lung cancer during anticoagulation. For tumor genesis a reactive or hyperplasic response after tracheotomy 6 years ago is considered. Resection is the treatment of choice because of the potential for infiltrative growth. But the decision to treat always depends on individual benefit.
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Affiliation(s)
- Y Vogel
- Medizinische Klinik für Gastroenterologie, Marien-Hospital Euskirchen
| | - I Wolff
- Medizinische Klinik für Gastroenterologie, Marien-Hospital Euskirchen
| | | | - R Büttner
- Institut für Pathologie der Universität Köln
| | - W Schulte
- Medizinische Klinik für Pneumologie, Kardiologie und Allergologie, Malteserkrankenhaus Bonn
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Trautmann M, Sievers E, Aretz S, Kindler D, Michels S, Friedrichs N, Renner M, Kirfel J, Steiner S, Huss S, Koch A, Penzel R, Larsson O, Kawai A, Tanaka S, Sonobe H, Waha A, Schirmacher P, Mechtersheimer G, Wardelmann E, Büttner R, Hartmann W. SS18-SSX fusion protein-induced Wnt/β-catenin signaling is a therapeutic target in synovial sarcoma. Oncogene 2013; 33:5006-16. [PMID: 24166495 DOI: 10.1038/onc.2013.443] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2013] [Revised: 09/11/2013] [Accepted: 09/16/2013] [Indexed: 12/11/2022]
Abstract
Synovial sarcoma is a high-grade soft tissue malignancy characterized by a specific reciprocal translocation t(X;18), which leads to the fusion of the SS18 (SYT) gene to one of three SSX genes (SSX1, SSX2 or SSX4). The resulting chimeric SS18-SSX protein is suggested to act as an oncogenic transcriptional regulator. Despite multimodal therapeutic approaches, metastatic disease is often lethal and the development of novel targeted therapeutic strategies is required. Several expression-profiling studies identified distinct gene expression signatures, implying a consistent role of Wnt/β-catenin signaling in synovial sarcoma tumorigenesis. Here we investigate the functional and therapeutic relevance of Wnt/β-catenin pathway activation in vitro and in vivo. Immunohistochemical analyses of nuclear β-catenin and Wnt downstream targets revealed activation of canonical Wnt signaling in a significant subset of 30 primary synovial sarcoma specimens. Functional aspects of Wnt signaling including dependence of Tcf/β-catenin complex activity on the SS18-SSX fusion proteins were analyzed. Efficient SS18-SSX-dependent activation of the Tcf/β-catenin transcriptional complex was confirmed by TOPflash reporter luciferase assays and immunoblotting. In five human synovial sarcoma cell lines, inhibition of the Tcf/β-catenin protein-protein interaction significantly blocked the canonical Wnt/β-catenin signaling cascade, accompanied by the effective downregulation of Wnt targets (AXIN2, CDC25A, c-MYC, DKK1, CyclinD1 and Survivin) and the specific suppression of cell viability associated with the induction of apoptosis. In SYO-1 synovial sarcoma xenografts, administration of small molecule Tcf/β-catenin complex inhibitors significantly reduced tumor growth, associated with diminished AXIN2 protein levels. In summary, SS18-SSX-induced Wnt/β-catenin signaling appears to be of crucial biological importance in synovial sarcoma tumorigenesis and progression, representing a potential molecular target for the development of novel therapeutic strategies.
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Affiliation(s)
- M Trautmann
- 1] Department of Pathology, University Hospital Cologne, Cologne, Germany [2] Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - E Sievers
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - S Aretz
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - D Kindler
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - S Michels
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - N Friedrichs
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - M Renner
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Kirfel
- Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - S Steiner
- Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - S Huss
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - A Koch
- Department of Neuropathology, Charité-Universitätsmedizin, Berlin, Germany
| | - R Penzel
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - O Larsson
- Departments of Oncology & Pathology, The Karolinska Institute, Stockholm, Sweden
| | - A Kawai
- Division of Orthopaedic Surgery, National Cancer Center Hospital, Tokyo, Japan
| | - S Tanaka
- Laboratory of Molecular & Cellular Pathology, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - H Sonobe
- Department of Laboratory Medicine, Chungoku Central Hospital, Fukuyama, Hiroshima, Japan
| | - A Waha
- Department of Neuropathology, University Hospital Bonn, Bonn, Germany
| | - P Schirmacher
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - G Mechtersheimer
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - E Wardelmann
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - R Büttner
- Department of Pathology, University Hospital Cologne, Cologne, Germany
| | - W Hartmann
- Department of Pathology, University Hospital Cologne, Cologne, Germany
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49
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Vollbrecht C, König K, Heukamp L, Büttner R, Odenthal M. [Molecular pathology of the lungs. New perspectives by next generation sequencing]. Pathologe 2013; 34:16-24. [PMID: 23389825 DOI: 10.1007/s00292-012-1704-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Lung cancer is one of the most frequent malignancies in the western world. Its frequent association with a wide spectrum of mutations in genes encoding various signal transducers that are often linked to therapy response, emphasizes the obvious need for improved, fast and highly efficient approaches in molecular pathology. Comprehensive analyses of the mutation status of progression and therapy relevant genes can be performed by the novel sequencing forms named next generation sequencing (NGS) providing extremely high capacities for ultra-deep sequence analyses. The 454 pyrosequencing method, the sequencing by synthesis and the semiconductor sequencing platform are now available for parallel sequencing approaches of multitudinous target genes linked to multiple tumor DNA applications. The "one molecule, one clone, one read" principle by the NGS approaches supplies not only information on allele frequencies and mutation rates but also has the advantage of a very sensitive detection of low frequency variants.
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Affiliation(s)
- C Vollbrecht
- Institut für Pathologie, Universitätsklinik zu Köln, Kerpener Str. 62, 50924, Köln, Deutschland
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50
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Abstract
Recent advances in the treatment of non-small cell lung cancer (NSCLC) are based on the identification of so-called driver mutations, resulting in a more personalized treatment setting. Currently about 15% of NSCLC patients benefit from improved treatment protocols based on the genetic background of the tumor. In the last few years cancer immunotherapy has returned to the center of attention and comprises a variety of treatment approaches incorporating adaptive, as well as innate immunity. Current strategies involve the use of monoclonal antitumor antibodies, cancer vaccines, adoptive transfer of ex vivo activated T and NK cells as well as the blockade of so-called immune checkpoints (immune inhibitory pathways). Especially the combination of current treatments with immunotherapy seems promising to achieve highly potent antitumor effects. However, a profound understanding of the dynamic and complex interaction between lung cancer and the host immune system and especially its immune checkpoints is the foundation to identify potential biomarkers for a personalized cancer immunotherapy approach.
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Affiliation(s)
- A Schultheis
- Institut für Pathologie, CIO Köln Bonn, Universitätsklinikum Köln, Kerpener Str. 62, 50937, Köln.
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