1
|
Houben J, Janssens M, Winkler C, Besser REJ, Dzygalo K, Fehn A, Hommel A, Lange K, Elding Larsson H, Lundgren M, Roloff F, Snape M, Szypowska A, Weiss A, Zapardiel-Gonzalo J, Zubizarreta N, Ziegler AG, Casteels K, Arnolds S, Bißbort M, Blasius K, Friedl N, Gezginci C, Göppel G, Heigermoser M, Höfelschweiger B, Jolink M, Kisfügedi K, Klein N, Lickert R, Matzke C, Alvarez KM, Niewöhner R, Scholz M, Schütte‐Borkovec K, Voß F, Weiß A, Gonzalo JMZ, Schmidt S, Sifft P, Kapfelsberger H, Vurucu M, Sarcletti K, Sporreiter M, Jacobson S, Zeller I, Warncke K, Bonifacio E, Lernmark Å, Todd JA, Achenbach P, Bonficio E, Larsson HE, Ziegler AG, Achenbach P, Schütte‐Borkovec K, Ziegler AG, Casteels K, Jannsen C, Rochtus A, Jacobs A, Morobé H, Paulus J, Vrancken B, Van den Driessche N, Van Heyste R, Houben J, Smets L, Vanhuyse V, Bonifacio E, Berner R, Arabi S, Blechschmidt R, Dietz S, Gemulla G, Gholizadeh Z, Heinke S, Hoffmann R, Hommel A, Lange F, Loff A, Morgenstern R, Ehrlich F, Loff A, Weigelt M, Zubizarreta N, Kordonouri O, Danne T, Galuschka L, Holtkamp U, Janzen N, Kruse C, Landsberg S, Lange K, Marquardt E, Reschke F, Roloff F, Semler K, von dem Berge T, Weiskorn J, Ziegler AG, Achenbach P, Bunk M, Färber‐Meisterjahn S, Grätz W, Greif I, Herbst M, Hofelich A, Kaiser M, Kaltenecker H, Karapinar E, Kölln A, Marcus B, Munzinger A, Ohli J, Ramminger C, Reinmüller F, Vollmuth V, Welzhofer T, Winkler C, Szypowska A, Ołtarzewski M, Dybkowska S, Dżygało K, Groele L, Kajak K, Owczarek D, Piechowiak K, Popko K, Skrobot A, Szpakowski R, Taczanowska A, Zduńczyk B, Zych A, Larsson HE, Lundgren M, Lernmark Å, Agardh D, Mortin SA, Aronsson CA, Bennet R, Brundin C, Dahlberg S, Fransson L, Jonsdottir B, Jönsson I, Maroufkhani S, Mestan Z, Nilsson C, Ramelius A, Amboh ET, Törn C, Ulvendag U, Way S, Snape M, Todd JA, Haddock G, Bendor‐Samuel O, Bland J, Choi E, Craik R, Davis K, Hawkins S, de la Horra A, Farooq Y, Scudder C, Smith I, Roseman F, Robinson H, Taj N, Vatish M, Willis L, Whelan C, Wishlade T. The emotional well-being of parents with children at genetic risk for type 1 diabetes before and during participation in the POInT-study. Pediatr Diabetes 2022; 23:1707-1716. [PMID: 36323590 DOI: 10.1111/pedi.13448] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION This study examined the emotional impact that parents experience when confronted with an increased genetic risk of type 1 diabetes (T1D) in their child. Population-based screening of neonates for genetic risk of chronic disease carries the risk of increased emotional burden for parents. METHODS Information was collected using a well-being questionnaire for parents of infants identified as having an increased risk for T1D in a multinational research study. Parents were asked to complete this questionnaire after they were told their child had an increased risk for T1D (Freder1k-study) and at several time points during an intervention study (POInT-study), where oral insulin was administered daily. RESULTS Data were collected from 2595 parents of 1371 children across five countries. Panic-related anxiety symptoms were reported by only 4.9% after hearing about their child having an increased risk. Symptoms of depression were limited to 19.4% of the parents at the result-communication visit and declined over time during the intervention study. When thinking about their child's risk for developing T1D (disease-specific anxiety), 47.2% worried, felt nervous and tense. Mothers and parents with a first-degree relative (FDR) with T1D reported more symptoms of depression and disease-specific anxiety (p < 0.001) than fathers and parents without a FDR. CONCLUSION Overall, symptoms of depression and panic-related anxiety are comparable with the German population. When asked about their child's risk for T1D during the intervention study, some parents reported disease-specific anxiety, which should be kept in mind when considering population-based screening. As certain subgroups are more prone, it will be important to continue psychological screening and, when necessary, to provide support by an experienced, multidisciplinary team.
Collapse
Affiliation(s)
- Janne Houben
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Martha Janssens
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Christiane Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Rachel Elizabeth Jane Besser
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | - Katarzyna Dzygalo
- Department of Pediatrics, Medical University of Warsaw, Warsaw, Poland
| | - Annika Fehn
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Angela Hommel
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karin Lange
- Medical Psychology Unit, Hannover Medical School, Hannover, Germany
| | - Helena Elding Larsson
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Pediatrics, Skåne University Hospital, Malmö, Sweden
| | - Markus Lundgren
- Unit for Pediatric Endocrinology, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of pediatrics, Kristianstad Hospital, Kristianstad, Sweden
| | - Frank Roloff
- Diabetes Center for Children and Adolescents, Children's Hospital AUF DER BULT, Hannover, Germany
| | - Matthew Snape
- Department of pediatrics, University of Oxford, Oxford, UK.,NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Trust, Oxford, UK
| | | | - Andreas Weiss
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Jose Zapardiel-Gonzalo
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany
| | - Nicole Zubizarreta
- Department of Pediatrics, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Anette-Gabriele Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich, Germany.,Forschergruppe Diabetes, Technische University Munich, Munich, Germany
| | - Kristina Casteels
- Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
2
|
Schmidt M, Rüttinger D, Sebastian M, Hanusch CA, Marschner N, Baeuerle PA, Wolf A, Göppel G, Oruzio D, Schlimok G, Steger GG, Wolf C, Eiermann W, Lang A, Schuler M. Phase IB study of the EpCAM antibody adecatumumab combined with docetaxel in patients with EpCAM-positive relapsed or refractory advanced-stage breast cancer. Ann Oncol 2012; 23:2306-2313. [PMID: 22357251 DOI: 10.1093/annonc/mdr625] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Targeted therapy options in HER2-negative breast cancer are limited. This open-label, multicenter phase IB dose-escalation trial was conducted to determine safety, tolerability, and antitumor activity of a combination of docetaxel (Taxotere) and increasing doses of adecatumumab, a human IgG1 antibody targeting epithelial cell adhesion molecule (EpCAM), in EpCAM-positive relapsed or primary refractory advanced-stage breast cancer. PATIENTS AND METHODS Patients pretreated with up to four prior chemotherapy regimens received increasing adecatumumab doses either every 3 weeks (q3w) or weekly (qw) combined with docetaxel (100 mg/m(2) q3w). Primary end points were safety and tolerability. Antitumor activity was evaluated according to RECIST. Clinical benefit was defined as complete or partial response or stable disease for ≥24 weeks. RESULTS Thirty-one evaluable patients were treated. Most adverse events were mild to moderate in severity. Neutropenia, leukocytopenia, lymphopenia, and diarrhea (dose-limiting) were the most frequent toxic effects. Maximum tolerated doses of adecatumumab given in combination with docetaxel were 550 mg/m(2) q3w and 360 mg/m(2) qw. Clinical benefit was observed in 44% of patients treated with q3w adecatumumab and docetaxel, increasing to 63% in patients with high EpCAM-expressing tumors. CONCLUSION Combination therapy of adecatumumab and docetaxel is safe, feasible, and potentially active in heavily pretreated advanced-stage breast cancer.
Collapse
Affiliation(s)
- M Schmidt
- Department of Obstetrics and Gynecology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - D Rüttinger
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - M Sebastian
- Department of Internal Medicine III, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | | | - N Marschner
- Practice for Oncology and Hematology, Freiburg
| | - P A Baeuerle
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - A Wolf
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - G Göppel
- Micromet, Inc., Bethesda, USA; Micromet AG, Munich
| | - D Oruzio
- Hospital Augsburg, II. Medical Center, Augsburg, Germany
| | - G Schlimok
- Hospital Augsburg, II. Medical Center, Augsburg, Germany
| | - G G Steger
- Medical University Vienna, Department of Oncology, Vienna, Austria
| | - C Wolf
- Cooperative Breast Center, Ulm, Germany
| | - W Eiermann
- Gynecological Hospital Red Cross, Munich
| | - A Lang
- State Hospital Feldkirch at State Hospital Rankweil, Rankweil, Austria
| | - M Schuler
- Department of Medical Oncology, West German Cancer Center, University Duisburg-Essen, Essen, Germany.
| |
Collapse
|