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Reuthner K, Aubele P, Menhart K, Rath P, Harrer DC, Herr W, Hahn J, Vogelhuber M, Heudobler D, Lueke F, Reichle A, Grube M. Case report: Sustained complete remission with all-oral MEPED therapy in a patient with Hodgkin's disease developing resistance to pembrolizumab. Front Pharmacol 2024; 15:1334233. [PMID: 38444946 PMCID: PMC10912635 DOI: 10.3389/fphar.2024.1334233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/26/2024] [Indexed: 03/07/2024] Open
Abstract
Targeted chemotherapy and immune checkpoint inhibitors (ICPi) have expanded the spectrum of therapies for patients with relapsed/refractory (r/r) Hodgkin's disease and significantly improved the proportion of patients with long-term disease control. However, there is no standardized therapeutic option in case of further progression. Recently, we demonstrated that therapy with MEPED (metronomic chemotherapy, everolimus, pioglitazone, etoricoxib, dexamethasone) is highly effective in patients with r/r Hodgkin's disease. The benefit after pre-treatment with ICPi has not been studied, yet. Here, we report a patient with progressive Hodgkin's disease on Pembrolizumab for the first time who achieved sustained complete remission (CR) after initiation of MEPED therapy. A 57-year-old patient was pre-treated with brentuximab vedotin for relapsed advanced Hodgkin's disease and had received Pembrolizumab for progression from November 2020 to July 2022. Due to further progression, MEPED therapy was started in August 2022 and continued until May 2023. It consisted of a strictly oral daily (28-day cycle) application of low-dose treosulfan 250 mg, everolimus 15 mg, pioglitazone 45 mg, etoricoxib 60 mg, and dexamethasone 0.5 mg. Treatment response was evaluated by F-18 FDG-PET/CT (PET/CT). CR was defined by a negative Deauville score (DS) of 1-3. Already 3 months after starting MEPED, a CR (DS: 3) was confirmed by PET/CT in November 2022. The next follow-up in May 2023 continued to show CR (DS: 3). The therapy was very well tolerated. No hematological or other organ toxicity was observed. However, in May 2023 the patient presented with leg edema and weight gain, most likely due to pioglitazone and the PET/CT revealed suspected everolimus-induced pneumonitis, so MEPED was discontinued and diuretic therapy and treatment with prednisolone was started with gradual dose reduction. This resulted in a rapid complete resolution of the symptoms. The next PET-CT in July 2023 continued to show CR (DS: 3) without evidence of pneumonitis. Currently, therapy with MEPED has not been resumed. In conclusion, we demonstrate for the first time that MEPED therapy is highly effective in a patient with Hodgkin's disease who has been refractory to ICPi. Sustained CR was achieved over 11 months after initiation of MEPED therapy. Further studies on a larger patient cohort should be performed.
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Affiliation(s)
- K. Reuthner
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - P. Aubele
- Medical Care Center (MVZ), Oncology, Hospital of Straubing, Straubing, Germany
| | - K. Menhart
- Department of Nuclear Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - P. Rath
- Department of Nuclear Medicine, University Hospital of Regensburg, Regensburg, Germany
| | - D. C. Harrer
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - W. Herr
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - J. Hahn
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - M. Vogelhuber
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - D. Heudobler
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
- Bavarian Cancer Research Center (BZKF), University Hospital Regensburg, Regensburg, Germany
| | - F. Lueke
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
- Division of Personalized Tumor Therapy, Fraunhofer Institute for Toxicology and Experimental Medicine, Regensburg, Germany
| | - A. Reichle
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - M. Grube
- Department of Internal Medicine III, Hematology and Oncology, University Hospital of Regensburg, Regensburg, Germany
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Rasim K, Suttner S, Vogelhuber M, Herr W, Gessner A, Seelbach-Goebel B, Reuschel E. Epstein-Barr-Virus (EBV)-assoziiertes Burkitt-Lymphom in der Schwangerschaft. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Rasim
- Lehrstuhl der Universität Regensburg für Gynäkologie und Geburtshilfe, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder
| | - S Suttner
- Lehrstuhl der Universität Regensburg für Gynäkologie und Geburtshilfe, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder
| | - M Vogelhuber
- Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Medizin III
| | - W Herr
- Universitätsklinikum Regensburg, Klinik und Poliklinik für Innere Medizin III
| | - A Gessner
- Institut für Mikrobiologie und Hygiene der Universitätsklinik Regensburg
| | - B Seelbach-Goebel
- Lehrstuhl der Universität Regensburg für Gynäkologie und Geburtshilfe, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder
| | - E. Reuschel
- Lehrstuhl der Universität Regensburg für Gynäkologie und Geburtshilfe, Klinik St. Hedwig, Krankenhaus der Barmherzigen Brüder
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Heudobler D, Schulz C, Fischer J, Staib P, Wehler T, Südhoff T, Schichtl T, Wilke J, Hahn J, Lüke F, Vogelhuber M, Klobuch S, Pukrop T, Herr W, Held S, Beckers K, Bouche G, Reichle A. Pioglitazone and clarithromycin combined with metronomic low-dose chemotherapy versus nivolumab in patients with advanced non-small cell lung cancer treated in 2nd-line and beyond: Outcomes from a randomized phase II trial (ModuLung). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz260.092] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Utpatel K, Calvisi DF, Köhler G, Kühnel T, Niesel A, Verloh N, Vogelhuber M, Neu R, Hosten N, Schildhaus HU, Dietmaier W, Evert M. [Erratum to: Complexity of PEComas : Diagnostic approach, molecular background, clinical management]. Pathologe 2019; 40:454. [PMID: 31263908 DOI: 10.1007/s00292-019-0636-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- K Utpatel
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - D F Calvisi
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - G Köhler
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsmedizin Greifswald, Greifswald, Deutschland
| | - T Kühnel
- Abteilung für Hals-Nasen-Ohren-Heilkunde, Universität Regensburg, Regensburg, Deutschland
| | - A Niesel
- Abteilung für Gynäkologie, Krankenhaus Preetz, Preetz, Deutschland
| | - N Verloh
- Abteilung für Radiologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - M Vogelhuber
- Klinik für Hämatologie und internistische Onkologie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - R Neu
- Abteilung für Thoraxchirurgie, Universitätsklinikum Regensburg, Regensburg, Deutschland
| | - N Hosten
- Radiologische Abteilung, Universitätsklinikum Greifswald, Greifswald, Deutschland
| | - H-U Schildhaus
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Deutschland
| | - W Dietmaier
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - M Evert
- Institut für Pathologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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Pankrath AL, Weißflog G, Mehnert A, Niederwieser D, Döhner H, Hönig K, Gündel H, Vogelhuber M, Friedrich M, Ernst J. The relation between dyadic coping and relationship satisfaction in couples dealing with haematological cancer. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12595] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2016] [Indexed: 11/29/2022]
Affiliation(s)
- A.-L. Pankrath
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - G. Weißflog
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - A. Mehnert
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - D. Niederwieser
- Department of Haematology and Medical Oncology; University Hospital Leipzig; Leipzig Germany
| | - H. Döhner
- Department of Internal Medicine III; University of Ulm; Ulm Germany
| | - K. Hönig
- Clinic of Psychosomatic Medicine and Psychotherapy; University of Ulm; Ulm Germany
| | - H. Gündel
- Clinic of Psychosomatic Medicine and Psychotherapy; University of Ulm; Ulm Germany
| | - M. Vogelhuber
- Department of Internal Medicine III; University Medical Centre Regensburg; Regensburg Germany
| | - M. Friedrich
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - J. Ernst
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
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Hart C, Vogelhuber M, Hafner C, Landthaler M, Berneburg M, Haferkamp S, Herr W, Reichle A. Biomodulatory metronomic therapy in stage IV melanoma is well-tolerated and may induce prolonged progression-free survival, a phase I trial. J Eur Acad Dermatol Venereol 2015; 30:e119-e121. [PMID: 26417987 PMCID: PMC5108438 DOI: 10.1111/jdv.13391] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- C Hart
- Department of Internal Medicine III, Haematology & Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - M Vogelhuber
- Department of Internal Medicine III, Haematology & Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - C Hafner
- Department of Dermatology, University Hospital of Regensburg, Regensburg, Germany
| | - M Landthaler
- Department of Dermatology, University Hospital of Regensburg, Regensburg, Germany
| | - M Berneburg
- Department of Dermatology, University Hospital of Regensburg, Regensburg, Germany
| | - S Haferkamp
- Department of Dermatology, University Hospital of Regensburg, Regensburg, Germany
| | - W Herr
- Department of Internal Medicine III, Haematology & Oncology, University Hospital of Regensburg, Regensburg, Germany
| | - A Reichle
- Department of Internal Medicine III, Haematology & Oncology, University Hospital of Regensburg, Regensburg, Germany.
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Vogelhuber M, Feyerabend S, Stenzl A, Suedhoff T, Schulze M, Huebner J, Oberneder R, Wieland W, Mueller S, Eichhorn F, Heinzer H, Schmidt K, Baier M, Ruebel A, Birkholz K, Bakhshandeh-Bath A, Andreesen R, Herr W, Reichle A. Erratum to: Biomodulatory Treatment of Patients with Castration-Resistant Prostate Cancer: A Phase II Study of Imatinib with Pioglitazone, Etoricoxib, Dexamethasone and Low-Dose Treosulfan. Cancer Microenviron 2015; 8:43-4. [PMID: 25651886 DOI: 10.1007/s12307-015-0165-y] [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] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- M Vogelhuber
- Department of Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Germany
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Vogelhuber M, Feyerabend S, Stenzl A, Suedhoff T, Schulze M, Huebner J, Oberneder R, Wieland W, Mueller S, Eichhorn F, Heinzer H, Schmidt K, Baier M, Ruebel A, Birkholz K, Bakhshandeh-Bath A, Andreesen R, Herr W, Reichle A. Biomodulatory Treatment of Patients with Castration-Resistant Prostate Cancer: A Phase II Study of Imatinib with Pioglitazone, Etoricoxib, Dexamethasone and Low-Dose Treosulfan. Cancer Microenviron 2014; 8:33-41. [PMID: 25503648 PMCID: PMC4449347 DOI: 10.1007/s12307-014-0161-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 10/24/2014] [Indexed: 11/25/2022]
Abstract
Therapeutic options for patients with castration-resistant prostate cancer (CRPC) remain limited. In a multicenter, Phase II study, 65 patients with histologically confirmed CRPC received a biomodulatory regimen during the six-month core study. Treatment comprised daily doses of imatinib mesylate, pioglitazone, etoricoxib, treosulfan and dexamethasone. The primary endpoint was prostate-specific antigen (PSA) response. Responders could enter an extension phase until disease progression or intolerable toxicity occurred. Mean PSA was 45.3 ng/mL at baseline, and 77 % of patients had a PSA doubling time <3 months. Of the 61 evaluable patients, 37 patients (60.6 %) responded or had stable disease and 23 of them (37.7 % of 61 patients) were PSA responders. Among the 23 responders mean PSA decreased from 278.9 ± 784.1 ng/mL at baseline to 8.8 ± 11.6 ng/mL at the final visit (week 24). The progression-free survival (PFS) was 467 days in the ITT population. Of the 947 adverse events, 57.6 % were suspected to be drug-related, 13.8 % led to dose adjustment or permanent discontinuation and 40.2 % required concomitant medication. This novel combination approach led to an impressive PSA response rate of 37.7 % in CRPC patients. The good PSA response and PFS rate combined with the manageable toxicity profile suggest an alternative treatment option.
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Affiliation(s)
- M. Vogelhuber
- Department of Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - S. Feyerabend
- Department of Urology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
| | - A. Stenzl
- Department of Urology, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen, Germany
| | - T. Suedhoff
- Department of Hematology and Oncology, Hospital Passau, Innstrasse 76, 94032 Passau, Germany
| | - M. Schulze
- Outpatient Center for Urology and Oncology, Hauptstrasse 10, 04416 Markkleeberg, Germany
| | - J. Huebner
- Department of Oncology, J. W. Goethe University, Theodor-Stern-Kai 7, 60323 Frankfurt, Germany
| | - R. Oberneder
- Urologic Hospital München-Planegg, Germeringer Str. 32, 82152 Planegg, Germany
| | - W. Wieland
- Department of Urology, Hospital St. Josef, University Regensburg, Landshuter Strasse 65, 93053 Regensburg, Germany
| | - S. Mueller
- Department of Urology, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany
| | - F. Eichhorn
- Outpatient Center, Rinckstrasse 7-9, 83435 Bad Reichenhall, Germany
| | - H. Heinzer
- Martini-Clinic at University Hospital Hamburg-Eppendorf, Martinistrasse 52, 20246 Hamburg, Germany
| | - K. Schmidt
- Novartis Pharma GmbH, Roonstrasse 25, 90429 Nuernberg, Germany
| | - M. Baier
- Novartis Pharma GmbH, Roonstrasse 25, 90429 Nuernberg, Germany
| | - A. Ruebel
- Novartis Pharma GmbH, Roonstrasse 25, 90429 Nuernberg, Germany
| | - K. Birkholz
- Novartis Pharma GmbH, Roonstrasse 25, 90429 Nuernberg, Germany
| | - A. Bakhshandeh-Bath
- Outpatient Center for Medical Oncology, Waitzstrasse 22, 22607 Hamburg, Germany
| | - R. Andreesen
- Department of Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - W. Herr
- Department of Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
| | - A. Reichle
- Department of Hematology and Oncology, University Hospital Regensburg, Franz-Josef-Strauß-Allee 11, 93053 Regensburg, Germany
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Walter B, Schrettenbrunner I, Vogelhuber M, Grassinger J, Bross K, Wilke J, Suedhoff T, Berand A, Wieland WF, Rogenhofer S, Andreesen R, Reichle A. Pioglitazone, etoricoxib, interferon-α, and metronomic capecitabine for metastatic renal cell carcinoma: final results of a prospective phase II trial. Med Oncol 2011; 29:799-805. [DOI: 10.1007/s12032-011-9982-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2010] [Accepted: 05/09/2011] [Indexed: 11/30/2022]
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Reichle A, Vogelhuber M, Feyerabend S, Suedhoff T, Schulze M, Hubner J, Oberneder R, Baier M, Ruebel A, Birkholz K, Bakhshandeh-Bath A, Andreesen R. A phase II study of imatinib with pioglitazone, etoricoxib, dexamethasone, and low-dose treosulfan: Combined anti-inflammatory, immunomodulatory, and angiostatic treatment in patients (pts) with castration-refractory prostate cancer (CRPC). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.4599] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Walter B, Rogenhofer S, Vogelhuber M, Berand A, Wieland WF, Andreesen R, Reichle A. Modular therapy approach in metastatic castration-refractory prostate cancer. World J Urol 2010; 28:745-50. [DOI: 10.1007/s00345-010-0567-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 05/03/2010] [Indexed: 12/20/2022] Open
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Reichle A, Lugner A, Ott C, Klebl F, Vogelhuber M, Berand A, Andreesen R. Control of cancer-associated inflammation and survival: Results from a prospective randomized phase II trial in gastric cancer. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.e15584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e15584 Background: An angiostatic approach was used to assess the impact of anti-inflammatory therapy in combination with metronomic low-dose chemotherapy. Methods: A randomized multi-institutional phase II trial was designed to select metronomic chemotherapy (arm A: capecitabine 1 g orally twice daily for 14 days with one week break until tumor progression) or combined anti-inflammatory/angiostatic treatment (arm B: capecitabine as mentioned above plus etoricoxib 60 mg orally, day 1+, and pioglitazone 60 mg orally, day 1+) for further evaluation. Patients with refractory or progressive disease following any first-line therapy except capecitabine or frail were eligible. According to the one stage design, a sample size of 64 patients was calculated for the primary objective, improvement of response rate. Results: As similar response rates were observed (arm A/B 15/14%) after the accrual of 42 patients, the study was closed (n=20 (A), n=22 (B); median age 69 years (range 46 to 86ys); frail A/B n=9/11). Median progression- free survival for arm A/B was 3.0/2.9 months (P=0.878), and overall survival 5.0/6.1 months (P=0.778). In both treatment arms a significant decline of serum C-reactive protein (CRP) levels was observed within the first 4 to 6 weeks on treatment, A/B P= 0.01/0.04, respectively. CRP response > 50% from baseline was associated with a significantly improved overall survival in arm A/B (3.1 versus 11.0 months, P= 0.023/ 3.3 versus 7.1 months, P= 0.078) indicating an impact of inflammation-control on survival. WHO grade 3 (no grade 4) toxicities were reported in arm A/B in 20% and 23%, respectively, mostly due to hand-foot-syndrome. Conclusions: Metronomic low- dose chemotherapy in gastric cancer may induce anti-inflammatory response, but the chosen additional anti-inflammatory approach neither has impact on tumor-associated inflammation nor on response or survival rate. In a historical comparison, CRP-responder have similar outcome as patients treated with combination chemotherapy in first-line. No significant financial relationships to disclose.
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Affiliation(s)
- A. Reichle
- University Hospital of Regensburg, Regensburg, Germany
| | - A. Lugner
- University Hospital of Regensburg, Regensburg, Germany
| | - C. Ott
- University Hospital of Regensburg, Regensburg, Germany
| | - F. Klebl
- University Hospital of Regensburg, Regensburg, Germany
| | - M. Vogelhuber
- University Hospital of Regensburg, Regensburg, Germany
| | - A. Berand
- University Hospital of Regensburg, Regensburg, Germany
| | - R. Andreesen
- University Hospital of Regensburg, Regensburg, Germany
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Reichle A, Walpinski S, Vogelhuber M, Wiedmann K, Berand A, Endlicher E, Klebl F, Schölmerich J, Andreesen R, Wiest R. Targeted anti-inflammatory and angiostatic therapy in pretreated patients with advanced hepatocellular carcinoma. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Vogelhuber M, Georgi J, Rüschoff J, Lenner A, Lang B, Schott G, Menninger H. Aktive Polymyositis mit nur grenzwertiger Kreatinkinaseerhöhung bei Überlappungssyndrom. AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043715] [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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Vogelhuber M, Georgi J, Landthaler M, Menninger H. Die idiopathische Osteolyse (Gorham-Stout) mit Gelenkbeteiligung? AKTUEL RHEUMATOL 2008. [DOI: 10.1055/s-2008-1043682] [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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Reichle A, Walter B, Berand A, Vogelhuber M, Bross K, Wilke J, Wieland W, Andreesen R, Rogenhofer S. Induction of complete remission in metastatic hormone-refractory prostate cancer: A combined anti-inflammatory therapy approach. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.15636] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
15636 Background: The present multi-centre phase II study was designed to support the hypothesis that networking agents binding to ubiquitous accessible targets in metastatic hormone-refractory prostate cancer (HRPC) may counteract neoplasia-specific aberrant cellular functions, thereby mediating objective response (primary endpoint). Method: Patients with metastatic HRPC, received both an anti- inflammatory and angiostatic therapy consisting of low-dose chemotherapy with capecitabine 1 g twice daily for 14 days every 3 weeks, day 15+, COX-2 blockade with etoricoxib 60 mg daily, day 1+, combined with two transcription modulators, pioglitazone 60 mg daily, day 1+, plus dexamethason 1 mg daily for 14 days, every 3 weeks, day 15+, until disease progression. The study was planned using the Simon optimal design. Results: Thirty-six consecutive patients (N= 22 (61%) chemo-naive, n= 14 (39%) with preceding chemotherapies, mean 2.1 regimen) with metastatic HRPC, confirmed PSA increase, assessable response, and ECOG 0–2 were enrolled between 1/03 to 5/06. Objective response occurred in 10 of 13 cases (N/n: 41%/7%) with PSA (and C-reactive protein) response >50% (N/n: 45%/21%). Median time to PSA response was 2.4 months (range 1.0 to 7.3 months). Two of three patients responding with PSA <4 ng/ml achieved complete remission after 9 and 16 months, 16 patients stable disease (N/n: 41%/64%), and 5 patients experienced progressive disease (N/n: 14%/14%). Median progression-free survival (PFS) was 3.6 months (range 0.5 to 28.5) and median overall survival (OS) 14.4 months (range 0.6 to 37.2). Multivariate analysis recognized pre-treatment with chemotherapy as negative predictor for both OS (hazard ratio 2.26 (CI 95%: 0.970; 5.277), p=0.05) and PFS (HR 2.47 (CI 95%: 1.146; 5.348), p= 0.02), and <50% PSA response as negative predictor for PFS (HR 0.38 (CI 95%: 0.171; 0.857), p= 0.01). Toxicities > WHO grade II were reported: Hand-foot syndrome (n=1), anemia (n=6), edema (n=1), cushing syndrome (n=1), hydronephrosis (n=1). Conclusions: This is the first study reporting continuous complete remissions in HRPC with a biomodulatory therapy approach. Further, the study may clinically support the upper mentioned hypothesis. No significant financial relationships to disclose.
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Affiliation(s)
- A. Reichle
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - B. Walter
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - A. Berand
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - M. Vogelhuber
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - K. Bross
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - J. Wilke
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - W. Wieland
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - R. Andreesen
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
| | - S. Rogenhofer
- University of Regensburg, Regensburg, Germany; University Hospital of Regensburg, Regensburg, Germany; Hospital of Fuerth, Fuerth, Germany
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