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Hepp P, Tesch H, Forstbauer H, Rezai M, Beck T, Schrader I, Kleine-Tebbe A, Hucke J, Finas D, Soeling U, Zahm DM, Weiss E, Beckmann MW, Janni W, Rack B. Abstract P2-10-25: Prognostic value of relative change in tumor marker CA 27.29 in early stage breast cancer – The SUCCESS trial. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p2-10-25] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: MUC1 based tumor markers like CA27.29 (TM) in breast cancer are routinely used in metastatic disease as early marker for treatment efficacy. However, in early stage disease data is sparse. In this analysis, we looked at the impact of individual change in CA27.29 on prognosis instead of using a threshold.
Methods: The SUCCESS Trial compares FEC-docetaxel (Doc) vs. FEC-Doc-Gemcitabine (Doc-G) regime and two vs. five year treatment with Zoledronat in 3754 patients (pts) with primary breast cancer (N+ or high risk N0). We measured CA27.29 after surgery but before chemotherapy (CHT) as baseline and compared it to CA27.29 levels 2 years thereafter with the ST AIA-PACK Ca27.29 reagent using MUC-1 for AIA-600II (Tosoh Bioscience, Tessenderlo, Belgium).
Results: CA27.29 data is available of 2,015 pts. 119 pts (5.9%) had TM over the threshold of 32U/ml before CHT and 56 (2.8%) 2years thereafter. To examine the relative change of tumor marker, pts were divided into 3 groups:
increase: change >=5 U/ml; stable: change <±5U/ml; decrease: change > = −5 U/ml.
123 (6.1%) pts had increasing (>=5 U/ml), 1419 (70.4%) had stable, 473 (23.5%) had decreasing TM levels from before CHT to 2 years thereafter. The majority of pts with increasing TM (86 pts; 69.9%) had levels below the usual threshold of 32U/ml at all times. Patients with an increase >=5 U/ml had an 81% increased risk for recurrence (HR = 1.810 [CI: 1.111–2.948]) and reduced overall survival (HR = 1.020 [CI: 1.004–1.037]). In the multivariate analysis taking into account tumor size, nodal status, grading, age, hormonal and HER2/neu receptor status increasing CA27.29 levels were an independent prognostic marker.
Conclusions: An increase of the tumor marker CA27.29 2 years after CHT compared to pre-chemotherapy baseline was associated with a worse prognosis. By using this approach, more patients at risk for recurrence were detected than with the standard threshold approach. Therefore, the use of relative change could help to identify more patients at risk for relapse who might benefit from an intensified follow up.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-10-25.
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Affiliation(s)
- P Hepp
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - H Tesch
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - H Forstbauer
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - M Rezai
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - T Beck
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - I Schrader
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - A Kleine-Tebbe
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - J Hucke
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - D Finas
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - U Soeling
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - D-M Zahm
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - E Weiss
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - MW Beckmann
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - W Janni
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
| | - B Rack
- University Düsseldorf; Praxis Prof. Tesch Frankfurt; Gemeinschaftspraxis Dr. Forstbauer & Dr. Ziske Troisdorf; Luisenkrankenhaus Düsseldorf; Städtisches Klinikum Rosenheim; Henriettenstiftung Krankenhaus Hannover; DRK Kliniken Berlin Köpenick; Bethesda Krankenhaus Wuppertal; Universitätsklinikum Schleswig-Holstein, Campus Lübeck; Gemeinschaftspraxis Siehl & Söling; SRH Wald-Klinikum Gera; Klinikum Sindelfingen-Böblingen; Universitätsfrauenklinik Erlangen; Universitätsfrauenklinik Munich
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von Minckwitz G, Rezai M, Loibl S, Fasching PA, Huober J, Tesch H, Bauerfeind I, Hilfrich J, Eidtmann H, Gerber B, Hanusch C, Blohmer JU, Costa SD, Jackisch C, Paepke S, Schneeweiss A, Kuemmel S, Denkert C, Mehta K, Untch M. Abstract P1-14-01: Adding capecitabine and trastuzumab to neoadjuvant breast cancer chemotherapy - first survival analysis of the GBG/AGO intergroup-study GeparQuattro. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p1-14-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Previous results of the GeparQuattro study demonstrated that adding capecitabine either simultaneously or sequentially to EC-Docetaxel (D) neoadjuvant chemotherapy could not increase pathological complete response rates (pCR) (von Minckwitz G, JCO 2010). However, patients with HER2-positive disease treated simultaneously with trastuzumab showed a significant higher pCR rate than patients with HER2-negative disease treated with chemotherapy alone (Untch M, JCO 2010). We here report survival after a median follow up of 58 months including 279 relapses and 191 deaths.
Patients and methods: Patients with either large operable (cT3) and locally advanced (cT4) tumors, or hormone-receptor (HR)-negative receptor status, or HR-positive tumors but clinically node-positive disease were recruited to receive 4 cycles of EC (90mg/m2/600mg/m2) and randomized to either 4 cycles of D (100mg/m2) or 4 cycles of DX (75mg/m2/1800mg/m2) or 4 cycles of D (75mg/m2) followed by 4 cycles of X (1800mg/m2) (D→X). Patients with HER-2 positive tumors received 1 year of trastuzumab, the first part concurrent to all chemotherapy cycles. All patients with HR+ tumors received endocrine therapy according to current standard. The intent-to-treat survival analysis included 1421 patients for the chemotherapy question and 1495 patients for the trastuzumab question. Analyses were adjusted by age, stage, size, nodal status, histologic type, grade, hormone-receptor (HR) and HER2-status at baseline (if applicable).
Results: No difference in DFS and OS was seen for patients receiving D, DX or D-X overall (hazard ratio 0.978, p = 0.984 and hazard ratio 0.986, p = 0.684, respectively) as well as by phenotype defined according to St. Gallen (all P>0.354).
Patients with HER2-positive disease treated additionally with trastuzumab showed significantly better OS (p = 0.015) compared to patients with HER2-negative disease treated with chemotherapy alone. DFS was significantly better for trastuzumab-treated patients with HR-negative tumors (p = 0.046), but not with HR-positive tumors (p = 0.790). OS after first relapse was significantly better in trastuzumab-retreated patients with HER2-positive tumors (p = 0.032) compared to relapsed patients with HER2-negative tumors.
Patients with an early response after 4 cycles, with a clinical response at surgery and with a pCR showed a significantly better DFS and OS compared to patients without pCR (p = 0.022, P < 0.0001, P < 0.0001). This benefit was most prominent in patients with triple-negative tumors.
Conclusions: Survival analysis of the GeparQuattro study confirmed the results of the primary endpoint analysis on pCR. Capecitabine could not improve outcome when added to anthracycline-taxane-based chemotherapy. As suggested by a recent integrated multi-level meta-analysis (von Minckwitz, BCRT 2011) effect of capecitabine could not be properly assessed in this study as planned docetaxel doses in arms DX and D®X were lower than in arm D. Survival of HER-2 positive patients surmounts that of HER2-negative patients if trastuzumab is used in the neoadjuvant as well as in the metastatic setting.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P1-14-01.
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Affiliation(s)
- G von Minckwitz
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - M Rezai
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - S Loibl
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - PA Fasching
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - J Huober
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - H Tesch
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - I Bauerfeind
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - J Hilfrich
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - H Eidtmann
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - B Gerber
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - C Hanusch
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - J-U Blohmer
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - S-D Costa
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - C Jackisch
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - S Paepke
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - A Schneeweiss
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - S Kuemmel
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - C Denkert
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - K Mehta
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
| | - M Untch
- German Breast Group, Neu-Isenburg; Louisenkrankenhaus Düsseldorf; University Erlangen; University Duesseldorf; Bethanien-Kankenhaus Frankfurt; Klinikum Landshut; Eilenriedeklinik Duesseldorf; University Kiel; University Rostock; Roteskreuzklinikum Muenchen; Sankt Gertrauden Berlin; University Magdeburg; Klinikum Offenbach; Frauenklinik München; University Heidelberg; Kliniken Essen Mitte; Charite Berlin; Helios Kliniken Berlin
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Eiermann W, Rezai M, Kümmel S, Kühn T, Warm M, Friedrichs K, Schneeweiss A, Markmann S, Eggemann H, Hilfrich J, Jackisch C, Witzel I, Eidtmann H, Bachinger A, Hell S, Blohmer J. The 21-gene recurrence score assay impacts adjuvant therapy recommendations for ER-positive, node-negative and node-positive early breast cancer resulting in a risk-adapted change in chemotherapy use. Ann Oncol 2012; 24:618-24. [PMID: 23136233 PMCID: PMC3574549 DOI: 10.1093/annonc/mds512] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [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: 12/29/2022] Open
Abstract
Background We carried out a prospective clinical study to evaluate the impact of the Recurrence Score (RS) on treatment decisions in early breast cancer (EBC). Patients and methods A total of 379 eligible women with estrogen receptor positive (ER+), HER2-negative EBC and 0–3 positive lymph nodes were enrolled. Treatment recommendations, patients' decisional conflict, physicians' confidence before and after knowledge of the RS and actual treatment data were recorded. Results Of the 366 assessable patients 244 were node negative (N0) and 122 node positive (N+). Treatment recommendations changed in 33% of all patients (N0 30%, N+ 39%). In 38% of all patients (N0 39%, N+ 37%) with an initial recommendation for chemoendocrine therapy, the post-RS recommendation changed to endocrine therapy, in 25% (N0 22%, N+ 39%) with an initial recommendation for endocrine therapy only to combined chemoendocrine therapy, respectively. A patients' decisional conflict score improved by 6% (P = 0.028) and physicians' confidence increased in 45% (P < 0.001) of all cases. Overall, 33% (N0 29%, N+ 38%) of fewer patients actually received chemotherapy as compared with patients recommended chemotherapy pre-test. Using the test was cost-saving versus current clinical practice. Conclusion RS-guided chemotherapy decision-making resulted in a substantial modification of adjuvant chemotherapy usage in node-negative and node-positive ER+ EBC.
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Affiliation(s)
- W Eiermann
- Interdisciplinary Oncology Center, Munich.
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Nestle-Krämling C, Haack S, Rezai M, Janni W, Budach W, Boelke E. Bevacizumab in der Brustkrebstherapie – Management schwerer Wundheilungsstörungen. Geburtshilfe Frauenheilkd 2012. [DOI: 10.1055/s-0032-1329439] [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: 10/27/2022] Open
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Kraemer S, Malter W, Roethlisberger M, Ludwig S, Mallmann P, Rezai M. 597 Partial Mastectomy Reconstruction During Breast-conserving Surgery – Classification of Oncoplastic Techniques. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70662-7] [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: 10/28/2022]
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Eiermann W, Rezai M, Kummel S, Kuhn T, Warm M, Friedrichs K, Benkow A, Blohmer J. 302 Using the 21-gene Breast Cancer Assay in Adjuvant Decision-making in ER-positive (ER+) Early Breast Cancer (EBC) is Cost-effective: Results of a Large Prospective German Multicenter Study. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70368-4] [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: 10/28/2022]
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Alavi N, Ebrahimi M, Rezai M. 588 Why Some Surgeons Omit Sentinel Node Biopsy in Breast Cancer Patients? Barriers to Popularize Sentinel Node Biopsy in Low Resource Areas. Eur J Cancer 2012. [DOI: 10.1016/s0959-8049(12)70653-6] [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: 11/24/2022]
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Pourmand G, Ramezani R, Sabahgoulian B, Nadali F, Mehrsai AR, Nikoobakht MR, Allameh F, Hossieni SH, Seraji A, Rezai M, Haidari F, Dehghani S, Razmandeh R, Pourmand B. Preventing Unnecessary Invasive Cancer-Diagnostic Tests: Changing the Cut-off Points. Iran J Public Health 2012; 41:47-52. [PMID: 23113134 PMCID: PMC3481674] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2011] [Accepted: 12/12/2011] [Indexed: 12/02/2022]
Abstract
BACKGROUND To determine a cut-off point of tPSA and PSAD to prevent unnecessary invasive cancer-diagnosing tests in the community. METHODS This study was performed on 688 consecutive patients referred to our center due to prostatism, suspicious lesions on digital rectal examination and/or elevated serum PSA levels. All patients underwent transrectal ultrasound guided biopsies and obtained PSAD. Serum levels of tPSA and fPSA were measured by chemiluminescence. Comparisons were done using tests of accuracy (AUC-ROC). RESULTS Prostate cancer was detected in 334 patients, whereas the other 354 patients were suffering from benign prostate diseases. The mean tPSA in case and control groups were 28.32±63.62 ng/ml and 7.14±10.04 ng/ml; the mean f/tPSA ratios were 0.13± 0.21 and 0.26±0.24 in PCa and benign prostate disease groups; the mean PSAD rates were 0.69±2.24, 0.12±0.11, respectively. Statistically significant differences were found (P <0.05). Using ROC curve analysis, it was revealed that AUC was 0.78 for tPSA and 0.80 for f/tPSA. Sensitivity was 71% for the cut-off value of 7.85ng/ml. For f/tPSA ratio, the optimal cut-off value was 0.13 which produced the sensitivity of 81.4% and for PSAD, it was15%. CONCLUSIONS As this trial is different from the European and American values, we should be more cautious in dealing with the prostate cancer upon the obtained sensitivity and specificity for PCa diagnosis (7.85ng/mL for tPSA, 15% for PSAD and 0.13 for f/tPSA ratio).
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Affiliation(s)
- G Pourmand
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author: Fax: +9821 6634 8561, E-mail address:
| | - R Ramezani
- CDC Cancer Office, Ministry of Health and Medical Education, Tehran, Iran
| | | | - F Nadali
- Dept. of Hematology, Allied Health Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - AR Mehrsai
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - MR Nikoobakht
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - F Allameh
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - SH Hossieni
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - A Seraji
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - M Rezai
- Bistoon Ultrasound Clinic, Tehran, Iran
| | - F Haidari
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - S Dehghani
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - R Razmandeh
- Urology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - B Pourmand
- Research Development Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Huober J, Hanusch C, Fasching PA, Rezai M, Eidtmann H, Kittel K, Schwedler K, Tesch H, Höß C, Mau C, Khandan F, Krabisch P, Loibl S, Nekljudova V, Untch M, von Minckwitz G. S3-6: Neoadjuvant Chemotherapy of Paclitaxel with or without Rad001: Results of the Non-Responder Part of the GEPARQUINTO Study (GBG 44). Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-s3-6] [Citation(s) in RCA: 3] [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: 11/16/2022]
Abstract
Abstract
Background:
The oral signal transduction inhibitor everolimus (RAD001 = R), binds selectively to mTOR (mammalian target of rapamycin), an intracellular protein kinase implicated in the control of cellular proliferation of activated T-lymphocytes and neoplastic cells. Phase II data suggested that R can enhance the clinical efficacy of endocrine treatment in the metastatic and neoadjuvant setting.
The GeparQuinto phase III study had 3 settings (HER2−positive: trastuzumab vs lapatinib; HER2−negative: +/− bevacizumab (Bev); HER2−negative non-responder: +/− R). Primary aim of the last setting was to improve pathological complete response (pCR) for patients with HER2−negative breast cancer not responding to 4x epirubicin/cyclophosphamide (EC) +/− Bev by adding R to weekly paclitaxel as neoadjuvant chemotherapy.
Patients and Methods:
Patients with untreated HER2−negative breast cancer were eligible if their tumors were stage cT3/4a-d; or estrogen (ER) and progesterone (PgR) receptor-negative; or ER/PgR-positive tumors with clinically N+ (for cT2) or pNSLN+ (for cT1). Only patients without response (<50% tumor reduction) to 4x EC+/−Bev were eligible and were randomized to receive further paclitaxel (Pac: 80 mg/m2 q1w x12) chemotherapy with or without R. Treatment with R started 21 to 35 days after the last application of EC with a dose escalation from 2.5 mg every 2nd day to 5 mg every day over 14 days and maintained at 5 mg/day for additional 10 weeks. Dose of R could be decreased to 2.5 mg/day in case of toxicity. Treatment with Pac started within 7–14 days after the start of R. pCR was defined as no invasive and no non-invasive tumor residuals in breast and nodes. We assumed a pCR rate of 5% for Pac based on the GeparDuo study and expected a pCR of 12.1% for Pac+R (odds ratio 2.62). A two-sided Pearson's C2 with a=0.05 and β=0.20 calculated a sample size of 566 P. One interim futility analysis after 1/3 of patients completed therapy was planned. Randomisation was stratified by participating center, ER/PgR status, extend of disease (T4 or N3 vs. T1-3 and N0-2) and pre-treatment with Bev or not.
Results:
Between 11/07 and 15/06/11 402 P were randomized to Pac (N=201) and Pac+R (N=201). Median age was 51.0 and 50.0 [-R/+R] years. Median clinical tumor size was 40/40 mm; 62%/55% had cT2, 18% / 20% cT3, and 16.7% / 16.7% cT4a-d tumors; 88% / 89% had non-lobular; 35% / 33% grade 3; 55% / 57% node-positive; and 29% / 27% ER and PgR-negative (triple-negative) disease.
The futility interim analysis was performed in 02/10, futility boundary was not reached and the trial was continued. After the other 2 settings completed accrual in 06/10, recruitment to the 3rd setting dropped such that it appeared not possible to recruit the full number of patients.. The trial will therefore close recruitment on June, 30th 2011 with an estimated statistical power of 65%. Results on histological response and surgical outcome will be reported.
Conclusion:
This will be the first report on efficacy data of neoadjuvant R + Pac for patients with early breast cancer. The results of the GeparQuinto study will have to be set into context with the results from the Bolero studies in metastatic disease.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr S3-6.
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Affiliation(s)
- J Huober
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - C Hanusch
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - PA Fasching
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - M Rezai
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - H Eidtmann
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - K Kittel
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - K Schwedler
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - H Tesch
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - C Höß
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - C Mau
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - F Khandan
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - P Krabisch
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - S Loibl
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - V Nekljudova
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - M Untch
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
| | - G von Minckwitz
- 1Kantonsspital St. Gallen/Universitäts-Frauenklinik Tübingen; Frauenklinik vom Roten Kreuz, München; Universitäts-Frauenklinik, Erlangen
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Jaeger BAS, Rack B, Jueckstock J, Salmen J, Ortmann U, Lorenz R, Rezai M, Beck T, Schneeweiss A, Zwingers T, Beckmann MW, Friese K, Janni W. P4-07-06: Correlation of Two Analytical Methods for Circulating Tumor Cells in Peripheral Blood of Patients with Primary Breast Cancer. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p4-07-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
While the evidence for circulating tumor cells (CTCs) as a prognostic marker in metastatic breast cancer has been well established, there is still a lack of data in primary disease. In the SUCCESS A trial two different techniques for the detection of CTCs in early breast cancer were prospectively evaluated.
Material and Methods: SUCCESS A compared FEC-Docetaxel vs. FEC-Docetaxel-Gemcitabine and 5 vs. 2 years of treatment with zoledronic acid in primary breast cancer patients and node positive or high-risk node negative disease. Two different techniques to detect CTCs were prospectively evaluated in two consecutive, but comparable subgroups of the whole study population.
In 3515 samples the CellSearch® System (Veridex, Warren, USA) was used for CTC detection. Immunomagnetic enrichment with an EPCAM-antibody was followed by labeling with monoclonal antibodies specific for cytokeratin (8, 18, 19) and leukocytes (CD45). 2165 samples were evaluated with a manual immunocytochemistry (MICC) protocol. Cytospins were prepared after mononuclear cell enrichment based on Oncoquick® centrifugation (greiner bio-one, Frickenhausen, Germany). Staining was performed with the monoclonal pancytokeratin antibody A45-B/B3 (Micromet, Munich, Germany) and the APAAP technique. Conventional light field microscopy (Axiophot; Zeiss, Oberkochen, Germany) was used for the detection of stained cells.
For both methods, the cut-off value for positivity was ≥ 1 CTC. All events were evaluated by two independent observers.
Results: CTCs were examined in a total number of 3243 patients before and after chemotherapy (CHT). The two subgroups evaluated with one or the other method were well-balanced regarding clinical parameters as tumor size, grading, lymph node-status, hormone receptors and Her2. Furthermore there was no significant correlation between the CTC positivity and one of these clinical parameters using CellSearch or the MICC, respectively (p > 0,05 using the chi square test each time).
Before adjuvant CHT 21. 3% (424 out of 1994) and 21.1 % (264 out of 1249) of the patients were found positive for CTCs using CellSearch® or the MICC respectively, with a mean CTC level of 5.9 (range: 1 to 827) and 3.1 (range: 1 to 256).
Immediately after CHT 21.9% (333 out of 1521) and 16.5% (151 out of 916) of the patients were positive for CTCs using CellSearch® or the MICC. The mean CTC level decreased to 3.0 (range: 1 to 124) and 2.1 (range: 1 to 23) in both analytical methods.
Using CellSearch® there was a significant correlation between the presence of CTCs before CHT and disease progression (p = 0.0044), as well as survival (p = 0.0001), whereas the MICC did not predict any of these (p = 0.3143 and p = 0.0801 respectively; the chi-square test was used each time).
Conclusion: We found comparable prevalence of CTCs before and after adjuvant chemotherapy both with the CellSearch® System or the MICC. However, prognostic relevance could only be shown for CTCs detected with the CellSearch® System. This may be attributed to the high standardization and reproducibility of the automated system, as well as the additional CD45 counterstaining. According to our findings, the FDA approved CellSearch® System should be used as gold standard for CTC detection in future clinical trials.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P4-07-06.
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Affiliation(s)
- BAS Jaeger
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - B Rack
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - J Jueckstock
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - J Salmen
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - U Ortmann
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - R Lorenz
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - M Rezai
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - T Beck
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - A Schneeweiss
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - T Zwingers
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - MW Beckmann
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - K Friese
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
| | - W Janni
- 1Klinikum der Ludwig-Maximilians-Universitaet -Campus Innenstadt, Munich, Germany; Heinrich Heine-Universitaet, Duesseldorf, Germany; Gemeinschaftspraxis Lorenz-HeckerWesche, Braunschweig, Germany; Luisenkrankenhaus, Duesseldorf, Germany; RoMed Klinikum Rosenheim, Rosenheim, Germany; University Hospital Heidelberg, Heidelberg, Germany; Estimate, Augsburg, Germany; Frauenklinik der Universitaet Erlangen, Erlangen, Germany
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Neugebauer JK, Rack BK, Kupka M, Dinkel C, Schneeweiss A, Schrader I, Tesch H, Rezai M, Söling U, Friese K, Beckmann MW, Janni W, Müller V. P5-14-05: Anti-Müllerian Hormone (AMH) Levels in Premenopausal Breast Cancer Patients Treated with Adjuvant Chemotherapy – A Translational Research Project of the SUCCESS Study. Cancer Res 2011. [DOI: 10.1158/0008-5472.sabcs11-p5-14-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Premenopausal women undergoing chemotherapy are at risk of premature ovarian failure and long term side-effects caused by premature menopause. However, knowledge about the rate of ovarian failure and potential markers to evaluate the ovarian reserve is limited, especially in the context of modern chemotherapy concepts. Therefore, Anti-Müllerian hormone (AMH) was measured at before, immediately after and 2 years after chemotherapy in premenopausal patients of the SUCCESS study.
Materials and Methods: The German SUCCESS trial is a multicenter phase III study comparing FEC-Docetaxel vs. FEC-Docetaxel+Gemcitabine as adjuvant treatment in patients with node positive or high risk node negative primary breast cancer. Blood samples were taken prior to and 4 weeks after last cycle of adjuvant chemotherapy, as well as after 2 years of follow up. We retrospecitvely identified 170 patients stratified premenopausal and aged 40 years or younger at trial entry, who received 3cycles of FEC (500/100/500mg/m2) q3w followed by 3 cycles of docetaxel (100mg/m2) q3w as one of the most commonly used chemotherapy regimens in Europe. Serum AMH levels were evaluated in a central laboratory by a manual immunoassay AMH DSL ELISA (Diagnostic Systems Laboratories, Webster, USA).
Results: Median age within this subgroup was 36 years (21-40 years). 48% of the patients had a tumor stage pT1 and 54% were node positive. 69% were hormone receptor positive and 29% Her2 positive. Median serum AMH level before adjuvant chemotherapy was 1.32 ng/ml (range <0.1−11.32). Immediately after chemotherapy AMH levels dropped in 96% of the patients below the threshold of detection (<0.1 ng/ml, range <0.1−3.9ng/ml). No association to classical prognostic markers, such as tumor stage, lymph node involvement, etc. was observed. After a follow up period of 2 years, serum was available from 95 patients. 76% of those patients showed no evidence of ovarian function indicated by AMH (<0.1 ng/ml, range <0.1−1.43ng/ml). AMH levels prior to and 2 years after chemotherapy were significantly correlated with older age, with a reduction of 0.14 ng/ml per life year (p=0.0025) and 0.01 ng/ml (p=0.017) respectively. 12 patients (7%) received optional gonadotropin-releasing hormone (GnRH) agonists during chemotherapy. These patients presented significantly higher AMH levels (+ 0.18 ng/ml; p=0.01) 2 years after cytotoxic treatment. Conclusion: In this retrospective analysis premenopausal patients showed a high rate of ***f ovarian insufficiency reflected by low serum AMH levels immediately after cytotoxic treatment and after 2 years of follow up. GnRH agonists given as ovarian protectants during chemotherapy may have an influence on serum AMH 2 years after chemotherapy. Further data from prospective trials with longer follow up are needed to evaluate the role of serum AMH as a predictor of ovarian failure in breast cancer patients exposed to chemotherapy.
Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-14-05.
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Affiliation(s)
- JK Neugebauer
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - BK Rack
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - M Kupka
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - C Dinkel
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - A Schneeweiss
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - I Schrader
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - H Tesch
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - M Rezai
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - U Söling
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - K Friese
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - MW Beckmann
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - W Janni
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
| | - V Müller
- 1Ludwig-Maximilians-Universität, Munich, Germany; University Hospital Heidelberg, Heidelberg, Germany; Henriettenstiftung Hannover, Hannover, Germany; Fachpraxis für Onkologie, Frankfurt, Germany; Luisenkrankenhaus Duesseldorf, Duesseldorf, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University Hospital Erlangen, Erlangen, Germany; Heinrich-Heine-Universität, Duesseldorf, Germany; University Medical Center, Hamburg-Eppendorf, Germany
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Bahmani ZA, Rezai M, Hosseini S, Regenstein J, Böhme K, Alishahi A, Yadollahi F. Chilled storage of golden gray mullet (Liza aurata). Lebensm Wiss Technol 2011. [DOI: 10.1016/j.lwt.2011.01.009] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Matuschek C, Prisack HB, Boelke E, Budach W, Janni W, Rezai M, Bojar H. Microarray-based gene expression profiles to predict ELISA-derived uPA and PAI-1 levels in breast cancer biopsies: A comparison between fresh frozen (FF) and formalin-fixed, paraffin-embedded (FFPE) samples. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.27_suppl.194] [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
194 Background: The urokinase plasminogen-activator (uPA) and its inhibitor (PAI-1) predict the benefit of node-negative breast cancer patients from chemotherapy. The determination of uPA and PAI-1 need(s) large amounts of tumor tissue. In contrast, microarray-based gene expression profiling (MGEP) requires only small quantities of FF tissue and is applicable to FFPE archival tissue. Identification of MPEG-derived surrogate markers for ELISA-based uPA/PAI-1 may facilitate their analysis together with MPEG-based predictive genes and metagenes. Methods: Three groups of breast cancer biopsies were analysed. Group A: 136 FF tissues from 2008-2009, group B: 85 FF tissues from 2010, group C: 20 independent FFPE tissues. Gene expression was assessed by Agilent 4x44K microarrays. Results: For group A a significant correlation between protein expression of uPA and uPA gene (PLAU) expression (r = 0.627 p < 0.001) and PAI-1 and PAI-1 genes (SERPINE1)(r = 0.281 p = 0.001) was found. Top sets of genes correlated with uPA/PAI-1 protein expression were extracted. For group B additional sets of top correlated genes were identified. The correlation of individual genes with uPA/PAI-1 protein expression was highest for their genes themselves (PLAU: r = 0.694 p < 0.001; SERPINE1 (r = 0.469 p < 0.001). Subsequently consensus gene sets were identified with a good performance for both biopsy sets. Only genes which were significantly correlated with their counterparts in group C were selected, resulting in a final 11-gene model (uPA metagene) and a 6-gene model (PAI-1 metagene). They significantly correlated with uPA/PAI-1 protein expression in all groups of biopsies (uPA: group A: r = 0.621, p < 0.001; group B: r = 0.771, p < 0.001; group C: r = 0.665, p = 0.005; for PAI-1: group A: r = 0.569, p < 0.001; group B: r = 0.687, p < 0.001; group C: r = 0.683, p = 0.008). Conclusions: Reliable MPEG-derived metagenes as surrogate markers for ELISA-based uPA/PAI-1 expression were identified.
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Affiliation(s)
- C. Matuschek
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - H. B. Prisack
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - E. Boelke
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - W. Budach
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - W. Janni
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - M. Rezai
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
| | - H. Bojar
- University of Duesseldorf, Duesseldorf, Germany; Institute for Molecular Pathology, Duesseldorf, Germany; Heinrich Heine University, Duesseldorf, Germany; Breast Center Düsseldorf Luisen Hospital, Düsseldorf, Germany; European Institute for Molecular Oncology, Duesseldorf, Germany
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Janni JW, Hepp PGM, Andergassen U, Harbeck N, Rack BK, Neugebauer JK, Annecke K, Wischnik A, Simon W, Rezai M, Fehm TN, Schneeweiss A, Fasching PA, Gerber B, Zwingers T, Sommer HL, Friese K, Kiechle M. Final multivariate analysis of obesity and survival in patients with node-positive primary breast cancer: The ADEBAR trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1020] [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: 11/20/2022] Open
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Denkert C, Kronenwett R, Loibl S, Nekljudova V, Darb-Esfahani S, Gerber B, Sinn B, Petry C, Bauerfeind I, Budczies J, Rezai M, Dietel M, Schrader I, Kunz G, Von Minckwitz G. RNA-based molecular tumor typing and immunological infiltrate as response predictors to neoadjuvant chemotherapy: Prospective validation in the GeparQuinto-PREDICT substudy. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10526] [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: 11/20/2022] Open
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Jueckstock JK, Rack BK, Zwingers T, Hepp PGM, Schneeweiss A, Beckmann MW, Lichtenegger W, Sommer HL, Pantel K, Tesch H, Forstbauer H, Lorenz R, Rezai M, Neugebauer JK, Andergassen U, Friese K, Janni W. Prognostic relevance of circulating tumor cells (CTC) before adjuvant chemotherapy in patients with breast cancer: Results of the German SUCCESS trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Matuschek C, Prisack HB, Boelke E, Budach W, Peiper M, Rezai M, Janni W, Bojar H. Microarray-based gene expression profiles reliably predict ELISA-derived uPA and PAI-1 levels in breast cancer biopsies, a comparison between fresh frozen (FF) and formalin-fixed paraffin-embedded (FFPE) samples. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10555] [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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Gerber B, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch CA, Kreienberg R, Solbach C, Jackisch C, Kunz G, Blohmer JU, Huober JB, Hauschild M, Loibl S, Nekljudova V, Untch M, Von Minckwitz G. Neoadjuvant bevacizumab and anthracycline–taxane-based chemotherapry in 686 triple-negative primary breast cancers: Seconday endpoint analysis of the GeparQuinto study (GBG 44). J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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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Hepp PGM, Rack BK, Tesch H, Rezai M, Beck T, Salmen J, Andergassen U, Ortmann U, Zwingers T, Beckmann MW, Lichtenegger W, Janni JW. Correlation of CA 27.29 and circulating tumor cells before, at the end, and 2 years after adjuvant chemotherapy in patients with primary breast cancer: The SUCCESS trial. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.10626] [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: 11/20/2022] Open
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Paisley AN, Banerjee M, Rezai M, Schofield RE, Balakrishnannair S, Herbert A, Lawrance JAL, Trainer PJ, Cruickshank JK. Changes in arterial stiffness but not carotid intimal thickness in acromegaly. J Clin Endocrinol Metab 2011; 96:1486-92. [PMID: 21346071 DOI: 10.1210/jc.2010-2225] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
CONTEXT Acromegaly increases cardiovascular morbidity. We tested the hypothesis that increased arterial stiffness together with left ventricular hypertrophy may be a contributory factor. PATIENTS AND DESIGN Fifty-six patients (40 males, 54 ± 13 yr; 25 active disease, 31 in remission) and 46 healthy controls (30 males, 52 ± 13 yr) underwent measurements of aortic pulse wave velocity (PWV), carotid Doppler (IMT), echocardiography, and cardiovascular risk factors. RESULTS Mean serum IGF-I was 323 ± 286 ng/ml (sd score 1.8 ± 1.9) in all patients. Age, body mass index, diastolic blood pressure (BP), and lipid levels were similar comparing patients and controls. Systolic BP (130.8 ± 19.9 vs. 122 ± 14 mm Hg controls, P < 0.01) and PWV (11.7 ± 3.8 vs. 9.7 ± 2.8 m/sec, 95% confidence interval -3.4 to -0.7, P <0.01) were higher in patients than controls. Regression analysis revealed age, presence of acromegaly, systolic BP, and body mass index, inversely, as significantly and independently associated with PWV. No difference in carotid IMT was seen (0.8 ± 0.2 patients vs. 0.7 ± 0.2 mm controls, P = 0.5) or between active/controlled disease. In the subset of participants with echocardiography (n = 32), left ventricular mass was higher by a mean of 38.2 g (95% confidence interval -80.9 to +4.6, P = 0.08). CONCLUSION In summary, patients with acromegaly had independently and significantly increased aortic PWV as evidence of arterial stiffening but unaltered carotid IMT compared with controls, also influenced by age and systolic BP. Premature cardiovascular disease in patients with acromegaly is likely related to pressure-related arterial and left ventricular stiffening rather than atherosclerotic disease.
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Affiliation(s)
- A N Paisley
- Department of Endocrinology, The Christie National Health Service Foundation Trust, Manchester M20 4BX, United Kingdom.
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Mondoly P, Rezai M, Duparc A, Rollin A, Hébrard A, Detis N, Chilon T, Maury P, Delay M, Carrié D. 177 Long term follow-up of patient implanted with ICD before 2000. Archives of Cardiovascular Diseases Supplements 2011. [DOI: 10.1016/s1878-6480(11)70179-3] [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: 10/18/2022]
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Kern P, Darsow M, Krämer S, Rezai M. Onkoplastik nach neoadjuvanter Therapie des Mammakarzinoms. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269943] [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: 10/18/2022] Open
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Kern P, Darsow M, Rezai M, Krämer S. Adjuvante Strahlentherapie und Brustrekonstruktion – was müssen wir beachten? Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269949] [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: 10/18/2022] Open
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Krämer S, Kern P, Darsow M, Rezai M. Skin-Sparing Mastektomie und Implantatrekonstruktion. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269951] [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: 10/18/2022] Open
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Krämer S, Darsow M, Kern P, Rezai M. Systematik der onkoplastischen Brustchirurgie. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269945] [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: 10/18/2022] Open
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Rezai M, Darsow M, Kern P, Krämer S. Autologe Brustrekonstruktion mit dem TRAM-Lappen – eine veraltete Technik? Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269953] [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: 10/18/2022] Open
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77
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Rezai M, Darsow M, Kern P, Krämer S. Entwicklung einer universellen Technik zur Reduktionsplastik. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1269948] [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: 10/18/2022] Open
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Rezai M, Finn J, Wu F, Cruickshank JK. BAS/BSCR11 Pulse wave velocity as a sensitive indicator of vascular risk across ethnic groups: a European Male Ageing (sub-)Study (EMAS). Heart 2010. [DOI: 10.1136/hrt.2010.205781.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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79
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Matuschek C, Boelke E, Budach W, Prisack H, Taskin H, Peiper M, Rezai M, Bojar H. Free methylated DNA in association of clinical signs and circulating blood tumor cells in patients with breast cancer. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.1068] [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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Stöblen F, Rezai M, Kümmel S. Bildgebung bei Patientinnen mit Brustimplantaten – Ergebnisse der 1st International Breast (Implant–) Conference 2009. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253075] [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: 10/19/2022]
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81
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Stöblen F, Stelkens-Gebhardt R, Kimmig R, Rezai M, Kümmel S. Diagnostische Wertigkeit eines automatisierten 3D-Ultraschallsystems im Mammographie-Screening-Setting. ROFO-FORTSCHR RONTG 2010. [DOI: 10.1055/s-0030-1253045] [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: 10/19/2022]
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82
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Rezai M, Sherratt N, Cruickshank J. P1.05 COMPARING AORTIC PULSE WAVE VELOCITY BY MAGNETIC RESONANCE IMAGING AND THE NEW OSCILLOMETRIC METHOD ARTERIOGRAPH. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.010] [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: 10/18/2022] Open
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83
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Rezai M, Cowan B, Young A, Sherratt N, Finn J, Wu F, Cruickshank J. P13.09 REGIONAL AORTIC PULSE WAVE VELOCITY VERSUS LEFT VENTRICULAR MASS IN CLASSIFYING CARDIOVASCULAR RISK DIFFERENCES; A MAGNETIC RESONANCE STUDY. Artery Res 2010. [DOI: 10.1016/j.artres.2010.10.141] [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: 11/24/2022] Open
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Hepp P, Rack B, Schneeweiss A, Schrader I, Lorenz R, Tesch H, Soeling U, Rezai M, Gerber B, Lichtenegger W, Beckmann M, Janni W. Dose Dependent Effects of G-CSF on Ca27.29 in Early Stage Breast Cancer Patients. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-6030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:13% of 2556 patients (pts) examined in the SUCCESS trial showed elevated levels of Ca27.29 only after chemotherapy (SABCS2008). Early data indicate a possible relationship between the administration of G-CSF and a rise in the tumor marker. This analysis focuses on the dose dependency of this effect.Methods:The SUCCESS Trial is a phase III trial comparing FEC-Docetaxel vs. FEC-Doc-Gemcitabine regime and 2 vs. 5 years of treatment with zoledronate in patients with primary breast cancer in 3754 pts (BC) (N+ or high risk). Blood samples for this analysis are drawn before and after chemotherapy (CHT). Ca27.29 has been measured with ST AIA-PACK Ca27.29 reagent using MUC-1 for AIA-600II (Tosoh Bioscience, Tessenderlo, Belgium). The cutoff for Ca27.29 is >=32 U/ml. For chi² analysis patients were grouped to increasing or not increasing values of Ca27.29 and 1 to 6 cycles with G-CSF or no G-CSF at all. The absolute difference of Ca27.29 values before and after CHT was correlated with the number of G-CSF cycles administered.Results:The analysis of Ca27.29 is based on the data of 2556 pts. 1252 pts (49%) received at least one course of G-CSF. 338 pts (13%) exceeded the threshold for CA27.29 only after CHT. In this group 209 pts (62%) received G-CSF and 129 (38%) did not. 1043 pts with stable or decreased CA27.29 received G-CSF (47%) and 1175 did not (53%). This difference was highly significant (p<0.0001). Correlating the number of G-CSF cycles received during CHT with the absolute difference in Ca27.29 levels showed a highly significant positive correlation of 0.13 (Spearman-Rho; p<0.0001[two-sided]).Discussion and Conclusion:This analysis gives strong evidence that there is a dose dependent correlation between elevated levels of CA27.29 post CHT and the application of G-CSF. This might be attributed to an illegitimate expression of MUC-1 in leucocytes during leucopoiesis. Whether this effect is also related to the destruction of remaining disseminated tumor cells needs to be further evaluated.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 6030.
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Affiliation(s)
- P. Hepp
- 1 Heinrich-Heine-University, Germany
| | - B. Rack
- 2 Ludwig Maximilians University, Germany
| | | | | | - R. Lorenz
- 5 Gemeinschaftspraxis Dr. R. Lorenz / N. Hecker, Germany
| | | | - U. Soeling
- 7 Gemeinschaftspraxis Siehl / Söling, Germany
| | | | | | | | | | - W. Janni
- 1 Heinrich-Heine-University, Germany
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Andergassen U, Rack B, Schneider A, Rezai M, Tesch H, Beck T, Söling U, Beckmann M, Lichtenegger W, Janni W. 5032 Effects of G-CSF on circulating tumour cells (CTC) and CA 27.29 in breast cancer patients. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70924-3] [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: 11/29/2022] Open
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Hepp P, Rack B, Schneider A, Rezai M, Tesch H, Beck T, Söling U, Lichtenegger W, Beckmann MW, Janni W. Effects of G-CSF on circulating tumor cells (CTC) and CA 27.29 in breast cancer patients. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.11027] [Citation(s) in RCA: 5] [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: 11/20/2022] Open
Abstract
11027 Background: Some recent publications indicated that the use of G-CSF could be connected to an increase in CTC as well as elevated levels of tumor markers such as CA 27.29. In the SUCCESS Trial CTC and CA27.29 are examined before and after adjuvant chemotherapy (CHT) in 3754 breast cancer patients (pts). Methods: The SUCCESS Trial is a phase III trial comparing FEC-Docetaxel vs. FEC-Doc-Gemcitabine regime and 2 vs. 5 years of treatment with zoledronate in patients with primary breast cancer (BC) (N+ or high risk). Blood samples are taken before and after CHT. CTC were assessed with the CellSearchSystem (Veridex, Warren, USA). After immunomagnetic enrichment with an anti-Epcam-antibody, cells were labeled with anti-cytokeratin (8,18,19) and anti-CD45 antibodies to distinguish epithelial cells and leukocytes. CA27.29 has been measured with ST AIA-PACK Ca27.29 reagent using MUC-1 for AIA-600II (Tosoh Bioscience, Tessenderlo, Belgium). The cutoff for CA27.29 is 32 U/ml and >1 cell for the CTC analysis. Patients were grouped to CTC/CA27.29 raise or no raise and 1 to 6 cycles with G-CSF or no G-CSF at all. Results: Data on 1510 pts are available for CTC analysis. 745 pts (49%) received at least one course of G-CSF. 117 pts (8%) showed an increase in CTC after CHT. In this group 52 (3%) pts received G-CSF and 65 (4%) did not. 693 pts with stable or decreased CTC received G-CSF (46%) and 700 did not (46%). There was no significant difference (p=0.29). The analysis of CA27.29 is based on the data of 2556 pts. 1252 pts (49%) received at least one course of G-CSF. 338 pts (13%) exceeded the threshold for CA27.29 only after CHT. In this group 209 pts (8%) received G-CSF and 129 (5%) did not. 1043 pts with stable or decreased CA27.29 received G-CSF (41%) and 1175 did not (46%). This difference was highly significant (p<0.0001). Conclusions: No evidence can be provided for a significant correlation between an increase in the number of CTC and the application of G-CSF over CHT. Nevertheless the results on CA27.29 showed a highly significant correlation between the administration of G-CSF and elevated CA27.29 levels directly after CHT. This could be a possible explanation for the often observed increase of tumor markers after CHT. [Table: see text]
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Affiliation(s)
- P. Hepp
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - B. Rack
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - A. Schneider
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - M. Rezai
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - H. Tesch
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - T. Beck
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - U. Söling
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - W. Lichtenegger
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - M. W. Beckmann
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
| | - W. Janni
- SUCCESS Study Group; Heinrich Heine University, Düsseldorf, Germany; Ludwig-Maximilians-University, Munich, Germany; Charité, Berlin, Germany; Luisenkrankenhaus, Düsseldorf, Germany; Praxis Prof. Tesch, Frankfurt, Germany; Städtisches Klinikum Rosenheim, Rosenheim, Germany; Gemeinschaftspraxis Siehl & Söling, Kassel, Germany; University of Erlangen, Erlangen, Germany; SUCCESS Study Group
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Rack BK, Janni W, Genss E, Schneeweiss A, Rezai M, Hilfrich J, Lorenz R, Chatsiproios D, Schneider A, Sommer H, Lichtenegger W, Beckmann MW, Friese K. Toxicity analysis of a phase III study evaluating FEC-Doc vs. FEC-Doc in combination with gemcitabine as adjuvant treatment for breast cancer – the SUCCESS-trial. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-4108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #4108
Background:
 Taxane containing regimens have been established as standard of care for node-positive primary breast cancer patients and have shown superiority to mere anthracycline containing regimens. The SUCCESS-trial evaluates, whether adjuvant taxane based treatment can be further improved by the addition of Gemcitabine.
 Methods:
 The SUCCESS-Study is an open-label randomized controlled, Phase III study comparing the disease free survival after randomisation in patients treated with 3 cycles of Epirubicin(100 mg/m²)-Fluorouracil(500)-Cyclophosphamide(500, FEC)-chemotherapy, followed by 3 cycles of Docetaxel(100 mg/mg², D) versus 3 cycles of FEC, followed by 3 cycles of Gemcitabine(1,000mg/m² d1,8)-Docetaxel(75 mg/m²)(DG). Complete, monitored toxicity data of 2.691 pts were available for this analysis.
 Results:
 Dose reduction >20% (3.97% vs 2.90%) and postponement of treatment cycles >7die (22,85% vs 14.19%) was rare, but more frequent in the FEC-DG arm (both p< .001). Cytostatic treatment was prematurely stopped in 119 pts (4,4%) receiving FEC-DG and in 103 pts (3,8%) with FEC-D (p=0,21). G-CSF support was applied in 850 (29.2%) vs. 602 pts (20.7%, p< .001). Toxicities NCI grade > 2 which occurred with incidence > 1% or significantly different in the two arms are depicted in Table 1. Afebrile and febrile neutropenia and anemia did not differ between the two arms, but thrombocytopenia was more frequent in FEC-DG (1.7%, p= .007). Hand-foot syndrome and neuropathy was more frequent in the FEC-D arm (p= .09 and p= .02, respectively).
 Conclusion:
 No unexpected toxicities were observed and severe adverse effects were rare in both treatment arms. With the addition of gemcitabine to FEC-D adjuvant chemotherapy toxicity was moderately increased. Outcome data will have to be awaited to further interpret these findings.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 4108.
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Affiliation(s)
- BK Rack
- 1 Ludwig-Maximilians-University, Muenchen, Germany
| | - W Janni
- 1 Ludwig-Maximilians-University, Muenchen, Germany
| | - E Genss
- 1 Ludwig-Maximilians-University, Muenchen, Germany
| | | | - M Rezai
- 3 Luisenkrankenhaus, Duesseldorf, Germany
| | | | - R Lorenz
- 5 Gemeinschaftspraxis Dr. R. Lorenz/N. Hecker, Braunschweig, Germany
| | - D Chatsiproios
- 5 Gemeinschaftspraxis Dr. R. Lorenz/N. Hecker, Braunschweig, Germany
| | - A Schneider
- 6 Charitè University Hospital, Berlin, Germany
| | - H Sommer
- 1 Ludwig-Maximilians-University, Muenchen, Germany
| | | | | | - K Friese
- 1 Ludwig-Maximilians-University, Muenchen, Germany
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Goudot G, Rezai M, Cruickshank J. P10.04 INFLUENCE OF 1,25(OH)2D3 (VITAMIN D) ON RESISTANCE ARTERY CONTRACTILITY. Artery Res 2009. [DOI: 10.1016/j.artres.2009.10.135] [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: 11/24/2022] Open
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89
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Rezai M, Krämer S. Kongressbericht. 7. Düsseldorfer Brustkrebs-Konferenz. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1039291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Brucker S, Schumacher C, Sohn C, Rezai M, Wallwiener M. Onkologische Qualitätssicherung am Beispiel des Mammakarzinom-Benchmarkings interdisziplinärer Brustzentren. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1038685] [Citation(s) in RCA: 2] [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: 10/22/2022] Open
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Graeser MK, Wuerstlein R, Bonatz G, Tuschen G, Nitz U, Schwenzer T, Schrappe G, Rezai M, Warm M. Benchmarking as an instrument in the quality management in the treatment of breast cancer in Germany from 2003 to 2006. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.17526] [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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Janni WJ, Genss E, Sommer HL, Rack BK, Schneeweiβ A, Rezai M, Hilfrich J, Schneider A, Lichtenegger W, Beckmann MW. The SUCCESS-Trial: Toxicity analysis of a phase III study evaluating the role of docetaxel and gemcitabine in the adjuvant therapy of breast cancer patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.551] [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: 11/20/2022] Open
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Untch M, Rezai M, Loibl S, Fasching P, Huober J, Tesch H, Bauerfeind I, Hilfrich J, Mehta K, von Minckwitz G. Neoadjuvant treatment of HER2 overexpressing primary breast cancer with trastuzumab given concomitantly to epirubicin/ cyclophosphamide followed by docetaxel ± capecitabine. First analysis of efficacy and safety of the GBG/AGO multicenter intergroup-study “GeparQuattro”. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70313-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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von Minckwitz G, Rezai M, Loibl S, Fasching P, Huober J, Tesch H, Bauerfeind I, Hilfrich J, Mehta K, Untch M. Capecitabine given concomitantly or in sequence with EC → docetaxel as neoadjuvant treatment for early breast cancer: GeparQuattro – a GBG/AGO intergroup-study. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70519-6] [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: 10/22/2022] Open
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Janni W, Genss E, Rack B, Sommer H, Rezai M, Schneider A, Lichtenegger W, Beckmann M, Schneeweiss A, Friese K. The SUCCESS-Trial -toxicity analysis of a phase III study evaluating the role of Docetaxel and Gemcitabine in the adjuvant therapy of breast cancer patients. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70554-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Graeser M, Wuerstlein R, Schmutzler R, Schwenzer T, Wiebringhaus H, Latos K, Nitz U, Schrappe G, Rezai M, Bonatz G, Tuschen G, Mallmann P, Warm M. Benchmarking als Qualitätssicherungsmassnahme in der Senologie und die Entwicklung von 2003 bis 2006 in Deutschland/NRW. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1075797] [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: 10/21/2022] Open
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Rack B, Schindlbeck C, Hofmann S, Schneeweiss A, Rezai M, Beckmann M, Pantel K, Schneider A, Janni W, Sommer H. 2001 ORAL Circulating tumor cells (CTCs) in peripheral blood of primary breast cancer patients – Results from the translational research program of the German SUCCESS-Trial. EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)70763-2] [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: 11/24/2022] Open
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Rack BK, Schindlbeck C, Hofmann S, Schneeweiss A, Rezai M, Beckmann M, Pantel K, Schneider A, Sommer H, Janni W. Circulating tumor cells (CTCs) in peripheral blood of primary breast cancer patients. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.10595] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [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
10595 Background: Detection of CTCs has been shown to predict decreased PFS and OAS in metastatic breast cancer, whereas only limited data has been published in the adjuvant setting. We evaluate the role of CTCs in peripheral blood at primary diagnosis and during adjuvant chemotherapy, endocrine and bisphophonate treatment within the SUCCESS-Trial (n=3,658 pts). Methods: We analyzed 23ml of peripheral blood from 1767 N+ and high risk N- primary breast cancer pts before systemic treatment. 852 of these pts have undergone follow-up blood sampling after completion of chemotherapy. The presence of CTCs was assessed with the CellSearchSystem (Veridex, Warren, USA). Briefly, after immunomagnetic enrichment with an anti-Epcam-antibody, cells were labelled with anti-cytokeratin (8,18,19) and anti-CD45 antibodies to distinguish epithelial cells and leukocytes. Results: 10% of pts with a blood sampling before systemic treatment (n=170) showed >1CTC before the start of systemic treatment (mean 13, range 2–827). While we found 2 CTCs in 5% of pts, 3% had 3–5 CTCs and 1% 6–10 and >10 CTCs each. The presence of CTCs did not correlate with tumor size (p=.07), grading (p=.30), hormonal status (p=.54) or Her2-Status of the primary tumor (p=.26). However, we observed a significant correlation with the presence of lymph node metastases (p=.015). None of 24 healthy individuals showed more than 1 CTC. Among those 852 pts with follow-up blood sampling after the completion of cytostatic treatment, 11% were CTC positive before starting systemic treatment (mean 7, range 2–166), while 7% of patients presented with >1CTC after completion of chemotherapy (mean 6, range 2–84). Of those, initially CTC positive, 10% remained positive (n=9) and 90% had a negative CTC test after chemotherapy (n=82). Of those initially CTC negative, 93% remained negative (n=711), whereas 7% returned with a positive CTC test (n=50) (p=.24). Conclusions: Our data show good feasibility of this highly standardized and easily applicable approach for the detection of CTCs in a large number of primary breast cancer patients. In a considerable number of patients, persistent CTCs can be detected after completion of cytostatic treatment. Whether this finding is prognostically relevant will have to been shown with longer follow-up of the SUCCESS-trial. No significant financial relationships to disclose.
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Affiliation(s)
- B. K. Rack
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - C. Schindlbeck
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - S. Hofmann
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - A. Schneeweiss
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - M. Rezai
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - M. Beckmann
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - K. Pantel
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - A. Schneider
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - H. Sommer
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
| | - W. Janni
- Klinikum der Ludwig-Maximilians-Universitaet, Munich, Germany; University of Heidelberg, Heidelberg, Germany; Breastcenter Duesseldorf Luisenkrankenhaus, Duesseldorf, Germany; University of Erlangen, Erlangen, Germany; University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Charite Campus Benjamin Franklin, Berlin, Germany
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Otukesh H, Sharifian M, Simfroosh N, Basiri A, Hoseini R, Sedigh N, Golnari P, Rezai M, Fereshtenejad M. Outcome of renal transplantation in children with low urinary tract abnormality. Transplant Proc 2006; 37:3071-4. [PMID: 16213308 DOI: 10.1016/j.transproceed.2005.08.026] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Patients with end-stage renal disease and lower urinary tract abnormality are often considered high risk for renal transplantation. METHODS AND SUBJECTS To examine the degree of risk, we studied patients who received renal transplants between 1985 and 2003. Forty eight patients had congenital lower urinary tract anomalies and 168 patients comprised a control group without these anomalies. RESULTS Mean age and distribution of sex were not significantly different between the case and the control group. Among patients with anomalies, 8% had delayed graft function; 75%, acute rejection; and 39.5%, chronic rejection. Among the controls 2.3% had delayed graft function; 59%, acute rejection; and 35%, chronic rejection. None of these differences was significant. Mean survival time was 6 years in affected patients and 7.3 years in the control group (P = .7). Among patients with anomalies the rate of graft survival in the first year after transplantation was 90%; and those in the third, fifth, and seventh years, 76%, 65%, and 40%, respectively. For the controls, the graft survivals were 88% at 1 year; 73% at 3 years; 70% at 5 years; and 49% at 7 years after transplantation. CONCLUSION This study showed that a history of lower urinary tract anomalies had no effect on graft function. Graft survival was not different among these patients compared with patients free of these anomalies.
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Affiliation(s)
- H Otukesh
- Labafi Nejad Hospital, Pasdaran Avenue, Tehran, Iran.
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Otukesh H, Sharifian M, Basiri A, Simfroosh N, Hoseini R, Sedigh N, Golnari P, Rezai M, Fereshtenejad M. Mycophenolate Mofetil in Pediatric Renal Transplantation. Transplant Proc 2005; 37:3012-5. [PMID: 16213289 DOI: 10.1016/j.transproceed.2005.08.030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Since kidney transplantation is the therapy of choice for children with end-stage renal disease (ESRD), we investigated the effects of mycophenolate mofetil (MMF) in pediatric renal transplantation. METHODS AND SUBJECTS Two hundred sixteen children received renal transplants between 1985 and 2003: 100 patients received MMF with cyclosporine and prednisolone (cases), and 116 patients, azathioprine with cyclosporine and prednisolone (controls). RESULTS The MMF group (100 patients) showed better graft survival and function than the AZA group (116 patients). Patients who received MMF immediately after transplantation experienced less graft loss and acute rejection episodes in the first 3 months after transplantation (P < .05). Patients who received MMF at the time of diagnosis of chronic rejection had stable renal function and remarkably better graft survival than those with chronic rejection who received AZA instead of MMF (P < .05). CONCLUSION This study suggests that MMF may stop persistent graft dysfunction in chronic rejection, improving graft survival in the short and long terms posttransplantation.
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