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Digklia A, Kollár A, Dietrich D, Kronig MN, Britschgi C, Rordorf T, Joerger M, Krasniqi F, Metaxas Y, Colombo I, Ribi K, Rothermundt C. SAKK57/16 Nab-paclitaxel and Gemcitabine in Soft Tissue Sarcoma (NAPAGE): a phase I/II trial. Eur J Cancer 2024; 197:113470. [PMID: 38096656 DOI: 10.1016/j.ejca.2023.113470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 11/27/2023] [Accepted: 11/29/2023] [Indexed: 01/02/2024]
Abstract
BACKGROUND To determine whether the combination of nab-paclitaxel with gemcitabine has activity in patients with pretreated soft tissue sarcoma (STS). PATIENTS AND METHODS NAPAGE is a phase Ib/II clinical trial investigating the combination of nab-paclitaxel (nab-pc) with gemcitabine employing two cohorts. One of a dose-de-escalation phase and one of expansion. In phase I, nab-pc was given at 150 mg/m2 in combination with gemcitabine 1000 mg/m2 every two weeks, until disease progression or unacceptable toxicity. This dose was recommended for phase II (RP2D), as there was no dose limiting toxicity (DLT) or discontinuations due to adverse events (AEs). The primary endpoint of the phase II was progression-free rate (PFR) at 3 months (H0: 20%, H1:40%). The secondary endpoints included progression free survival (PFS), overall survival (OS), AEs, objective response and patient-reported outcomes (PRO). Efficacy analysis was by intention to treat. RESULTS The 3-month PFR was 56.4% (95% confidence interval CI: 39.6-72.2%). The 3-month and 6-month PFS were 58.4% (95% CI: 41.3-72.1%) and 44.6% (95% CI: 28.4-59.5%), respectively. Median PFS was 5.3 months (95% CI: 1.4-8.2) and median OS was 12.8 months (95% CI: 10.5-39.2). The most common treatment-related grade ≥ 3 AE were neutropenia (18%), followed by anemia (2.6%), hypertension (2.6%) and alanine aminotransferase increase (2.6%). Grade 1 and grade 2 peripheral sensory neuropathy (PNP) occurred in 15.4% and 20.5%, respectively. No grade 3-4 PNP was reported. CONCLUSIONS Combining nab-pc and gemcitabine is safe. Promising activity is observed in pretreated STS patients with manageable toxicity. This regimen should be considered for further exploration.
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Affiliation(s)
- A Digklia
- Department of Oncology, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland.
| | - A Kollár
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - D Dietrich
- Swiss Group for Clinical Cancer Research (SAKK) Competence Center, Bern, Switzerland
| | - M N Kronig
- Department of Medical Oncology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - C Britschgi
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - T Rordorf
- Department of Medical Oncology and Hematology, University Hospital Zurich, Zurich, Switzerland
| | - M Joerger
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
| | - F Krasniqi
- Department of Medical Oncology, University Hospital of Basel, Basel, Switzerland
| | - Y Metaxas
- Department of Medical Oncology, Cantonal Hospital, Grison Chur, Switzerland, now at Cantonal Hospital Muensterlingen, Muensterlingen, Switzerland
| | - I Colombo
- Oncology Institute of Southern Switzerland, Ente Ospedaliero Cantonale, Bellinzona, Switzerland
| | - K Ribi
- International Breast Cancer Study Group IBCSG (IBCSG), Bern, Switzerland
| | - C Rothermundt
- Department of Medical Oncology and Hematology, Kantonsspital St. Gallen, St. Gallen, Switzerland
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Büttner T, Zarbl R, Krausewitz P, Strieth S, Kristiansen G, Eckstein M, Ralser D, Hölzel M, Ritter M, Ellinger J, Dietrich D, Klümper N. Detection of hypermethylated SHOX2 in circulating cell-free DNA post nephrectomy identifies patients with renal cell carcinoma at highest risk for disease recurrence independent of TNM. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01086-2] [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: 02/12/2023]
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3
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Digklia A, Kollar A, Kronig MN, Britschgi C, Rordorf T, Joerger M, Krasniqi F, Metaxas Y, Colombo I, Dietrich D, Chiquet S, Ribi K, Rothermundt C. 1495P SAKK 57/16 nab-paclitaxel and gemcitabine in soft tissue sarcoma (NAPAGE): Final results from the phase Ib/II trial with >2y median follow up. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.1598] [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: 11/17/2022] Open
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Matthews EA, Sun W, McMahon SM, Doengi M, Halka L, Anders S, Müller JA, Steinlein P, Vana NS, van Dyk G, Pitsch J, Becker AJ, Pfeifer A, Kavalali ET, Lamprecht A, Henneberger C, Stein V, Schoch S, Dietrich D. Optical analysis of glutamate spread in the neuropil. Cereb Cortex 2022; 32:3669-3689. [PMID: 35059716 PMCID: PMC9433421 DOI: 10.1093/cercor/bhab440] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Revised: 11/03/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
Fast synaptic communication uses diffusible transmitters whose spread is limited by uptake mechanisms. However, on the submicron-scale, the distance between two synapses, the extent of glutamate spread has so far remained difficult to measure. Here, we show that quantal glutamate release from individual hippocampal synapses activates extracellular iGluSnFr molecules at a distance of >1.5 μm. 2P-glutamate uncaging near spines further showed that alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA)-Rs and N-methyl-D-aspartate (NMDA)-Rs respond to distant uncaging spots at approximately 800 and 2000 nm, respectively, when releasing the amount of glutamate contained in approximately five synaptic vesicles. The uncaging-induced remote activation of AMPA-Rs was facilitated by blocking glutamate transporters but only modestly decreased by elevating the recording temperature. When mimicking release from neighboring synapses by three simultaneous uncaging spots in the microenvironment of a spine, AMPA-R-mediated responses increased supra-additively. Interfering with extracellular glutamate diffusion through a glutamate scavenger system weakly reduced field synaptic responses but not the quantal amplitude. Together, our data suggest that the neuropil is more permissive to short-range spread of transmitter than suggested by theory, that multivesicular release could regularly coactivate nearest neighbor synapses and that on this scale glutamate buffering by transporters primarily limits the spread of transmitter and allows for cooperative glutamate signaling in extracellular microdomains.
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Affiliation(s)
| | | | | | - M Doengi
- Institute of Physiology, Medical Faculty, University of Bonn, 53115 Bonn, Germany
| | - L Halka
- Institute of Physiology, Medical Faculty, University of Bonn, 53115 Bonn, Germany
| | - S Anders
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, 53127 Bonn, Germany
| | - J A Müller
- Section for Translational Epilepsy Research, Department of Neuropathology, University Hospital Bonn, 53127 Bonn, Germany
| | - P Steinlein
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany,Department of Pharmaceutics, Institute of Pharmacy, University of Bonn, Bonn, Germany
| | - N S Vana
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - G van Dyk
- Department of Neurosurgery, University Hospital Bonn, 53127 Bonn, Germany
| | - J Pitsch
- Section for Translational Epilepsy Research, Department of Neuropathology, University Hospital Bonn, 53127 Bonn, Germany,Department of Epileptology, University Hospital Bonn, 53127 Bonn, Germany
| | - A J Becker
- Section for Translational Epilepsy Research, Department of Neuropathology, University Hospital Bonn, 53127 Bonn, Germany,Department of Epileptology, University Hospital Bonn, 53127 Bonn, Germany
| | - A Pfeifer
- Institute of Pharmacology and Toxicology, University Hospital, University of Bonn, 53127 Bonn, Germany
| | - E T Kavalali
- Department of Pharmacology, The Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN 37240-7933, USA
| | - A Lamprecht
- Department of Pharmaceutics, Institute of Pharmacy, University of Bonn, Bonn, Germany
| | - C Henneberger
- Institute of Cellular Neurosciences, Medical Faculty, University of Bonn, 53127 Bonn, Germany,German Center for Neurodegenerative Diseases (DZNE), 53127 Bonn, Germany,Institute of Neurology, University College London, London, WC1N 3BG, UK
| | - V Stein
- Institute of Physiology, Medical Faculty, University of Bonn, 53115 Bonn, Germany
| | - S Schoch
- Address correspondence to Prof. Dr Dirk Dietrich, Department of Neurosurgery, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany. ; and Prof. Dr Susanne Schoch, Institute of Neuropathology, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany.
| | - D Dietrich
- Address correspondence to Prof. Dr Dirk Dietrich, Department of Neurosurgery, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany. ; and Prof. Dr Susanne Schoch, Institute of Neuropathology, University Hospital Bonn, Venusberg Campus 1, Bonn 53127, Germany.
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Wilkening A, Zhu L, Dietrich D, Haberl R. [Cerebrospinal fluid pleocytosis in posterior reversible encephalopathy syndrome]. Nervenarzt 2021; 93:402-404. [PMID: 34491375 DOI: 10.1007/s00115-021-01179-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 11/30/2022]
Affiliation(s)
- A Wilkening
- Klinik für Neurologie und Neurologische Intensivmedizin, München Klinik gGmbH, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, Sanatoriumsplatz 2, 81545, München, Deutschland.
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland.
| | - L Zhu
- Klinik für Neurologie und Neurologische Intensivmedizin, München Klinik gGmbH, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, Sanatoriumsplatz 2, 81545, München, Deutschland
| | - D Dietrich
- Klinik für Neurologie und Neurologische Intensivmedizin, München Klinik gGmbH, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, Sanatoriumsplatz 2, 81545, München, Deutschland
| | - R Haberl
- Klinik für Neurologie und Neurologische Intensivmedizin, München Klinik gGmbH, Akademisches Lehrkrankenhaus der Ludwig-Maximilians-Universität München, Sanatoriumsplatz 2, 81545, München, Deutschland
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Klümper N, Ralser D, Zarbl R, Schlack K, Schrader A, Rehlinghaus M, Hoffmann M, Niegisch G, Uhlig A, Trojan L, Steinestel J, Steinestel K, Wirtz R, Kristiansen G, Toma M, Hölzel M, Ritter M, Strieth S, Ellinger J, Dietrich D. PDCD1 methylation predicts response to anti–PD-1 based immunotherapy in advanced and metastatic renal cell carcinoma. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00925-8] [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: 11/29/2022]
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Ralser DJ, Klümper N, Kaiser C, Faridi A, Abramian A, Dietrich D. Epigenetische Regulation von PDCD1 (PD-1), PD-L1 (CD274) und PD-L2 (PDCD1LG2) als Biomarker in der Immuntherapie des triple negativen Mammakarzinoms. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- DJ Ralser
- Brustzentrum, Universitätsklinikum Bonn
| | - N Klümper
- Klinik für Urologie und Kinderurologie, Universitätsklinikum Bonn
| | - C Kaiser
- Brustzentrum, Universitätsklinikum Bonn
| | - A Faridi
- Brustzentrum, Universitätsklinikum Bonn
| | | | - D Dietrich
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Bonn
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Ribi K, Thuerlimann B, Schär C, Dietrich D, Cathomas R, Zuerrer U, Von Briel T, Anchisi S, Bohanes P, Blum V, von Burg P, Mannhart M, Caspar C, von Moos R, Mark M. 1867P Quality of life and pain in patients with metastatic bone disease from solid tumors treated with bone-targeted agents: A real-world cross-sectional study from Switzerland (SAKK 95/16). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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9
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Stenner-Liewen F, Cathomas R, Rothermundt C, Schardt J, Patrikidou A, Zihler D, Erdmann A, Küng M, Dietrich D, Berset C, Godar G, Berthold D, Läubli H. 716P Optimizing ipilimumab in metastatic renal cell carcinoma: SAKK 07/17 study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.788] [Citation(s) in RCA: 1] [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: 11/25/2022] Open
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10
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Franzen A, Bootz F, Dietrich D. [Prognostic and predictive methylation biomarkers in HNSCC : Epigenomic diagnostics for head and neck squamous cell carcinoma (HNSCC)]. HNO 2020; 68:911-915. [PMID: 32613323 DOI: 10.1007/s00106-020-00902-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prognostic and predictive biomarkers for personalized treatment management in head and neck squamous cell carcinoma (HNSCC) are of great clinical interest. OBJECTIVE DNA methylation is an epigenetic process involved in gene regulation and could be a source of potential prognostic and predictive biomarkers. METHODS This study comprises literature research in PubMed and own studies. RESULTS Gene methylation, e.g. of PITX2, is a strong, human papillomavirus (HPV)-independent prognostic biomarker. SHOX2 and SEPT9 methylation in circulating cell-free DNA within blood plasma correlates with tumor stage and prognosis. Methylation of diverse immune checkpoints, e.g., PD‑1, PD-L1, and CTLA4, is also prognostic and correlates with gene expression. CONCLUSION DNA methylation is a source of efficient prognostic blood plasma- and tissue-based biomarkers. However, prior to clinical implementation, studies must prove that biomarker-guided treatment selection can lead to better outcomes or reduced toxicity. The applicability of DNA methylation as a predictive biomarker for targeted drug-based cancer therapy seems promising, although further validation is needed.
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Affiliation(s)
- A Franzen
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - F Bootz
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland
| | - D Dietrich
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Bonn, Venusberg-Campus 1, 53127, Bonn, Deutschland.
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11
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Mark M, Thuerlimann B, Ribi K, Schaer C, Dietrich D, Zuerrer U, von Moos R. Patterns of care for patients with metastatic bone disease in solid tumors: A cross-sectional study (SAKK 95/16). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz265.043] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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12
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Digklia A, Britschgi C, Metaxas Y, Kollar A, Krasniqi F, Stathis A, Rordorf T, Colombo I, Mach N, Hofer S, Montemurro M, Stojcheva N, Dietrich D, Rothermundt C. SAKK 57/16 nab-paclitaxel and gemcitabine in soft tissue sarcoma (NAPAGE): Results from the phase I part of a phase I/II trial. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz283.021] [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: 11/12/2022] Open
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13
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Salvatore L, Bria E, Sperduti I, Hinke A, Hegewisch-Becker S, Aparicio T, Le Malicot K, Boige V, Koeberle D, Baertschi D, Dietrich D, Tortora G, Arnold D. Bevacizumab (BV) maintenance after first-line chemotherapy plus BV for metastatic colorectal cancer patients: a meta-analysis of individual patients data from 3 phase III studies. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz156.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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14
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Hill BJ, Padgett KR, Kalra V, Marcillo A, Bowen B, Pattany P, Dietrich D, Quencer R. Gadolinium DTPA Enhancement Characteristics of the Rat Sciatic Nerve after Crush Injury at 4.7T. AJNR Am J Neuroradiol 2017; 39:177-183. [PMID: 29097415 DOI: 10.3174/ajnr.a5437] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/24/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Traumatic peripheral nerve injury is common and results in loss of function and/or neuropathic pain. MR neurography is a well-established technique for evaluating peripheral nerve anatomy and pathology. However, the Gd-DTPA enhancement characteristics of acutely injured peripheral nerves have not been fully examined. This study was performed to determine whether acutely crushed rat sciatic nerves demonstrate Gd-DTPA enhancement and, if so, to evaluate whether enhancement is affected by crush severity. MATERIALS AND METHODS In 26 rats, the sciatic nerve was crushed with either surgical forceps (6- to 20-N compressive force) or a microvascular/microaneurysm clip (0.1-0.6 N). Animals were longitudinally imaged at 4.7T for up to 30 days after injury. T1WI, T2WI, and T1WI with Gd-DTPA were performed. RESULTS Forceps crush injury caused robust enhancement between days 3 and 21, while clip crush injury resulted in minimal-to-no enhancement. Enhancement after forceps injury peaked at 7 days and was seen a few millimeters proximal to, in the region of, and several centimeters distal to the site of crush injury. Enhancement after forceps injury was statistically significant compared with clip injury between days 3 and 7 (P < .04). CONCLUSIONS Gd-DTPA enhancement of peripheral nerves may only occur above a certain crush-severity threshold. This phenomenon may explain the intermittent observation of Gd-DTPA enhancement of peripheral nerves after traumatic injury. The observation of enhancement may be useful in judging the severity of injury after nerve trauma.
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Affiliation(s)
- B J Hill
- From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.)
| | - K R Padgett
- From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.) .,Radiation Oncology (K.R.P.).,Biomedical Engineering (K.R.P.)
| | - V Kalra
- Miller School of Medicine (V.K.), University of Miami, Miami, Florida
| | - A Marcillo
- Miami Project to Cure Paralysis (A.M., D.D.)
| | - B Bowen
- From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.)
| | - P Pattany
- From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.)
| | - D Dietrich
- Miami Project to Cure Paralysis (A.M., D.D.)
| | - R Quencer
- From the Departments of Radiology (B.J.H., K.R.P., B.B., P.P., R.Q.)
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15
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Granzin M, Mueller S, Soltenborn S, Dietrich D, Arendt A, Bari R, Law P, Mekes A, Moeker N, Leung W, Huppert V. Novel process for clinical scale purification of NK cells using a two step separation strategy within a single automated procedure. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.177] [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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16
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Branchi V, Schaefer P, Semaan A, Kania A, Lingohr P, Kalff JC, Schäfer N, Kristiansen G, Dietrich D, Matthaei H. Promoter hypermethylation of SHOX2 and SEPT9 is a potential biomarker for minimally invasive diagnosis in adenocarcinomas of the biliary tract. Clin Epigenetics 2016; 8:133. [PMID: 27999621 PMCID: PMC5153824 DOI: 10.1186/s13148-016-0299-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [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] [Received: 05/09/2016] [Accepted: 11/29/2016] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Biliary tract carcinoma (BTC) is a fatal malignancy which aggressiveness contrasts sharply with its relatively mild and late clinical presentation. Novel molecular markers for early diagnosis and precise treatment are urgently needed. The purpose of this study was to evaluate the diagnostic and prognostic value of promoter hypermethylation of the SHOX2 and SEPT9 gene loci in BTC. METHODS Relative DNA methylation of SHOX2 and SEPT9 was quantified in tumor specimens and matched normal adjacent tissue (NAT) from 71 BTC patients, as well as in plasma samples from an independent prospective cohort of 20 cholangiocarcinoma patients and 100 control patients. Receiver operating characteristic (ROC) curve analyses were performed to probe the diagnostic ability of both methylation markers. DNA methylation was correlated to clinicopathological data and to overall survival. RESULTS SHOX2 methylation was significantly higher in tumor tissue than in NAT irrespective of tumor localization (p < 0.001) and correctly identified 71% of BTC specimens with 100% specificity (AUC = 0.918; 95% CI 0.865-0.971). SEPT9 hypermethylation was significantly more frequent in gallbladder carcinomas compared to cholangiocarcinomas (p = 0.01) and was associated with large primary tumors (p = 0.01) as well as age (p = 0.03). Cox proportional hazard analysis confirmed microscopic residual tumor at the surgical margin (R1-resection) as an independent prognostic factor, while SHOX2 and SEPT9 methylation showed no correlation with overall survival. Elevated DNA methylation levels were also found in plasma derived from cholangiocarcinoma patients. SHOX2 and SEPT9 methylation as a marker panel achieved a sensitivity of 45% and a specificity of 99% in differentiating between samples from patients with and without cholangiocarcinoma (AUC = 0.752; 95% CI 0.631-0.873). CONCLUSIONS SHOX2 and SEPT9 are frequently methylated in biliary tract cancers. Promoter hypermethylation of SHOX2 and SEPT9 may therefore serve as a minimally invasive biomarker supporting diagnosis finding and therapy monitoring in clinical specimens.
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Affiliation(s)
- V Branchi
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - P Schaefer
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - A Semaan
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - A Kania
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - P Lingohr
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - J C Kalff
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - N Schäfer
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
| | - G Kristiansen
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - D Dietrich
- Institute of Pathology, University Hospital Bonn, Bonn, Germany.,Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - H Matthaei
- Department of General, Visceral, Thoracic and Vascular Surgery University Hospital Bonn, University of Bonn, Sigmund-Freud-Strasse 25, 53127 Bonn, Germany
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Goltz D, Gevensleben H, Grünen S, Dietrich J, Kristiansen G, Landsberg J, Dietrich D. PD-L1 (CD274) promoter methylation predicts survival in patients with acute myeloid leukemia. Leukemia 2016; 31:738-743. [PMID: 27840427 DOI: 10.1038/leu.2016.328] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Affiliation(s)
- D Goltz
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - H Gevensleben
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - S Grünen
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - J Dietrich
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
| | - G Kristiansen
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - J Landsberg
- Department of Dermatology, University Hospital Bonn, Bonn, Germany
| | - D Dietrich
- Institute of Pathology, University Hospital Bonn, Bonn, Germany.,Department of Otolaryngology, Head and Neck Surgery, University Hospital Bonn, Bonn, Germany
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Greiner-Perth R, Sellhast N, Perler G, Dietrich D, Staub LP, Röder C. Erratum to: Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey. Eur Spine J 2016; 25:2571. [PMID: 27142806 DOI: 10.1007/s00586-016-4600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Revised: 04/26/2016] [Accepted: 04/26/2016] [Indexed: 06/05/2023]
Affiliation(s)
- R Greiner-Perth
- Orthopädische und Neurochirurgische Gemeinschaftspraxis, Eppenreuther Straße 28, 95032, Hof, Germany
| | - N Sellhast
- Regionalspital Emmental AG, Hospital Burgdorf, Oberburgstrasse 54, 3400, Burgdorf, Switzerland
| | - G Perler
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
| | - D Dietrich
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
- Institute for Mathematical Statistics and Actuarial Science, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - L P Staub
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
| | - C Röder
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
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Puhr M, Hoefer J, Eigentler A, Dietrich D, van Leenders G, Uhl B, Hoogland M, Handle F, Schlick B, Neuwirt H, Sailer V, Kristiansen G, Klocker H, Culig Z. PIAS1 is a determinant of poor survival and acts as a positive feedback regulator of AR signaling through enhanced AR stabilization in prostate cancer. Oncogene 2016; 35:2322-32. [PMID: 26257066 PMCID: PMC4865476 DOI: 10.1038/onc.2015.292] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Revised: 06/10/2015] [Accepted: 07/06/2015] [Indexed: 01/19/2023]
Abstract
Novel drugs like Abiraterone or Enzalutamide, which target androgen receptor (AR) signaling to improve androgen deprivation therapy (ADT), have been developed during the past years. However, the application of these drugs is limited because of occurrence of inherent or acquired therapy resistances during the treatment. Thus, identification of new molecular targets is urgently required to improve current therapeutic prostate cancer (PCa) treatment strategies. PIAS1 (protein inhibitor of activated STAT1 (signal transducer and activator of transcription-1)) is known to be an important cell cycle regulator and PIAS1-mediated SUMOylation is essential for DNA repair. In this context, elevated PIAS1 expression has already been associated with cancer initiation. Thus, in the present study, we addressed the question of whether PIAS1 targeting can be used as a basis for an improved PCa therapy in combination with anti-androgens. We show that PIAS1 significantly correlates with AR expression in PCa tissue and in cell lines and demonstrate that high PIAS1 levels predict shorter relapse-free survival. Our patient data are complemented by mechanistic and functional in vitro experiments that identify PIAS1 as an androgen-responsive gene and a crucial factor for AR signaling via prevention of AR degradation. Furthermore, PIAS1 knockdown is sufficient to decrease cell proliferation as well as cell viability. Strikingly, Abiraterone or Enzalutamide treatment in combination with PIAS1 depletion is even more effective than single-drug treatment in multiple PCa cell models, rendering PIAS1 as a promising target protein for a combined treatment approach to improve future PCa therapies.
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Affiliation(s)
- M Puhr
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - J Hoefer
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - A Eigentler
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - D Dietrich
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - G van Leenders
- Institute of Pathology Erasmus Medical Center, Rotterdam, The Netherlands
| | - B Uhl
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - M Hoogland
- Institute of Pathology Erasmus Medical Center, Rotterdam, The Netherlands
| | - F Handle
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - B Schlick
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - H Neuwirt
- Department of Internal Medicine IV (Nephrology and Hypertension), Medical University of Innsbruck, Innsbruck, Austria
| | - V Sailer
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - G Kristiansen
- Institute of Pathology, University Hospital Bonn, Bonn, Germany
| | - H Klocker
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
| | - Z Culig
- Department of Urology, Medical University of Innsbruck, Innsbruck, Austria
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Greiner-Perth R, Sellhast N, Perler G, Dietrich D, Staub LP, Röder C. Dynamic posterior stabilization for degenerative lumbar spine disease: a large consecutive case series with long-term follow-up by additional postal survey. Eur Spine J 2016; 25:2563-70. [PMID: 27029541 DOI: 10.1007/s00586-016-4532-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Revised: 03/10/2016] [Accepted: 03/13/2016] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Dynamic stabilization of the degenerated spine was invented to overcome the negative side effects of fusion surgery like adjacent segment degeneration. Amongst various different implants DSS(®) is a pedicle-based dynamic device for stabilizing the spine and preserving motion. Nearly no clinical data of the implant have been reported so far. The current analysis presents results from a single spine surgeon who has been using DSS(®) for the past 5 years and recorded all treatment and outcome data in the international Spine Tango registry. MATERIALS/METHODS From the prospectively documented overall patient pool 436 cases treated with DSS(®) could be identified. The analysis was enhanced with a mailing of COMI patient questionnaires for generating longer-term follow-ups up to 4 years. RESULTS 387 patients (189 male, 198 female; mean age 67.3 years) with degenerative lumbar spinal disease including degenerative spondylolisthesis (6.1 %) could be evaluated. The type of degeneration was mainly spinal stenosis (89.9 %). After a mean follow-up of 1.94 years, the COMI score and NRS back and leg pain improved significantly and to a clinically relevant extent. The postoperative trend analysis could not determine a relevant deterioration of these outcomes until 4 years postoperative. 10 patients were revised (2.6 %) and the implant was removed; in most cases, a fusion was performed. Another 5 cases (1.3 %) had an extension of the dynamic stabilization system to the adjacent level. 84.2 % of patients rated that the surgery had helped a lot or had helped. DISCUSSION The results of this large consecutive series with a follow-up up to 4 years could demonstrate a good and stable clinical outcome after posterior dynamic stabilization with DSS(®). For degenerative diseases of the lumbar spine, this treatment seems to be a valid alternative to fusion surgery.
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Affiliation(s)
- R Greiner-Perth
- Orthopädische und Neurochirurgische Gemeinschaftspraxis, Eppenreuther Straße 28, 95032, Hof, Germany
| | - N Sellhast
- Regionalspital Emmental AG, Hospital Burgdorf, Oberburgstrasse 54, 3400, Burgdorf, Switzerland
| | - G Perler
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
| | - D Dietrich
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.,Institute for Mathematical Statistics and Actuarial Science, University of Bern, Sidlerstrasse 5, 3012, Bern, Switzerland
| | - L P Staub
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland.
| | - C Röder
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, 3012, Bern, Switzerland
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Kienle D, Winterhalder R, Koeberle D, Horber D, Kueng M, Saletti P, Helbling D, Bastian S, Dietrich D, Baertschi D, Pilop C, Von Moos R. 1322 Cetuximab monotherapy and cetuximab plus capecitabine as first-line treatment in elderly patients with RAS- and BRAF wild-type metastatic colorectal cancer. Results of the multicenter phase II trial SAKK 41/10. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30565-2] [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: 11/26/2022]
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22
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Fleischhacker M, Beyer J, Dietrich D, Ziehn U, Bork I, Lambrecht N, Schmidt B. Der DNA-Methylierungsmarker mSHOX2 im Plasma als prognostischer Marker beim fortgeschrittenen Lungenkarzinom – eine Pilotstudie. Pneumologie 2015. [DOI: 10.1055/s-0035-1544729] [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: 10/24/2022]
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Koeberle D, Betticher DC, von Moos R, Dietrich D, Brauchli P, Baertschi D, Matter K, Winterhalder R, Borner M, Anchisi S, Moosmann P, Kollar A, Saletti P, Roth A, Frueh M, Kueng M, Popescu RA, Schacher S, Hess V, Herrmann R. Bevacizumab continuation versus no continuation after first-line chemotherapy plus bevacizumab in patients with metastatic colorectal cancer: a randomized phase III non-inferiority trial (SAKK 41/06). Ann Oncol 2015; 26:709-714. [PMID: 25605741 DOI: 10.1093/annonc/mdv011] [Citation(s) in RCA: 107] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Chemotherapy plus bevacizumab is a standard option for first-line treatment in metastatic colorectal cancer (mCRC) patients. We assessed whether no continuation is non-inferior to continuation of bevacizumab after completing first-line chemotherapy. PATIENTS AND METHODS In an open-label, phase III multicentre trial, patients with mCRC without disease progression after 4-6 months of standard first-line chemotherapy plus bevacizumab were randomly assigned to continuing bevacizumab at a standard dose or no treatment. CT scans were done every 6 weeks until disease progression. The primary end point was time to progression (TTP). A non-inferiority limit for hazard ratio (HR) of 0.727 was chosen to detect a difference in TTP of 6 weeks or less, with a one-sided significance level of 10% and a statistical power of 85%. RESULTS The intention-to-treat population comprised 262 patients: median follow-up was 36.7 months. The median TTP was 4.1 [95% confidence interval (CI) 3.1-5.4] months for bevacizumab continuation versus 2.9 (95% CI 2.8-3.8) months for no continuation; HR 0.74 (95% CI 0.58-0.96). Non-inferiority could not be demonstrated. The median overall survival was 25.4 months for bevacizumab continuation versus 23.8 months (HR 0.83; 95% CI 0.63-1.1; P = 0.2) for no continuation. Severe adverse events were uncommon in the bevacizumab continuation arm. Costs for bevacizumab continuation were estimated to be ∼30,000 USD per patient. CONCLUSIONS Non-inferiority could not be demonstrated for treatment holidays versus continuing bevacizumab monotheray, after 4-6 months of standard first-line chemotherapy plus bevacizumab. Based on no impact on overall survival and increased treatment costs, bevacizumab as a single agent is of no meaningful therapeutic value. More efficient treatment approaches are needed to maintain control of stabilized disease following induction therapy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov, number NCT00544700.
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Affiliation(s)
- D Koeberle
- Department of Oncology, Kantonsspital St Gallen, St Gallen.
| | - D C Betticher
- Department of Oncology, Hôpital Fribourgeois, Fribourg
| | - R von Moos
- Department of Oncology, Kantonsspital Chur, Chur
| | | | | | | | - K Matter
- Institute of Pharmaceutical Medicine/ECPM, Basel
| | | | - M Borner
- Department of Oncology, Spitalzentrum Biel, Biel
| | - S Anchisi
- Department of Oncology, Hôpital de Sion, Sion
| | - P Moosmann
- Department of Oncology, Kantonsspital Aarau, Aarau
| | - A Kollar
- Department of Oncology, Inselspital Bern, Bern
| | - P Saletti
- Department of Oncology, IOSI, Bellinzona
| | - A Roth
- Department of Oncology, HCUG, Geneva
| | - M Frueh
- Department of Oncology, Kantonsspital St Gallen, St Gallen
| | - M Kueng
- Department of Oncology, Hôpital Fribourgeois, Fribourg
| | - R A Popescu
- Department of Oncology, Hirslanden Klinik Aarau, Aarau
| | - S Schacher
- Department of Oncology, Kantonsspital Winterthur, Winterthur
| | - V Hess
- Department of Oncology, Universitätsspital Basel, Basel, Switzerland
| | - R Herrmann
- Department of Oncology, Universitätsspital Basel, Basel, Switzerland
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Montemurro M, Cioffi A, Domont J, Rutkowski P, Roth A, von Moos R, Inauen R, Bui B, Burkhard R, Knuesli C, Bauer S, Cassier P, Schwarb H, Le Cesne A, Koeberle D, Baertschi D, Dietrich D, Biaggi C, Prior J, Leyvraz S. Long-Term Outcome of Dasatinib First-Line Treatment in Gastrointestinal Stromal Tumors: a Multicenter Two Stage Phase Ii Trial Sakk 56/07. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu354.7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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25
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Fuhrmann C, Schütte W, Nagel S, Reinicke D, Dietrich D, Schmidt B, Fleischhacker M. Der Lungenkarzinom-Marker mSHOX2 prä- und postoperativ. Pneumologie 2014. [DOI: 10.1055/s-0034-1367953] [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: 10/25/2022]
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26
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Beyer J, Bork I, Dietrich D, Reinicke D, Schmidt B, Fleischhacker M. Eignet sich frei zirkulierende mSHOX2 Plasma DNA zum Therapiemonitoring bei Patienten mit fortgeschrittenem Lungenkarzinom unter Chemo- oder Radiochemotherapie? Pneumologie 2014. [DOI: 10.1055/s-0034-1367955] [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: 10/25/2022]
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Huisamen B, George C, Dietrich D, Genade S. Cardioprotective and anti-hypertensive effects of Prosopis glandulosa in rat models of pre-diabetes. Cardiovasc J Afr 2013; 24:10-6. [PMID: 23612947 PMCID: PMC3734879 DOI: 10.5830/cvja-2012-069] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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] [Received: 06/07/2012] [Accepted: 10/12/2012] [Indexed: 11/06/2022] Open
Abstract
Aim Obesity and type 2 diabetes present with two debilitating complications, namely, hypertension and heart disease. The dried and ground pods of Prosopis glandulosa (commonly known as the Honey mesquite tree) which is part of the Fabaceae (or legume) family are currently marketed in South Africa as a food supplement with blood glucose-stabilising and anti-hypertensive properties. We previously determined its hypoglycaemic effects, and in the current study we determined the efficacy of P glandulosa as anti-hypertensive agent and its myocardial protective ability. Methods Male Wistar rats were rendered either pre-diabetic (diet-induced obesity: DIO) or hypertensive (high-fat diet: HFD). DIO animals were treated with P glandulosa (100 mg/kg/day for the last eight weeks of a 16-week period) and compared to age-matched controls. Hearts were perfused ex vivo to determine infarct size. Biometric parameters were determined at the time of sacrifice. Cardiac-specific insulin receptor knock-out (CIRKO) mice were similarly treated with P glandulosa and infarct size was determined. HFD animals were treated with P glandulosa from the onset of the diet or from weeks 12–16, using captopril (50 mg/kg/day) as the positive control. Blood pressure was monitored weekly. Results DIO rats and CIRKO mice: P glandulosa ingestion significantly reduced infarct size after ischaemia–reperfusion. Proteins of the PI-3-kinase/PKB/Akt survival pathway were affected in a manner supporting cardioprotection. HFD model: P glandulosa treatment both prevented and corrected the development of hypertension, which was also reflected in alleviation of water retention. Conclusion P glandulosa was cardioprotective and infarct sparing as well as anti-hypertensive without affecting the body weight or the intra-peritoneal fat depots of the animals. Changes in the PI-3-kinase/PKB/Akt pathway may be causal to protection. Results indicated water retention, possibly coupled to vasoconstriction in the HFD animals, while ingestion of P glandulosa alleviated both. We concluded that treatment of pre-diabetes, type 2 diabetes or hypertension with P glandulosa poses possible beneficial health effects.
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Abe Y, Aberle C, dos Anjos JC, Barriere JC, Bergevin M, Bernstein A, Bezerra TJC, Bezrukhov L, Blucher E, Bowden NS, Buck C, Busenitz J, Cabrera A, Caden E, Camilleri L, Carr R, Cerrada M, Chang PJ, Chimenti P, Classen T, Collin AP, Conover E, Conrad JM, Crespo-Anadón JI, Crum K, Cucoanes A, D’Agostino MV, Damon E, Dawson JV, Dazeley S, Dietrich D, Djurcic Z, Dracos M, Durand V, Ebert J, Efremenko Y, Elnimr M, Erickson A, Etenko A, Fallot M, Fechner M, von Feilitzsch F, Felde J, Fernandes SM, Fischer V, Franco D, Franke AJ, Franke M, Furuta H, Gama R, Gil-Botella I, Giot L, Göger-Neff M, Gonzalez LFG, Goodenough L, Goodman MC, Goon JTM, Greiner D, Haag N, Habib S, Hagner C, Hara T, Hartmann FX, Haser J, Hatzikoutelis A, Hayakawa T, Hofmann M, Horton-Smith GA, Hourlier A, Ishitsuka M, Jochum J, Jollet C, Jones CL, Kaether F, Kalousis LN, Kamyshkov Y, Kaplan DM, Kawasaki T, Keefer G, Kemp E, de Kerret H, Kibe Y, Konno T, Kryn D, Kuze M, Lachenmaier T, Lane CE, Langbrandtner C, Lasserre T, Letourneau A, Lhuillier D, Lima HP, Lindner M, López-Castaño JM, LoSecco JM, Lubsandorzhiev BK, Lucht S, McKee D, Maeda J, Maesano CN, Mariani C, Maricic J, Martino J, Matsubara T, Mention G, Meregaglia A, Meyer M, Miletic T, Milincic R, Miyata H, Mueller TA, Nagasaka Y, Nakajima K, Novella P, Obolensky M, Oberauer L, Onillon A, Osborn A, Ostrovskiy I, Palomares C, Pepe IM, Perasso S, Perrin P, Pfahler P, Porta A, Potzel W, Pronost G, Reichenbacher J, Reinhold B, Remoto A, Röhling M, Roncin R, Roth S, Rybolt B, Sakamoto Y, Santorelli R, Sato F, Schönert S, Schoppmann S, Schwetz T, Shaevitz MH, Shimojima S, Shrestha D, Sida JL, Sinev V, Skorokhvatov M, Smith E, Spitz J, Stahl A, Stancu I, Stokes LFF, Strait M, Stüken A, Suekane F, Sukhotin S, Sumiyoshi T, Sun Y, Svoboda R, Terao K, Tonazzo A, Toups M, Trinh Thi HH, Valdiviesso G, Veyssiere C, Wagner S, Watanabe H, White B, Wiebusch C, Winslow L, Worcester M, Wurm M, Yermia F, Zimmer V. Direct measurement of backgrounds using reactor-off data in Double Chooz. Int J Clin Exp Med 2013. [DOI: 10.1103/physrevd.87.011102] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Rieger B, Tamcan O, Dietrich D, Müller U. Ageing Challenges the Results of any Outcome Study: How to Address the Effects of Ageing on Activities of Daily Living. J Int Med Res 2012; 40:726-33. [DOI: 10.1177/147323001204000237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES: Clinical study results might be substantially biased by the effects of ageing, resulting in considerable underestimation of treatment efficacy, especially when assessing activities of daily living (ADL) in elderly people. This study aimed to define age- and comorbidity-related normative values in ADL. METHODS: In cross-sectional sampling, 23 763 German-speaking Swiss individuals were contacted. Valid questionnaires from 16 191 (68%) eligible individuals ≥ 18 years of age were included in the study. Age-related ADL reference values were calculated using questionnaire data. RESULTS: The sample was representative of the German-speaking Swiss population as determined by 2003 census data. Age- and pain-related ADL reference values were plotted and confirmed that disability increased with increasing age. CONCLUSIONS: The use of ADL scales that provide age- and comorbidity-related reference values for outcome studies or studies focusing on the elderly is recommended in order to reduce the effect of bias.
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Affiliation(s)
- B Rieger
- Orthopaedic Clinic of Bern, Bern, Switzerland
| | - O Tamcan
- Institute for Evaluative Research in Orthopaedic Surgery
| | - D Dietrich
- Institute for Mathematics, University of Bern, Bern, Switzerland
| | - U Müller
- Institute for Evaluative Research in Orthopaedic Surgery
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30
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Abe Y, Aberle C, Akiri T, dos Anjos JC, Ardellier F, Barbosa AF, Baxter A, Bergevin M, Bernstein A, Bezerra TJC, Bezrukhov L, Blucher E, Bongrand M, Bowden NS, Buck C, Busenitz J, Cabrera A, Caden E, Camilleri L, Carr R, Cerrada M, Chang PJ, Chimenti P, Classen T, Collin AP, Conover E, Conrad JM, Cormon S, Crespo-Anadón JI, Cribier M, Crum K, Cucoanes A, D'Agostino MV, Damon E, Dawson JV, Dazeley S, Dierckxsens M, Dietrich D, Djurcic Z, Dracos M, Durand V, Efremenko Y, Elnimr M, Endo Y, Etenko A, Falk E, Fallot M, Fechner M, von Feilitzsch F, Felde J, Fernandes SM, Franco D, Franke AJ, Franke M, Furuta H, Gama R, Gil-Botella I, Giot L, Göger-Neff M, Gonzalez LFG, Goodman MC, Goon JTM, Greiner D, Guillon B, Haag N, Hagner C, Hara T, Hartmann FX, Hartnell J, Haruna T, Haser J, Hatzikoutelis A, Hayakawa T, Hofmann M, Horton-Smith GA, Ishitsuka M, Jochum J, Jollet C, Jones CL, Kaether F, Kalousis L, Kamyshkov Y, Kaplan DM, Kawasaki T, Keefer G, Kemp E, de Kerret H, Kibe Y, Konno T, Kryn D, Kuze M, Lachenmaier T, Lane CE, Langbrandtner C, Lasserre T, Letourneau A, Lhuillier D, Lima HP, Lindner M, Liu Y, López-Castanõ JM, LoSecco JM, Lubsandorzhiev BK, Lucht S, McKee D, Maeda J, Maesano CN, Mariani C, Maricic J, Martino J, Matsubara T, Mention G, Meregaglia A, Miletic T, Milincic R, Milzstajn A, Miyata H, Motta D, Mueller TA, Nagasaka Y, Nakajima K, Novella P, Obolensky M, Oberauer L, Onillon A, Osborn A, Ostrovskiy I, Palomares C, Peeters SJM, Pepe IM, Perasso S, Perrin P, Pfahler P, Porta A, Potzel W, Queval R, Reichenbacher J, Reinhold B, Remoto A, Reyna D, Röhling M, Roth S, Rubin HA, Sakamoto Y, Santorelli R, Sato F, Schönert S, Schoppmann S, Schwan U, Schwetz T, Shaevitz MH, Shrestha D, Sida JL, Sinev V, Skorokhvatov M, Smith E, Spitz J, Stahl A, Stancu I, Strait M, Stüken A, Suekane F, Sukhotin S, Sumiyoshi T, Sun Y, Sun Z, Svoboda R, Tabata H, Tamura N, Terao K, Tonazzo A, Toups M, Trinh Thi HH, Veyssiere C, Wagner S, Watanabe H, White B, Wiebusch C, Winslow L, Worcester M, Wurm M, Yanovitch E, Yermia F, Zbiri K, Zimmer V. Indication of reactor ν(e) disappearance in the Double Chooz experiment. Phys Rev Lett 2012; 108:131801. [PMID: 22540693 DOI: 10.1103/physrevlett.108.131801] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Indexed: 05/31/2023]
Abstract
The Double Chooz experiment presents an indication of reactor electron antineutrino disappearance consistent with neutrino oscillations. An observed-to-predicted ratio of events of 0.944±0.016(stat)±0.040(syst) was obtained in 101 days of running at the Chooz nuclear power plant in France, with two 4.25 GW(th) reactors. The results were obtained from a single 10 m(3) fiducial volume detector located 1050 m from the two reactor cores. The reactor antineutrino flux prediction used the Bugey4 flux measurement after correction for differences in core composition. The deficit can be interpreted as an indication of a nonzero value of the still unmeasured neutrino mixing parameter sin(2)2θ(13). Analyzing both the rate of the prompt positrons and their energy spectrum, we find sin(2)2θ(13)=0.086±0.041(stat)±0.030(syst), or, at 90% C.L., 0.017<sin(2)2θ(13)<0.16.
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Affiliation(s)
- Y Abe
- Department of Physics, Tokyo Institute of Technology, Tokyo, 152-8551, Japan
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Schmidt B, Kneip C, Fleischhacker M, Dietrich D, Liebenberg V, Field J. SHOX2 DNA Methylierung in Plasma – ein vielversprechender Biomarker für die Detektion von Lungenkrebs. Pneumologie 2012. [DOI: 10.1055/s-0032-1302885] [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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Schmidt B, Liloglou L, Dietrich D, Liebenberg V, Field J. SHOX2 DNA Methylierung – ein validierter Biomarker für Lungenkrebs in Bronchialaspiraten. Pneumologie 2012. [DOI: 10.1055/s-0032-1302806] [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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Hasinger O, Schatz P, Dietrich D, Ivascu C, Sledziewski A, Hartmann A. 1435 POSTER Prostate Cancer Prognosis by Real-time PCR Analysis of PITX2 Methylation. Eur J Cancer 2011. [DOI: 10.1016/s0959-8049(11)70928-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Bernhard J, Dietrich D, Glimelius B, Hess V, Bodoky G, Scheithauer W, Herrmann R. Estimating prognosis and palliation based on tumour marker CA 19-9 and quality of life indicators in patients with advanced pancreatic cancer receiving chemotherapy. Br J Cancer 2010; 103:1318-24. [PMID: 20877359 PMCID: PMC2990612 DOI: 10.1038/sj.bjc.6605929] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background: To investigate the prognostic value of quality of life (QOL) relative to tumour marker carbohydrate antigen (CA) 19-9, and the role of CA 19-9 in estimating palliation in patients with advanced pancreatic cancer receiving chemotherapy. Methods: CA 19-9 serum concentration was measured at baseline and every 3 weeks in a phase III trial (SAKK 44/00–CECOG/PAN.1.3.001). Patients scored QOL indicators at baseline, and before each administration of chemotherapy (weekly or bi-weekly) for 24 weeks or until progression. Prognostic factors were investigated by Cox models, QOL during chemotherapy by mixed-effect models. Results: Patient-rated pain (P<0.02) and tiredness (P<0.03) were independent predictors for survival, although less prognostic than CA 19-9 (P<0.001). Baseline CA 19-9 did not predict QOL during chemotherapy, except for a marginal effect on pain (P<0.05). Mean changes in physical domains across the whole observation period were marginally correlated with the maximum CA 19-9 decrease. Patients in a better health status reported the most improvement in QOL within 20 days before maximum CA 19-9 decrease. They indicated substantially less pain and better physical well-being, already, early on during chemotherapy with a maximum CA 19-9 decrease of ⩾50% vs <50%. Conclusion: In advanced pancreatic cancer, pain and tiredness are independent prognostic factors for survival, although less prognostic than CA 19-9. Quality of life improves before best CA 19-9 response but the maximum CA 19-9 decrease has no impact on subsequent QOL. To estimate palliation by chemotherapy, patient's perception needs to be taken into account.
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Affiliation(s)
- J Bernhard
- SAKK Coordinating Center, Bern, Switzerland.
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Schmidt B, Liebenberg V, Dietrich D, Schlegel T, Kneip C, Seegebarth A, Flemming N, Liloglu T, Walshaw M, Fleischhacker M, Witt C, Field J. Methylierung von SHOX2 in Bronchiallavage: ein hochspezifischer molekularer Tumormarker für das Lungenkarzinom. Pneumologie 2010. [DOI: 10.1055/s-0030-1251121] [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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Tejpar S, Bosman F, Delorenzi M, Fiocca R, Yan P, Klingbiel D, Dietrich D, Van Cutsem E, Labianca R, Roth A. Microsatellite instability (MSI) in stage II and III colon cancer treated with 5FU-LV or 5FU-LV and irinotecan (PETACC 3-EORTC 40993-SAKK 60/00 trial). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4001] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [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
4001 Background: Patients with high MSI (MSI H) tumors are increasingly being recognized as a prognostic and predictive subgroup in colon cancer (COC). We investigated the incidence of MSI-H in stage II (n=395) and stage III (n=859) COC, its association with histopathological variables and its prognostic and predictive impact. Methods: The study accrued 3278 patients with Stage II and Stage III COC to receive post-operative 5-FU -LV with or without irinotecan (IRI). Paraffin tissue blocks of 1327/1405 available patients were successfully analyzed for MSI status using the NCI extended panel of 10 markers. MSI-H was defined as instability in ≥3 markers. Relapse Free Survival (RFS) and Overall Survival (OS, median follow up 68 months) were assessed. Results: MSI H was present in 22% (85) of Stage II and 12% (103)of Stage III colon cancer . MSI H status was significantly associated with age <60, higher T stage, higher grade, lower N stage and right sided tumor location. The table presents univariate RFS and OS hazard rates (with 95% confidence intervals) for prognostic and predictive impact per stage and arm, estimated by a survival regression analysis using Cox proportional hazards model and of selected P values by Wald tests. Conclusions: Microsatellite instability is a strong prognostic factor for RFS and OS when considering Stage II and Stage III COC. Subgroup analysis suggests a stronger effect in Stage II than in Stage III, but is limited by sample size and multiple testing. Taken together with differences in incidence between the stages, this may suggest stage specific biological effects of MSI. In contrast to previous reports (a) in Stage II the prognostic effect of MSI remained significant even in pts treated with 5FU (w/o IRI),(b) There is no evidence for an effect of the addition of IRI. [Table: see text] [Table: see text]
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Affiliation(s)
- S. Tejpar
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - F. Bosman
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - M. Delorenzi
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - R. Fiocca
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - P. Yan
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - D. Klingbiel
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - D. Dietrich
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - E. Van Cutsem
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - R. Labianca
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
| | - A. Roth
- UZ Gasthuisberg-Katholieke University Leuven, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; Swiss Institute of Bioinformatics, Lausanne, Switzerland; University of Genova, Genova, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Swiss Group for Clinical Cancer Research (SAKK), Bern, Switzerland; Ospedali Riuniti, Bergamo, Italy; University Hospital of Geneva, Geneva, Switzerland
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Roth AD, Tejpar S, Yan P, Fiocca R, Dietrich D, Delorenzi M, Labianca R, Cunningham D, Van Cutsem E, Bosman F. Stage-specific prognostic value of molecular markers in colon cancer: Results of the translational study on the PETACC 3-EORTC 40993-SAKK 60–00 trial. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.4002] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [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
4002 Background: We compared the incidence of molecular markers in stage II (SII) and III (SIII) colon cancer and tested their prognostic value per stage, using PETACC 3, an adjuvant trial with 3,278 patients. We included expression of P53, SMAD4, thymidylate synthetase (TS) and hTERT, mutations of KRAS and BRAF, microsatellite instability (MSI) and 18qLOH. Methods: 1,564 formalin fixed paraffin embedded tissue blocks were prospectively collected and DNA from normal and tumor tissue was extracted after macrodissection. High P53, TS and hTERT expression and SMAD4 loss were assessed by immunohistochemistry. MSI was studied with 10 markers. KRAS exon 2 and BRAF exon 15 mutations were analyzed by allele specific real time PCR. 18qLOH was studied by pyrosequencing 7 SNPs. Prognostic value of the markers was analysed per stage by Cox regression for Relapse Free Survival (RFS). Results: marker frequencies and stage specific p-values in prognostic models in 420 SII and 984 SIII patients are listed in the table . Significant differences in frequency per stage were found for all markers except KRAS and BRAF. An interaction test for differences between marker prognostic value for SII and SIII was significant for MSI (p=0.04) and 18qLOH (p=0.04) in SII. Multivariate analysis including markers, T stage, N stage (for SIII), Tu grade, age <60, sex, treatment arm, and Tu site found T stage (p=0.0001) and MSI (p=0.02) as independently significant clinical predictors in SII; N stage (p<0.0001), T stage (p<0.0001), SMAD4 (p<0.0001) and P53 (p=0.01) in SIII. Conclusions: Molecular markers in colon cancer have a stage specific prognostic value. The possibility that the stages represent different diseases, rather than sequential steps in the evolution of a single disease, needs to be considered. [Table: see text] [Table: see text]
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Affiliation(s)
- A. D. Roth
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - S. Tejpar
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - P. Yan
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - R. Fiocca
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - D. Dietrich
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - M. Delorenzi
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - R. Labianca
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - D. Cunningham
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - E. Van Cutsem
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - F. Bosman
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gathuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group of Cancer Research (SAKK), Bern, Switzerland; Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
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Röder C, Staub L, Dietrich D, Zweig T, Melloh M, Aebi M. Benchmarking with Spine Tango: potentials and pitfalls. Eur Spine J 2009; 18 Suppl 3:305-11. [PMID: 19337759 DOI: 10.1007/s00586-009-0943-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Revised: 03/11/2009] [Accepted: 03/12/2009] [Indexed: 12/01/2022]
Abstract
The newly released online statistics function of Spine Tango allows comparison of own data against the aggregated results of the data pool that all other participants generate. This comparison can be considered a very simple way of benchmarking, which means that the quality of what one organization does is compared with other similar organizations. The goal is to make changes towards better practice if benchmarking shows inferior results compared with the pool. There are, however, pitfalls in this simplified way of comparing data that can result in confounding. This means that important influential factors can make results appear better or worse than they are in reality and these factors can only be identified and neutralized in a multiple regression analysis performed by a statistical expert. Comparing input variables, confounding is less of a problem than comparing outcome variables. Therefore, the potentials and limitations of automated online comparisons need to be considered when interpreting the results of the benchmarking procedure.
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Affiliation(s)
- Christoph Röder
- MEM Research Center for Orthopaedic Surgery, Institute for Evaluative Research in Orthopaedic Surgery, University of Bern, Stauffacherstrasse 78, 3014 Bern, Switzerland.
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Ohlmeier M, Zhang Y, Bode L, Sieg S, Feutl S, Ludwig H, Emrich H, Dietrich D. Amantadine Reduces Mania in Borna Disease Virus-Infected Non-Psychotic Bipolar Patients. Pharmacopsychiatry 2008; 41:202-3. [DOI: 10.1055/s-2008-1078748] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Gerber D, Dietrich D, Koeberle D, Saletti P, Borner M, Caspar CB, Mingrone W, Beretta K, Herrmann R. Clinical benefit and quality of life in patients with advanced biliary tract cancer receiving gemcitabine plus capecitabine (GemCap): Results from a multicenter phase II trial (SAKK 44/02). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.15531] [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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Roth AD, Yan P, Dietrich D, Fiocca R, Bodoky G, Labianca R, Cunningham D, Van Cutsem E, Bosman F, Tejpar S. Is UGT1A1*28 homozygosity the strongest predictor for severe hematotoxicity in patients treated with 5-fluorouracil (5-FU)-irinotecan (IRI)? Results of the PETACC 3 - EORTC 40993 -SAKK 60/00 trial comparing IRI/5-FU/folinic acid (FA) to 5-FU/FA in stage II- III colon cancer (COC) patients. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.4036] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Münte T, Heinze HJ, Bartusch S, Dietrich D, Scholz M. Ereigniskorrelierte Potentiale und Gedächtnisleistung: 2. Wiedererkennen von Wörtern. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Heinze HJ, Münte T, Dietrich D, Bartusch S, Scholz M. Ereigniskorrelierte Potentiale und Gedächtnisleistung: 1. Vergleich von intentionalem und inzidentellem Lernmodus. KLIN NEUROPHYSIOL 2008. [DOI: 10.1055/s-2008-1060779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Borner M, Koeberle D, Von Moos R, Saletti P, Rauch D, Hess V, Trojan A, Helbling D, Pestalozzi B, Caspar C, Ruhstaller T, Roth A, Kappeler A, Dietrich D, Lanz D, Mingrone W. Adding cetuximab to capecitabine plus oxaliplatin (XELOX) in first-line treatment of metastatic colorectal cancer: a randomized phase II trial of the Swiss Group for Clinical Cancer Research SAKK. Ann Oncol 2008; 19:1288-1292. [PMID: 18349029 DOI: 10.1093/annonc/mdn058] [Citation(s) in RCA: 98] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND To determine the activity and tolerability of adding cetuximab to the oxaliplatin and capecitabine (XELOX) combination in first-line treatment of metastatic colorectal cancer (MCC). PATIENTS AND METHODS In a multicenter two-arm phase II trial, patients were randomized to receive oxaliplatin 130 mg/m(2) on day 1 and capecitabine 1000 mg/m(2) twice daily on days 1-14 every 3 weeks alone or in combination with standard dose cetuximab. Treatment was limited to a maximum of six cycles. RESULTS Seventy-four patients with good performance status entered the trial. Objective partial response rates after external review and radiological confirmation were 14% and 41% in the XELOX and in the XELOX + Cetuximab arm, respectively. Stable disease has been observed in 62% and 35% of the patients, with 76% disease control in both arms. Cetuximab led to skin rash in 65% of the patients. The median overall survival was 16.5 months for arm A and 20.5 months for arm B. The median time to progression was 5.8 months for arm A and 7.2 months for arm B. CONCLUSION Differences in response rates between the treatment arms indicate that cetuximab may improve outcome with XELOX. The correct place of the cetuximab, oxaliplatin and fluoropyrimidine combinations in first-line treatment of MCC has to be assessed in phase III trials.
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Affiliation(s)
- M Borner
- Institute of Medical Oncology, Inselspital, Bern, Switzerland.
| | - D Koeberle
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - R Von Moos
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - P Saletti
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Rauch
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - V Hess
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Trojan
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Helbling
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - B Pestalozzi
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - C Caspar
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - T Ruhstaller
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Roth
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - A Kappeler
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Dietrich
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - D Lanz
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
| | - W Mingrone
- Institute of Medical Oncology, Inselspital, Bern, Switzerland
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- Institute of Medical Oncology, Inselspital, Bern, Switzerland
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Koeberle D, Saletti P, Borner M, Caspar C, Strasser F, Ruhstaller T, Mora O, Dietrich D, Gerber D, Herrmann R. 3524 POSTER High rate of clinical benefit response in patients with advanced biliary tract cancer receiving gemcitabine plus capecitabine. A prospective, multicenter phase II trial of the Swiss Group for Clinical Cancer Research (SAKK 44/02). EJC Suppl 2007. [DOI: 10.1016/s1359-6349(07)71027-3] [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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Kollmar CI, Verner L, Dietrich D, Lampen-Imkamp S. Das maligne neuroleptische Syndrom; Differentialdiagnosen und Therapieoptionen anhand einer Falldarstellung. Pharmacopsychiatry 2007. [DOI: 10.1055/s-2007-991769] [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: 10/21/2022]
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Dietrich T, Stosch U, Dietrich D, Kaiser W, Bernimoulin JP, Joshipura K. Prediction of Periodontal Disease From Multiple Self-Reported Items in a German Practice-Based Sample. J Periodontol 2007; 78:1421-8. [PMID: 17608613 DOI: 10.1902/jop.2007.060212] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Ascertainment of periodontal disease using self-reported measures would be useful for large epidemiologic studies. This study evaluates whether a combination of self-reported items with established risk factors in a predictive model can assess periodontal disease accurately. METHODS Responses of 246 subjects to a detailed questionnaire were compared to their periodontal disease history as assessed from radiographs. Multiple regression modeling was used to construct predictive models using self-reported items and established risk factors. RESULTS Depending on the definition of gold-standard periodontal disease, two or three self-reported items were selected for the predictive models, in addition to age, gender, and smoking. Self-reported tooth mobility was associated strongly with periodontal disease independent of other risk factors and was selected in all models. For dichotomous definitions of periodontal disease, discrimination of predictive logistic regression models was good with areas under the receiver operating characteristic curve >0.80. Assessment of periodontal disease history based on extreme quantiles of model-predicted values yielded high sensitivity and specificity. CONCLUSION The combination of several self-reported items may be useful for ascertainment of periodontal disease in epidemiologic studies.
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Affiliation(s)
- T Dietrich
- Department of Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, Boston, MA, USA.
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Roth AD, Tejpar S, Yan P, Fiocca R, Dietrich D, Bodoky G, Labianca R, Cunningham D, Van Cutsem E, Bosman F. Tissue biomarkers (BIOM) in colon cancer (COC): The translational study on the randomized phase III trial comparing infused irinotecan/5-fluorouracil (5-FU)/folinic acid (FA) to 5-FU/FA in stage II-III COC patients (pts). J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.4022] [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: 11/20/2022] Open
Abstract
4022 Background and Aims: PETACC 3 is a large adjuvant trial with 3,005 COC pts. The value of BIOM in COC in adjuvant setting is still a matter of debate because of lack of large data sets. We took advantage of PETACC 3 to assess P53, SMAD4, thymidylate synthetase (TS), telomerase (HTERT) expressions, UGT1A1 genotype, KRAS and BRAF mutations, microsatellite instability (MSI), 18q and 8p LOH with regard to their prognostic and predictive value and their individual interactions on a very large homogeneous cohort of COC pts. In addition we investigated the association between UGT1A1 genotype and occurrence of diarrhoea and Gd 4 neutropenia. Methods: 1,564 formalin fixed paraffin embedded (FFPE) tissue blocks of PETACC 3 pts were prospectively collected and 5–20μ sections cut. DNA from normal (Nor) and tumoral (Tu) tissue was extracted after section microdissection. P53, SMAD4, TS and HTERT were assessed by immunohistochemistry (IHC); MSI was typed with 10 markers, KRAS exon 2 and BRAF exon 15 mutations by allele specific real time PCR on Tu DNA; 18q and 8p LOH by typing multiple SNPs by pyrosequencing on Nor/Tu DNA; UGT1A1 genotypes by PCR and fragment sizing on Nor DNA. Prognostic/predictive value of each BIOM is analysed by Cox regression for disease free survival and by logistic regression for specific toxicity. Associations between any 2 categorized BIOM and between each BIOM and each known prognostic variable are tested by chi-square tests. Results: DNA of 1405 pts was extracted and successfully analyzed in 97.1% for KRAS, 98.6% for BRAF, 94% for 18q LOH, 93.6% for MSI, 86% for UGT1A1, 8p LOH is still ongoing. Of 1530 pts slides IHC analysis was successful in 94.5% for P53, 94.2% for SMAD4, 82.9% for TS, 53.9% for HTERT. The clinical database was made available in Nov 06 and statistical analysis started on Dec 11th 2006. Conclusion: This is the largest multicenter centrally coordinated tissue BIOM study performed in COC to date. The high success rate of analysis shows that large prospective BIOM studies can be performed on routine FFPE material. Final results on the prognostic/predictive value of each molecular BIOM will be available at the meeting. No significant financial relationships to disclose.
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Affiliation(s)
- A. D. Roth
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - S. Tejpar
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - P. Yan
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - R. Fiocca
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - D. Dietrich
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - G. Bodoky
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - R. Labianca
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - D. Cunningham
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - E. Van Cutsem
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
| | - F. Bosman
- Geneva University Hospital, Geneva, Switzerland; University Hospital Gasthuisberg, Leuven, Belgium; Lausanne University, Lausanne, Switzerland; University of Genova, Genova, Italy; Swiss Group for Clinical Cancer Research, Bern, Switzerland; St Laszlo Hospital, Budapest, Hungary; Ospedali Riuniti, Bergamo, Italy; The Royal Marsden Hospital, Sutton, United Kingdom
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Dietrich D, Schuster M, Lesche R, Haedicke W, Kristiansen G. [Multiplexed methylation analysis--a new technology to analyse the methylation pattern of laser microdissected cells of normal breast tissue, DCIS and invasive ductal carcinoma of the breast]. Verh Dtsch Ges Pathol 2007; 91:197-207. [PMID: 18314615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
AIMS DNA methylation has been shown to play an important role in breast cancer pathogenesis, but up until now it is not clear how the tissue components contribute to the overall methylation of the sample, because microdissection does not provide sufficient material for most standard methylation assays. METHODS We developed a technology to analyse several methylation markers in a limited number of cells dissected from tissue sections. To evaluate the technology, we analysed, among others, the methylation markers PITX2, RASSF1A and TFF1 in 79 samples of three PITX2 methylation positive invasive ductal carcinomas. The microdissected samples were from the invasive part, the intraductal part, the stroma, tumor infiltrating lymphocytes, chest wall muscle, adipose tissue and healthy ducts. RESULTS The multiplexed methylation analysis allows for the quantitative analysis of methylation patterns in microdissected samples with as few as 100 genome copies. In all analysed patients PITX2 and RASSF1A were highly methylated in invasive and intraductal carcinoma cells compared to other tissue components. TFF1 behaved inversely. PITX2 showed some methylation in normal adjacent breast tissue. The methylation of the individual markers varied little within one tissue type and between blocks. CONCLUSIONS This technology is a powerful tool to analyse the methylation of multiple markers in different microdissected tissue components. Methylation patterns may differ significantly between different markers and tissue components. This technology may help to analyse different transitions states of breast and other cancers.
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Leyvraz S, Herrmann R, Guillou L, Honegger HP, Christinat A, Fey MF, Sessa C, Wernli M, Cerny T, Dietrich D, Pestalozzi B. Treatment of advanced soft-tissue sarcomas using a combined strategy of high-dose ifosfamide, high-dose doxorubicin and salvage therapies. Br J Cancer 2006; 95:1342-7. [PMID: 17031396 PMCID: PMC2360595 DOI: 10.1038/sj.bjc.6603420] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Having determined in a phase I study the maximum tolerated dose of high-dose ifosfamide combined with high-dose doxorubicin, we now report the long-term results of a phase II trial in advanced soft-tissue sarcomas. Forty-six patients with locally advanced or metastatic soft-tissue sarcomas were included, with age <60 years and all except one in good performance status (0 or 1). The chemotherapy treatment consisted of ifosfamide 10 g m−2 (continuous infusion for 5 days), doxorubicin 30 mg m−2 day−1 × 3 (total dose 90 mg m−2), mesna and granulocyte-colony stimulating factor. Cycles were repeated every 21 days. A median of 4 (1–6) cycles per patient was administered. Twenty-two patients responded to therapy, including three complete responders and 19 partial responders for an overall response rate of 48% (95% CI: 33–63%). The response rate was not different between localised and metastatic diseases or between histological types, but was higher in grade 3 tumours. Median overall survival was 19 months. Salvage therapies (surgery and/or radiotherapy) were performed in 43% of patients and found to be the most significant predictor for favourable survival (exploratory multivariate analysis). Haematological toxicity was severe, including grade ⩾3 neutropenia in 59%, thrombopenia in 39% and anaemia in 27% of cycles. Three patients experienced grade 3 neurotoxicity and one patient died of septic shock. This high-dose regimen is toxic but nonetheless feasible in multicentre settings in non elderly patients with good performance status. A high response rate was obtained. Prolonged survival was mainly a function of salvage therapies.
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Affiliation(s)
- S Leyvraz
- Centre Pluridisciplinaire d'Oncologie, University Hospital, CHUV BH06, Rue du Bugnon 46, Lausanne, Switzerland.
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