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Lorenzen S, Knorrenschild JR, Pauligk C, Hegewisch-Becker S, Seraphin J, Thuss-Patience P, Kopp HG, Dechow T, Vogel A, Luley KB, Pink D, Stahl M, Kullmann F, Hebart H, Siveke J, Egger M, Homann N, Probst S, Goetze TO, Al-Batran SE. Phase III randomized, double-blind study of paclitaxel with and without everolimus in patients with advanced gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). Int J Cancer 2020; 147:2493-2502. [PMID: 32339253 DOI: 10.1002/ijc.33025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 03/17/2020] [Accepted: 03/31/2020] [Indexed: 12/27/2022]
Abstract
The RADPAC trial evaluated paclitaxel with everolimus in patients with advanced gastroesophageal cancer (GEC) who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen. Patients were randomly assigned to receive paclitaxel (80 mg/m2 ) on day 1, 8 and 15 plus everolimus (10 mg daily, arm B) d1-d28 or placebo (arm A), repeated every 28 days. Primary end point was overall survival (OS). Efficacy was assessed in the intention-to-treat population and safety in all patients who received at least one dose of treatment. This trial is registered with ClinicalTrials.gov, number NCT01248403. Between October 2011 and September 2015, 300 patients (median age: 62 years; median lines prior therapy: 2; 47.7% of patients had prior taxane therapy) were randomly assigned (arm A, 150, arm B, 150). In the intention to treat population, there was no significant difference in progression-free survival (PFS; everolimus, 2.2 vs placebo, 2.07 months, HR 0.88, P = .3) or OS (everolimus, 6.1 vs placebo, 5.0 months, HR 0.93, P = .54). For patients with prior taxane use, everolimus improved PFS (everolimus, 2.7 vs placebo 1.8 months, HR 0.69, P = .03) and OS (everolimus, 5.8 vs placebo 3.9 months, HR 0.73, P = .07). Combination of paclitaxel and everolimus was associated with significantly more grade 3-5 mucositis (13.3% vs 0.7%; P < .001). The addition of everolimus to paclitaxel did not improve outcomes in pretreated metastatic gastric/gastroesophageal junction (GEJ) cancer. Activity was seen in the taxane pretreated group. Additional biomarker studies are planned to look for subgroups that may have a benefit.
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Affiliation(s)
- Sylvie Lorenzen
- Third Department of Internal Medicine (Hematology/Medical Oncology), Klinikum Rechts der Isar, Technische Universität München, Munich, Germany
| | | | - Claudia Pauligk
- Krankenhaus Nordwest, University Cancer Center, Frankfurt, Germany.,Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest, Frankfurt, Germany
| | | | | | - Peter Thuss-Patience
- Department of Hematology, Oncology and Tumor Immunology, Charite-University Medicine Berlin, Berlin, Germany
| | | | | | | | | | - Daniel Pink
- Helios Klinikum Bad Saarow, Department of Internal Medicine- Hematology, Oncology and Stem Cell Transplantation, Greifswald University Hospital, Greifswald, Germany
| | - Michael Stahl
- Department of Medical Oncology, Evang. Kliniken Essen-Mitte gGmbH, Essen, Germany
| | - Frank Kullmann
- First Department of Medicine, Nordoberpfalz Hospital, Weiden, Germany
| | | | - Jens Siveke
- Second Department of Internal Medicine, Technical University, Munich, Germany.,Institute for Developmental Cancer Therapeutics, West German Cancer Center, University Hospital Essen, Essen, Germany
| | | | - Nils Homann
- Department of Internal Medicine II, Academic Teaching Hospital Wolfsburg, Wolfsburg, Germany
| | | | - Thorsten Oliver Goetze
- Krankenhaus Nordwest, University Cancer Center, Frankfurt, Germany.,Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest, Frankfurt, Germany
| | - Salah-Eddin Al-Batran
- Krankenhaus Nordwest, University Cancer Center, Frankfurt, Germany.,Institut für Klinische Krebsforschung IKF GmbH at Krankenhaus Nordwest, Frankfurt, Germany
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Pauligk C, Lorenzen S, Goetze T, Riera Knorrenschild J, Hegewisch Becker S, Seraphin J, Thuss-Patience P, Kopp HG, Dechow T, Vogel A, Luley K, Pink D, Stahl M, Kullmann F, Hebart H, Siveke J, Egger M, Homann N, Probst S, Al-Batran SE. A randomized, double-blind, multi-center phase III study evaluating paclitaxel with and without RAD001 in patients with gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx369.054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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3
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Lorenzen S, Riera Knorrenschild J, Pauligk C, Goetze TO, Hegewisch-Becker S, Seraphin J, Thuss-Patience PC, Kopp HG, Dechow TN, Vogel A, Luley KB, Pink D, Stahl M, Kullmann F, Hebart HF, Siveke JT, Egger M, Homann N, Probst S, Al-Batran SE. A randomized, double-blind, multi-center phase III study evaluating paclitaxel with and without RAD001 in patients with gastric or esophagogastric junction carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.15_suppl.4027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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
4027 Background: There is a need for effective treatments in the second- or further line setting in advanced gastric cancer, especially for new agents. In the current trial we evaluated paclitaxel with RAD001 (everolimus) in patients with gastric carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen. Methods: This is a randomized, double-blind, multi-center phase III study. Patients with gastric carcinoma or adenocarcinoma of the esophagogastric junction (EGJ) who have progressed after treatment with a fluoropyrimidine/platinum-containing regimen were randomly assigned to receive Paclitaxel (80 mg/m2) on day 1, 8 and 15 plus placebo (arm A) or RAD001 (10mg daily, arm B) d1-d28, repeated every 28 days as 2nd, 3rd or 4th line therapy. Primary end point was overall survival (OS), secondary endpoints were best overall response, disease control rate, progression free survival (PFS) and toxicity. Results: 300 patients (median age: 62 years; median lines prior therapy: 2; 47.7% of patients had prior taxane therapy) were randomly assigned (Arm A, 150, Arm B, 150). In the intention to treat population, there was no significant difference in median PFS (placebo, 2.07 vs. RAD001, 2.2 months, HR 0.88, p = 0.3) or median OS (placebo, 5.0 vs. RAD001, 6.1 months, HR 0.93, p = 0.54). For patients with prior taxane use, RAD001 improved PFS (placebo 1.8 vs. RAD001, 2.7 months, HR 0.69, p = 0.03) and OS (placebo 3.9 vs. RAD001, 5.8 months, HR 0.73, p = 0.07). Combination of paclitaxel and RAD001 was tolerable, but the RAD001 arm was associated with significantly more grade 3-5 mucositis (13.3% vs. 0.7%; p < 0.001). Conclusions: The addition of RAD001 to paclitaxel/RAD001 did not improve outcomes in pretreated metastatic gastric/EGJ cancer. Of note, activity was seen in the taxane pretreated group. Additional biomarker studies are planned to look for subgroups that may have a benefit. Clinical trial information: 2009-018092-14.
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Affiliation(s)
- Sylvie Lorenzen
- Third Department of Internal Medicine (Hematology/Medical Oncology), Klinikum rechts der Isar, Technische Universitat Munchen, Munich, Germany
| | | | - Claudia Pauligk
- Institute of Clinical Cancer Research (IKF) at Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt, Germany
| | - Thorsten Oliver Goetze
- Institute of Clinical Cancer Research (IKF) at Krankenhaus Nordwest, UCT-University Cancer Center, Frankfurt, Germany
| | | | | | - Peter C. Thuss-Patience
- Department of Hematology, Oncology and Tumor Immunology, Charite-University Medicine Berlin, Berlin, Germany
| | | | | | - Arndt Vogel
- Clinic of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | | | - Daniel Pink
- Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | | | | | | | - Jens T. Siveke
- West German Cancer Center, University Hospital, Essen, Germany
| | | | - Nils Homann
- Department of Internal Medicine II, Academic Teaching Hospital Wolfsburg, Wolfsburg, Germany
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Al-Batran SE, Riera-Knorrenschild J, Pauligk C, Goetze TO, Hegewisch-Becker S, Seraphin J, Thuss-Patience PC, Kopp HG, Dechow TN, Vogel A, Luley KB, Pink D, Stahl M, Kullmann F, Hebart HF, Siveke JT, Egger M, Homann N, Probst S, Lorenzen S. A randomized, double-blind, multicenter phase III study evaluating paclitaxel with and without RAD001 in patients with gastric cancer who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen (RADPAC). J Clin Oncol 2017. [DOI: 10.1200/jco.2017.35.4_suppl.4] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
4 Background: There is a need for effective treatments in the second- or further line setting in advanced gastric cancer, especially for new agents. In the current trial we evaluated paclitaxel with RAD001 (everolimus) in patients with gastric carcinoma who have progressed after therapy with a fluoropyrimidine/platinum-containing regimen. Methods: This is a randomized, double-blind, multi-center phase III study. Patients with gastric carcinoma or adenocarcinoma of the esophagogastric junction which has progressed after treatment with a fluoropyrimidine/platinum-containing regimen were randomly assigned to receive Paclitaxel (80 mg/m2) on day 1, 8 and 15 plus placebo (arm A) or RAD001 (10mg daily, arm B) d1-d28, repeated every 28 days as 2nd, 3rd or 4thline therapy. Primary end point was overall survival (OS), secondary endpoints were best overall response, disease control rate, progression free survival (PFS) and toxicity. Results: 300 patients (median age: 62 years; median lines prior therapy: 2) were randomly assigned (Arm A, 150, Arm B, 150). Response rate (complete and partial response) was 8.0% (95%CI: 4.2%-13.6%) in the paclitaxel/RAD001 arm and 7.3% (95% CI: 3.7%-12.7%) in the paclitaxel/placebo arm (p = 0.4).There was no significant difference in median PFS (placebo, 2.07 vs. RAD001, 2.2 months, HR 0.88, p = 0.3) and median OS (placebo, 5.1 vs. RAD001, 6.1 months, HR 0.92, p = 0.48). Combination of paclitaxel and RAD001 was tolerable, but the placebo arm was associated with significantly less (any grade) mucositis (15.8% vs. 37.2%), fever (10.3% vs 20.7%), leukopenia (11.6% vs. 21.4%), neutropenia (13.0% vs. 27.6%) and thrombocytopenia (2.1% vs 14.5%). Conclusions: The addition of RAD001 to paclitaxel/RAD001 did not significantly improve outcomes in pretreated metastatic gastric or esophagogastric junction adenocarcinoma. Additional biomarker studies are planned to look for subgroups that may have a benefit. Clinical trial information: NCT01248403.
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Affiliation(s)
| | | | - Claudia Pauligk
- Krankenhaus Nordwest, University Cancer Center, Frankfurt, Germany
| | | | | | | | - Peter C. Thuss-Patience
- Department of Hematology, Oncology and Tumor Immunology, Charite-University Medicine Berlin, Berlin, Germany
| | | | | | | | | | - Daniel Pink
- Helios Klinikum Bad Saarow, Bad Saarow, Germany
| | - Michael Stahl
- Department of Medical Oncology, Kliniken Essen-Mitte, Essen, Germany
| | - Frank Kullmann
- First Department of Medicine, Nordoberpfalz Hospital, Weiden, Germany
| | | | - Jens T. Siveke
- Second Department of Internal Medicine, Technical University, Munich, Germany
| | | | - Nils Homann
- Department of Internal Medicine II, Academic Teaching Hospital Wolfsburg, Wolfsburg, Germany
| | | | - Sylvie Lorenzen
- Third Department of Internal Medicine (Hematology/Medical Oncology), Klinikum rechts der Isar, Technische Universitat Munchen, Munich, Germany
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Quidde J, Denne L, Kutscheidt A, Kindler M, Kirsch A, Kripp M, Petersen V, Schulze M, Seraphin J, Tummes D, Arnold D, Stein A. Baseline and On-Treatment Markers Determining Prognosis of First-Line Chemotherapy in Combination with Bevacizumab in Patients with Metastatic Colorectal Cancer. Oncol Res Treat 2017; 40:21-26. [DOI: 10.1159/000454774] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2016] [Accepted: 11/28/2016] [Indexed: 11/19/2022]
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Stein A, Petersen V, Schulze M, Seraphin J, Hoeffkes HG, Valdix AR, Schroeder J, Herrenberger J, Boxberger F, Leutgeb B, Hinke A, Kutscheidt A, Arnold D. Bevacizumab plus chemotherapy as first-line treatment for patients with metastatic colorectal cancer: results from a large German community-based observational cohort study. Acta Oncol 2015; 54:171-8. [PMID: 25307517 DOI: 10.3109/0284186x.2014.961649] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND After approval of bevacizumab in Germany in 2005 for the treatment of unresectable advanced or refractory colorectal cancer (CRC), this observational cohort study was initiated to assess the efficacy and safety of bevacizumab with various chemotherapy regimen in patients with metastatic CRC (mCRC). MATERIAL AND METHODS To facilitate enrolment of a typical mCRC population, eligibility criteria were minimised. Choice of chemotherapy regimen was at the physicians' discretion, but influenced by current registration status. Predefined endpoints were treatment characteristics, response rate, progression-free survival (PFS), overall survival (OS) and adverse events assessed as potentially related to bevacizumab treatment. Patients were followed for up to four years. RESULTS In total 1777 eligible patients were enrolled at 261 sites from January 2005 to June 2008. Median age: 64 years (range 19-100); male 62%; ECOG performance status 0-1/≥ 2 89%/11%. Chemotherapy choice was fluoropyrimidine (FU) 12%, FU/oxaliplatin 18%, FU/irinotecan 64%, no chemotherapy concurrent to bevacizumab 2% and other 4%. Best investigator-assessed response rate was 60% (complete response 10%, partial response 51%). Median PFS was 10.2 months and median OS was 24.8 months. CONCLUSIONS The efficacy and safety profile of bevacizumab in this population of mCRC patients with different chemotherapy regimens is consistent with that observed in other patient registries/non-randomised trials and also corresponds well with data from similar treatment arms of phase III trials.
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Affiliation(s)
- Alexander Stein
- Department of Oncology, Hematology, BMT with section Pneumology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Oettle H, Riess H, Stieler JM, Heil G, Schwaner I, Seraphin J, Görner M, Mölle M, Greten TF, Lakner V, Bischoff S, Sinn M, Dörken B, Pelzer U. Second-line oxaliplatin, folinic acid, and fluorouracil versus folinic acid and fluorouracil alone for gemcitabine-refractory pancreatic cancer: outcomes from the CONKO-003 trial. J Clin Oncol 2014; 32:2423-9. [PMID: 24982456 DOI: 10.1200/jco.2013.53.6995] [Citation(s) in RCA: 305] [Impact Index Per Article: 30.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
PURPOSE To assess the efficacy of a second-line regimen of oxaliplatin and folinic acid-modulated fluorouracil in patients with advanced pancreatic cancer who have experienced progression while receiving gemcitabine monotherapy. PATIENTS AND METHODS A randomized, open-label, phase III study was conducted in 16 institutions throughout Germany. Recruitment ran from January 2004 until May 2007, and the last follow-up concluded in December 2012. Overall, 168 patients age 18 years or older who experienced disease progression during first-line gemcitabine therapy were randomly assigned to folinic acid and fluorouracil (FF) or oxaliplatin and FF (OFF). Patients were stratified according to the presence of metastases, duration of first-line therapy, and Karnofsky performance status. RESULTS Median follow-up was 54.1 months, and 160 patients were eligible for the primary analysis. The median overall survival in the OFF group (5.9 months; 95% CI, 4.1 to 7.4) versus the FF group (3.3 months; 95% CI, 2.7 to 4.0) was significantly improved (hazard ratio [HR], 0.66; 95% CI, 0.48 to 0.91; log-rank P = .010). Time to progression with OFF (2.9 months; 95% CI, 2.4 to 3.2) versus FF (2.0 months; 95% CI, 1.6 to 2.3) was significantly extended also (HR, 0.68; 95% CI, 0.50 to 0.94; log-rank P = .019). Rates of adverse events were similar between treatment arms, with the exception of grades 1 to 2 neurotoxicity, which were reported in 29 patients (38.2%) and six patients (7.1%) in the OFF and FF groups, respectively (P < .001). CONCLUSION Second-line OFF significantly extended the duration of overall survival when compared with FF alone in patients with advanced gemcitabine-refractory pancreatic cancer.
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Affiliation(s)
- Helmut Oettle
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany.
| | - Hanno Riess
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Jens M Stieler
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Gerhard Heil
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Ingo Schwaner
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Jörg Seraphin
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Martin Görner
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Matthias Mölle
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Tim F Greten
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Volker Lakner
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Sven Bischoff
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Marianne Sinn
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Bernd Dörken
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
| | - Uwe Pelzer
- Helmut Oettle, Hanno Riess, Jens M. Stieler, Sven Bischoff, Marianne Sinn, Bernd Dörken, and Uwe Pelzer, Charitě Universitätsmedizin; Ingo Schwaner, Clinical Center, Berlin; Helmut Oettle, Clinical Center, Friedrichschafen; Gerhard Heil, Clinical Center, Lüdenscheid; Jörg Seraphin, Clinical Center, Northeim; Martin Görner, Clinical Center, Bielefeld; Matthias Mölle, Clinical Center, Dresden; Tim F. Greten, Hannover Medical School, Hannover; and Volker Lakner, Clinical Center, Rostock, Germany
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Braulke F, Jung K, Schanz J, Götze K, Müller-Thomas C, Platzbecker U, Germing U, Brümmendorf TH, Bug G, Ottmann O, Giagounidis AAN, Stadler M, Hofmann WK, Schafhausen P, Lübbert M, Schlenk RF, Blau IW, Ganster C, Pfeiffer S, Shirneshan K, Metz M, Detken S, Seraphin J, Jentsch-Ullrich K, Böhme A, Schmidt B, Trümper L, Haase D. Molecular cytogenetic monitoring from CD34+ peripheral blood cells in myelodysplastic syndromes: first results from a prospective multicenter German diagnostic study. Leuk Res 2013; 37:900-6. [PMID: 23623559 DOI: 10.1016/j.leukres.2013.03.019] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2013] [Revised: 03/14/2013] [Accepted: 03/25/2013] [Indexed: 11/30/2022]
Abstract
The gold standard of cytogenetic analysis in myelodysplastic syndromes (MDS) is conventional chromosome banding (CCB) analysis of bone marrow (BM) metaphases. Most aberrations can also be detected by fluorescence-in situ-hybridization (FISH). For this prospective multicenter German diagnostic study (www.clinicaltrials.gov: #NCT01355913) 360 patients, as yet, were followed up to 3 years by sequential FISH analyses of immunomagnetically enriched CD34+ peripheral blood (PB) cells using comprehensive FISH probe panels, resulting in a total number of 19,516 FISH analyses. We demonstrate that CD34+ PB FISH correlates significantly with CCB analysis and represents a feasible method for a reliable non-invasive cytogenetic monitoring from PB.
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Affiliation(s)
- Friederike Braulke
- Department of Hematology and Oncology, University of Goettingen, Germany.
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Moehler M, Al-Batran SE, Andus T, Anthuber M, Arends J, Arnold D, Aust D, Baier P, Baretton G, Bernhardt J, Boeing H, Böhle E, Bokemeyer C, Bornschein J, Budach W, Burmester E, Caca K, Diemer WA, Dietrich CF, Ebert M, Eickhoff A, Ell C, Fahlke J, Feussner H, Fietkau R, Fischbach W, Fleig W, Flentje M, Gabbert HE, Galle PR, Geissler M, Gockel I, Graeven U, Grenacher L, Gross S, Hartmann JT, Heike M, Heinemann V, Herbst B, Herrmann T, Höcht S, Hofheinz RD, Höfler H, Höhler T, Hölscher AH, Horneber M, Hübner J, Izbicki JR, Jakobs R, Jenssen C, Kanzler S, Keller M, Kiesslich R, Klautke G, Körber J, Krause BJ, Kuhn C, Kullmann F, Lang H, Link H, Lordick F, Ludwig K, Lutz M, Mahlberg R, Malfertheiner P, Merkel S, Messmann H, Meyer HJ, Mönig S, Piso P, Pistorius S, Porschen R, Rabenstein T, Reichardt P, Ridwelski K, Röcken C, Roetzer I, Rohr P, Schepp W, Schlag PM, Schmid RM, Schmidberger H, Schmiegel WH, Schmoll HJ, Schuch G, Schuhmacher C, Schütte K, Schwenk W, Selgrad M, Sendler A, Seraphin J, Seufferlein T, Stahl M, Stein H, Stoll C, Stuschke M, Tannapfel A, Tholen R, Thuss-Patience P, Treml K, Vanhoefer U, Vieth M, Vogelsang H, Wagner D, Wedding U, Weimann A, Wilke H, Wittekind C. [German S3-guideline "Diagnosis and treatment of esophagogastric cancer"]. Z Gastroenterol 2011; 49:461-531. [PMID: 21476183 DOI: 10.1055/s-0031-1273201] [Citation(s) in RCA: 151] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- M Moehler
- Medizinische Klinik und Poliklinik, Johannes-Gutenberg-Universität, Langenbeckstraße 1, 55101 Mainz.
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Dederke B, Schumann C, Seraphin J, Wagner TOF, Rittmeyer A, Eschenburg H, Harich H, Vehling-Kaiser U, Esser M, Heinrich B. Erlotinib (Tarceva®) in der Routinebehandlung des nicht-kleinzelligen Lungenkarzinoms nach Versagen einer vorangegangenen Chemotherapie. Pneumologie 2011. [DOI: 10.1055/s-0031-1272215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Arnold D, Petersen V, Kindler M, Schulze M, Seraphin J, Hinke A, Srock S, Kutscheidt A. Patterns of maintenance treatment (Tx) following first-line bevacizumab (bev) plus chemotherapy (CT) for metastatic colorectal cancer (mCRC): Results from a large German community-based cohort study. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
502 Background: As a result of the long PFS with bev-containing combinations in first-line mCRC, discontinuation of at least one CT component after an “induction” period and continuation with “maintenance” Tx is common. It is anticipated that duration and patterns of maintenance Tx may affect PFS. Methods: We analysed induction and maintenance Tx in a large observational cohort study of bev + various first-line CT regimens. Results of the entire cohort were reported earlier [Arnold et al. ASCO GI 2010]. Results: From Jan 05 to Jun 08, 1620 patients (pts) were enrolled at 261 sites. 1,307 pts (81% of total) received bev + fluoropyrimidine-oxaliplatin (n=306, 23.5%) or fluoropyrimidine-irinotecan (n=1,001, 76.5%). While Tx reduction was not predefined, after induction 271 pts (21%) received de-escalated maintenance Tx: bev alone (n=106; 8%), or bev + CT (n=165; 13%). Median Tx duration for pts receiving bev alone was 8.7 mo for induction and 3.2 mo for maintenance. Pts receiving bev + CT maintenance had shorter induction (5.1 mo) but longer maintenance (4.4 mo). Median PFS (after induction) with bev maintenance was 10.8 mo vs. 13.5 mo for bev + CT maintenance. Data are available from 161 pts with bev + CT maintenance after induction with oxaliplatin (n=97) or irinotecan (n=64). Median total Tx duration was 9.6 mo for oxaliplatin-based induction and 10.9 mo for irinotecan-based induction; median induction duration was 4.1 and 5.5 mo, and maintenance duration was 4.3 and 4.4 mo, respectively. Median PFS (after induction) was 12.8 and 14.1 mo, respectively. Progressive disease (PD) has not yet occurred in 165 pts (62% of maintenance cohort). A high proportion of pts received Tx until PD (74% and 79%, respectively). Conclusions: Both de-escalation strategies led to long PFS and a high number of pts treated ′until PD′. A trend towards better PFS was observed in pts receiving bev + CT maintenance vs. single-agent bev. The ongoing randomized AIO KRK 0207 trial is prospectively evaluating three different maintenance strategies after induction with bev + fluoropyrimidine + oxaliplatin. [Table: see text]
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Affiliation(s)
- D. Arnold
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - V. Petersen
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - M. Kindler
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - M. Schulze
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - J. Seraphin
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - A. Hinke
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - S. Srock
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
| | - A. Kutscheidt
- Hubertus Wald Tumor Center, University Cancer Center Hamburg, Hamburg, Germany; Practice, Heidenheim, Germany; Onkologische Schwerpunktpraxis, Berlin, Germany; Ambulante Onkologie Zittau, Zittau, Germany; Haematologisch-Onkologische Schwerpunktpraxis Northeim, Northeim, Germany; WiSP Research Institute, Langenfeld, Germany; Roche Pharma AG, Grenzach-Wyhlen, Germany
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Diel I, Bergner R, Seraphin J. 5069 Ibandronate in clinical practice: renal safety and tolerability in patients with metastatic breast cancer. EJC Suppl 2009. [DOI: 10.1016/s1359-6349(09)70961-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Schmidt M, Seraphin J, Luhn B, Soeling U. Major issues in the treatment of metastatic bone disease: renal safety and maintained bone pain effectiveness of ibandronate in breast cancer patients in clinical practice; interim results of a non interventional study in Germany. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-1159] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #1159
Background: Bone pain is one of the most debilitating manifestations of metastatic bone disease (MBD) due to breast cancer (BC). Bisphosphonates (BP) effectively prevent skeletal related events (SRE) in MBD and independently reduce bone pain. As kidney is a main target organ of BP related toxicity, renal safety is of major importance for risk/benefit assessment of BPs. Ibandronate (IBA), a third generation amino-BP has shown its clinical efficacy and safety in randomized clinical trials (RCT). The present non interventional study (NIS) was initiated to verify those results under real life conditions.
 Patients and methods: This interim analysis is based on 1897 clinically evaluable BC patients with MBD, mean age 63.3 +11.9 years. 1219 (64 %) were BP-naive, 213 (11.2 %) had been pretreated with (IBA), 465 (24.5 %) with other BPs, mainly zoledronic acid (ZOL) (294; 15.5 %) and pamidronate (PAM) (157; 8.3 %). Mean duration [months + SD] of BP pretreatment was considerably longer for PAM (22.7 + 22.7) and ZOL (20 + 17.9) than for IBA (12.8 +11.9). After inclusion patients received 6 mg IBA i. v. every 4 weeks or 50 mg p. o. daily at the physician's discretion over 24 weeks, additionally to their individual cancer treatment. Pain status (10 point VAS), analgesic use (WHO escalation stages), renal function (serum creatinine; Creatinine clearance (CrCl) calc.), standard lab-data and SRE incidence were recorded at regular 4 weeks intervals.
 Results: Baseline pain score differed by BP pretreatment and was highest in BP-naive patients (3.5 + 2.4), compared to pretreated with other BPs (3.2 + 2.5) or IBA (2.8 + 2.2), being the lowest. Mean pain score gradually decreased by every visit, reaching its min. value at study end. This represented a pain reduction of 10 – 40 %, depending of BP pretreatment status, and was achieved in 66 % of total study population. In parallel, there was an overall reduction in analgesic use of 9.2 % (WHO staging), with an increase of 5 % in patients with no need for analgesics. Changes in renal function during the observation period were balanced across all subgroups, with 8 – 15 ml/min maximum change in CrCl and no severe renal adverse events had been reported; significantly more patients pretreated with ZOL (26 %) showed signs of decreased renal function at baseline (S-Crea < 1.2 mg/dl), compared to IBA- (11 %), PAM- (16 %) or without BP-pretreatment (8 %). There was no significant correlation between decreased renal function at baseline and BP-pretreatment duration. 6 cases of osteonecrosis of the jaw had been reported, in two of which IBA was the only BP involved. There were 11 % premature study terminations. In 99 % of the remaining patients IBA treatment was intended to be continued.
 Conclusion: In this interim analysis of a large scale NIS, IBA showed marked and sustained pain relief in BC patients with MBD without escalation of analgesic use and a renal safety profile comparable to results of RCTs.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 1159.
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Affiliation(s)
- M Schmidt
- 1 Universitaetsklinikum Mainz, Mainz, Germany
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Wavreille G, Seraphin J, Chantelot C, Marchandise X, Fontaine C. Ligament fibre recruitment of the elbow joint during gravity-loaded passive motion: an experimental study. Clin Biomech (Bristol, Avon) 2008; 23:193-202. [PMID: 17997206 DOI: 10.1016/j.clinbiomech.2007.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2007] [Revised: 09/23/2007] [Accepted: 09/25/2007] [Indexed: 02/07/2023]
Abstract
BACKGROUND Knowledge of elbow collateral ligament length during passive motion is essential in understanding ligament physiology and pathology, such as tightness and instability. METHODS Five anatomical unembalmed specimens were passively placed in six flexion positions together with three forearm rotations, using equipment with gravity as motion force. These 18 positions were recorded using CT-scan. Three-dimensional data of ligament insertions were obtained through anatomical millimetre sections. Ligament length was measured in each position. FINDINGS In neutral rotation, the lateral collateral ligament was long between 0 degrees and 30 degrees as well as at 90 degrees, and short between about 60 degrees and 120 degrees of flexion. In pronation, it was long at about 0 degrees and between 60 degrees and 120 degrees, short at about 30 degrees of flexion. In supination, it was long at about 30 degrees and 90 degrees and short between 120 degrees and 150 degrees of flexion. In any forearm rotation, the highest length of the anterior bundle of the ulnar collateral ligament was measured at about 90 degrees, its smallest length between 120 degrees and 150 degrees of flexion, position at which the posterior bundle length was greatest. INTERPRETATION At 60 degrees of flexion, the collateral ligaments were slackened in any forearm rotations. Forearm rotation plays an indirect role in the posterolateral stability of elbow as it changes length of the lateral collateral ligament. This ligament can be tested passively at 90 degrees of flexion in supination, the anterior bundle of the ulnar collateral ligament between 0 degrees and 30 degrees in neutral rotation and the posterior bundle between 120 degrees and 150 degrees in neutral rotation.
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Affiliation(s)
- G Wavreille
- Department of Anatomy, Faculty of Medicine Henri Warembourg, University of Lille2, and Department of Orthopedic Surgery, Upper limb Surgery Unit, Roger Salengro Hospital, Emile Laine Street, 59037 Lille cedex, France.
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Defoin JF, Debonne T, Rambourg MO, Seraphin J, Buffet M, Jaussaud M, Bertault R, Fay R, Digeon B. [Acute psychiatric syndrome and quinolones]. J Toxicol Clin Exp 1990; 10:469-72. [PMID: 2135062] [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: 12/30/2022]
Abstract
A case of Flumequine poisoning is described; a 13-year-old girl was admitted for a psychiatric syndrome. 3 hours after, seizures, coma, and metabolic disorders were observed. Infectious, encephalitic or diabetic diseases were suspected, but not confirmed. After 12 hours of a symptomatic treatment, the clinical status improved and the patient was discharged. At that time a tablet was found in her bedroom and a mas spectrographic analysis was positive for Flumequine. This case report is in agreement with previous observations and confirms the small therapeutic index of quinolone, and the absolute necessity to assess carefully a psychiatric diagnosis.
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Affiliation(s)
- J F Defoin
- SAMU 51/Centre Anti-Poisons-Service du Docteur G.A. SEYS-C.H.R.U. Reims
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