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Livingstone E, Gogas H, Kandolf-Sekulovic L, Meier F, Eigentler TK, Ziemer M, Terheyden PAM, Gesierich AH, Herbst RA, Kähler KC, Ziogas DC, Mijuskovic Z, Garzarolli M, Garbe C, Roesch A, Ugurel S, Gutzmer R, Grob JJ, Kiecker F, Utikal J, Windemuth-Kieselbach C, Eckhardt S, Zimmer L, Schadendorf D. Early switch from run-in treatment with vemurafenib plus cobimetinib to atezolizumab after 3 months leads to rapid loss of tumour control in patients with advanced BRAFV600-positive melanoma: The ImmunoCobiVem phase 2 randomised trial. Eur J Cancer 2023; 190:112941. [PMID: 37482012 DOI: 10.1016/j.ejca.2023.112941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 07/25/2023]
Abstract
AIM ImmunoCobiVem investigated whether a planned switch to atezolizumab after achieving tumour control during run-in with vemurafenib + cobimetinib improves progression-free survival (PFS) and overall survival (OS) compared to continuous targeted therapy (TT) in patients with previously untreated advanced BRAFV600-mutated melanoma. METHODS In this multicenter phase 2 study, patients received vemurafenib plus cobimetinib. After 3months, patients without progressive disease (PD) were randomly assigned (1:1) to continue vemurafenib + cobimetinib (Arm A) or switch to atezolizumab (Arm B) until first documented PD (PD1). Primary outcome was PFS1 (time from start of run-in until PD1 or death). OS and safety were also assessed. RESULTS Of 185 patients enroled between November 2016 and December 2019, 135 were randomly assigned after the run-in period (Arm A, n = 69; Arm B, n = 66). Median PFS1 was significantly longer in Arm A versus Arm B (13.9 versus 5.9months; hazard ratio [HR] 0.55; 95% confidence interval [CI], 0.37-0.84; PStratified=0.001). Median OS was not reached in either arm (HR 1.22; 95%CI, 0.69-2.16; PStratified=0.389); 2-year OS was higher in Arm B versus Arm A (67%; 95%CI, 53-78 versus 58%; 95%CI, 45-70). Grade 3/4 AEs occurred in 55% of patients in Arm A and 64% in Arm B; treatment-related AEs led to discontinuation of any drug in 7% and 9% of patients, respectively. CONCLUSION In patients with BRAFV600-mutated advanced melanoma who achieve tumour control with TT, early switch at 3months to atezolizumab led to rapid loss of tumour control but provided a numerical OS benefit at 2years compared with continued TT.
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Affiliation(s)
- E Livingstone
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - H Gogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - L Kandolf-Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - F Meier
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany; Skin Cancer Center at the University Cancer Centre and National Center for Tumor Diseases, Dresden, Germany
| | - T K Eigentler
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - M Ziemer
- Department of Dermatology, University of Leipzig Medical Center, Leipzig, Germany
| | | | - A H Gesierich
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | | | - K C Kähler
- Department of Dermatology, Venerology, and Allergology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - D C Ziogas
- First Department of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - Z Mijuskovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia
| | - M Garzarolli
- Department of Dermatology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University of Tübingen, Tübingen, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - S Ugurel
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - R Gutzmer
- Department of Dermatology, Skin Cancer Center Hannover, Hannover Medical School, Hannover, Germany; Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum, Minden, Germany
| | - J J Grob
- Aix-Marseille University, Timone Hospital (APHM), Marseille, France
| | - F Kiecker
- Department of Dermatology, Venereology and Allergology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany; Department of Dermatology and Venereology, Vivantes Hospital Neukölln, Berlin, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany; DKFZ-Hector Cancer Institute at the University Medical Center Mannheim, Mannheim, Germany
| | | | | | - L Zimmer
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany; German Cancer Consortium, Partner Site Essen, Essen, Germany.
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Şener ÖÇ, Hein T, Albrecht JD, Melchers S, Utikal J, Nicolay J. Preclinical investigation of combined NFkB inhibition and ECP in cutaneous T-cell lymphoma. Eur J Cancer 2022. [DOI: 10.1016/s0959-8049(22)00608-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Grimmelmann I, Haferkamp S, Kähler K, Meier F, Pföhler C, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1079P Comparison of effectiveness and safety of nivolumab monotherapy or in combination therapy with ipilimumab in therapy-naïve and pretreated patients with advanced melanoma within the German noninterventional study NICO. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1464] [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: 10/20/2022] Open
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Ugurel S, Schadendorf D, Horny K, Sucker A, Schramm S, Utikal J, Pföhler C, Herbst R, Schilling B, Blank C, Becker JC, Paschen A, Zimmer L, Livingstone E, Horn PA, Rebmann V. Elevated baseline serum PD-1 or PD-L1 predicts poor outcome of PD-1 inhibition therapy in metastatic melanoma. Ann Oncol 2021; 31:144-152. [PMID: 31912789 DOI: 10.1016/j.annonc.2019.09.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 19.0] [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: 04/09/2019] [Revised: 09/16/2019] [Accepted: 09/19/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Programmed cell death protein 1 (PD-1) checkpoint inhibition has recently advanced to one of the most effective treatment strategies in melanoma. Nevertheless, a considerable proportion of patients show upfront therapy resistance and baseline predictive biomarkers of treatment outcome are scarce. In this study we quantified PD-1 and programmed death-ligand 1 (PD-L1) in baseline sera from melanoma patients in relation to therapy response and survival. PATIENTS AND METHODS Sera taken at therapy baseline from a total of 222 metastatic melanoma patients (two retrospectively selected monocentric discovery cohorts, n = 130; one prospectively collected multicentric validation cohort, n = 92) and from 38 healthy controls were analyzed for PD-1 and PD-L1 concentration by sandwich enzyme-linked immunosorbent assay. RESULTS Melanoma patients showed higher serum concentrations of PD-1 (P = 0.0054) and PD-L1 (P < 0.0001) than healthy controls. Elevated serum PD-1 and PD-L1 levels at treatment baseline were associated with an impaired best overall response (BOR) to anti-PD-1 (P = 0.014, P = 0.041), but not to BRAF inhibition therapy. Baseline PD-1 and PD-L1 serum levels correlated with progression-free (PFS; P = 0.0081, P = 0.053) and overall survival (OS; P = 0.055, P = 0.0062) in patients who received anti-PD-1 therapy, but not in patients treated with BRAF inhibitors. By combining both markers, we obtained a strong discrimination between favorable and poor outcome of anti-PD-1 therapy, with elevated baseline serum levels of PD-1 and/or PD-L1 associated with an impaired BOR (P = 0.037), PFS (P = 0.048), and OS (P = 0.0098). This PD-1/PD-L1 combination serum biomarker was confirmed in an independent multicenter validation set of serum samples prospectively collected at baseline of PD-1 inhibition (BOR, P = 0.019; PFS, P = 0.038; OS, P = 0.022). Multivariable Cox regression demonstrated serum PD-1/PD-L1 as an independent predictor of PFS (P = 0.010) and OS (P = 0.003) in patients treated with PD-1 inhibitors. CONCLUSION Our findings indicate PD-1 and PD-L1 as useful serum biomarkers to predict the outcome of PD-1 inhibition therapy in melanoma patients and to select patients for PD-1-based versus BRAF-based therapy strategies.
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Affiliation(s)
- S Ugurel
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Horny
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Translational Skin Cancer Research, German Consortium of Translational Cancer Research (DKTK), Essen, Germany
| | - A Sucker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - S Schramm
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg and Department of Dermatology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - C Pföhler
- Department of Dermatology, Saarland University Medical Center, Homburg/Saar, Germany
| | - R Herbst
- Department of Dermatology, Helios Klinikum Erfurt, Erfurt, Germany
| | - B Schilling
- Department of Dermatology, University Hospital Würzburg, Würzburg, Germany
| | - C Blank
- Department of Molecular Oncology and Immunology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - J C Becker
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany; Translational Skin Cancer Research, German Consortium of Translational Cancer Research (DKTK), Essen, Germany
| | - A Paschen
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - E Livingstone
- Department of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany; German Consortium of Translational Cancer Research (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P A Horn
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - V Rebmann
- Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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Gutzmer R, Eigentler T, Mohr P, Weichenthal M, Dücker P, Gebhardt C, Göppner D, Haferkamp S, Kähler K, Meier F, Pföhler C, Satzger I, Sickmann T, Sindrilaru A, Terheyden P, Ugurel S, Ulrich J, Utikal J, Weishaupt C, Schadendorf D. 1104P Nivolumab (NIVO) monotherapy or combination therapy with ipilimumab (NIVO+IPI) in advanced melanoma patients with brain metastases: Real-world evidence from the German non-interventional study NICO. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1227] [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: 10/23/2022] Open
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Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Chiarion-Sileni V, Lebbe C, Mandalá M, Millward M, Arance A, Bondarenko I, Haanen JBAG, Hansson J, Utikal J, Ferraresi V, Mohr P, Probachai V, Schadendorf D, Nathan P, Robert C, Ribas A, Davies MA, Lane SR, Legos JJ, Mookerjee B, Grob JJ. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2019; 30:1848. [PMID: 31406976 PMCID: PMC6927319 DOI: 10.1093/annonc/mdz221] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
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7
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Shannan B, Matschke J, Chauvistré H, Vogel F, Klein D, Meier F, Westphal D, Bruns J, Rauschenberg R, Utikal J, Forschner A, Berking C, Terheyden P, Dabrowski E, Gutzmer R, Rafei-Shamsabadi D, Meiss F, Heinzerling L, Zimmer L, Livingstone E, Váraljai R, Hoewner A, Horn S, Klode J, Stuschke M, Scheffler B, Marchetto A, Sannino G, Grünewald TGP, Schadendorf D, Jendrossek V, Roesch A. Sequence-dependent cross-resistance of combined radiotherapy plus BRAF V600E inhibition in melanoma. Eur J Cancer 2019; 109:137-153. [PMID: 30721788 DOI: 10.1016/j.ejca.2018.12.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [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: 11/21/2018] [Revised: 12/22/2018] [Accepted: 12/29/2018] [Indexed: 01/04/2023]
Abstract
INTRODUCTION Treatment of patients with metastatic melanoma is hampered by drug-resistance and often requires combination with radiotherapy as last-resort option. However, also after radiotherapy, clinical relapses are common. METHODS & RESULTS Our preclinical models indicated a higher rate of tumour relapse when melanoma cells were first treated with BRAFV600E inhibition (BRAFi) followed by radiotherapy as compared to the reverse sequence. Accordingly, retrospective follow-up data from 65 stage-IV melanoma patients with irradiated melanoma brain metastases confirmed a shortened duration of local response of mitogen-activated protein kinase (MAPK)-inhibitor-pretreated compared with MAPK-inhibitor-naïve intracranial metastases. On the molecular level, we identified JARID1B/KDM5B as a cellular marker for cross-resistance between BRAFi and radiotherapy. JARID1Bhigh cells appeared more frequently under upfront BRAFi as compared with upfront radiation. JARID1B favours cell survival by transcriptional regulation of genes controlling cell cycle, DNA repair and cell death. CONCLUSION The level of cross-resistance between combined MAPK inhibition and radiotherapy is dependent on the treatment sequence. JARID1B may represent a novel therapy-overarching resistance marker.
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Affiliation(s)
- B Shannan
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Matschke
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - H Chauvistré
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - F Vogel
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - D Klein
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - F Meier
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - D Westphal
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Bruns
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - R Rauschenberg
- Skin Cancer Center National Center for Tumor Diseases, Department of Dermatology, Medical Faculty and University Hospital Carl Gustav Carus, TU Dresden, Germany
| | - J Utikal
- Skin Cancer Unit German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology University Medical Center Mannheim, Heidelberg University, Mannheim, Germany
| | - A Forschner
- Department of Dermatology, Center for Dermatooncology, University Hospital Tübingen, Germany
| | - C Berking
- Department of Dermatology and Allergy, University Hospital of Munich, Munich, Germany
| | - P Terheyden
- Department of Dermatology, University of Luebeck, Luebeck, Germany
| | - E Dabrowski
- Department of Dermatology, Klinikum Ludwigshafen, Ludwigshafen, Germany
| | - R Gutzmer
- Skin Cancer Centre, Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - D Rafei-Shamsabadi
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - F Meiss
- Department of Dermatology, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Germany
| | - L Heinzerling
- Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - L Zimmer
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Elisabeth Livingstone
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - Renáta Váraljai
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Hoewner
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - S Horn
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - J Klode
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - M Stuschke
- Department of Radiotherapy, West German Cancer Center, University Hospital, University of Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Essen, Germany
| | - B Scheffler
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - A Marchetto
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - G Sannino
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany
| | - T G P Grünewald
- Max-Eder Research Group for Pediatric Sarcoma Biology, Institute of Pathology, Faculty of Medicine, LMU Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Schadendorf
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany
| | - V Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen, Medical School, Germany
| | - A Roesch
- Department of Dermatology, University Hospital Essen, West German Cancer Center, University Duisburg-Essen and the German Cancer Consortium (DKTK) University of Duisburg-Essen, Germany.
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Jabulowsky R, Loquai C, Derhovanessian E, Mitzel-Rink H, Utikal J, Hassel J, Kaufmann R, Pinter A, Diken M, Gold M, Heesen L, Schreeb K, Schwarck-Kokarakis D, Kreiter S, Gaiser M, Jäger D, Grabbe S, Türeci Ö, Sahin U. A first-in-human phase I/II clinical trial assessing novel mRNA-lipoplex nanoparticles encoding shared tumor antigens for immunotherapy of malignant melanoma. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.109] [Citation(s) in RCA: 2] [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: 11/13/2022] Open
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El-Battrawy I, Schimanski T, Lan H, Cyganek L, Zhao Z, Lang S, Diecke S, Zimmermann WH, Utikal J, Wieland T, Rudic B, Tueluemen E, Borggrefe M, Zhou XB, Akin I. 4288A cellular model of Brugada Syndrome with CACNB2 mutation of human-induced pluripotent stem cell-derived cardiomyocytes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.4288] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- I El-Battrawy
- University Medical Centre of Mannheim, Mannheim, Germany
| | - T Schimanski
- University Medical Centre of Mannheim, Mannheim, Germany
| | - H Lan
- University Medical Centre of Mannheim, Mannheim, Germany
| | - L Cyganek
- Stem Cell Unit, Clinic for Cardiology and Pneumology, University Medical Center Göttingen, Göttingen, Göttingen, Germany
| | - Z Zhao
- University Medical Centre of Mannheim, Mannheim, Germany
| | - S Lang
- University Medical Centre of Mannheim, Mannheim, Germany
| | - S Diecke
- University Medical Centre of Mannheim, Max Delbrück Center for Molecular Medicine, Berlin, Mannheim, Germany
| | - W H Zimmermann
- Institute of Pharmacology and Toxicology, University of Göttingen, Göttingen, Germany, Göttingen, Germany
| | - J Utikal
- University Medical Centre of Mannheim, Mannheim, Germany
| | - T Wieland
- University Medical Centre of Mannheim, Mannheim, Germany
| | - B Rudic
- University Medical Centre of Mannheim, Mannheim, Germany
| | - E Tueluemen
- University Medical Centre of Mannheim, Mannheim, Germany
| | - M Borggrefe
- University Medical Centre of Mannheim, Mannheim, Germany
| | - X B Zhou
- University Medical Centre of Mannheim, Mannheim, Germany
| | - I Akin
- University Medical Centre of Mannheim, Mannheim, Germany
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Zhao Z, Lan H, El-Battrawy I, Yuecel G, Li X, Lang S, Buljubasic F, Zimmermann WH, Cyganek L, Utikal J, Wieland T, Borggrefe M, Zhou X, Akin I. P3821Lipopolysaccharides inhibited T-type calcium channels in human-induced pluripotent stem cell-derived cardiomyocytes. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy563.p3821] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Z Zhao
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - H Lan
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - I El-Battrawy
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - G Yuecel
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - X Li
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - S Lang
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - F Buljubasic
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - W H Zimmermann
- Institute of Pharmacology and Toxicology, University of Göttingen,, Göttingen, Germany
| | - L Cyganek
- Institute of Pharmacology and Toxicology, University of Göttingen,, Göttingen, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, University Medical Center Mannheim, University of Heidelberg, Mannheim, Germany
| | - T Wieland
- Institute of Experimental and Clinical Pharmacology and Toxicology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - M Borggrefe
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - X Zhou
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - I Akin
- First Department of Medicine, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Lobeck A, Weiss C, Orouji A, Koch PS, Heck M, Utikal J, Koenen W, Faulhaber J, Klemke CD, Felcht M. [Single center analysis of the dermatosurgical patient cohort of a tumor center in Germany]. Hautarzt 2018; 68:377-384. [PMID: 28361252 DOI: 10.1007/s00105-017-3951-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [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: 11/26/2022]
Abstract
BACKGROUND The incidence of skin cancer continues to increase. However, little is known about the dermatosurgical characteristics of the patients. PATIENTS AND METHODS In this single center, retrospective study, dermatosurgical reports of all patients treated because of basal cell carcinomas (BCC), squamous cell carcinomas (SCC), and malignant melanoma (MM) between 2004 and 2013 were analyzed. RESULTS During the observed period, the number of operated BCC rose by a factor of 1.86 and the number of MM by a factor of 2.3. In comparison to BCC/MM, there was a disproportionately high increase of SCC by a factor of 4.02. The average age was 71.5 ± 13.4 years (minimum: 14 years; maximum: 104 years), whereupon a significant increase of male age and a significant decrease of female age occurred. Almost 70% of all tumors were located in the head and neck area. The nose was most commonly treated. CONCLUSIONS During the last 10 years, the cohort of dermatosurgical patients changed in the tumor center. This should be verified in multicenter studies.
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Affiliation(s)
- A Lobeck
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - C Weiss
- Medizinische Statistik, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Mannheim, Deutschland
| | - A Orouji
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - P-S Koch
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
| | - M Heck
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
- Dermatologische Praxis Dr. Heck und Kollegen, Griesheim, Deutschland
| | - J Utikal
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
- Klinische Kooperationseinheit Dermatoonkologie, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Deutschland
| | - W Koenen
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
- Dermatologie im Fronhof, Bad Dürkheim, Deutschland
| | - J Faulhaber
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
- Dermatologische Gemeinschaftspraxis: Dr. Weller, Prof. Dr. Faulhaber & Kollegen, Schwäbisch Gmünd, Deutschland
| | - C-D Klemke
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland
- Hautklinik, Städtisches Klinikum Karlsruhe, Akademisches Lehrkrankenhaus der Universität Freiburg, Karlsruhe, Deutschland
| | - M Felcht
- Dermatologie, Venerologie und Allergologie, Exzellenzzentrum Dermatologie des Landes Baden-Württemberg, Universitätsmedizin Mannheim (UMM) der Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Deutschland.
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Long GV, Flaherty KT, Stroyakovskiy D, Gogas H, Levchenko E, de Braud F, Larkin J, Garbe C, Jouary T, Hauschild A, Chiarion-Sileni V, Lebbe C, Mandalà M, Millward M, Arance A, Bondarenko I, Haanen JBAG, Hansson J, Utikal J, Ferraresi V, Mohr P, Probachai V, Schadendorf D, Nathan P, Robert C, Ribas A, Davies MA, Lane SR, Legos JJ, Mookerjee B, Grob JJ. Dabrafenib plus trametinib versus dabrafenib monotherapy in patients with metastatic BRAF V600E/K-mutant melanoma: long-term survival and safety analysis of a phase 3 study. Ann Oncol 2018; 28:1631-1639. [PMID: 28475671 PMCID: PMC5834102 DOI: 10.1093/annonc/mdx176] [Citation(s) in RCA: 421] [Impact Index Per Article: 70.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Indexed: 02/07/2023] Open
Abstract
Background Previous analysis of COMBI-d (NCT01584648) demonstrated improved progression-free survival (PFS) and overall survival (OS) with combination dabrafenib and trametinib versus dabrafenib monotherapy in BRAF V600E/K-mutant metastatic melanoma. This study was continued to assess 3-year landmark efficacy and safety after ≥36-month follow-up for all living patients. Patients and methods This double-blind, phase 3 study enrolled previously untreated patients with BRAF V600E/K-mutant unresectable stage IIIC or stage IV melanoma. Patients were randomized to receive dabrafenib (150 mg twice daily) plus trametinib (2 mg once daily) or dabrafenib plus placebo. The primary endpoint was PFS; secondary endpoints were OS, overall response, duration of response, safety, and pharmacokinetics. Results Between 4 May and 30 November 2012, a total of 423 of 947 screened patients were randomly assigned to receive dabrafenib plus trametinib (n = 211) or dabrafenib monotherapy (n = 212). At data cut-off (15 February 2016), outcomes remained superior with the combination: 3-year PFS was 22% with dabrafenib plus trametinib versus 12% with monotherapy, and 3-year OS was 44% versus 32%, respectively. Twenty-five patients receiving monotherapy crossed over to combination therapy, with continued follow-up under the monotherapy arm (per intent-to-treat principle). Of combination-arm patients alive at 3 years, 58% remained on dabrafenib plus trametinib. Three-year OS with the combination reached 62% in the most favourable subgroup (normal lactate dehydrogenase and <3 organ sites with metastasis) versus only 25% in the unfavourable subgroup (elevated lactate dehydrogenase). The dabrafenib plus trametinib safety profile was consistent with previous clinical trial observations, and no new safety signals were detected with long-term use. Conclusions These data demonstrate that durable (≥3 years) survival is achievable with dabrafenib plus trametinib in patients with BRAF V600-mutant metastatic melanoma and support long-term first-line use of the combination in this setting.
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Affiliation(s)
- G. V. Long
- Melanoma Institute Australia, The University of Sydney, and Royal North Shore and Mater Hospitals, North Sydney, Australia
- Correspondence to: Prof. Georgina V. Long, Melanoma Institute Australia, The University of Sydney, 40 Rocklands Road, North Sydney 2060, NSW, Australia. Tel: +61-2-9911-7200; E-mail:
| | - K. T. Flaherty
- Developmental Therapeutics and Melanoma Programs, Massachusetts General Hospital Cancer Center, Boston, USA
| | | | - H. Gogas
- First Department of Medicine, “Laiko” General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - E. Levchenko
- Petrov Research Institute of Oncology, Saint Petersburg, Russia
| | - F. de Braud
- Dipartimento di Medicina Oncologica, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - J. Larkin
- Royal Marsden NHS Foundation Trust, London, UK
| | - C. Garbe
- Department of Dermatology, University of Tübingen, Tübingen, Germany
| | - T. Jouary
- Service D'oncologie Médicale, Hopital Francois Mitterrand, Pau, France
| | - A. Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein, Kiel, Germany
| | - V. Chiarion-Sileni
- Melanoma and Oesophageal Oncology Unit, Veneto Oncology Institute–IRCCS, Padova, Italy
| | - C. Lebbe
- APHP Dermatology and CIC Departments, INSERM U976, University Paris Diderot, Paris, France
| | - M. Mandalà
- Department of Oncology and Hematology, Papa Giovanni XXIII Hospital, Bergamo, Italy
| | - M. Millward
- Medical Oncology Department, Sir Charles Gairdner Hospital, Perth, Australia
| | - A. Arance
- Department of Medical Oncology, Hospital Clinic of Barcelona, Barcelona, Spain
| | - I. Bondarenko
- Dnipropetrovsk State Medical Academy, Clinical Hospital #4, Dnipropetrovsk, Ukraine
| | | | - J. Hansson
- Department of Oncology-Pathology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
| | - J. Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim and Heidelberg, Germany
| | - V. Ferraresi
- Department of Medical Oncology A, Regina Elena National Cancer Institute, Rome, Italy
| | - P. Mohr
- Dermatologisches Zentrum Buxtehude, Elbe Kliniken Buxtehude, Buxtehude, Germany
| | - V. Probachai
- Dnipropetrovsk Clinical Oncology Center of Dnipropetrovsk State Council, Dnipropetrovsk, Ukraine
| | - D. Schadendorf
- Department of Dermatology, University Hospital Essen, Essen, Germany
- German Cancer Consortium, Heidelberg, Germany
| | - P. Nathan
- Mount Vernon Cancer Centre, Northwood, UK
| | - C. Robert
- Gustave Roussy, Département de Médecine Oncologique, Service de Dermatologie et Université Paris-Sud, Faculté de Médecine, Villejuif, France
| | - A. Ribas
- Department of Medicine, Hematology/Oncology, UCLA Jonsson Comprehensive Cancer Center, Los Angeles, USA
| | - M. A. Davies
- Melanoma Medical Oncology and Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, USA
| | - S. R. Lane
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - J. J. Legos
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - B. Mookerjee
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - J.-J. Grob
- Service de Dermatologie, Centre Hospitalo-Universitaire Timone, Aix-Marseille Université, Marseille, France
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Miller M, Sahin U, Derhovanessian E, Kloke BP, Simon P, Bukur V, Albrecht C, Paruzynski A, Löwer M, Kuhn A, Schreeb K, Attig S, Brueck AK, Bolte S, Grabbe S, Höller C, Utikal J, Huber C, Loquai C, Türeci Ö. IVAC MUTANOME: A first-in-human phase I clinical trial targeting individual mutant neoantigens for the treatment of melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx712.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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14
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Heesen L, Jabulowsky R, Loquai C, Utikal J, Gebhardt C, Hassel J, Kaufmann R, Pinter A, Derhovanessian E, Diken M, Kranz L, Haas H, Attig S, Kuhn A, Langguth P, Schwarck-Kokarakis D, Jäger D, Grabbe S, Türeci Ö, Sahin U. A first-in-human phase I/II clinical trial assessing novel mRNA-lipoplex nanoparticles encoding shared tumor antigens for potent melanoma immunotherapy. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx711.030] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Borchers S, Maβlo C, Müller CA, Tahedl A, Volkind J, Nowak Y, Umansky V, Esterlechner J, Frank MH, Ganss C, Kluth MA, Utikal J. Detection of ABCB5 tumour antigen-specific CD8 + T cells in melanoma patients and implications for immunotherapy. Clin Exp Immunol 2017; 191:74-83. [PMID: 28940439 DOI: 10.1111/cei.13053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2017] [Indexed: 01/09/2023] Open
Abstract
ATP binding cassette subfamily B member 5 (ABCB5) has been identified as a tumour-initiating cell marker and is expressed in various malignancies, including melanoma. Moreover, treatment with anti-ABCB5 monoclonal antibodies has been shown to inhibit tumour growth in xenotransplantation models. Therefore, ABCB5 represents a potential target for cancer immunotherapy. However, cellular immune responses against ABCB5 in humans have not been described so far. Here, we investigated whether ABCB5-reactive T cells are present in human melanoma patients and tested the applicability of ABCB5-derived peptides for experimental induction of human T cell responses. Peripheral blood mononuclear cells (PBMNC) isolated from blood samples of melanoma patients (n = 40) were stimulated with ABCB5 peptides, followed by intracellular cytokine staining (ICS) for interferon (IFN)-γ and tumour necrosis factor (TNF)-α. To evaluate immunogenicity of ABCB5 peptides in naive healthy donors, CD8 T cells were co-cultured with ABCB5 antigen-loaded autologous dendritic cells (DC). ABCB5 reactivity in expanded T cells was assessed similarly by ICS. ABCB5-reactive CD8+ T cells were detected ex vivo in 19 of 29 patients, melanoma antigen recognised by T cells (MART-1)-reactive CD8+ T cells in six of 21 patients. In this small, heterogeneous cohort, reactivity against ABCB5 was significantly higher than against MART-1. It occurred significantly more often and independently of clinical characteristics. Reactivity against ABCB5 could be induced in 14 of 16 healthy donors in vitro by repeated stimulation with peptide-loaded autologous DC. As ABCB5-reactive CD8 T cells can be found in the peripheral blood of melanoma patients and an ABCB5-specific response can be induced in vitro in naive donors, ABCB5 could be a new target for immunotherapies in melanoma.
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Affiliation(s)
- S Borchers
- RHEACELL GmbH & Co. KG, Heidelberg, Germany
| | - C Maβlo
- RHEACELL GmbH & Co. KG, Heidelberg, Germany
| | | | - A Tahedl
- TICEBA GmbH, Heidelberg, Germany
| | | | - Y Nowak
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - V Umansky
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | | | - M H Frank
- Transplant Research Program, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.,Harvard Stem Cell Institute, Harvard University, Cambridge, MA, USA.,School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - C Ganss
- RHEACELL GmbH & Co. KG, Heidelberg, Germany.,TICEBA GmbH, Heidelberg, Germany
| | - M A Kluth
- RHEACELL GmbH & Co. KG, Heidelberg, Germany.,TICEBA GmbH, Heidelberg, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ) and Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
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16
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Schadendorf D, Flaherty K, Nathan P, Hersey P, Garbe C, Milhem M, Demidov L, Mohr P, Hassel J, Rutkowski P, Dummer R, Utikal J, Kiecker F, Larkin J, D’Amelio A, Huang Y, Mookerjee B, Robert C. Five-year efficacy and safety update from METRIC: Trametinib vs chemotherapy in patients with BRAF V600E/K–mutant advanced or metastatic melanoma. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx377.013] [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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Reinhard R, Gebhardt C, Schmieder A, Umansky V, Utikal J. Recurrent tattoo reactions in a patient treated with BRAF and MEK inhibitors. J Eur Acad Dermatol Venereol 2017; 31:e375-e377. [DOI: 10.1111/jdv.14181] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [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)
- R. Reinhard
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - C. Gebhardt
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - A. Schmieder
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
| | - V. Umansky
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - J. Utikal
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
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18
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Haselmann V, Gebhardt C, Brechtel I, Duda A, Sucker A, Utikal J, Schadendorf D, Neumaier M. Analysis of BRAF V600E mutation status – concordance of results from circulating tumor DNA and tissue-based testing and impact on prediction of the clinical course in patients undergoing BRAFi therapy. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.40] [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: 11/15/2022] Open
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19
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Gutzmer R, Rivoltini L, Levchenko E, Testori A, Utikal J, Ascierto PA, Demidov L, Grob JJ, Ridolfi R, Schadendorf D, Queirolo P, Santoro A, Loquai C, Dreno B, Hauschild A, Schultz E, Lesimple TP, Vanhoutte N, Salaun B, Gillet M, Jarnjak S, De Sousa Alves PM, Louahed J, Brichard VG, Lehmann FF. Safety and immunogenicity of the PRAME cancer immunotherapeutic in metastatic melanoma: results of a phase I dose escalation study. ESMO Open 2016; 1:e000068. [PMID: 27843625 PMCID: PMC5070281 DOI: 10.1136/esmoopen-2016-000068] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [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: 04/21/2016] [Accepted: 04/22/2016] [Indexed: 12/23/2022] Open
Abstract
Purpose The PRAME tumour antigen is expressed in several tumour types but in few normal adult tissues. A dose-escalation phase I/II study (NCT01149343) assessed the safety, immunogenicity and clinical activity of the PRAME immunotherapeutic (recombinant PRAME protein (recPRAME) with the AS15 immunostimulant) in patients with advanced melanoma. Here, we report the phase I dose-escalation study segment. Patients and methods Patients with stage IV PRAME-positive melanoma were enrolled to 3 consecutive cohorts to receive up to 24 intramuscular injections of the PRAME immunotherapeutic. The RecPRAME dose was 20, 100 or 500 µg in cohorts 1, 2 and 3, respectively, with a fixed dose of AS15. Adverse events (AEs), including predefined dose-limiting toxicity (DLT) and the anti-PRAME humoral response (ELISA), were coprimary end points. Cellular immune responses were evaluated using in vitro assays. Results 66 patients were treated (20, 24 and 22 in the respective cohorts). AEs considered by the investigator to be causally related were mostly grade 1 or 2 injection site symptoms, fatigue, chills, fever and headache. Two DLTs (grade 3 brain oedema and proteinuria) were recorded in two patients in two cohorts (cohorts 2 and 3). All patients had detectable anti-PRAME antibodies after four immunisations. Percentages of patients with predefined PRAME-specific-CD4+T-cell responses after four immunisations were similar in each cohort. No CD8+ T-cell responses were detected. Conclusions The PRAME immunotherapeutic had an acceptable safety profile and induced similar anti-PRAME-specific humoral and cellular immune responses in all cohorts. As per protocol, the phase II study segment was initiated to further evaluate the 500 µg PRAME immunotherapeutic dose. Trial registration number NCT01149343, Results.
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Affiliation(s)
- R Gutzmer
- Skin Cancer Center Hannover , Hannover Medical School , Hannover , Germany
| | - L Rivoltini
- Unit of Immunotherapy of Human Tumors , Fondazione RCCS Istituto Nazionale dei Tumori , Milan , Italy
| | - E Levchenko
- Petrov Research Institute of Oncology , St. Petersburg , Russia
| | - A Testori
- Istituto Europeo Di Oncologia , Milano , Italy
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
| | - P A Ascierto
- Melanoma, Cancer Immunotherapy and Innovative Therapies Unit , Istituto Nazionale Tumori Fondazione Pascale , Naples , Italy
| | - L Demidov
- Cancer Research Center , Moscow , Russia
| | - J J Grob
- Aix Marseille University Hôpital de la Timone, Service de Dermatologie , Marseille , France
| | - R Ridolfi
- Immunotherapy Unit , Romagna Cancer Institute IRST- IRCCS , Meldola , Italy
| | - D Schadendorf
- Department of Dermatology , University Hospital Essen , Essen , Germany
| | - P Queirolo
- Istituto Nazionale per la Ricerca sul Cancro Oncologia Medica , Genova , Italy
| | - A Santoro
- Humanitas Cancer Center, Istituto Clinico Humanitas IRCCS , Rozzano , Italy
| | - C Loquai
- Department of Dermatology , University of Mainz , Mainz , Germany
| | - B Dreno
- Dermatology Clinic , Hôpital Hôtel-Dieu, CHU Nantes , Nantes , France
| | - A Hauschild
- Department of Dermatology , Skin Cancer Center, Schleswig-Holstein University Hospital , Kiel , Germany
| | - E Schultz
- Department of Dermatology , Paracelsus Medical University, Klinikum Nuremberg , Nuremberg , Germany
| | - T P Lesimple
- Département d'Oncologie Médicale , Centre Eugène Marquis , Rennes , France
| | | | - B Salaun
- GSK Vaccines , Rixensart , Belgium
| | - M Gillet
- GSK Vaccines , Rixensart , Belgium
| | | | - P M De Sousa Alves
- GSK Vaccines, Rixensart, Belgium; Celyad, Mont-Saint-Guibert, Rixensart, Belgium
| | | | - V G Brichard
- GSK Vaccines, Rixensart, Belgium; Vianova-Biosciences, Lasne, Belgium
| | - F F Lehmann
- GSK Vaccines, Rixensart, Belgium; Celyad, Mont-Saint-Guibert, Rixensart, Belgium
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20
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Schneider T, Sevko A, Heussel CP, Umansky L, Beckhove P, Dienemann H, Safi S, Utikal J, Hoffmann H, Umansky V. Serum inflammatory factors and circulating immunosuppressive cells are predictive markers for efficacy of radiofrequency ablation in non-small-cell lung cancer. Clin Exp Immunol 2015; 180:467-74. [PMID: 25644608 DOI: 10.1111/cei.12596] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2015] [Indexed: 12/20/2022] Open
Abstract
In recent years, percutaneous radiofrequency ablation (RFA) has been developed as a new tool in the treatment of non-small-cell lung cancer (NSCLC) in non-surgical patients. There is growing evidence that RFA-mediated necrosis can modulate host immune responses. Here we analysed serum inflammatory factors as well as immunosuppressive cells in the peripheral blood to discover possible prognostic indicators. Peripheral blood and serum samples were collected before RFA and within 3 months after the treatment in a total of 12 patients. Inflammatory cytokines and growth factors were measured in serum by the Bio-Plex assay. Myeloid-derived suppressor cells (MDSCs) and regulatory T cells (Tregs ) were evaluated in the peripheral blood via flow cytometry. In patients developing local or lymphogenic tumour relapse (n=4), we found an early significant increase in the concentration of tumour necrosis factor (TNF)-α as well as chemokine (C-C motif) ligand (CCL)-2 and CCL-4 compared to patients without relapse (n=4) and healthy donors (n=5). These changes were associated with an elevated activity of circulating MDSC indicated by an increased nitric oxide (NO) production in these cells. Elevated serum levels of TNF-α, CCL-2 and CCL-4 associated with an increased NO production in circulating MDSCs might be an early indicator of the incomplete RFA and subsequently a potential tumour relapse in NSCLC.
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Affiliation(s)
- T Schneider
- Department of Thoracic Surgery, St Vincentius Kliniken, Karlsruhe, Germany
| | - A Sevko
- Skin Cancer Unit, German Cancer Research Center, Heidelberg and Department of Dermatology, Venerology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Heidelberg, Germany
| | - C P Heussel
- Department of Diagnostic and Interventional Radiology with Nuclear Medicine, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - L Umansky
- Department of Translational Immunology, German Cancer Research Center, Heidelberg, Germany
| | - P Beckhove
- Department of Translational Immunology, German Cancer Research Center, Heidelberg, Germany
| | - H Dienemann
- Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - S Safi
- Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Center, Heidelberg and Department of Dermatology, Venerology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Heidelberg, Germany
| | - H Hoffmann
- Department of Thoracic Surgery, Thoraxklinik, Heidelberg University, Heidelberg, Germany
| | - V Umansky
- Skin Cancer Unit, German Cancer Research Center, Heidelberg and Department of Dermatology, Venerology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Heidelberg, Germany
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Wezel F, Novak D, Larribere L, Galach M, Unger C, Utikal J. 1006 Directed differentiation of human induced pluripotent stem cells (hiPS) for urothelial cell-based tissue-engineering therapies. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/s1569-9056(15)60994-0] [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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Ugurel S, Loquai C, Kähler K, Hassel J, Berking C, Zimmer L, Haubitz I, Satzger I, Müller-Brenne T, Mikhaimer N, Becker J, Kilian K, Schadendorf D, Heinzerling L, Kaatz M, Utikal J, Göppner D, Pföhler C, Pflugfelder A, Mössner R, Gutzmer R. A multicenter DeCOG study on predictors of vemurafenib therapy outcome in melanoma: pretreatment impacts survival. Ann Oncol 2015; 26:573-82. [DOI: 10.1093/annonc/mdu573] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Livingstone E, Krajewski C, Eigentler TK, Windemuth-Kieselbach C, Benson S, Elsenbruch S, Hauschild A, Rompel R, Meiss F, Mauerer A, Kähler KC, Dippel E, Möllenhoff K, Kilian K, Mohr P, Utikal J, Schadendorf D. Prospective evaluation of follow-up in melanoma patients in Germany - results of a multicentre and longitudinal study. Eur J Cancer 2015; 51:653-67. [PMID: 25638778 DOI: 10.1016/j.ejca.2015.01.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [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: 12/08/2014] [Accepted: 01/05/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Patient numbers requiring long-term melanoma surveillance are constantly rising. Surveillance is costly and guideline recommendations vary substantially. METHODS In this German nationwide study, information on surveillance and treatment of patients diagnosed with melanoma and melanoma in situ (MMis) between April and June 2008 was prospectively collected over four years. Additionally, patient self-report questionnaires were evaluated to assess anxiety, depression, health-related quality of life, socio-demographic information and use of disease specific health information sources at year 4 after primary diagnosis. RESULTS Complete data was available for 668 patients from 67 centres, of whom 96.0% were in regular melanoma surveillance. In year 3-4 of surveillance, only 55.6% of locoregionary metastases were detected during surveillance visits. Only 33.3% were self-detected by the patient even though 69.4% were documented as being clinically visible or palpable. Costs of 4year surveillance of 550 patients without tumour recurrence (stage I-IIC and MMis) accumulated to 228,155.75 €. Guideline-adherence for follow-up frequency, lymph node ultrasound, S100 serum level tests and diagnostic imaging recommendations was approximately 60% in year 3-4 of surveillance. Multivariate regression analysis showed that certain patient/tumour characteristics and regional differences were significantly associated with guideline deviations. The percentage of patients who exceeded published cut-off scores indicating clinically relevant symptoms of anxiety and depression were significantly increased. Patients frequently reported lack of psychosocial support and education but ascribed great importance to these. CONCLUSIONS We recommend further reduction of melanoma follow-up in low-risk melanoma patients and improvement of psycho-social support and patient education for all melanoma patients.
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Affiliation(s)
- E Livingstone
- Dept. of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Hufelandstr. 55, 45122 Essen, Germany.
| | - C Krajewski
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - T K Eigentler
- Dept. of Dermatology, University Tübingen, Liebermeisterstr. 25, 72076 Tübingen, Germany
| | | | - S Benson
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - S Elsenbruch
- Institute of Medical Psychology and Behavioral Immunobiology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45122 Essen, Germany
| | - A Hauschild
- Dept. of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105 Kiel, Germany
| | - R Rompel
- Dept. of Dermatology Kassel, Clinical Centre Kassel, Mönchebergstr. 41, 34125 Kassel, Germany
| | - F Meiss
- Dept. of Dermatology, University Medical Centre Freiburg, Hauptstr. 7, 79104 Freiburg, Germany
| | - A Mauerer
- Dept. of Dermatology, University Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg, Germany
| | - K C Kähler
- Dept. of Dermatology, University Hospital Schleswig-Holstein, Campus Kiel, Schittenhelmstr. 7, 24105 Kiel, Germany
| | - E Dippel
- Dept. of Dermatology, Clinical Centre Ludwigshafen, Bremserstr. 79, 67073 Ludwigshafen, Germany
| | - K Möllenhoff
- Dept. of Dermatology, Ruhr-University Bochum, Gudrunstr. 56, 44791 Bochum, Germany
| | - K Kilian
- Dept. of Dermatology, Ludwig-Maximilians University Munich, Frauenlobstrasse 9-11, 80337 München, Germany
| | - P Mohr
- Dept. of Dermatology, Elbekliniken Stade-Buxtehude GmbH, Am Krankenhaus 1, 21614 Buxtehude, Germany
| | - J Utikal
- Skin Cancer Unit, German Cancer Research Centre (DKFZ), Im Neuenheimer Feld 280, 69120 Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht-Karl University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim, Germany
| | - D Schadendorf
- Dept. of Dermatology, University Hospital Essen, University of Duisburg-Essen, Essen, Hufelandstr. 55, 45122 Essen, Germany
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Gebhardt C, Ziegler B, Stadler S, Goerdt S, Utikal J. Complete remission of treatment-refractory advanced angiosarcoma of the scalp by protracted intralesional interleukin-2 therapy. Br J Dermatol 2014; 172:1156-8. [PMID: 25204400 DOI: 10.1111/bjd.13400] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- C Gebhardt
- Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg, Germany; Department of Dermatology, Venereology and Allergology, University Medical Center Mannheim, Ruprecht-Karl University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
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Orouji A, Goerdt S, Utikal J, Leverkus M. Multiple highly and moderately differentiated squamous cell carcinomas of the skin during vismodegib treatment of inoperable basal cell carcinoma. Br J Dermatol 2014; 171:431-3. [DOI: 10.1111/bjd.12840] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- A. Orouji
- Department of Dermatology, Venereology and Allergology; University Medical Center; Theodor-Kutzer-Ufer 1-3 68135 Mannheim Germany
- Ruprecht-Karl-University of Heidelberg; Mannheim Germany
| | - S. Goerdt
- Department of Dermatology, Venereology and Allergology; University Medical Center; Theodor-Kutzer-Ufer 1-3 68135 Mannheim Germany
- Ruprecht-Karl-University of Heidelberg; Mannheim Germany
| | - J. Utikal
- Department of Dermatology, Venereology and Allergology; University Medical Center; Theodor-Kutzer-Ufer 1-3 68135 Mannheim Germany
- Ruprecht-Karl-University of Heidelberg; Mannheim Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
| | - M. Leverkus
- Department of Dermatology, Venereology and Allergology; University Medical Center; Theodor-Kutzer-Ufer 1-3 68135 Mannheim Germany
- Ruprecht-Karl-University of Heidelberg; Mannheim Germany
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Haus G, Utikal J, Geraud C, Goerdt S, Leverkus M. CD30‐positive lymphoproliferative disorder in a red tattoo: regional lymphomatoid papulosis typeCor pseudolymphoma? Br J Dermatol 2014; 171:668-70. [DOI: 10.1111/bjd.13024] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- G. Haus
- Department of Dermatology, Venereology and Allergology University Medical Center Mannheim Ruprecht‐Karl‐University of Heidelberg Theodor‐Kutzer‐Ufer 1–3 Mannheim 68135 Germany
| | - J. Utikal
- Department of Dermatology, Venereology and Allergology University Medical Center Mannheim Ruprecht‐Karl‐University of Heidelberg Theodor‐Kutzer‐Ufer 1–3 Mannheim 68135 Germany
- Skin Cancer Unit German Cancer Research Center (DKFZ) Heidelberg Germany
| | - C. Geraud
- Department of Dermatology, Venereology and Allergology University Medical Center Mannheim Ruprecht‐Karl‐University of Heidelberg Theodor‐Kutzer‐Ufer 1–3 Mannheim 68135 Germany
| | - S. Goerdt
- Department of Dermatology, Venereology and Allergology University Medical Center Mannheim Ruprecht‐Karl‐University of Heidelberg Theodor‐Kutzer‐Ufer 1–3 Mannheim 68135 Germany
| | - M. Leverkus
- Department of Dermatology, Venereology and Allergology University Medical Center Mannheim Ruprecht‐Karl‐University of Heidelberg Theodor‐Kutzer‐Ufer 1–3 Mannheim 68135 Germany
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Kaskel P, Lange U, Sander S, Huber M, Utikal J, Leiter U, Krähn G, Meurer M, Kron M. Ultraviolet exposure and risk of melanoma and basal cell carcinoma in Ulm and Dresden, Germany. J Eur Acad Dermatol Venereol 2014; 29:134-42. [DOI: 10.1111/jdv.12488] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Accepted: 02/25/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - U. Lange
- Department of Dermatology; Technical University of Dresden; Dresden Germany
| | - S. Sander
- Institute of Epidemiology and Medical Biometry; University of Ulm; Ulm Germany
| | - M.A. Huber
- Department of Dermatology; University of Ulm; Ulm Germany
| | - J. Utikal
- Department of Dermatology; University of Ulm; Ulm Germany
- Skin Cancer Unit; German Cancer Research Center (DKFZ); Heidelberg Germany
- Department of Dermatology, Venereology and Allergology; University Medical Center Mannheim; Ruprecht-Karl University of Heidelberg; Mannheim Germany
| | - U. Leiter
- Department of Dermatology; University of Ulm; Ulm Germany
- Center of Dermato-Oncology; Department of Dermatology; University of Tübingen; Tübingen Germany
| | - G. Krähn
- Department of Dermatology; University of Ulm; Ulm Germany
| | - M. Meurer
- Department of Dermatology; Technical University of Dresden; Dresden Germany
| | - M. Kron
- Institute of Epidemiology and Medical Biometry; University of Ulm; Ulm Germany
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Schilling B, Sondermann W, Zhao F, Griewank KG, Livingstone E, Sucker A, Zelba H, Weide B, Trefzer U, Wilhelm T, Loquai C, Berking C, Hassel J, Kähler KC, Utikal J, Al Ghazal P, Gutzmer R, Goldinger SM, Zimmer L, Paschen A, Hillen U, Schadendorf D. Differential influence of vemurafenib and dabrafenib on patients' lymphocytes despite similar clinical efficacy in melanoma. Ann Oncol 2014; 25:747-753. [PMID: 24504444 PMCID: PMC4433519 DOI: 10.1093/annonc/mdt587] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [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: 09/17/2013] [Revised: 10/21/2013] [Accepted: 12/02/2013] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Since the majority of melanomas eventually become resistant and progress, combining selective BRAF inhibitors (BRAFi) with immunotherapies has been proposed to achieve more durable treatment responses. Here, we explored the impact of selective BRAFi on the hosts' immune system. PATIENTS AND METHODS Clinical data, whole blood counts (WBC) and serum lactate dehydrogenase (LDH) of 277 vemurafenib- and 65 dabrafenib-treated melanoma patients were evaluated. The frequency and phenotype of lymphocyte subpopulations were determined by flow cytometry while T cell cytokine secretion was measured by multiplex assays. RESULTS Progression-free survival (PFS) as well as overall survival (OS) were similar in patients treated with either BRAFi. High pretreatment LDH was associated with shorter PFS and OS in both groups. During therapy, peripheral lymphocytes decreased by 24.3% (median, P < 0.0001) in vemurafenib-treated patients but remained unchanged in dabrafenib-treated patients (+1.2%, P = 0.717). Differentiation of peripheral lymphocytes of vemurafenib-treated patients showed a significant decrease in CD4(+) T cells (P < 0.05). Within CD4(+) T cells obtained during treatment, an increase in CCR7(+)CD45RA(+) (naïve) and a decrease in CCR7(+)CD45RA(-) (central memory) populations were found (P < 0.01 for both). Furthermore, secretion of interferon-γ and interleukin-9 by CD4(+) T cells was significantly lower in samples obtained during vemurafenib treatment compared with baseline samples. CONCLUSION While both compounds have comparable clinical efficacy, vemurafenib but not dabrafenib decreases patients peripheral lymphocyte counts and alters CD4(+) T cell phenotype and function. Thus, selective BRAFi can significantly affect patients' peripheral lymphocyte populations. Fully understanding these effects could be critical for successfully implementing combinatorial therapies of BRAFi with immunomodulatory agents.
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Affiliation(s)
- B Schilling
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK).
| | - W Sondermann
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - F Zhao
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - K G Griewank
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - E Livingstone
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - A Sucker
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - H Zelba
- University Medical Center, University of Tübingen, Tübingen
| | - B Weide
- German Cancer Consortium (DKTK); University Medical Center, University of Tübingen, Tübingen
| | - U Trefzer
- German Cancer Consortium (DKTK); Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Humboldt University, Berlin
| | - T Wilhelm
- German Cancer Consortium (DKTK); Department of Dermatology, Venerology and Allergy, Charité Universitätsmedizin Berlin, Humboldt University, Berlin
| | - C Loquai
- German Cancer Consortium (DKTK); Department of Dermatology, University of Mainz, Mainz
| | - C Berking
- German Cancer Consortium (DKTK); Department of Dermatology and Allergology, Ludwig-Maximilian University, Munich
| | - J Hassel
- German Cancer Consortium (DKTK); Department of Dermatology, Heidelberg University Hospital, Heidelberg
| | - K C Kähler
- Department of Dermatology, Venerology and Allergology, University of Schleswig-Holstein Hospital, Campus Kiel
| | - J Utikal
- German Cancer Consortium (DKTK); Skin Cancer Unit, German Cancer Research Center (DKFZ), Heidelberg; Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim
| | - P Al Ghazal
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - R Gutzmer
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - S M Goldinger
- Department of Dermatology, University Hospital Zurich, Zurich, Switzerland
| | - L Zimmer
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - A Paschen
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - U Hillen
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
| | - D Schadendorf
- Department of Dermatology, University Hospital, West German Cancer Center, University Duisburg-Essen, Essen; German Cancer Consortium (DKTK)
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Leufke C, Leykauf J, Krunic D, Jauch A, Holtgreve-Grez H, Böhm-Steuer B, Bröcker EB, Mauch C, Utikal J, Hartschuh W, Purdie KJ, Boukamp P. The telomere profile distinguishes two classes of genetically distinct cutaneous squamous cell carcinomas. Oncogene 2013; 33:3506-18. [DOI: 10.1038/onc.2013.323] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 05/14/2013] [Accepted: 06/17/2013] [Indexed: 12/12/2022]
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Robert C, Flaherty K, Hersey P, Nathan P, Garbe C, Milhem M, Demidov L, Hassel J, Rutkowski P, Mohr P, Dummer R, Trefzer U, Larkin J, Utikal J, Casey M, Sherman L, Crist W, Wu F, Patel K, Schadendorf D. Efficacité du trametinib (T), sur la survie sans progression (SSP) et la survie globale (SG), en comparaison à la chimiothérapie (C) chez des patients (pts) ayant un mélanome métastatique (MM) avec mutation de BRAFV600E/K. Ann Dermatol Venereol 2012. [DOI: 10.1016/j.annder.2012.10.079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Gutzmer R, Rivoltini L, Levchenko E, Testori A, Utikal J, Ascierto P, Salaun B, Vanhoutte N, Gillet M, Brichard V. Immunogenicity and Safety of the Prame Cancer Immunotherapeutic in Metastatic Melanoma: Phase I/II Dose Escalation Study. Ann Oncol 2012. [DOI: 10.1016/s0923-7534(20)33672-3] [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: 11/26/2022] Open
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Manousaridis I, Mavridou S, Goerdt S, Leverkus M, Utikal J. Cutaneous side effects of inhibitors of the RAS/RAF/MEK/ERK signalling pathway and their management. J Eur Acad Dermatol Venereol 2012; 27:11-8. [PMID: 22540151 DOI: 10.1111/j.1468-3083.2012.04546.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mutations in genes encoding for proteins along the RAS-RAF-MEK-ERK pathway have been detected in a variety of tumor entities, including malignant melanoma, thyroid, colonic and ovarian carcinomas, and some sarcomas. Thus, a number of inhibitors of this pathway have been developed, whose antitumor potential is currently being assessed in different clinical trials. Up to now one drug of this category (vemurafenib) has been approved by the FDA and the European Commission for late-stage melanoma. Although these new targeted anticancer therapies are generally considered to be safe and well tolerated, certain toxicities have been attributed to them, with cutaneous side effects being perhaps the most frequent amongst them. Based on results of clinical trials and on case series, a distinct profile of cutaneous toxicity has been observed, which is similar to that of EGFR and multikinase inhibitors. As exanthema, palmar-plantar erythrodysesthesia syndrome, hyperkeratosis, xerosis, pruritus, photosensitivity, and paronychia, can be controlled in most cases with common conservative modalities, special attention should be given to the early detection of epithelial skin tumors (mainly keratoakanthomas) that can be induced during therapy with these agents. This report reviews all current published data on cutaneous side effects of RAS-RAF-MEK-ERK pathway inhibitors, and attempts to provide the clinician with clear hints for their management.
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Affiliation(s)
- I Manousaridis
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
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Booken N, Heck M, Nicolay JP, Klemke CD, Goerdt S, Utikal J. Oral aprepitant in the therapy of refractory pruritus in erythrodermic cutaneous T-cell lymphoma. Br J Dermatol 2011; 164:665-7. [PMID: 21039410 DOI: 10.1111/j.1365-2133.2010.10108.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Cranial fasciitis is a rare variation of nodular fasciitis that occurs in the region of the capillitium. We report on a 29-year-old patient who presented with a 2-month history of a tumor progressively increasing in size located on the occiput. Histological examination revealed a tumor, consisting of tightly packed spindle-shaped cells with underlying myxoid stroma, which extended from the dermis to the subcutis. Actin and vimentin were detected by immunohistochemistry. We established a diagnosis of cranial fasciitis and excised the tumor. Especially when a child or young adult presents with a tumor in the skull area, consideration should be given to cranial fasciitis in the differential diagnosis to avoid unnecessary and possibly very invasive treatment approaches.
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Affiliation(s)
- M Linke
- Klinik für Dermatologie, Venerologie und Allergologie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Ruprecht-Karls-Universität Heidelberg, Theodor-Kutzer-Ufer 1-3, 68135, Mannheim, Deutschland
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Utikal J, Peitsch WK, Kemmler N, Booken N, Hildenbrand R, Gladisch R, Goerdt S, Goebeler M. Bullous eosinophilic cellulitis associated with ulcerative colitis: effective treatment with sulfasalazine and glucocorticoids. Br J Dermatol 2007; 156:764-6. [PMID: 17263808 DOI: 10.1111/j.1365-2133.2006.07729.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Utikal J, Zimpfer A, Thoelke A, Figl R, Hildenbrand R, Kettelhack C, Goerdt S, Schadendorf D, Ugurel S. Complete remission of multiple satellite and in-transit melanoma metastases after sequential treatment with isolated limb perfusion and topical imiquimod. Br J Dermatol 2006; 155:488-91. [PMID: 16882203 DOI: 10.1111/j.1365-2133.2006.07333.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Booken D, Velten FW, Utikal J, Goerdt S, Bayerl C. Allergische Kontaktdermatitis durch Kolophonium und Terpentin in Harzen unbehandelter Kiefernholzmöbel. Hautarzt 2006; 57:1013-5. [PMID: 16523280 DOI: 10.1007/s00105-006-1097-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [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: 11/28/2022]
Abstract
Pine wood is one of the most used raw products in furniture manufacturing in Europe. High concentrations of colophony and turpentine can be extracted from pine resins. A 45-year-old woman developed a contact dermatitis of the face and hands due to a sensitization to colophony and turpentine after she had bought untreated pine chairs. The increased use of untreated pine in the furniture industry might result in an increase of colophony and turpentine-induced contact allergies. Therefore, the slogan "untreated=harmless" should be considered critically in such cases.
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Affiliation(s)
- D Booken
- Klinik für Dermatologie, Venerologie und Allergologie, Klinikum Mannheim gGmbH, Universitätsklinikum Mannheim, Ruprecht-Karls-Universität Heidelberg, Mannheim, Germany.
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Ugurel S, Utikal J, Mohr P, Helmbold P, Pfoehler C, Schiller M, Kellner I, Schadendorf D. Imatinib in locally advanced dermatofibrosarcoma protuberans (DFSP): A phase II trial of the Dermatologic Cooperative Oncology Group (DeCOG). J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.9561] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
9561 Background: DFSP is known for its low metastatic potential but locally infiltrative growth, hereby enforcing extensive and often multiple surgical procedures. DFSP cells were recently shown to display chromosomal translocations of the regions 17q22 and 22q13, resulting in an autocrine growth stimulation loop via the platelet-derived growth factor (PDGF) pathway. The tyrosine kinase inhibitor imatinib blocks PDGF signal transduction, thus offering a new therapeutic option for DFSP patients. This multicenter phase II trial was aimed to investigate the efficacy of imatinib in locally advanced DFSP. Methods: The primary study endpoint was objective response, secondary endpoints were safety and relapse-free survival. Patients with histological proof of locally advanced primary or relapsed DFSP, measurable tumor parameters according to RECIST, and no evidence of distant metastases were eligible. Patients received imatinib 600 mg/d PO. Tumor measurements were performed at week 6 and 12, and every 8 weeks thereafter. At the end of imatinib treatment, at the earliest after week 12, residual tumors were surgically excised with histological proof of tumor-free margins. Results: By January 2006, nine out of 13 recruited patients were evaluable for response (per protocol, PP), three are still on treatment and one stopped treatment after 12 days due to side effects. Among the nine PP patients, seven partial responses, one stabilization, and one progression were observed. Five responders showed an ongoing tumor shrinkage until complete surgical excision, whereas two patients revealed an initial response at 6 weeks, followed by a disease progression at 12 weeks. None of the patients developed distant metastases under treatment or thereafter. Side effects were mostly mild to moderate (CTC grade 1–2). Severe side effects (CTC grade 3–4), reversible angina pectoris and septicemia, respectively, were observed in two patients. Conclusions: The study results indicate imatinib as a potent systemic treatment option in locally advanced DFSP. However, a subset of DFSP patients appeared resistant to imatinib, either primarily after treatment onset, or secondarily after showing an initial response. No significant financial relationships to disclose.
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Affiliation(s)
- S. Ugurel
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - J. Utikal
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - P. Mohr
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - P. Helmbold
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - C. Pfoehler
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - M. Schiller
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - I. Kellner
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
| | - D. Schadendorf
- Skin Cancer Unit, German Cancer Research Center, Mannheim, Germany; Department of Dermatology, Mannheim, Germany; Department of Dermatology, Buxtehude, Germany; Department of Dermatology, Halle, Germany; Department of Dermatology, Homburg, Germany; Department of Dermatology, Muenster, Germany; Department of Dermatology, Erfurt, Germany
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Poenitz N, Simon-Ackermann J, Gratchev A, Qadoumi M, Klemke CD, Stadler R, Kremer A, Radenhausen M, Henke U, Assaf C, Utikal J, Goerdt S, Dippel E. Overexpression of c- myb in Leukaemic and Non-Leukaemic Variants of Cutaneous T-Cell Lymphoma. Dermatology 2005; 211:84-92. [PMID: 16088151 DOI: 10.1159/000086434] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2004] [Accepted: 10/25/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The c-myb oncogene is a transcription factor that regulates proliferation, differentiation and apoptosis of haematopoietic cells and activated T cells by binding to promoter sequences of such genes as c-myc or bcl-2 that are expressed in cutaneous T-cell lymphoma (CTCL). OBJECTIVE Our study was performed in order to evaluate c-myb expression as a quantitative parameter for differential diagnosis in leukaemic and non-leukaemic variants of CTCL. METHODS c-myb expression was analysed in lesional skin and in the peripheral blood of 21 patients with mycosis fungoides (MF), 15 patients with Sézary syndrome (SS) and 15 patients with inflammatory skin diseases using immunohistochemistry and semiquantitative as well as quantitative RT-PCR. RESULTS Immunohistochemistry confirmed expression of c-myb in the lesional skin of the majority of CTCL patients with a tendency towards higher expression in SS (1.86 +/- 0.5) versus MF (1.2 +/- 0.7) while c-myb was absent from the lesional skin of patients with inflammatory skin diseases. c-myb was overexpressed in the peripheral blood in all SS patients (100% SS vs. 35.7% MF) at a high expression level (51,335.31 +/- 31,960.32 AU in SS vs. 1,226.35 +/- 1,258.29 AU in MF using semiquantitative RT-PCR, and 5.72 x 10(-2) +/- 2.27 x 10(-2) in SS vs. 0.91 x 10(-2) +/- 1.18 x 10(-2) in MF vs. 0.24 x 10(-2) +/- 0.11 x 10(-2) in inflammatory skin disease using quantitative RT-PCR). CD4+ cells from the peripheral blood of SS patients and cell lines in vitro showed the highest c-myb expression levels upon quantitative RT-PCR (23.27 x 10(-2) and 10.78 x 10(-2) +/- 7.24 x 10(-2)). CONCLUSION Overexpression of c-myb in skin lesions of both non-leukaemic and leukaemic CTCL independent of the stage of the disease indicates that it acts early in disease development. Nevertheless, if positive, c-myb expression in lesional skin is a clear-cut diagnostic marker for CTCL as compared to inflammatory skin diseases. High-level expression of c-myb in the peripheral blood as assessed by quantitative RT-PCR constitutes an additional diagnostic parameter for SS and may be especially useful in cases in which morphological determination of Sézary cells or FACS analysis of CD7 and CD26 remain inconclusive.
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MESH Headings
- Adult
- Age Factors
- Aged
- Aged, 80 and over
- Biomarkers, Tumor/blood
- Blotting, Southern
- Case-Control Studies
- Cohort Studies
- Female
- Gene Expression Regulation, Neoplastic
- Genes, myb/genetics
- Humans
- Immunohistochemistry
- Lymphoma, T-Cell, Cutaneous/blood
- Lymphoma, T-Cell, Cutaneous/genetics
- Lymphoma, T-Cell, Cutaneous/pathology
- Male
- Middle Aged
- Mycosis Fungoides/blood
- Mycosis Fungoides/genetics
- Mycosis Fungoides/pathology
- Neoplasm Staging
- Prognosis
- Reference Values
- Reverse Transcriptase Polymerase Chain Reaction
- Risk Assessment
- Sensitivity and Specificity
- Sex Factors
- Sezary Syndrome/genetics
- Sezary Syndrome/mortality
- Sezary Syndrome/pathology
- Skin Neoplasms/genetics
- Skin Neoplasms/mortality
- Skin Neoplasms/pathology
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Affiliation(s)
- N Poenitz
- Department of Dermatology, Venereology and Allergology, University Medical Centre Mannheim, Ruprecht Karl University of Heidelberg, Mannheim, Germany.
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Dippel E, Klemke CD, Pönitz N, Utikal J, Kurzen H, Goerdt S. Von der Morphologie zur Molekularbiologie: Entwicklungen der Dermatohistopathologie am Beispiel des kutanen T-Zell-Lymphoms. Akt Dermatol 2005. [DOI: 10.1055/s-2004-826131] [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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41
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Gratchev A, Kzhyshkowska J, Utikal J, Goerdt S. Interleukin-4 and dexamethasone counterregulate extracellular matrix remodelling and phagocytosis in type-2 macrophages. Scand J Immunol 2005; 61:10-7. [PMID: 15644118 DOI: 10.1111/j.0300-9475.2005.01524.x] [Citation(s) in RCA: 118] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Alternatively activated macrophages (Mphi2) are induced by Th2 cytokines and by glucocorticoids (GC), and can be distinguished from classically activated effector macrophages (Mphi1) on the basis of their anti-inflammatory properties. In addition, Mphi2 are involved in Th2/Th1 skewing, enhance antigen uptake and processing and support tissue remodelling and healing. In order to elucidate the heterogeneity of Mphi2 population systematically, we analysed a number of genes involved in extracellular matrix (ECM) remodelling, inflammation and phagocytosis in Mphi2 populations generated with interleukin-4 (IL-4) or GC. Using real-time polymerase chain reaction, we demonstrated that the ECM component, tenascin-C, is stimulated by IL-4, whereas it is suppressed by dexamethasone. The ECM remodelling enzymes--MMP-1 and MMP-12--and tissue transglutaminase (TG) showed a similar regulation pattern. FXIIIa, another putative Mphi2-associated TG, was synergistically regulated by IL-4 and GC. Enzyme-linked immunosorbent assay analysis revealed that the production of Mphi2-associated chemokines, AMAC-1, MCP-4 or TARC, was induced by IL-4 and was modulated by GC. Phagocytosis of opsonized and non-opsonized particles was stimulated by GC, whereas IL-4 had only a modulatory effect, what may be partially explained by the expression pattern of hMARCO, a scavenger receptor for non-opsonized particles, that was strongly and selectively induced by GC. In conclusion, stimulation of Mphi with IL-4 and GC regulate antagonistically the expression of ECM remodelling-related molecules and phagocytosis of opsonized and non-opsonized particles.
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Affiliation(s)
- A Gratchev
- Department of Dermatology, University Medical Center Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim, Germany.
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42
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Gratchev A, Kzhyshkowska J, Duperrier K, Utikal J, Velten FW, Goerdt S. The receptor for interleukin-17E is induced by Th2 cytokines in antigen-presenting cells. Scand J Immunol 2004; 60:233-7. [PMID: 15320879 DOI: 10.1111/j.0300-9475.2004.01443.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.2] [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: 11/29/2022]
Abstract
Interleukin-17E (IL-17E) (IL-25) is a recently identified cytokine capable to induce Th2-associated cytokine production (IL-5 and IL-13) and T helper 2 (Th2)-type pathologies in animal models. The IL-17E-responsive cell population in vivo was described to be a further uncharacterized non-T-, non-B-splenic accessory cell. Despite the identification of IL-17BR as the receptor for IL-17E, the cell population expressing IL-17BR has hitherto not been identified. Here, we show that human monocyte-derived Th2-skewed antigen-presenting cells (APC2) express membrane-bound and soluble forms of IL-17BR on the mRNA and protein level upon stimulation with IL-4, IL-10, IL-13 or transforming growth factor-betain vitro. These results indicate that IL-17BR-expressing APC2s may mediate the development of the IL-17E-mediated immunological reaction patterns observed in vivo.
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Affiliation(s)
- A Gratchev
- Department of Dermatology, University Medical Centre Mannheim, Ruprecht-Karls University of Heidelberg, Mannheim, Germany.
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Zimpfer A, Röckmann H, Zimpfer-Rechner C, Utikal J, Dippel E, Feller G, Goerdt S, Schadendorf D. Neurofibromatose Typ 1 - Klinik und Genetik (Synonym: Morbus von Recklinghausen). Akt Dermatol 2004. [DOI: 10.1055/s-2004-825851] [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: 10/26/2022]
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44
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Leiter U, Utikal J, Schubert R, Krähn G, Kaskel P. UV-Schutz durch Kleidung? Ergebnisse einer Umfrage. Akt Dermatol 2003. [DOI: 10.1055/s-2003-822271] [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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Dippel E, Utikal J, Feller G, Fackel N, Klemke CD, Happle R, Goerdt S. Nevi flammei affecting two contralateral quadrants and nevus depigmentosus: a new type of phacomatosis pigmentovascularis? Am J Med Genet A 2003; 119A:228-30. [PMID: 12749070 DOI: 10.1002/ajmg.a.20128] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [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: 11/06/2022]
Abstract
Here, we report on a 64-year-old-woman with nevi flammei affecting two contralateral quadrants, venous insufficiency of the right leg, and asymmetry of the arms, in association with a linear nevus depigmentosus. This combination of vascular and pigmentary abnormalities may represent a novel type of phacomatosis pigmentovascularis caused by non-allelic twin-spotting.
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Affiliation(s)
- E Dippel
- Department of Dermatology, Venereology, and Allergology, University Medical Center, Mannheim, Ruprecht-Karl University of Heidelberg, Mannheim, Germany
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Udart M, Utikal J, Krähn GM, Peter RU. Chromosome 7 aneusomy. A marker for metastatic melanoma? Expression of the epidermal growth factor receptor gene and chromosome 7 aneusomy in nevi, primary malignant melanomas and metastases. Neoplasia 2001; 3:245-54. [PMID: 11494118 PMCID: PMC1505589 DOI: 10.1038/sj/neo/7900156] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2000] [Accepted: 01/15/2001] [Indexed: 11/09/2022]
Abstract
Receptor tyrosine kinases such as the epidermal growth factor receptor (EGFR) play an important role in a variety of malignant neoplasias, making the search for aberrations in the relevant chromosomes an important issue. Differential expression of the EGFR gene was investigated by reverse transcriptase (RT)-PCR on tissue samples of normal skin, nevi, primary melanomas, and melanoma metastases. The EGFR gene is located on chromosome 7p12.3-p12.1. To determine the number of chromosomes 7 in cell nuclei of the mentioned tissue samples we performed fluorescence in situ hybridization (FISH) on touch preparations, using a DNA probe that hybridizes specifically to the centromeric region of chromosome 7. Additionally, chromosome 7 number in interphase nuclei was determined in short-term primary cell cultures of nevi, primary melanomas, and metastases. The highest EGFR gene expression frequency was found in melanoma metastases. By FISH we detected the highest fraction of cell nuclei with more than two chromosomes 7 in the group of metastases. Our results suggest that overexpression of the EGFR gene might play an important role in metastasis of malignant melanoma. This is well reflected by polysomy 7, possibly accounting for an increased EGFR gene copy number.
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Affiliation(s)
- M Udart
- Department of Dermatology, University of Ulm, Ulm, Germany.
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48
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Kraehn GM, Utikal J, Udart M, Greulich KM, Bezold G, Kaskel P, Leiter U, Peter RU. Extra c-myc oncogene copies in high risk cutaneous malignant melanoma and melanoma metastases. Br J Cancer 2001; 84:72-9. [PMID: 11139316 PMCID: PMC2363612 DOI: 10.1054/bjoc.2000.1535] [Citation(s) in RCA: 97] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Amplification and overexpression of the c-myc gene have been associated with neoplastic transformation in a plethora of malignant tumours. We applied interphase fluorescence in situ hybridization (FISH) with a locus-specific probe for the c-myc gene (8q24) in combination with a corresponding chromosome 8 alpha-satellite probe to evaluate genetic alterations in 8 primary melanomas and 33 advanced melanomas and compared it to 12 melanocytic nevi, 7 safety margins and 2 cases of normal skin. Additionally, in metaphase spreads of 7 melanoma cell lines a whole chromosome 8 paint probe was used. We investigated the functionality of the c-myc gene by detecting c-myc RNA expression with RT-PCR and c-myc protein by immunohistochemistry. 4/8 primary melanomas and 11/33 melanoma metastases showed additional c-myc signals relative to the centromere of chromosome 8 copy number. None of the nevi, safety margins or normal skin samples demonstrated this gain. In 2/7 melanoma cell lines (C32 and WM 266-4) isochromosome 8q formation with a relative gain of c-myc copies and a loss of 8p was observed. The highest c-myc gene expression compared to GAPDH was found in melanoma metastases (17.5%). Nevi (6.6%) and primary melanomas (5.0%) expressed the c-myc gene on a lower level. 72.7% of the patients with c-myc extra copies had visceral melanoma metastases (UICC IV), patients without c-myc gain in 35.0% only. The collective with additional c-myc copies also expressed the gene on a significantly higher level. These results indicate that a c-myc gain in relation to the centromere 8 copy number might be associated with advanced cutaneous melanoma.
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Affiliation(s)
- G M Kraehn
- Department of Dermatology, University of Ulm, Ulm, Germany
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Abstract
The receptor tyrosine kinases (RTKs) epidermal growth factor receptor (EGFR), HER2, HER3 and HER4 are involved in the pathogenesis of multiple human malignant neoplasias. However, their role in the carcinogenesis of basal cell carcinomas (BCC) and squamous cell carcinomas (SCC) remains to be elucidated. In order to further define the role of these RTKs, 56 human skin tissue samples of normal skin, BCC and SCC were studied by conventional and differential and quantitative reverse transcriptase-polymerase chain reaction (rtPCR). EGFR and HER3 were predominantly expressed in the BCCs and SCCs, while HER2 was ubiquitously expressed. HER4 was not expressed in any sample. Since in vitro studies have provided compelling evidence that heterodimer formation of these receptors are associated with different signal transduction processes, coexpression patterns might be decisive for the induction and maintenance of a malignant phenotype. These results confirm this concept: isolated HER2 expression and EGFR/HER2 were predominantly found in normal skin, while HER2/HER3 and the triple expression of EGFR/HER2/HER3 were seen more frequently in the BCCs and SCCs compared with normal skin (50% and 40% compared with 26%, respectively). The activation of HER3, in addition to EGFR and HER2, might therefore be associated with the malignant phenotype. However, due to the small numbers in this study, further confirmation of the patterns is needed.
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Affiliation(s)
- G Krähn
- Department of Dermatology, University of Ulm, Oberer Eselsberg 40, D-89081 Ulm, Germany.
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Abstract
BACKGROUND The incidence of skin cancer has been rising since the 1950s. About 75% of skin cancer-associated deaths are caused by malignant melanoma. Nodular malignant melanoma accounts for 20% of melanocytic malignant tumors and is associated with a relatively poor prognosis. Extensive research has been undertaken, but a molecular marker that can predict a more aggressive course of melanoma still has not been found. METHODS The authors applied cytogenetic and molecular genetic techniques to a case of nodular malignant melanoma. They used comparative genomic hybridization (CGH) to identify chromosomal regions affected by genomic changes and interphase fluorescence in situ hybridization (FISH) on touch preparations of the tissue to elucidate the CGH findings further. To investigate the functionality of the affected c-MYC gene, the authors detected its transcript via reverse transcription and polymerase chain reaction. RESULTS CGH revealed a copy number gain in the 6p and 8q24-8qter region. FISH with c-MYC and centromere eight specific probes revealed that the tumor, in contrast to unaffected skin, was characterized by a gain in copy numbers of the c-MYC gene. The c-MYC gene transcript was detected at higher levels in the tumor than in the tissue taken from the safety margin. CONCLUSIONS The WAF1 gene located on chromosome 6p, which in this case had a copy number gain, might be involved in melanoma pathogenesis. The authors suggest that the c-MYC gene plays an important role in melanoma development and progression. The c-MYC gene seems to be affected by gaining functional copies, leading to a change in the normally regulated gene-dose effect.
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Affiliation(s)
- K M Greulich
- Department of Dermatology, University of Ulm, Ulm, Germany
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