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Kümmel S, Schmid P, Harbeck N, Takahashi M, Untch M, Boileau JF, Cortes J, McArthur H, Dent R, O’Shaughnessy J, Pusztai L, Foukakis T, Park Y, Hui R, Cardoso F, Denkert C, Zhu Y, Pan W, Karantza V, Fasching P. P125 Neoadjuvant pembrolizumab + chemotherapy vs placebo + chemotherapy followed by adjuvant pembrolizumab vs placebo for early TNBC: surgical outcomes from the phase 3 KEYNOTE-522 study. Breast 2023. [DOI: 10.1016/s0960-9776(23)00242-4] [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: 03/15/2023] Open
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Rupp J, Fessler J, Hayer S, Dreo B, Lackner A, Fasching P, Helberg W, Schlenke P, Thiel J, Steiner G, Cornelia W, Stradner M. POS0408 TRANSFER OF HUMAN RHEUMATOID ARTHRITIS MONONUCLEAR CELLS INDUCES ARTHRITIS IN IMMUNODEFICIENT HLA-DR4 TRANSGENIC MICE. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundRheumatoid arthritis (RA) is a systemic autoimmune disease leading to erosive joint destruction. Although the exact pathogenesis is still elusive, the strong association of certain HLA class II molecules, such as HLA-DRB1*0401 (HLA-DR4), suggest involvement of CD4+ T cells (1,2). Mouse models of RA mimic specific aspects of the disease but are limited by the differences between human and murine immune systems.ObjectivesWe aimed to establish a humanized mouse model (humice) carrying DR4+ RA PBMCs to study its role in the pathogenesis of RA without putting patients at risk.MethodsPeripheral blood mononuclear cells (PBMC) of HLA-DR4 positive RA patients or controls were isolated and injected into NSG-Ab0 DR4 mice (NOD-scid IL2Rgammanull mice lacking MHC class II while expressing the human HLA-DR4) to create humice. Human immune cell composition within humice was profiled using flow cytometry. Development of RA was monitored by examination of the joints and micro computed tomography analysis. Joints were analysed by histology regarding pannus formation, bone erosions, cartilage damage, and human cell infiltration.ResultsTransfer of RA PBMCs induced arthritis in humice recapitulating hallmarks of RA including immune cell infiltration, pannus formation, increased osteoclastogenesis, cartilage damage, and bone erosions. Arthritis was dependent on the implanted human cells as NSG-Ab0 DR4 mice without transfer of human PBMCs did not develop arthritis. T-helper 1 (Th1) cells, dominated the human immune cell composition in humice, while regulatory T cells (Tregs) were diminished compared to donor PBMC composition. Mice humanized with cells from RA patients were more likely to develop inflammatory joint disease, compared to healthy HLA-DR4 positive controls (RA donor 70% vs. healthy control 20%, p=0.00196). CTLA-4 Ig treatment prevented arthritis development in this model (p=0.0055).ConclusionHumice carrying DR4+ RA PBMCs developed an RA-like erosive joint disease driven by the implanted human immune system. The data implies that the disease can be transferred by arthritogenic cells found in the peripheral blood of RA patients. This model will allow new insights into the pathogenesis of RA.References[1]Goulielmos GN, Zervou MI, Myrthianou E, Burska A, Niewold TB, Ponchel F. Genetic data: The new challenge of personalized medicine, insights for rheumatoid arthritis patients. Gene Available from: http://www.ncbi.nlm.nih.gov/pubmed/26869316[2]Holoshitz J. The rheumatoid arthritis HLA–DRB1 shared epitope. Curr Opin Rheumatol Available from: http://www.ncbi.nlm.nih.gov/pubmed/20061955Disclosure of InterestsNone declared.
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Blum S, Fasching P, Hildebrandt T, Lermann J, Heindl F, Born T, Lubrich H, Antoniadis S, Becker K, Fahlbusch C, Heusinger K, Burghaus S, Beckmann M, Hein A. Epidemiologische Faktoren bei verschiedenen klinischen Formen der Endometriose – eine Fall-Fall-Untersuchung. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- S Blum
- Frauenklinik des Universitätsklinikums Erlangen
| | - P Fasching
- Frauenklinik des Universitätsklinikums Erlangen
| | | | - J Lermann
- Frauenklinik des Universitätsklinikums Erlangen
| | - F Heindl
- Frauenklinik des Universitätsklinikums Erlangen
| | - T Born
- Frauenklinik des Universitätsklinikums Erlangen
| | - H Lubrich
- Frauenklinik des Universitätsklinikums Erlangen
| | | | - K Becker
- Frauenklinik des Universitätsklinikums Erlangen
| | - C Fahlbusch
- Frauenklinik des Universitätsklinikums Erlangen
| | - K Heusinger
- Frauenklinik des Universitätsklinikums Erlangen
| | - S Burghaus
- Frauenklinik des Universitätsklinikums Erlangen
| | - M Beckmann
- Frauenklinik des Universitätsklinikums Erlangen
| | - A Hein
- Frauenklinik des Universitätsklinikums Erlangen
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Riecke K, Mueller V, Neunhöffer T, Weide R, Schmidt M, Park-Simon TW, Mundhenke C, Polasik A, Hesse T, Lübbe K, Laakmann E, Thill M, Fasching P, Denkert C, Fehm T, Nekljudova V, Rey J, Loibl S, Witzel I. Predicting prognosis of breast cancer patients with brain metastases in the BMBC registry – comparison of three different prognostic scores. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- K Riecke
- Universitätklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie
| | - V Mueller
- Universitätklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie
| | | | - R Weide
- Institut für Versorgungsforschung in der Onkologie
| | | | | | | | | | - T Hesse
- Agaplesion Diakonieklinikum Rotenburg
| | - K Lübbe
- Diakovere Henriettenstift, Breast Center
| | - E Laakmann
- Universitätklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie
| | - M Thill
- Agaplesion Markus Krankenhaus
| | | | - C Denkert
- Institut für Pathologie UKGM – Universitätsklinikum Marburg
| | - T Fehm
- Universitätsklinikum Düsseldorf
| | | | - J Rey
- German Breast Group, GBG Forschungs GmbH
| | - S Loibl
- German Breast Group, GBG Forschungs GmbH
| | - I Witzel
- Universitätklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie
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Peuker CA, Yaghobramzi S, Lüftner D, Brucker S, Decker T, Fasching P, Fehm T, Janni W, Kümmel S, Schneeweiss A, Schuler M, Busse A. Einfluss des CDK4/6-Inhibitors Ribociclib auf die periphere Immunantwort beim Hormonrezeptor-positiven Mammakarzinom. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1714608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2023] Open
Affiliation(s)
- CA Peuker
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Hämatologie, Onkologie und Tumorimmunologie
| | - S Yaghobramzi
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Hämatologie, Onkologie und Tumorimmunologie
| | - D Lüftner
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Hämatologie, Onkologie und Tumorimmunologie
| | | | - T Decker
- Gemeinschaftspraxis Onkologie Ravensburg
| | - P Fasching
- Frauenklinik, Universitätsklinikum Erlangen
| | - T Fehm
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Düsseldorf
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Ulm
| | - S Kümmel
- Klinik für Senologie/Interdisziplinäres Brustkrebszentrum, Kliniken Essen-Mitte
| | - A Schneeweiss
- Klinik für Frauenheilkunde und Geburtshilfe, Universität Heidelberg
| | - M Schuler
- Klinik für Medizinische Onkologie, Universitätsklinikum Essen
| | - A Busse
- Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin, Klinik für Hämatologie, Onkologie und Tumorimmunologie
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Erber R, Hartmann A, Fasching P, Stöhr R, Beckmann M, Zentgraf M, Ruebner M, Huebner H, Fischer J, Guerini Rocco E, Viale G, Cayre A, Penault-Llorca F, Caniego Casa T, Palacios Calvo J, Jank P, Denkert C, Khoury L, Mairinger T, Ferrazzi F. 28P Europe-side external quality assessment (EQA) of RNA based testing of ER, PR, HER2 and Ki67 in invasive breast cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hartkopf AD, Brucker SY, Taran FA, Harbeck N, von Au A, Naume B, Pierga JY, Hoffmann O, Beckmann MW, Rydén L, Fehm T, Aft R, Montserrat S, Walter V, Rack B, Schuetz F, Borgen E, Ta MH, Bittner AK, Fasching P, Fernö M, Krawczyk N, Weilbaecher K, Margelí M, Hahn M, Jueckstock J, Domschke C, Bidard FC, Kasimir-Bauer S, Schoenfisch B, Kurt AG, Wallwiener M, Gebauer G, Wallwiener D, Janni W, Pantel K. Abstract GS5-07: International pooled analysis of the prognostic impact of disseminated tumor cells from the bone marrow in early breast cancer: Results from the PADDY study. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-gs5-07] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
As early breast cancer might relapse even after complete removal of breast and lymphnodes, the disease must persist in secondary sites. The detection of disseminated tumor cells (DTC) in the bone marrow (BM) has been described as a surrogate of residual disease. Various trials showed an impaired prognosis of DTC positive early breast cancer (EBC) patients. The PADDY (Pooled Analysis of DTC Detection in Early Breast Cancer) study is a large international pooled analysis that aimed to assess the prognostic impact of DTC detection in patients with EBC.
Methods
A pre-specified protocol was followed, and centers known to practice BM sampling for DTC detection were contacted for individual patient data. Patients with EBC, with available follow-up data and BM sampling before any anti-cancer treatment were eligible. BM aspirates were collected at the time of primary surgery. DTC were identified by antibody (A45-B/B3, AE1/AE3, 2E11 and E29) staining against cytokeratin. The DTC status was compared to other prognostic factors using the chi-squared test. Univariate log-rank test and multivariate cox regression were used to compare survival of DTC positive versus DTC negative patients.
Results
Individual data from 10,320 patients (11 centers from Europe and USA) were included with a median follow-up of 91 months. Of all patients, 2,823 (27.4 %) were DTC positive. DTC detection was associated with higher tumor grade, higher T stage, nodal positivity, ER and PR negativity, and HER2 positivity (all p<0.001). In univariate analyses, overall, breast cancer specific, disease-free and distant disease-free survival (OS, BCSS, DFS, DDFS) were significantly shorter in DTC positive patients with p-values of <0.001. Multivariate analyses showed the DTC status to be an independent prognostic marker for OS, BCSS, DFS and DDFS with hazard ratios (HR) and 95%-confidence intervals (CI) of 1.23 (95%-CI: 1.06-1.42, p=0.007), 1.38 (95%-CI: 1.11-1.72, p=0.004), 1.29 (95%-CI: 1.10-1.50, p=0.001) and 1.32 (95%-CI: 1.10-1.58, p=0.003), respectively.
Conclusions
Detection of DTC in the bone marrow is an independent prognostic marker in patients with non-metastatic breast cancer. Further studies should investigate the impact of DTC on metastatic cancer progression and their role for clinical decision making.
Citation Format: Hartkopf AD, Brucker SY, Taran F-A, Harbeck N, von Au A, Naume B, Pierga J-Y, Hoffmann O, Beckmann MW, Rydén L, Fehm T, Aft R, Montserrat S, Walter V, Rack B, Schuetz F, Borgen E, Ta M-H, Bittner A-K, Fasching P, Fernö M, Krawczyk N, Weilbaecher K, Margelí M, Hahn M, Jueckstock J, Domschke C, Bidard F-C, Kasimir-Bauer S, Schoenfisch B, Kurt AG, Wallwiener M, Gebauer G, Wallwiener D, Janni W, Pantel K. International pooled analysis of the prognostic impact of disseminated tumor cells from the bone marrow in early breast cancer: Results from the PADDY study [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr GS5-07.
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Affiliation(s)
- AD Hartkopf
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - SY Brucker
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F-A Taran
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Harbeck
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A von Au
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Naume
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J-Y Pierga
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - O Hoffmann
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - MW Beckmann
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - L Rydén
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Fehm
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - R Aft
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Montserrat
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Walter
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Rack
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F Schuetz
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - E Borgen
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M-H Ta
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - A-K Bittner
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - P Fasching
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Fernö
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - N Krawczyk
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Weilbaecher
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Margelí
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Hahn
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - J Jueckstock
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - C Domschke
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - F-C Bidard
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - S Kasimir-Bauer
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - B Schoenfisch
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - AG Kurt
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - M Wallwiener
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - G Gebauer
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - D Wallwiener
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - W Janni
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - K Pantel
- University of Tuebingen, Tuebingen, Germany; Breast Center, University of Munich (LMU), Munic, Germany; Heidelberg University Hospital, National Center for Tumor Diseases (NCT), Heidelberg, Germany; Oslo University Hospital - and Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway; Institut Curie, Paris and Saint Cloud, Paris, France; University Hospital of Essen, Essen, Germany; Comprehensive Cancer Center Erlangen-EMN, Erlangen University Hospital, Friedrich-Alexander University, Erlangen-Nuremberg, Germany; Lund University, Lund, Sweden; Duesseldorf University Hospital, Duesseldorf, Germany; Washington University, St. Louis, MO; Hospital Germans Trias I Pujol, Badalona, Spain; Ulm University Hospital, Ulm, Germany; Oslo University Hospital, Oslo, Norway; ICO-Badalona, Medical Oncology Service. B-ARGO, Badalona, Germany; Asklepios Klinik Barmbek and Nord-Heidberg, Hamburg, Spain; Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Lüftner D, Schuetz F, Schneeweiss A, Grischke EM, Bloch W, Decker T, Uleer C, Salat C, Förster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Guderian G, Hanson S, Fasching P. Abstract P6-18-08: Everolimus + exemestane for HR+ advanced breast cancer in routine clinical practice- Final results from the non-interventional trial, BRAWO. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p6-18-08] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: In the pivotal BOLERO-2 trial, everolimus (EVE) + exemestane (EXE) more than doubled the median progression-free survival (PFS) vs EXE alone in hormone receptor positive (HR+), human epidermal growth factor-receptor 2-negative (HER2-) advanced breast cancer (ABC) recurring/progressing on/after prior non-steroidal aromatase inhibitors (NSAIs). BRAWO is a German non-interventional study conducted in patients (pts) with HR+, HER2–ABC receiving EVE + EXE, according to Summary of Product Characteristics (SmPC), in routine clinical practice. Here we report the final PFS and safety results.
Methods: This multicenter study documented 2100 pts between October 2012 and December 2017 across 341 sites in Germany. Postmenopausal women with HR+, HER2– ABC with recurrence or progression after a NSAI were included. Primary observation parameters included the evaluation of the effectiveness of EVE + EXE used in routine care for the entire pt group.
Results: In the final analysis, out of the 2100 documented pts, 2074 were included in the full analysis set. The median time since the primary diagnosis was 7.1 years and the median time from first sign of relapse (local recurrence or distant metastases) was 2.1 years. At baseline, 54.1% of pts presented with visceral metastases and 50.1% had an ECOG performance status of 0. Approximately, 63% of pts started with EVE 10 mg (median duration of exposure: 5.1 months; 95% CI, 4.6-5.4), while 34.1% started with EVE 5 mg (median duration of exposure: 4.6 months; 95% CI, 4.1-5.2).
The distribution of treatment lines was as follows: first line, 28.7% (n=595); second line, 31.9% (n=662); third line, 18.1% (n=376); fourth line, 10.7% (n=221) and, fifth line and later, 10.6% (n=220). Treatment was discontinued by 55.7% of pts (n=1170) due to progressive disease and 26% of pts (n=546) due to adverse events. The Kaplan-Meier estimate of the median PFS was 6.6 months (95% CI, 6.2-7.0). The best overall responses, based on clinical routine, were complete response, 0.8% (n=17), partial response, 7.4% (n=150), and stable disease, 41.3% (n=842). The general safety profile was consistent with the previously reported safety findings. The most common adverse events were stomatitis (any grade: 42.6%, grade 3: 3.8%, grade 4: <0.1%) and fatigue (any grade: 19.8%, grade 3: 1.5%).
Conclusions: Data from BRAWO support EVE + EXE as a suitable treatment option with a reasonable safety profile for HR+, HER2− ABC recurring or progressing on/after prior NSAIs.
Citation Format: Lüftner D, Schuetz F, Schneeweiss A, Grischke E-M, Bloch W, Decker T, Uleer C, Salat C, Förster F, Schmidt M, Mundhenke C, Tesch H, Jackisch C, Fischer T, Guderian G, Hanson S, Fasching P. Everolimus + exemestane for HR+ advanced breast cancer in routine clinical practice- Final results from the non-interventional trial, BRAWO [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P6-18-08.
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Affiliation(s)
- D Lüftner
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - F Schuetz
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - A Schneeweiss
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - E-M Grischke
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - W Bloch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - T Decker
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Uleer
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Salat
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - F Förster
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - M Schmidt
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Mundhenke
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - H Tesch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - C Jackisch
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - T Fischer
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - G Guderian
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - S Hanson
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - P Fasching
- Charité University Medicine, Campus Benjamin Franklin, Berlin, Germany; University Hospital Heidelberg, Heidelberg, Germany; Universitäts-Frauenklinik Tubingen, Eberhard Karls University, Tubingen, Germany; German Sport University Cologne, Cologne, Germany; Studienzentrum Onkologie Ravensburg, Ravensburg, Germany; Gyn.-onkologische Gemeinschaftspraxis Hildesheim, Hildesheim, Germany; Hematology -Oncology Clinic, Munich, Germany; Poliklinik GmbH Chemnitz, Chemnitz, Germany; Johannes Gutenberg University, Mainz, Germany; University of Kiel, Kiel, Germany; Oncological Practice Bethanien, Frankfurt, Germany; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Winicker Norimed GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Nuernberg, Germany; Novartis Pharma GmbH, Goettingen, Germany; University Hospital Erlangen, Comprehensive Cancer Center Erlangen-EMN, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
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9
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Lanzinger S, Schmid SM, Welp R, Zimmermann A, Fasching P, Wagner S, Holl RW. Clinical inertia among patients with type 2 diabetes mellitus treated with DPP-4i and/or SGLT-2i. Diabetes Res Clin Pract 2018; 146:162-171. [PMID: 30367902 DOI: 10.1016/j.diabres.2018.10.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 10/05/2018] [Accepted: 10/19/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Failure to intensify treatment of patients with type 2 diabetes (T2D) in a timely manner is a common challenge. If newer oral anti-diabetic drugs (NOADs) such as dipeptidyl peptidase-4 inhibitors (DPP-4i) and sodium/glucose cotransporter 2 inhibitors (SGLT-2i) do not achieve metabolic control, injectable therapy like insulin or glucagon-like Peptide 1 (GLP-1) receptor agonists are required. We investigated the time in poor glycaemic control (PC, HbA1c > 7%, >7.5%, >8%) in adults with T2D treated with DPP-4i/SGLT-2i until treatment intensification with insulin/GLP-1 or until the most recent documented visit. METHODS T2D ≥ 18 years were identified from the diabetes patient follow-up registry (DPV), which captures data from diabetes specialist care. Patients with ≥2 documented visits with DPP-4i/SGLT-2i treatment and with the most recent treatment year ≥2015 were included. RESULTS The study population consisted of 4576 patients treated with DPP-4i/SGLT-2i. A subgroup of 1416 patients were intensified with an injectable therapy. Mean time in PC until intensification with insulin/GLP-1 was 16.7 months (HbA1c > 7%), 15.7 and 15.1 months (HbA1c > 7.5%, HbA1c > 8%) in this subgroup, respectively. Mean time in PC until most recent visit was 12.6, 9.9 and 8.4 months in the subgroup of patients without treatment intensification. CONCLUSIONS Even with NOADs, a substantial proportion of T2D do not achieve good metabolic control. These findings may be due to individualized target setting for HbA1c, or reluctance of patients and physicians towards injectable therapy. Effective diabetes management strategies are necessary to reduce the risk of adverse outcomes and to increase quality of life in T2D.
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Affiliation(s)
- S Lanzinger
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany.
| | - S M Schmid
- German Center for Diabetes Research (DZD), München-Neuherberg, Germany; Department of Internal Medicine 1, University of Lübeck, Germany
| | - R Welp
- Internal Medicine, Knappschafts-Krankenhaus, Bottrop, Germany
| | - A Zimmermann
- Specialized Diabetes Practice, Bad Aibling, Germany
| | - P Fasching
- 5th Medical Department, Wilhelminenspital, Vienna, Austria
| | - S Wagner
- Medical Clinic II, Donauisar Clinical Center Deggendorf, Germany
| | - R W Holl
- Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany; German Center for Diabetes Research (DZD), München-Neuherberg, Germany
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10
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Tzschaschel M, Westernhagen U, Rack B, Schneweiss A, Müller V, Fehm T, Gade J, Lorenz R, Rezai M, Tesch H, Söling U, Polasik A, Schochter F, De Gregorio A, Mahner S, Schindlbeck C, Beckmann M, Fasching P, Janni W, Friedl TW. Gibt es einen Zusammenhang zwischen BMI und dem Nachweis von CTCs bei Patientinnen mit frühem Hochrisiko Mammakarzinom? Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
| | | | - B Rack
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - A Schneweiss
- Nationales Centrum für Tumorerkrankungen, Heidelberg, Deutschland
| | - V Müller
- Universitätsklinikum Hamburg Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - T Fehm
- Klinikum der Heinrich-Heine-Universität, Düsseldorf, Deutschland
| | - J Gade
- Diakoniekrankenhaus Friederikenstift, Klinik für Gynäkologie, Hannover, Deutschland
| | - R Lorenz
- Gemeinschaftspraxis Dr. Lorenz, Hecker und Wesche, Braunschweig, Deutschland
| | - M Rezai
- Luisenkrankenhaus Düsseldorf, Klinik für Gynäkologie und Geburtshilfe, Düsseldorf, Deutschland
| | - H Tesch
- Onkologische Gemeinschaftspraxis, Frankfurt, Deutschland
| | - U Söling
- Gemeinschaftspraxis Siehl und Soeling, Kassel, Deutschland
| | - A Polasik
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - F Schochter
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | | | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Klinikum der Ludwig-Maximilians-Universität München, München, Deutschland
| | - C Schindlbeck
- Klinikum Traunstein, Frauenklinik, Traunstein, Deutschland
| | - M Beckmann
- Friedrich-Alexander Universität Erlangen-Nürnberg, Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - P Fasching
- Friedrich-Alexander Universität Erlangen-Nürnberg, Frauenklinik, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - W Janni
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
| | - TW Friedl
- Universitätsfrauenklinik Ulm, Ulm, Deutschland
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11
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Krause S, Friedl T, Fehm T, Romashova T, Fasching P, Schneeweiss A, Müller V, Taran FA, Polasik A, Tzschaschel M, De Gregorio A, Meier-Stiegen F, Janni W, Huober J. DETECT V – Vergleich der HER2-zielgerichteten dualen Blockade plus Ribociclib in Kombination mit Chemotherapie oder endokriner Therapie bei Patientinnen mit HER2-positivem und HR-positivem metastasiertem Mammakarzinom. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- S Krause
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - T Friedl
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - T Fehm
- Heinrich-Heine- Universität Düsseldorf, Frauenklinik, Düsseldorf, Deutschland
| | - T Romashova
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - P Fasching
- Universitätsklinik Erlangen, Frauenklinik, Erlangen, Deutschland
| | - A Schneeweiss
- Universitätsfrauenklinik Heidelberg, Frauenklinik, Heidelberg, Deutschland
| | - V Müller
- Universitätsfrauenklinik Hamburg-Eppendorf, Frauenklinik, Hamburg, Deutschland
| | - FA Taran
- Universitätsfrauenklinik Tübingen, Frauenklinik, Tübingen, Deutschland
| | - A Polasik
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - M Tzschaschel
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - A De Gregorio
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - F Meier-Stiegen
- Heinrich-Heine- Universität Düsseldorf, Frauenklinik, Düsseldorf, Deutschland
| | - W Janni
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
| | - J Huober
- Universitätsklinikum Ulm, Frauenklinik, Ulm, Deutschland
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12
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Riecke K, Müller V, Laakmann E, Weide R, Park-Simon TW, Schmidt M, Fasching P, Hesse T, Schem C, Bechtner C, Würschmidt F, Würstlein R, Fehm T, Moebus V, Burchardi N, Loibl S, Witzel I. Validierung des Breast-GPA Scores bei Patientinnen mit Hirnmetastasen eines Mammakarzinoms im BMBC-Register (GBG-79). Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- K Riecke
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - V Müller
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - E Laakmann
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
| | - R Weide
- Praxisklinik für Hämatologie und Onkologie Koblenz, Koblenz, Deutschland
| | - TW Park-Simon
- Medizinische Hochschule Hannover, Klinik für Frauenheilkunde und Geburtshilfe, Hannover, Deutschland
| | - M Schmidt
- Johannes Gutenberg-Universität Mainz, Klinik und Poliklinik für Geburtshilfe und Frauengesundheit, Mainz, Deutschland
| | - P Fasching
- Universitätsklinikum Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Klinik und Poliklinik für Gynäkologie und Geburtshilfe, Comprehensive Cancer Center Erlangen-EMN (CCC), Erlangen, Deutschland
| | - T Hesse
- Agaplesion Diakonieklinikum Rotenburg, Gynäkologie und gynäkologische Onkologie, Rotenburg, Deutschland
| | - C Schem
- Mammazentrum am Krankenhaus Jerusalem, Hamburg, Deutschland
- Universitätsklinikum Schleswig-Holstein-UKSH, Klinik für Gynäkologie, Kiel, Deutschland
| | - C Bechtner
- Klinikum Memmingen, Frauenklinik, Memmingen, Deutschland
| | - F Würschmidt
- Radiologische Allianz Hamburg, Hamburg, Deutschland
| | - R Würstlein
- Ludwig Maximilians Universität, Brustzentrum, Abteilung für Gynäkologie und Geburtshilfe und CCC München, München, Deutschland
| | - T Fehm
- Translationale Forschungsgruppe der Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO-Trafo), Düsseldorf, Deutschland
| | - V Moebus
- Breast Study Group der Arbeitsgemeinschaft für Gynäkologische Onkologie (AGO-B), Frankfurt am Main, Deutschland
| | - N Burchardi
- German Breast Group GmbH, Neu-Isenburg, Deutschland
| | - S Loibl
- German Breast Group GmbH, Neu-Isenburg, Deutschland
| | - I Witzel
- Universitätsklinikum Hamburg-Eppendorf, Klinik und Poliklinik für Gynäkologie, Hamburg, Deutschland
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13
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Janni WJ, Harbeck N, Rack B, Gluz O, Schneeweiss A, Kates R, Fehm T, Kreipe H, Kümmel S, Würstlein R, Hartkopf A, Clemens M, Reimer T, Friedl T, Häberle L, Fasching P, Nitz U. Abstract P6-13-01: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p6-13-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- WJ Janni
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - N Harbeck
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - B Rack
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - O Gluz
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - A Schneeweiss
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - R Kates
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - T Fehm
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - H Kreipe
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - S Kümmel
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - R Würstlein
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - A Hartkopf
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - M Clemens
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - T Reimer
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - T Friedl
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - L Häberle
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - P Fasching
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
| | - U Nitz
- Universitätsfrauenklinik, Ulm, Germany; Universitätsfrauenklinik, Munich, Germany; Evangelisches Krankenhaus Bethesda Brustzentrum, Mönchengladbach, Germany; Universitätsfrauenklinik, Heidelberg, Germany; Women Study Group, Mönchengladbach, Germany; Universitätsfrauenklinik, Düsseldorf, Germany; Universitätsklinikum, Hannover, Germany; Brustzentrum Essen-Mitte, Essen, Germany; Universitätsfrauenklinik, Tübingen, Germany; Mutterhaus, Trier, Germany; Universitätsfrauenklinik, Rostock, Germany; Universitätsfrauenklinik, Erlangen, Germany
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Ignatiadis M, Litiere S, Rothe F, Riethdorf S, Proudhon C, Fehm T, Aalders K, Forstbauer H, Fasching P, Brain E, Vuylsteke P, Guardiola E, Lorenz R, Pantel K, Tryfonidis K, Janni W, Piccart M, Sotiriou C, Rack B, Pierga JY. Abstract P1-13-09: Withdrawn. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-13-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was withdrawn by the authors.
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Affiliation(s)
- M Ignatiadis
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - S Litiere
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - F Rothe
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - S Riethdorf
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - C Proudhon
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - T Fehm
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Aalders
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - H Forstbauer
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - P Fasching
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - E Brain
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - P Vuylsteke
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - E Guardiola
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - R Lorenz
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Pantel
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - K Tryfonidis
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - W Janni
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - M Piccart
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - C Sotiriou
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - B Rack
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
| | - J-Y Pierga
- Institut Jules Bordet, Brussels, Belgium; European Organization for Research and Treatment of Cancer (EORTC) Headquarters, Brussels, Belgium; University Medical Center Hamburg-Eppendorf, Center of Experimental Medicine; Circulating Biomarker Lab, SIRIC, Institut Curie; Forschungslabore der Frauenklinik des Universitätsklinikums; Haemotologic-Oncologic Practice Dres; Universitetsklinikum Erlangen; Institut Curie - Hôpital René Huguenin; CHU UCL Namur - Site Sainte-Elisabeth; Centre Hospitalier de la Dracénie; Gemeinschaftspraxis Lorenz / Hecker / Wesche; Universitaetsklinikum Ulm; Ludwig-Maximilians-Universitaet; Institut Curie
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Brennan MB, Wiley D, Wang D, Wang X, Fasching P. Abstract P3-15-01: The effect of participation in RCT on outcomes in patients with early breast cancer compared to the general breast cancer population. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p3-15-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Breast cancer trial enrollment, while slightly higher than some other histologies, still remains low, at less than 4%. Research suggests lack of clinical trial participation is due to poor patient and clinician commitment and interest. Increasing incentive for trial participation may enhance engagement of patients and healthcare providers leading to increased patient enrollment. One incentive would be to understand benefits of trial participation with regards to better survival and outcomes. The purpose of this study is to determine differences in survival, overall and breast cancer specific, and surgical management, for women who participate in early breast cancer randomized clinical trials (RCT) compared to the general breast cancer population who received similar standard therapy outside of a RCT.
Methods: Patients included in this retrospective analysis were from one of three (3) international, randomize, adjuvant breast cancer trials (RCT-participants) and women with breast cancer from the general U.S. population, from Surveillance Epidemiology and End Results Program (SEER-13), the controls. Women diagnosed between 1997-2004 with invasive breast cancer, tumor (T) size 1-3, lymph node (LN) positive (LN1/2), hormone receptor positive or negative, HER2 positive or negative, treated with surgery, adjuvant radiation, and chemotherapy were included in the analysis. In this study, propensity score analysis (PSA) was done to provide weight to each data point for each variable in order to more closely represent similar populations. PSA, considered superior to a standard Cox multivariate analysis as it attempts to reduce the bias due to confounding or correlated predictive variables. Subsequently, the propensity score was applied to a Cox proportional hazards model to determine hazard ratios (HR), with a Wald 95% confidence interval (CI), of trial participation on survival. Similarly, PSA was done for surgical outcomes. A multivariate logistic regression was performed to calculate the odds ratios, with a Wald 95% CI, to determine if RCT participation compared to the SEER-13 control had an impact on surgical outcomes, mastectomy versus breast conserving surgery (BCS).
Results: The total sample size was 9255 patients, 1795 RCT-participants and 7460 SEER-13 controls. After controlling for all other significant predictors of survival, RCT participation significantly reduced risk of breast cancer related death at 5-years by more than 25% and 18% at 10 years [HR: 0.75 (95% CI: 0.64-0.87); p=0.00020; and HR: 0.83 (95% CI: 0.74-0.93); p=0.00165, respectively]. Additionally, we demonstrated a significant reduction in risk of all-cause mortality for RCT-participants, at both 5-years and 10-years [HR: 0.83 (95% CI: 0.72--0.95); p=0.009; and HR: 0.79 (95% CI: 0.71-0.87); p<0.00001, respectively]. Additionally, RCT-participants were significantly less likely to undergo invasive surgical management (mastectomy) compared to SEER-13 controls [OR: 0.78 (95% CI: 0.66-0.92;) p=0.03].
Conclusion: RCT-participants have a reduced risk of death at 5 years and 10 years compared to the general breast cancer population. Additionally, RCT-participants are less likely to undergo mastectomy than the SEER-13 controls.
Citation Format: Brennan MB, Wiley D, Wang D, Wang X, Fasching P. The effect of participation in RCT on outcomes in patients with early breast cancer compared to the general breast cancer population [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P3-15-01.
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Affiliation(s)
- MB Brennan
- UCLA-School of Medicine, Los Angeles, CA; UCLA-School of Nursing, Los Angeles, CA; University Hospital Erlangen-Fridrich-Alexander-University Erlangen-EMN, Erlangen, Germany
| | - D Wiley
- UCLA-School of Medicine, Los Angeles, CA; UCLA-School of Nursing, Los Angeles, CA; University Hospital Erlangen-Fridrich-Alexander-University Erlangen-EMN, Erlangen, Germany
| | - D Wang
- UCLA-School of Medicine, Los Angeles, CA; UCLA-School of Nursing, Los Angeles, CA; University Hospital Erlangen-Fridrich-Alexander-University Erlangen-EMN, Erlangen, Germany
| | - X Wang
- UCLA-School of Medicine, Los Angeles, CA; UCLA-School of Nursing, Los Angeles, CA; University Hospital Erlangen-Fridrich-Alexander-University Erlangen-EMN, Erlangen, Germany
| | - P Fasching
- UCLA-School of Medicine, Los Angeles, CA; UCLA-School of Nursing, Los Angeles, CA; University Hospital Erlangen-Fridrich-Alexander-University Erlangen-EMN, Erlangen, Germany
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Jaeger BAS, Neugebauer J, Andergassen U, Melcher C, Schochter F, Mouarrawy D, Ziemendorff G, Clemens M, V Abel E, Heinrich G, Schueller K, Schneeweiss A, Fasching P, Beckmann MW, Scholz C, Friedl TWP, Friese K, Pantel K, Fehm T, Janni W, Rack B. The HER2 phenotype of circulating tumor cells in HER2-positive early breast cancer: A translational research project of a prospective randomized phase III trial. PLoS One 2017; 12:e0173593. [PMID: 28586395 PMCID: PMC5460789 DOI: 10.1371/journal.pone.0173593] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2016] [Accepted: 02/22/2017] [Indexed: 12/14/2022] Open
Abstract
Background HER2 is one of the predominant therapeutic targets in breast cancer. The metastatic selection process may lead to discrepancies between the HER2 status of the primary tumor and circulating tumor cells (CTCs). This study analyzed the HER2 status of CTCs in patients with HER2-positive primary breast cancer at the time of diagnosis. Aim of the study was to assess potential discordance of HER2 status between primary tumor and CTCs, as this may have important implications for the use of HER2-targeted therapy. Methods The number and HER2 status of CTCs out of 30ml peripheral blood were assessed in 642 patients using the CellSearch System (Janssen Diagnostics, USA). The cutoff for CTC positivity was the presence of at least 1 CTC, and the cutoff for HER2 positivity of CTCs was the presence of at least 1 CTC with a strong HER2 staining. Results 258 (40.2%) of the 642 patients were positive for CTCs (median 2; range 1–1,689). 149 (57.8%) of these 258 patients had at least 1 CTC with strong HER2 staining. The presence of HER2-positive CTCs was not associated with tumor size (p = 0.335), histopathological grading (p = 0.976), hormone receptor status (ER: p = 0.626, PR: p = 0.263) or axillary lymph node involvement (p = 0.430). Overall, 83 (32.2%) of the CTC-positive patients exclusively had CTCs with strong HER2 staining, whereas 31 (12.0%) had only CTCs with negative HER2 staining. Within-sample variation in the HER2 status of CTCs was found in 86 (57.8%) of the 149 patients with more than 1 CTC. Conclusion This study demonstrated that discordance between the HER2 expression of CTCs and that of the primary tumor frequently occurs in early breast cancer. Future follow-up evaluation will assess whether this discrepancy may contribute to trastuzumab resistance.
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Affiliation(s)
- B A S Jaeger
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Hospital, Duesseldorf, Germany
| | - J Neugebauer
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - U Andergassen
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Munich, Germany
| | - C Melcher
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Hospital, Duesseldorf, Germany
| | - F Schochter
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - D Mouarrawy
- Hospital Bremerhaven-Reinkenheide, Bremerhaven, Germany
| | | | - M Clemens
- Krankenanstalten Mutterhaus der Borromäerinnen, Trier, Germany
| | - E V Abel
- Hospital Schwäbisch Gmuend, Mutlangen, Germany
| | - G Heinrich
- Praxis Dr. Heinrich, Fuerstenwalde, Germany
| | - K Schueller
- Stat-up Statistische Beratung und Dienstleistung, Munich, Germany
| | - A Schneeweiss
- Department of Gynecology and Obstetrics in the National Center for Tumor Disease, University Hospital Heidelberg, Heidelberg, Germany
| | - P Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - M W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - Ch Scholz
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - T W P Friedl
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - K Friese
- Hospital Bad Trissl, Bad Trissl, Germany
| | - K Pantel
- Institute for Tumor Biology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - T Fehm
- Department of Gynecology and Obstetrics, Heinrich-Heine-University Hospital, Duesseldorf, Germany
| | - W Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - B Rack
- Department of Gynecology and Obstetrics, Ludwig-Maximilians-University Hospital, Munich, Germany
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Schwandt A, Denkinger M, Fasching P, Pfeifer M, Wagner C, Weiland J, Zeyfang A, Holl RW. Welche der Formeln Cockcroft-Gault, MDRD und CKD-EPI schätzt die gemessene glomeruläre Funktion am besten? Ergebnisse einer multizentrischen Studie mit 36.507 erwachsenen Patienten mit Typ 1 oder Typ 2 Diabetes aus der DPV-Datenbank. DIABETOL STOFFWECHS 2017. [DOI: 10.1055/s-0037-1601602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- A Schwandt
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, ZIBMT, Ulm, Germany
| | - M Denkinger
- AGAPLESION Bethesda Klinik, Geriatrie der Universität Ulm, Ulm, Germany
| | - P Fasching
- Wilhelminenspital, 5. Medizinischen Abteilung, Wien, Austria
| | - M Pfeifer
- Klinik Tettnang, Diabeteszentrum, Tettnang, Germany
| | - C Wagner
- Diabeteszentrum, Saaldorf-Surheim, Germany
| | - J Weiland
- Klinik Bad Reichenhall, Insitut für Innere Medizin, Bad Reichenhall, Germany
| | - A Zeyfang
- Sana Klinik Bethesda, Stuttgart, Germany
| | - RW Holl
- Universität Ulm, Institut für Epidemiologie und Medizinische Biometrie, ZIBMT, Ulm, Germany
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van Mackelenberg M, Denkert C, Nekljudova V, Karn T, Schem C, Marme F, Stickeler E, Jackisch C, Hanusch C, Huober J, Fasching P, Blohmer JU, Kümmel S, Müller V, Schneeweiss A, Untch M, von Minckwitz G, Weber K, Loibl S. Abstract P1-09-11: Outcome after neoadjuvant chemotherapy in progesterone receptor negative breast cancer patients – A pooled analysis of individual patient data from ten prospectively randomized controlled neoadjuvant trials. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p1-09-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
The estrogen receptor (ER) as a nuclear transcription factor alters the transcription of estrogen sensitive genes to which the progesterone receptor gene belongs. The ER has also been described to exert non genomic effects by interacting with several cell signalling pathways that do not initially involve increases in gene transcription. These different patterns of action of the ER lead to the assumption that in tumors that utilize the non-genomic ER activity in order to stimulate tumorigenesis and proliferation progesterone receptor (PgR) expression would be decreased or absent. Therefore lack of PgR expression could be a surrogate marker of altered growth factor signalling. The aim of this study was to investigate if PgR expression may act as a predictive factor for response to neoadjuvant chemotherapy and long-term outcome in breast cancer patients.
Methods
5613 patients with primary breast cancer, follow-up, positive ER expression; HER2+ and HER2- from overall 10 (n=9785) German neoadjuvant trials receiving an anthracycline and taxane based chemotherapy were included. The pathologic complete response (pCR)(ypT0, ypN0), long term survival data (disease free survival (DFS), distant disease free survival (DDFS), overall survival (OS) and local recurrence free survival (LRFS)) and early relapse, defined as DFS <37 months, were compared according to their PgR expression, overall and in subgroups defined by HER2.
Results
Tumors lacking PgR expression (1172 patients) were more often of grade 3 (38.4% v 26.3%; p<0.001), tended to have an advanced clinical nodal involvement (6.8% v 4.7%; p=0.004) and were more likely to demonstrate HER2 positivity (36.2% v 22.3%; p<0.001).
pCR rates were significantly higher in PgR negative patients in the entire cohort (13.8% v 7.5%; p<0.001) as well as in the HER2 negative subgroup (11.2% v 5.8%; p<0.001) whereas there was no significant difference in the HER2 positive (22.1% v 18%; p=0.117). After adjusting for known predictive factors in the multivariable logistic regression analysis PgR negativity was an independent predictive factor for pCR overall (OR 1.76; p<0.001) and in the HER2 negative patients (OR 1.99; p<0.001).
PgR negativity was also significantly associated with an early relapse overall (32.8% v 25.7%; p<0.001) and in the subgroups defined by HER2 (HER2- 32.2% v 24.9%; p<0.001 and HER2+ 39.9%v 30.5%; p=0.002).
Patients with PgR negative disease had a significantly worse DFS, OS, DDFS and LRFS (p<0.001, respectively). Multivariable Cox regression analysis revealed that PgR was an independent prognostic factor. This was also observed in the HER2+ and- subgroups. Interestingly, in the PgR negative tumors HER2 status did not influence long-term outcome.
Conclusion
This analysis demonstrates that ER positive and PgR negative tumors represent a specific subset in primary breast cancer patients associated with higher response but also worse long term outcome after neoadjuvant chemotherapy. Interestingly, PgR negativity served as an independent predictive factor for achieving a pCR after neoadjuvant chemotherapy and therefore its status should be considered when deciding on systemic treatment.
Citation Format: van Mackelenberg M, Denkert C, Nekljudova V, Karn T, Schem C, Marme F, Stickeler E, Jackisch C, Hanusch C, Huober J, Fasching P, Blohmer J-U, Kümmel S, Müller V, Schneeweiss A, Untch M, von Minckwitz G, Weber K, Loibl S. Outcome after neoadjuvant chemotherapy in progesterone receptor negative breast cancer patients – A pooled analysis of individual patient data from ten prospectively randomized controlled neoadjuvant trials [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P1-09-11.
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Affiliation(s)
- M van Mackelenberg
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - C Denkert
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - V Nekljudova
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - T Karn
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - C Schem
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - F Marme
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - E Stickeler
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - C Jackisch
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - C Hanusch
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - J Huober
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - P Fasching
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - J-U Blohmer
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - S Kümmel
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - V Müller
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - A Schneeweiss
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - M Untch
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - G von Minckwitz
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - K Weber
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
| | - S Loibl
- German Breast Group, Neu-Isenburg; Charite Berlin; Universitätsklinikum Frankfurt; Universitätsklinikum Schleswig-Holstein Kiel; Universitätsklinikum Heidelberg; Universitätsklinikum Aachen; Sana Klinikum Offenbach; Universitätsklinikum München; Universitätsklinikum Ulm; Universitätsklinikum Erlangen; Kliniken Essen-Mitte, Essen; Universitätsklinikum Hamburg; Helios Kliniken Berlin-Buch
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Keilmann L, Graf J, Simoes E, Wißlicen K, Rava L, Wallwiener C, Walter CB, Hartkopf A, Taran A, Wallwiener S, Fasching P, Brucker SY, Wallwiener M. Bereitschaft zur Nutzung technikbasierter Erhebungen (ePRO) bei Mammakarzinom-Patientinnen in der adjuvanten und metastasierten Situation in Abhängigkeit von soziodemographischen Merkmalen, gesundheitsbezogener Lebensqualität, Erkrankungsstatus und Technikskills. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1593248] [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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Weigand A, Boos AM, Tasbihi K, Beier JP, Beckmann MW, Fasching P, Rübner M, Strissel PL, Strick R, Horch RE. Isolation und Charakterisierung von verschiedenen Zelltypen aus Mammakarzinomen und gesundem Mammagewebe zur Analyse von Zell-Zell-Interaktionen. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0036-1592804] [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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Graf J, Simoes E, Wißlicen K, Rava L, Walter CB, Hartkopf A, Keilmann L, Taran A, Wallwiener S, Fasching P, Brucker SY, Wallwiener M. Willingness of Patients with Breast Cancer in the Adjuvant and Metastatic Setting to Use Electronic Surveys (ePRO) Depends on Sociodemographic Factors, Health-related Quality of Life, Disease Status and Computer Skills. Geburtshilfe Frauenheilkd 2016; 76:535-541. [PMID: 27239062 PMCID: PMC4873300 DOI: 10.1055/s-0042-105872] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/01/2016] [Accepted: 04/01/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction: Because of the often unfavorable prognosis, particularly for patients with metastases, health-related quality of life is extremely important for breast cancer patients. In recent years, data on patient-relevant endpoints is being increasingly collected electronically; however, knowledge on the acceptance and practicability of, and barriers to, this form of data collection remains limited. Material and Methods: A questionnaire was completed by 96 patients to determine to what extent existing computer skills, disease status, health-related quality of life and sociodemographic factors affect patients' potential willingness to use electronics methods of data collection (ePRO). Results: 52 of 96 (55 %) patients reported a priori that they could envisage using ePRO. Patients who a priori preferred a paper-based survey (pPRO) tended to be older (ePRO 53 years vs. pPRO 62 years; p = 0.0014) and typically had lower levels of education (p = 0.0002), were in poorer health (p = 0.0327) and had fewer computer skills (p = 0.0003). Conclusion: Barriers to the prospective use of ePRO were identified in older patients and patients with a lower quality of life. Given the appropriate conditions with regard to age, education and current health status, opportunities to participate should be provided to encourage patients' willingness to take part and ensure the validity of survey results. Focusing on ease of use of ePRO applications and making applications more patient-oriented and straightforward appears to be the way forward.
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Affiliation(s)
- J. Graf
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
- Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
- Abteilung Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Tübingen, Tübingen
| | - E. Simoes
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
- Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
- Stabsstelle Sozialmedizin, Universitätsklinikum Tübingen, Tübingen
| | - K. Wißlicen
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - L. Rava
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - C. B. Walter
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - A. Hartkopf
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - L. Keilmann
- Abteilung für Allgemeine Frauenheilkunde und Geburtshilfe, Universitätsklinikum Heidelberg, Heidelberg
| | - A. Taran
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - S. Wallwiener
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - P. Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Erlangen
| | - S. Y. Brucker
- Department für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
- Forschungsinstitut für Frauengesundheit, Universitätsklinikum Tübingen, Tübingen
| | - M. Wallwiener
- Abteilung für Allgemeine Frauenheilkunde und Geburtshilfe, Universitätsklinikum Heidelberg, Heidelberg
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Fasching P. Genomics von Prävention bis Früherkennung: Brauchen wir noch Bildgebung? ROFO-FORTSCHR RONTG 2016. [DOI: 10.1055/s-0036-1581615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Loibl S, Budczies J, Weichert W, Furlanetto J, Stenzinger A, Pfarr N, von Minckwitz G, Jackisch C, Schneeweiss A, Fasching P, Schmatloch S, Aktas B, Nekljudova V, Weber K, Untch M, Denkert C. Abstract P3-07-03: PIK3CA mutations predict resistance to trastuzumab/pertuzumab and nab-paclitaxel in primary HER2-positive breast cancer – Massive parallel sequencing analysis of 293 pretherapeutic core biopsies of the GeparSepto study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p3-07-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Phosphatidylinositol 3-kinase mutations (PIK3CA) are common in breast cancer (BC). Mutations are predominantly found in hot-spots located in the helical and kinase domains (exons 9 and 20). We recently demonstrated that PIK3CA mutations predict lower pathological complete response (pCR) to double blockade with trastuzumab/lapatinib in HER2+ve primary BC.
Methods: We evaluated PIK3CA mutations in 293/403 HER2+ve tumors of participants of the neoadjuvant GeparSepto (G7) study (Untch et al. SABCS 2014). The G7 study investigated the effect of exchanging paclitaxel for nab-paclitaxel prior to EC. All patients received trastuzumab and pertuzumab. The G7 study showed a significantly higher pCR rate in patients receiving nab-paclitaxel. HER2, hormone receptors (HR), Ki67 and tumor infiltrating lymphocytes (TILs) were centrally assessed prior to randomization. PIK3CA mutations in exons 9 and 20 were evaluated in formalin-fixed, paraffin embedded core biopsies taken before therapy using deep targeted massive parallel sequencing with a minimum coverage of 500 and a mean coverage of 6520 and 6346 per amplicon, (exon9 and exon 20). Only non-synonymous mutations in the coding region that were called at variant allele frequency ≥10% were taken into consideration. Only cases with a tumor cell content of ≥20% were included.
Results: In the G7 study, 396 patients with HER2+ve BC have been randomized from 06/2012 to 01/2014 and started treatment. From these 293 could be sequenced. Median age in the analyzed cohort was 49 years (range 22-75); most tumors were cT1-2 (89.9%); cN0 (54.4%); ductal invasive (88.7%), grade 3 (53.9%), HR+ve (69.6%), Ki67>20% (69.3%), LPBC-negative (83.2%). Overall, 22.2% of the tumors were found to have a PIK3CA mutation, 20.1% in HR+ve and 27.0% in HR-ve. Overall, the pCR rate was significantly lower in the PIK3CA mutant tumors compared to the wild type (wt) group (47.7% vs. 66.7%; p=0.009). This effect was seen both in the HR+ve (43.9% vs. 61.3%; p=0.052) and the HR-ve population (54.2% vs. 80.0%; p=0.029). There was also a significant difference in pCR according to PIK3CA mutation status dependant on the taxane. In the nab-paclitaxel group, pCR rates were significantly lower in patients with PIK3CA mutations compared to those without PIK3CA mutations (38.7% vs. 72.0%; p=0.001), whereas in the paclitaxel group, there was no significant difference between patients with and without a PIK3CA mutation (55.9% vs. 60.9%; p=0.690). The respective interaction could be demonstrated in univariate (p=0.039) as well as multivariate regression analysis (p=0.010) after adjusting for known baseline factors.
Conclusion: Patients with PIK3CA mutant HER2+ve BC have a significantly lower pCR rate compared to patients with wt tumors. In contrast to the results with double anti-HER2 blockade consisting of trastuzumab/lapatinib, the effect was evident irrespective of the HR status. In addition, PIK3CA mutation status was significantly associated with higher pCR following nab-paclitaxel.
The project has partly been funded within the EU-FP7 project RESPONSIFY No 278659 and the German Cancer Consortium (DKTK).
Citation Format: Loibl S, Budczies J, Weichert W, Furlanetto J, Stenzinger A, Pfarr N, von Minckwitz G, Jackisch C, Schneeweiss A, Fasching P, Schmatloch S, Aktas B, Nekljudova V, Weber K, Untch M, Denkert C. PIK3CA mutations predict resistance to trastuzumab/pertuzumab and nab-paclitaxel in primary HER2-positive breast cancer – Massive parallel sequencing analysis of 293 pretherapeutic core biopsies of the GeparSepto study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-03.
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Affiliation(s)
- S Loibl
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - J Budczies
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - W Weichert
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - J Furlanetto
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - A Stenzinger
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - N Pfarr
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - G von Minckwitz
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - C Jackisch
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - A Schneeweiss
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - P Fasching
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - S Schmatloch
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - B Aktas
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - V Nekljudova
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - K Weber
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - M Untch
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
| | - C Denkert
- German Breast Group, Neu-Isenburg, Germany; Charite University of Berlin, Berlin, Germany; University Hospital Heidleberg, Heidelberg, Germany; Sana Klinikum Offenbach, Offenbach, Germany; University Hospital Erlangen, Erlangen, Germany; Elisabeth Krankenhaus Kassel, Kassel, Germany; University Hospital Sen, Essen, Germany; Helios Kliniken Berlin-Buch, Berlin, Germany
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Ruddy KJ, Rack B, Schwitulla J, Lambrechts D, Haeberle L, Schramm A, Trapp E, Scholz C, Beutler AS, Ginsburg E, Couch F, Partridge AH, Wang L, Weinshilboum RM, Janni W, Vachon C, Fasching P. Abstract P4-10-07: Genetic predictors of chemotherapy-related amenorrhea. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p4-10-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Chemotherapy-related amenorrhea (CRA) impacts quality of life and reproductive options, and may play a role in treatment decision-making for young breast cancer patients. Although age, increasing doses of alkylating agents, and tamoxifen are known to increase the risk of chemotherapy-related amenorrhea (CRA), it is difficult to predict which women will develop CRA in order to inform fertility preservation and treatment decisions. We sought to investigate whether single nucleotide polymorphisms (SNPs) that have been associated with a younger age at natural menopause and ovarian reserve in non-oncologic populations were predictive of CRA in two large German clinical trials that administered gonadotoxic chemotherapy.
Methods: A total of 1322 premenopausal participants under age 50 who enrolled in SUCCESS B (a phase 3 trial of FEC-docetaxel-trastuzumab +/- gemcitabine for high risk early stage breast cancer) or SUCCESS C (a phase 3 trial of FEC-docetaxel-cyclophosphamide vs. docetaxel-cyclophosphamide that also tested the efficacy of a weight loss intervention in early stage breast cancer patients) were eligible for this study. We excluded patients who were receiving ovarian suppression. On these trials, menstrual status was self-reported as amenorrheic or not every three months after chemotherapy. Bloods were stored and patients provided consent for DNA analysis. We genotyped nine candidate SNPs in six genes (rs2002555 and rs11170547 in AMHR2, rs6166 in FSHR, rs10852344 <60kb from TNFRSF17/RUNDC2A/ GSPT1, rs12461110 in NLRP11, rs1801133 in MTHFR, rs2066470 in MTHRF, rs3810682 in BMP15, and rs615942 in COASY), and examined their association with CRA at 12-month and 24-month time points using logistic regression adjusted for age, BMI, and tamoxifen.
Results: Of the 554 eligible women with SNP data and menstrual data at 12 months, 70% reported CRA; of the 458 eligible women with SNP data and menstrual data at 24 months, 69% reported CRA. The two SNPs in AMHR2 showed suggestive associations with CRA at 12 and 24 months. [Final results pending].
Conclusions: Genetic variation in AMHR2 may be associated with CRA. Additional research will be needed to validate these findings in other breast cancer survivors and to identify additional SNPs that may be associated with CRA. Together with other clinical factors, genetic variation may improve our ability to predict who will experience CRA, and may inform reproductive and treatment decision-making in cancer patients.
Citation Format: Ruddy KJ, Rack B, Schwitulla J, Lambrechts D, Haeberle L, Schramm A, Trapp E, Scholz C, Beutler AS, Ginsburg E, Couch F, Partridge AH, Wang L, Weinshilboum RM, Janni W, Vachon C, Fasching P. Genetic predictors of chemotherapy-related amenorrhea. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-10-07.
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Affiliation(s)
- KJ Ruddy
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - B Rack
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - J Schwitulla
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - D Lambrechts
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - L Haeberle
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - A Schramm
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - E Trapp
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - C Scholz
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - AS Beutler
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - E Ginsburg
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - F Couch
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - AH Partridge
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - L Wang
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - RM Weinshilboum
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - W Janni
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - C Vachon
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
| | - P Fasching
- Mayo Clinic, Rochester, MN; Ludwig-Maximilian University, Munich, Germany; University of Erlangen, Ernlagen, Germany; University of Leuven, Leuven, Belgium; University Hospital Erlangen, Erlangen, Germany; University of Ulm, Ulm, Germany; Dana-Farber Cancer Institute, Boston, MA
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Lüftner D, Grischke E, Fasching P, Decker T, Schneeweiss A, Uleer C, Foerster F, Wimberger P, Kluth-Pepper B, Schubert J, Bloch W, Tesch H, Schuetz F, Jackisch C. 1869 Disease characteristics of subgroup patients treated with everolimus + exemestane for <12 months, ≥12 to <18months, and ≥18 months - Results of the 3rd interim analysis of the non-interventional trial BRAWO. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30819-x] [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]
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Fasching P, Niederacher D, Fehm T. Kongressbericht. 6. Wissenschaftliches Symposium der AGO-TraFo. Geburtshilfe Frauenheilkd 2015. [DOI: 10.1055/s-0035-1546092] [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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Scheuing N, Stingl J, Dapp A, Denkinger MD, Fasching P, Jehle PM, Merger S, Mühldorfer S, Pieper U, Schuler A, Zeyfang A, Holl RW. Glukozentrische Diabetestherapie bei geriatrischen Patienten mit Demenz sinnvoll? Multizentrische DPV-Daten von insgesamt 215.932 Typ-2-Diabetespatienten zeigen signifikant erhöhte Hypoglykämierate bei 6.771 Patienten mit komorbider Demenz. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549772] [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]
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Fasching P. Molekulare Bildgebung/Diagnostik. ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551196] [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]
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Schulz-Wendtland R, Fasching P, Uder M. Fusion oder Hybrid in der Mammadiagnostik? ROFO-FORTSCHR RONTG 2015. [DOI: 10.1055/s-0035-1551193] [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]
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von Minckwitz G, Loibl S, Untch M, Eidtmann H, Rezai M, Fasching PA, Tesch H, Eggemann H, Schrader I, Kittel K, Hanusch C, Huober J, Solbach C, Jackisch C, Kunz G, Blohmer JU, Hauschild M, Fehm T, Nekljudova V, Gerber B, Gnauert K, Heinrich B, Prätz T, Groh U, Tanzer H, Villena C, Tulusan A, Liedtke B, Blohmer JU, Kittel K, Mau C, Potenberg J, Schilling J, Just M, Weiss E, Bückner U, Wolfgarten M, Lorenz R, Doering G, Feidicker S, Krabisch P, Deichert U, Augustin D, Kunz G, Kast K, von Minckwitz G, Nestle-Krämling C, Rezai M, Höß C, Terhaag J, Fasching P, Staib P, Aktas B, Kühn T, Khandan F, Möbus V, Solbach C, Tesch H, Stickeler E, Heinrich G, Wagner H, Abdallah A, Dewitz T, Emons G, Belau A, Rethwisch V, Lantzsch T, Thomssen C, Mattner U, Nugent A, Müller V, Noesselt T, Holms F, Müller T, Deuker JU, Schrader I, Strumberg D, Uleer C, Solomayer E, Runnebaum I, Link H, Tomé O, Ulmer HU, Conrad B, Feisel-Schwickardi G, Eidtmann H, Schumacher C, Steinmetz T, Bauerfeind I, Kremers S, Langanke D, Kullmer U, Ober A, Fischer D, Kohls A, Weikel W, Bischoff J, Freese K, Schmidt M, Wiest W, Sütterlin M, Dietrich M, Grießhammer M, Burgmann DM, Hanusch C, Rack B, Salat C, Sattler D, Tio J, von Abel E, Christensen B, Burkamp U, Köhne CH, Meinerz W, Graßhoff ST, Decker T, Overkamp F, Thalmann I, Sallmann A, Beck T, Reimer T, Bartzke G, Deryal M, Weigel M, Huober J, Weder P, Steffens CC, Lemster S, Stefek A, Ruhland F, Hofmann M, Schuster J, Simon W, Kronawitter U, Clemens M, Fehm T, Janni W, Latos K, Bauer W, Roßmann A, Bauer L, Lampe D, Heyl V, Hoffmann G, Lorenz-Salehi F, Hackmann J, Schlag R. Survival after neoadjuvant chemotherapy with or without bevacizumab or everolimus for HER2-negative primary breast cancer (GBG 44-GeparQuinto)†. Ann Oncol 2014; 25:2363-2372. [PMID: 25223482 DOI: 10.1093/annonc/mdu455] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The GeparQuinto study showed that adding bevacizumab to 24 weeks of anthracycline-taxane-based neoadjuvant chemotherapy increases pathological complete response (pCR) rates overall and specifically in patients with triple-negative breast cancer (TNBC). No difference in pCR rate was observed for adding everolimus to paclitaxel in nonearly responding patients. Here, we present disease-free (DFS) and overall survival (OS) analyses. PATIENTS AND METHODS Patients (n = 1948) with HER2-negative tumors of a median tumor size of 4 cm were randomly assigned to neoadjuvant treatment with epirubicin/cyclophosphamide followed by docetaxel (EC-T) with or without eight infusions of bevacizumab every 3 weeks before surgery. Patients without clinical response to EC ± Bevacizumab were randomized to 12 weekly cycles paclitaxel with or without everolimus 5 mg/day. To detect a hazard ratio (HR) of 0.75 (α = 0.05, β = 0.8) 379 events had to be observed in the bevacizumab arms. RESULTS With a median follow-up of 3.8 years, 3-year DFS was 80.8% and 3-year OS was 89.7%. Outcome was not different for patients receiving bevacizumab (HR 1.03; P = 0.784 for DFS and HR 0.974; P = 0.842 for OS) compared with patients receiving chemotherapy alone. Patients with TNBC similarly showed no improvement in DFS (HR = 0.99; P = 0.941) and OS (HR = 1.02; P = 0.891) when treated with bevacizumab. No other predefined subgroup (HR+/HER2-; locally advanced (cT4 or cN3) or not; cT1-3 or cT4; pCR or not) showed a significant benefit. No difference in DFS (HR 0.997; P = 0.987) and OS (HR 1.11; P = 0.658) was observed for nonearly responding patients receiving paclitaxel with or without everolimus overall as well as in subgroups. CONCLUSIONS Long-term results, in opposite to the results of pCR, do not support the neoadjuvant use of bevacizumab in addition to an anthracycline-taxane-based chemotherapy or everolimus in addition to paclitaxel for nonearly responding patients. CLINICAL TRIAL NUMBER NCT 00567554, www.clinicaltrials.gov.
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Affiliation(s)
- G von Minckwitz
- Headquarter, German Breast Group, Neu-Isenburg; Department of Gynaecology and Obstetrics, University Hospital, Frankfurt.
| | - S Loibl
- Headquarter, German Breast Group, Neu-Isenburg
| | - M Untch
- Department of Gynaecology and Obstetrics, Klinikum Berlin-Buch, Berlin
| | - H Eidtmann
- Department of Gynaecology and Obstetrics, University Hospital, Kiel
| | - M Rezai
- Breast Center, Luisenkrankenhaus, Düsseldorf
| | - P A Fasching
- Department of Gynaecology and Obstetrics, University Hospital, Erlangen
| | - H Tesch
- Department of Medical Oncology, Chop GmbH, Frankfurt
| | - H Eggemann
- Department of Gynaecology and Obstetrics, University Hospital, Magdeburg
| | - I Schrader
- Department of Gynaecology and Obstetrics, Henriettenstiftung, Hannover
| | - K Kittel
- Department of Gynaecology and Obstetrics, Praxisklinik, Berlin
| | - C Hanusch
- Department of Gynaecology and Obstetrics, Rot-Kreuz-Klinikum, München
| | - J Huober
- Department of Gynaecology and Obstetrics, University Hospital, Ulm
| | - C Solbach
- Department of Gynaecology and Obstetrics, University Hospital, Frankfurt
| | - C Jackisch
- Department of Gynaecology and Obstetrics, Sana-Klinikum, Offenbach
| | - G Kunz
- Department of Gynaecology and Obstetrics, St Johannes Hospital, Dortmund
| | - J U Blohmer
- Department of Gynaecology and Obstetrics, St Gertrauden-Hospital, Berlin
| | - M Hauschild
- Department of Gynaecology and Obstetrics, Hospital, Rheinfelden
| | - T Fehm
- Department of Gynaecology and Obstetrics, University Hospital, Tübingen
| | | | - B Gerber
- Department of Gynaecology and Obstetrics, University Hospital, Rostock, Germany
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Hack C, Hüttner N, Paepke D, Voiß P, Dobos G, Kümmel S, Münstedt K, Kiechle M, Fasching P, Beckmann M. Integrative Medizin in der Gynäkologischen Onkologie – Möglichkeiten und Grenzen Teil 1. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0033-1350906] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- C. Hack
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen – Europäische Metropolregion Nürnberg
| | - N. Hüttner
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen – Europäische Metropolregion Nürnberg
| | - D. Paepke
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München
| | - P. Voiß
- Brustzentrum und Klinik für Senologie der Kliniken Essen-Mitte, Essen
| | - G. Dobos
- Klinik für Naturheilkunde und Integrative Medizin der Kliniken Essen-Mitte, Essen
| | - S. Kümmel
- Brustzentrum und Klinik für Senologie der Kliniken Essen-Mitte, Essen
| | - K. Münstedt
- Frauenklinik des Universitätsklinikums Gießen, Gießen
| | - M. Kiechle
- Frauenklinik des Klinikums rechts der Isar, Technische Universität München, München
| | - P. Fasching
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen – Europäische Metropolregion Nürnberg
| | - M. Beckmann
- Universitäts-Brustzentrum Franken, Frauenklinik des Universitätsklinikums Erlangen, Friedrich-Alexander Universität Erlangen-Nürnberg, Comprehensive Cancer Center Erlangen – Europäische Metropolregion Nürnberg
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Lux M, Hildebrandt T, Bani M, Loehberg C, Schrauder M, Rauh C, Jud S, Fasching P, Hartmann A, Beckmann M. Health Economic Evaluation of Different Decision Aids for the Individualised Treatment of Patients with Breast Cancer. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0032-1328627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M. Lux
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - T. Hildebrandt
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - M. Bani
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - C. Loehberg
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - M. Schrauder
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - C. Rauh
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - S. Jud
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - P. Fasching
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - A. Hartmann
- Institute of Pathology, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
| | - M. Beckmann
- Frauenklinik, Universitätsklinikum Erlangen, Universitäts-Brustzentrum CCC ER-EMN, Erlangen
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Lux M, Maass N, Schütz F, Schwidde I, Fasching P, Fehm T, Janni W, Kümmel S, Kolberg HC, Lüftner D. Breast Cancer 2013 - Interpretation of New and Known Data. Geburtshilfe Frauenheilkd 2013. [DOI: 10.1055/s-0032-1328691] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Affiliation(s)
- M. Lux
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
| | - N. Maass
- Department of Gynecology and Obstetrics, University Hospital Aachen, Aachen
| | - F. Schütz
- Frauenklinik, Universitätsklinikum Heidelberg, Heidelberg
| | - I. Schwidde
- Klinik für Senologie, Kliniken Essen Mitte, Essen
| | - P. Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen
| | - T. Fehm
- Department of Gynecology and Obstetrics, University Hospital Düsseldorf, Heinrich Heine Universität Düsseldorf, Düsseldorf
| | - W. Janni
- Frauenklinik, Klinikum der Universität Ulm, Ulm
| | - S. Kümmel
- Klinik für Senologie, Kliniken Essen Mitte, Essen
| | - H.-C. Kolberg
- Klinik für Gynäkologie und Geburtshilfe, Marienhospital Bottrop, Bottrop
| | - D. Lüftner
- Medizinische Klinik und Poliklinik II, Campus Charité Mitte, Berlin
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Untch M, Prinzler J, Fasching P, Müller BM, Gade S, Meinhold-Heerlein I, Huober J, Karn T, Liedtke C, Loibl S, Müller V, Rack B, Schem C, Darb-Esfahani S, von Minckwitz G, Denkert C. Abstract P3-06-05: Expression of SPARC in human breast cancer and its predictive value in the GeparTrio neoadjuvant trial. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-06-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Secreted protein acidic and rich in cysteine (SPARC) is an albumin-binding protein and associated with poor prognosis in multiple cancers.
The aim of this analysis was to determine the frequency of SPARC expression among different molecular breast cancer subtypes and to evaluate its predictive value for therapy response after neoadjuvant anthracycline/taxane based chemotherapy (CTX) in participants of the GeparTrio trial.
Methods: We evaluated tumoral SPARC expression by immunohistochemistry on tissue microarrays (TMAs) constructed from formalin-fixed paraffin-embedded (FFPE) pre-treatment core biopsies from 667 patients (pts) of the GeparTrio trial. The details of the GeparTrio study design are described elsewhere (von Minckwitz, JNCI 2008). Cutoffs for SPARC expression were determined using the web-based software Cutoff Finder (http://molpath.charite.de/cutoff/).
Results: SPARC protein expression was measurable by IHC on the TMAs and 176 (26.4 %) of 667 tumors were SPARC positive. SPARC expression was increased in pts with triple-negative breast cancer (TNBC) compared to hormone receptor or HER2 positive subtypes (p = 0.039).
SPARC positivity was associated with an increased pCR rate in the overall population (p < 0.001). SPARC negative tumors had a pCR rate of 15%, which increased to 27% in SPARC positive tumors. Similarly, in TNBC the pCR rate increased from 26% in SPARC negative tumors to 47% in SPARC positive tumors (p = 0.032).
In multivariate logistic regression analysis adjusted for standard clinicopathological factors, SPARC was independently predictive in the overall population (p = 0.010) as well as the subgroups of pts with TNBC (p = 0.036).
Conclusions: SPARC is expressed in all biological breast cancer subtypes with TNBC revealing the highest expression rate. Our data suggest that SPARC expression may provide predictive information for response to neoadjuvant CTX.
As SPARC is an albumin-binding protein and might mediate intratumoral accumulation of nab-Paclitaxel, prospective analysis of SPARC expression is planned in the GeparSepto trial.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-06-05.
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Affiliation(s)
- M Untch
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - J Prinzler
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - P Fasching
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - BM Müller
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - S Gade
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - I Meinhold-Heerlein
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - J Huober
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - T Karn
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - C Liedtke
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - S Loibl
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - V Müller
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - B Rack
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - C Schem
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - S Darb-Esfahani
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - G von Minckwitz
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
| | - C Denkert
- Helios Klinikum Berlin-Buch, Germany; Charité Universitätsmedizin Berlin, Germany; Universitätsklinikum Erlangen, Germany; German Breast Group, Germany; Universitätsklinikum Aachen, Germany; Universitätsklinikum Düsseldorf, Germany; Universitätsklinikum Frankfurt am Main, Germany; Universitätsklinikum Münster, Germany; Universitätsklinikum Hamburg-Eppendorf, Germany; Universitätsklinikum München; Universitätsklinikum Schleswig-Holstein, Germany
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Kümmel S, Kolberg H, Lüftner D, Lux M, Maass N, Schütz F, Fasching P, Fehm T, Janni W. Mammakarzinom 2011 – Neue Aspekte. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0031-1280313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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Meier-Meitinger M, Häberle L, Fasching P, Schulz-Wendtland R, Uder M, Adamietz B. Größenbestimmung von malignen Brusttumoren mit sechs unterschiedlichen Methoden. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Adamietz B, Meier-Meitinger M, Schulz-Wendtland R, Uder M, Schwab S, Fasching P. Neue diagnostische Kriterien in der Real-time-Elastographie zur Abschätzung der Dignität von Brustläsionen. ROFO-FORTSCHR RONTG 2011. [DOI: 10.1055/s-0031-1279234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fehm T, Janni W, Kümmel S, Lüftner D, Lux M, Schütz F, Fasching P. Review: SABCS 2010 – Aktuelle Therapie der Patientin mit einem Mammakarzinom. Geburtshilfe Frauenheilkd 2011. [DOI: 10.1055/s-0030-1271020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Adamietz BR, Meier-Meitinger M, Fasching P, Beckmann M, Hartmann A, Uder M, Häberle L, Schulz-Wendtland R, Schwab SA. New diagnostic criteria in real-time elastography for the assessment of breast lesions. Ultraschall Med 2011; 32:67-73. [PMID: 21165816 DOI: 10.1055/s-0029-1245821] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
PURPOSE Elastography is a new ultrasonographic method that has been examined as a diagnostic tool for breast lesions. This study was intended to create and define new elastographic criteria allowing assessment of whether breast lesions are malignant or benign. MATERIALS AND METHODS 217 patients with a total of 245 breast lesions of unknown malignancy underwent ultrasound examination. The new eSie Touch Elasticity Imaging technology (Siemens, Erlangen, Germany) was used with a 10-MHz linear transducer (Acuson Antares). Lesions were examined using B-mode and real-time elastography (RTE). Each lesion was histologically assessed by core biopsy. Five RTE characteristics were examined: elasticity proportion (EP), different location on RTE in comparison with B-mode (MV), different contrast patterns (SOS), dorsal lesion limitation visibility and different size on RTE in comparison with B-mode. RESULTS 54 malignant lesions (54 %) appeared inelastic, in contrast to the benign control group (34.5 %; P = 0.001). A completely elastic pattern was visible in 10 malignant (10 %) and 39 benign lesions (26.9 %). MV was identified in 23 cases, with 22 of the lesions being malignant and one benign. The SOS was negative in 89 malignant lesions (89 %) and positive in 100 benign lesions. The dorsal lesion limitation was visible on RTE without B-mode in 88 malignant lesions (88 %) and 27 benign lesions (18.6 %). The size was assessed as larger in 45 malignant lesions (45 %) and seven benign lesions (4.8 %). CONCLUSION SOS and a larger tumor size on RTE are specific characteristics of malignant breast lesions. EP, MV and distal mass border are further helpful signs to assess the malignancy of tumors.
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Affiliation(s)
- B R Adamietz
- Universität Erlangen, Diagnostische Radiologie, Erlangen
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Fasching P, Fehm T, Janni W, Kümmel S, Lüftner D, Lux M, Maass N. Aktuelle Therapie der Patientin mit einem Mammakarzinom. Geburtshilfe Frauenheilkd 2010. [DOI: 10.1055/s-0030-1250437] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Schmidt R, Marksteiner M, Dal-Bianco P, Ransmayr G, Bancher C, Benke T, Wancata J, Fischer P, Leblhuber CF, Psota G, Ackerl M, Alf C, Berek K, Croy A, Delazer M, Fasching P, Frühwald T, Fruhwürth G, Fuchs-Nieder B, Gatterer G, Grossmann J, Hinterhuber H, Iglseder B, Imarhiagbe D, Jagsch C, Jellinger K, Kalousek M, Kapeller P, Ladurner G, Lampl C, Lechner A, Lingg A, Nakajima T, Rainer M, Reisecker F, Spatt J, Walch T, Uranüs M, Walter A. [Consensus statement "Dementia 2010" of the Austrian Alzheimer Society]. Neuropsychiatr 2010; 24:67-87. [PMID: 20605003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
The Austrian Alzheimer Society developed evidence-based guidelines based on a systematic literature search and criteria-guided assessment with subsequent transparent determination of grades of clinical recommendation. The authors evaluated currently available therapeutic approaches for the most common forms of dementia and focused on diagnosis and pharmacological intervention, taking into consideration the situation in Austria. The purpose of these guidelines is the rational and cost-effective use of diagnostic and therapeutic measures in dementing illnesses. Users are physicians and all other providers of care for patients with dementia in Austria.
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Affiliation(s)
- Reinhold Schmidt
- Universitätsklinik für Neurologie, Medizinische Universität Graz,
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Mueller V, Riethdorf S, Rack B, Janni W, Fasching P, Pantel K, Gebauser G, Solomayer E, Aktas B, Kasemier-Bauer S, Fehm T. Prospective Evaluation of Serum HER2 and HER2 Expression on Circulating Tumor Cells in Patients with Metastatic Breast Cancer within the DETECT Study. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-3050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Assessment of HER2 status at the time of metastatic disease might help to optimize treatment decisions in patients with no HER2 status determined at first diagnosis and could also be helpful since HER2 status may change during disease progression. In this context, determination of serum HER2 or the evaluation of HER2 status on circulating tumor cells (CTC) is of potential relevance especially for optimizing HER2-directed therapy. The aim of this study was therefore to determine the serum HER2 status and the HER2 status of CTC from corresponding patients.Methods: Blood samples were obtained in a prospective multicenter setting from 251 patients with metastatic breast cancer at the time of disease progression. Serum HER2 was determined using the commercial HER2 ELISA-kit (Oncogene Science). CTC were detected and HER2 expression was assessed with the CellSearch™ system (Veridex).Results: 119 of 251 (47%) metastatic patients had elevated serum HER2 levels above 15 ng/mL. Serum HER2 was elevated in 49 (66%) of 74 patients with HER2 positive primary tumors, in 57 of 148 (39%) with HER2 negative primary tumors and in 13 of 29 (45%) patients with unknown HER2 primary tumor status. CTC were detected in 133 of 243 evaluable patients (5 or more cells), in these HER2 overexpression on CTC (strong overexpression in at least one cell) was detected in 52 cases (39%). Only 20 of these patients had a HER2 positive primary tumor. In patients with HER2 positive CTC, serum levels were above the cut off in 34 of 52 (65%), while in those with HER2 negative CTC 44 of 81 (54%) showed elevated HER2 serum levels. Concordance between HER2 status of circulating tumor cells and elevated serum HER2 was seen in 71 of 133 patients (53%).Conclusions: Our study demonstrates with a prospective design that also in patients with initially negative HER2 tumor status elevated serum HER2 levels and/or HER2 positive CTC can be detected at the time of metastatic disease. This is of clinical relevance since these patients in current practice do not have access to HER2 targeted therapy.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3050.
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Affiliation(s)
- V. Mueller
- 1University Medical Center Hamburg, Germany
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- 4Heinrich Heine University, Germany
| | | | | | | | | | - B. Aktas
- 8University Medical Center, Germany
| | | | - T. Fehm
- 7University Medical Center, Germany
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43
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Goecke TW, Reulbach U, Lux MP, Knörr J, Fasching P, Bleich S, Kornhuber J, Beckmann MW. Prä-, peri- und postpartale Depressivität. Implikationen für die klinische Praxis. Erkenntnisse aus FRAMES (Franconian Maternal Health Evaluation Studies). Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1238948] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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44
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Lux M, Fasching P, Bani M, Schrauder M, Loehberg C, Oppelt P, Hildebrandt T, Grün A, Beckmann M, Goecke T. Marketing von Brust- und Perinatalzentren – Sind Patientinnen mit dem Produkt „zertifiziertes Zentrum“ vertraut? Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-0029-1185549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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45
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Lux M, Brauch H, Fehm T, Janni W, Maass N, Rody A, Harbeck N, Niederacher D, Beckmann M, Fasching P. Pharmakogenetik in der antihormonellen Therapie von Patientinnen mit einem Mammakarzinom. Geburtshilfe Frauenheilkd 2009. [DOI: 10.1055/s-2008-1039205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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46
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Wagner S, Bani M, Fasching P, Schrauder M, Löhberg C, Beckmann M, Lux M. Ist ein Brustzentrum finanzierbar? – Berechnung einzelner Leistungen am Beispiel des Universitäts-Brustzentrums Franken (UBF). Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-2008-1039170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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47
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Alkasi O, Meinhold-Heerlein I, Zaki R, Fasching P, Maass N, Jonat W. Long-term Disease-free Survival After Hormonal Therapy of a Patient with Recurrent Low Grade Endometrial Stromal Sarcoma. Geburtshilfe Frauenheilkd 2008. [DOI: 10.1055/s-0028-1089008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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48
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Hasmuller S, Wirtz R, Lenhard M, Riickert S, Kahlert S, Bauerfeind I, Ditsch N, Ruhl I, Fasching P, Untch M. Response of basal-like tumors defined by ESR Her-2/neu, MLPH and MMP7 to neoadjuvant chemotherapy. EJC Suppl 2008. [DOI: 10.1016/s1359-6349(08)70789-4] [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: 11/30/2022] Open
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49
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Wagner S, Ganslandt T, Keiling C, Jap D, Fasching P, Lux M, Beckmann M. Ist ein Brustzentrum finanzierbar? - Ein Kalkulationsmodell für das Universitäts-Brustzentrum Franken (UBF). Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-965584] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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50
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Jud S, Schrauder M, Lux M, Fasching P, Beckmann M, Löhberg C. Signalhemmer in der gynäkologischen Onkologie. Geburtshilfe Frauenheilkd 2007. [DOI: 10.1055/s-2007-965764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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