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Kaiser C, Wilhelm T, Walter S, Singer S, Keller E, Baltzer PAT. Cancer detection rate of breast-MR in supplemental screening after negative mammography in women with dense breasts. Preliminary results of the MA-DETECT-Study after 200 participants. Eur J Radiol 2024; 176:111476. [PMID: 38710116 DOI: 10.1016/j.ejrad.2024.111476] [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] [Received: 02/05/2024] [Revised: 03/20/2024] [Accepted: 04/17/2024] [Indexed: 05/08/2024]
Abstract
BACKGROUND Due to increased cancer detection rates (CDR), breast MR (breast MRI) can reduce underdiagnosis of breast cancer compared to conventional imaging techniques, particularly in women with dense breasts. The purpose of this study is to report the additional breast cancer yield by breast MRI in women with dense breasts after receiving a negative screening mammogram. METHODS For this study we invited consecutive participants of the national German breast cancer Screening program with breast density categories ACR C & D and a negative mammogram to undergo additional screening by breast MRI. Endpoints were CDR and recall rates. This study reports interim results in the first 200 patients. At a power of 80% and considering an alpha error of 5%, this preliminary population size is sufficient to demonstrate a 4/1000 improvement in CDR. RESULTS In 200 screening participants, 8 women (40/1000, 17.4-77.3/1000) were recalled due to positive breast MRI findings. Image-guided biopsy revealed 5 cancers in 4 patients (one bilateral), comprising four invasive cancers and one case of DCIS. 3 patients revealed 4 invasive cancers presenting with ACR C breast density and one patient non-calcifying DCIS in a woman with ACR D breast density, resulting in a CDR of 20/1000 (95%-CI 5.5-50.4/1000) and a PPV of 50% (95%-CI 15.7-84.3%). CONCLUSION Our initial results demonstrate that supplemental screening using breast MRI in women with heterogeneously dense and very dense breasts yields an additional cancer detection rate in line with a prior randomized trial on breast MRI screening of women with extremely dense breasts. These findings are highly important as the population investigated constitutes a much higher proportion of women and yielded cancers particularly in women with heterogeneously dense breasts.
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Affiliation(s)
- Cgn Kaiser
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Germany.
| | - T Wilhelm
- German National Screening Unit Radiologie Franken-Hohenlohe, BW, Germany
| | - S Walter
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Germany
| | - S Singer
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Germany
| | - E Keller
- Institute of Clinical Radiology and Nuclear Medicine, University Medical Centre Mannheim, Medical Faculty Mannheim-University of Heidelberg, Germany
| | - P A T Baltzer
- Department of Biomedical Imaging and Image-guided therapy, Allgemeines Krankenhaus Wien, Medical University of Vienna, Austria
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Fang Y, Barrows D, Dabas Y, Carroll TS, Singer S, Tap WD, Nacev BA. ATRX guards against aberrant differentiation in mesenchymal progenitor cells. Nucleic Acids Res 2024:gkae160. [PMID: 38477352 DOI: 10.1093/nar/gkae160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 01/19/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024] Open
Abstract
Alterations in the tumor suppressor ATRX are recurrently observed in mesenchymal neoplasms. ATRX has multiple epigenetic functions including heterochromatin formation and maintenance and regulation of transcription through modulation of chromatin accessibility. Here, we show in murine mesenchymal progenitor cells (MPCs) that Atrx deficiency aberrantly activated mesenchymal differentiation programs. This includes adipogenic pathways where ATRX loss induced expression of adipogenic transcription factors and enhanced adipogenic differentiation in response to differentiation stimuli. These changes are linked to loss of heterochromatin near mesenchymal lineage genes together with increased chromatin accessibility and gains of active chromatin marks. We additionally observed depletion of H3K9me3 at transposable elements, which are derepressed including near mesenchymal genes where they could serve as regulatory elements. Finally, we demonstrated that loss of ATRX in a mesenchymal malignancy, undifferentiated pleomorphic sarcoma, results in similar epigenetic disruption and de-repression of transposable elements. Together, our results reveal a role for ATRX in maintaining epigenetic states and transcriptional repression in mesenchymal progenitors and tumor cells and in preventing aberrant differentiation in the progenitor context.
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Affiliation(s)
- Yan Fang
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
- Laboratory of Chromatin Biology and Epigenetics, The Rockefeller University, New York, NY 10065, USA
| | - Douglas Barrows
- Bioinformatics Resource Center, The Rockefeller University, New York, NY10065, USA
| | - Yakshi Dabas
- Laboratory of Chromatin Biology and Epigenetics, The Rockefeller University, New York, NY 10065, USA
| | - Thomas S Carroll
- Bioinformatics Resource Center, The Rockefeller University, New York, NY10065, USA
| | - Sam Singer
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY10065, USA
| | - Benjamin A Nacev
- Department of Medicine, University of Pittsburgh, Pittsburgh, PA 15213, USA
- Department of Pathology, University of Pittsburgh, Pittsburgh, PA 15213, USA
- UPMC Hillman Cancer Center, Pittsburgh, PA 15213, USA
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Kelly CM, Qin LX, Whiting KA, Richards AL, Avutu V, Chan JE, Chi P, Dickson MA, Gounder MM, Keohan ML, Movva S, Nacev BA, Rosenbaum E, Adamson T, Singer S, Bartlett EK, Crago AM, Yoon SS, Hwang S, Erinjeri JP, Antonescu CR, Tap WD, D’Angelo SP. A Phase II Study of Epacadostat and Pembrolizumab in Patients with Advanced Sarcoma. Clin Cancer Res 2023; 29:2043-2051. [PMID: 36971773 PMCID: PMC10752758 DOI: 10.1158/1078-0432.ccr-22-3911] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 02/15/2023] [Accepted: 03/22/2023] [Indexed: 03/29/2023]
Abstract
PURPOSE Epacadostat, an indole 2,3 dioxygenase 1 (IDO1) inhibitor, proposed to shift the tumor microenvironment toward an immune-stimulated state, showed early promise in melanoma but has not been studied in sarcoma. This study combined epacadostat with pembrolizumab, which has modest activity in select sarcoma subtypes. PATIENTS AND METHODS This phase II study enrolled patients with advanced sarcoma into five cohorts including (i) undifferentiated pleomorphic sarcoma (UPS)/myxofibrosarcoma, (ii) liposarcoma (LPS), (iii) leiomyosarcoma (LMS), (iv) vascular sarcoma, including angiosarcoma and epithelioid hemangioendothelioma (EHE), and (v) other subtypes. Patients received epacadostat 100 mg twice daily plus pembrolizumab at 200 mg/dose every 3 weeks. The primary endpoint was best objective response rate (ORR), defined as complete response (CR) and partial response (PR), at 24 weeks by RECIST v.1.1. RESULTS Thirty patients were enrolled [60% male; median age 54 years (range, 24-78)]. The best ORR at 24 weeks was 3.3% [PR, n = 1 (leiomyosarcoma); two-sided 95% CI, 0.1%-17.2%]. The median PFS was 7.6 weeks (two-sided 95% CI, 6.9-26.7). Treatment was well tolerated. Grade 3 treatment-related adverse events occurred in 23% (n = 7) of patients. In paired pre- and post-treatment tumor samples, no association was found between treatment and PD-L1 or IDO1 tumor expression or IDO-pathway-related gene expression by RNA sequencing. No significant changes in serum tryptophan or kynurenine levels were observed after baseline. CONCLUSIONS Combination epacadostat and pembrolizumab was well tolerated and showed limited antitumor activity in sarcoma. Correlative analyses suggested that inadequate IDO1 inhibition was achieved.
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Affiliation(s)
- Ciara M. Kelly
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Li-Xuan Qin
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center
| | - Karissa A. Whiting
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center
| | - Allison L. Richards
- Marie-Josée and Henry R. Kravis Center for Molecular Oncology, Memorial Sloan Kettering Cancer Center
| | - Viswatej Avutu
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Jason E. Chan
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Ping Chi
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Mark A. Dickson
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Mrinal M. Gounder
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Mary Louise Keohan
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Sujana Movva
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Benjamin A. Nacev
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Evan Rosenbaum
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Travis Adamson
- Department of Medicine, Memorial Sloan Kettering Cancer Center
| | - Sam Singer
- Department of Surgery, Memorial Sloan Kettering Cancer Center
| | | | - Aimee M. Crago
- Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Sam S. Yoon
- Department of Surgery, Memorial Sloan Kettering Cancer Center
| | - Sinchun Hwang
- Department of Radiology, Memorial Sloan Kettering Cancer Center
| | | | | | - William D. Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
| | - Sandra P. D’Angelo
- Department of Medicine, Memorial Sloan Kettering Cancer Center
- Department of Medicine, Weill Cornell Medical College
- Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center
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Bossart M, Plett H, Krämer B, Braicu E, Czogalla B, Klar M, Singer S, Mayr D, Staebler A, du Bois A, Kommoss S, Link T, Burges A, Heitz F, Grube M, Trillsch F, Harter P, Wimberger P, Buderath P, Hasenburg A. Depression and anxiety in women with malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST): an analysis of the AGO-CORSETT database. Arch Gynecol Obstet 2023; 307:1155-1162. [PMID: 36127525 PMCID: PMC10023613 DOI: 10.1007/s00404-022-06781-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/31/2022] [Indexed: 11/12/2022]
Abstract
INTRODUCTION The intention of this study was to evaluate the level of anxiety and depression of malignant ovarian germ cell (MOGCT) and sex cord stromal tumors (SCST) survivors and to identify possible alterable cofactors. METHODS CORSETT was an observational, multicenter, mixed retrospective/prospective cohort study of the AGO Studygroup. Women who had been diagnosed with MOGCTs and SCSTs between 2001 and 2011 were asked to complete the Hospital Anxiety and Depression Scale (HADS) to evaluate distress. Predictors of distress (type of surgery, chemotherapy, time since diagnosis, recurrence, second tumor, pain) were investigated using multivariate linear regression analysis. RESULTS 150 MOGCT and SCST patients with confirmed histological diagnosis completed the questionnaire median seven years after diagnosis. They had a HADS total score ≥ 13 indicating severe mental distress in 34% of cases. Patients after fertility-conserving surgery had lower probability of severe mental distress than those without fertility-conserving treatment (β = - 3.1, p = 0.04). Pain was associated with the level of distress in uni- and multivariate analysis (coef 0.1, p < 0.01, coef. Beta 0.5). DISCUSSION Severe mental distress was frequent in patients with MOGCT and SCST and the level of pain was associated with the level of distress. Fertility conserving therapy, however, was associated with less mental distress. Screening and treatment of pain and depression is required to improve mental well-being in survivors of MOGCT and SCST.
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Affiliation(s)
- M Bossart
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg im Breisgau, Germany.
- Department of Gynecology and Obstetrics, St. Josefskrankenhaus Freiburg, Freiburg im Breisgau, Germany.
| | - H Plett
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte (KEM), Essen, Germany
| | - B Krämer
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - E Braicu
- Department of Gynecology, Charité Berlin, Campus Virchow Clinic, Berlin, Germany
| | - B Czogalla
- Department of Obstetrics and Gynecology, University Hospital, Ludwig- Maximilians- University Munich, Munich, Germany
| | - M Klar
- Department of Gynecology and Obstetrics, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, Division of Epidemiology and Health Care Research, University Medical Center Mainz, Mainz, Germany
- Department of Gynecology and Obstetrics, University Medical Center Mainz, Mainz, Germany
| | - D Mayr
- Institut of Pathology, Ludwig-Maximilians- University Munich, Munich, Germany
| | - A Staebler
- Division of Gynecologic Pathology, Institute of Pathology and Neuropathology, University of Tuebingen, Tuebingen, Germany
| | - A du Bois
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte (KEM), Essen, Germany
| | - S Kommoss
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - T Link
- Department of Gynecology and Obstetrics, Technische Universität Dresden Dresden and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - A Burges
- Department of Obstetrics and Gynecology, University Hospital, Ludwig- Maximilians- University Munich, Munich, Germany
| | - F Heitz
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte (KEM), Essen, Germany
| | - M Grube
- Department of Women's Health, Tuebingen University Hospital, Tuebingen, Germany
| | - F Trillsch
- Department of Obstetrics and Gynecology, University Hospital, Ludwig- Maximilians- University Munich, Munich, Germany
| | - P Harter
- Department of Gynecology & Gynecologic Oncology, Ev. Kliniken Essen-Mitte (KEM), Essen, Germany
| | - P Wimberger
- Department of Gynecology and Obstetrics, Technische Universität Dresden Dresden and National Center for Tumor Diseases (NCT/UCC), Dresden, Germany
| | - P Buderath
- Department of Gynecology and Obstetrics, University Hospital Essen, Essen, Germany
| | - A Hasenburg
- Department of Gynecology and Obstetrics, University Medical Center Mainz, Mainz, Germany
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Chan JE, Rub J, Sussman C, Grbovic-huezo O, Tap WD, Antonescu C, Singer S, Betel D, Tammela T. Abstract B008: Investigating the evolution of undifferentiated soft tissue sarcomas in a genetically engineered mouse model. Clin Cancer Res 2022. [DOI: 10.1158/1557-3265.sarcomas22-b008] [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
Undifferentiated soft tissue sarcomas (USTS) are an aggressive class of sarcomas with few effective treatment options. Because of the rarity of these sarcomas and the paucity of representative disease models, little is known about how they develop. We used single cell transcriptomics to study the initiation and evolution of an USTS in an autochthonous genetically engineered mouse model. We profiled multiple stages of tumor development and identified intermediary cell states that define sarcomagenesis. Interestingly, we identify two discrete evolutionary pathways that arise in parallel in the mouse model. To determine the human relevance of our findings, we are developing machine learning approaches to compare cell states between the mouse model with single-cell transcriptomes that we generated from patient-derived xenografts. This cross-species comparison will uncover core USTS cell states and define their ancestral state transitions. Our ultimate goal is to identify essential molecular features of USTS, which may represent entry points for future therapeutic strategies.
Citation Format: Jason E. Chan, Jonathan Rub, Carleigh Sussman, Olivera Grbovic-huezo, William D. Tap, Cristina Antonescu, Sam Singer, Doron Betel, Tuomas Tammela. Investigating the evolution of undifferentiated soft tissue sarcomas in a genetically engineered mouse model [abstract]. In: Proceedings of the AACR Special Conference: Sarcomas; 2022 May 9-12; Montreal, QC, Canada. Philadelphia (PA): AACR; Clin Cancer Res 2022;28(18_Suppl):Abstract nr B008.
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Affiliation(s)
- Jason E. Chan
- 1Memorial Sloan Kettering Cancer Center, New York, NY,
| | | | | | | | | | | | - Sam Singer
- 1Memorial Sloan Kettering Cancer Center, New York, NY,
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Cavalieri S, Vener C, LeBlanc M, Lopez Perez L, Fico G, Resteghini C, Monzani D, Marton G, Moreira-Soares M, Filippidou D, Almeida A, Bilbao A, Mehanna H, Singer S, Thomas S, Lacerenza L, Manfuso A, Mercalli F, Martinelli E, Licitra L. 708TiP BD4QoL: A multicenter randomized trial for monitoring quality of life (QoL) by intelligent tools in head and neck cancer (HNC) survivors after curative treatment. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.832] [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: 11/01/2022] Open
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Yan J, Chen Y, Patel AJ, Warda S, Lee CJ, Nixon BG, Wong EW, Miranda-Román MA, Yang N, Wang Y, Pachai MR, Sher J, Giff E, Tang F, Khurana E, Singer S, Liu Y, Galbo PM, Maag JL, Koche RP, Zheng D, Antonescu CR, Deng L, Li MO, Chen Y, Chi P. Tumor-intrinsic PRC2 inactivation drives a context-dependent immune-desert microenvironment and is sensitized by immunogenic viruses. J Clin Invest 2022; 132:e153437. [PMID: 35852856 PMCID: PMC9433107 DOI: 10.1172/jci153437] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 07/14/2022] [Indexed: 02/01/2023] Open
Abstract
Immune checkpoint blockade (ICB) has demonstrated clinical success in "inflamed" tumors with substantial T cell infiltrates, but tumors with an immune-desert tumor microenvironment (TME) fail to benefit. The tumor cell-intrinsic molecular mechanisms of the immune-desert phenotype remain poorly understood. Here, we demonstrated that inactivation of the polycomb-repressive complex 2 (PRC2) core components embryonic ectoderm development (EED) or suppressor of zeste 12 homolog (SUZ12), a prevalent genetic event in malignant peripheral nerve sheath tumors (MPNSTs) and sporadically in other cancers, drove a context-dependent immune-desert TME. PRC2 inactivation reprogramed the chromatin landscape that led to a cell-autonomous shift from primed baseline signaling-dependent cellular responses (e.g., IFN-γ signaling) to PRC2-regulated developmental and cellular differentiation transcriptional programs. Further, PRC2 inactivation led to diminished tumor immune infiltrates through reduced chemokine production and impaired antigen presentation and T cell priming, resulting in primary resistance to ICB. Intratumoral delivery of inactivated modified vaccinia virus Ankara (MVA) enhanced tumor immune infiltrates and sensitized PRC2-loss tumors to ICB. Our results identify molecular mechanisms of PRC2 inactivation-mediated, context-dependent epigenetic reprogramming that underline the immune-desert phenotype in cancer. Our studies also point to intratumoral delivery of immunogenic viruses as an initial therapeutic strategy to modulate the immune-desert TME and capitalize on the clinical benefit of ICB.
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Affiliation(s)
- Juan Yan
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Yuedan Chen
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
| | - Amish J. Patel
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Sarah Warda
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Cindy J. Lee
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Briana G. Nixon
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
- Immunology Program, Sloan Kettering Institute
| | - Elissa W.P. Wong
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Miguel A. Miranda-Román
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
- Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, and
| | - Ning Yang
- Dermatology Service, Department of Medicine, MSK Cancer Center, New York, New York, USA
| | - Yi Wang
- Dermatology Service, Department of Medicine, MSK Cancer Center, New York, New York, USA
| | - Mohini R. Pachai
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Jessica Sher
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Emily Giff
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
| | - Fanying Tang
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
- Institute for Computational Biomedicine
- Meyer Cancer Center, and
| | - Ekta Khurana
- Institute for Computational Biomedicine
- Meyer Cancer Center, and
- Department of Physiology and Biophysics, Weill Cornell Medicine, New York, New York, USA
| | - Sam Singer
- Department of Surgery, MSK Cancer Center, New York, New York, USA
| | - Yang Liu
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Phillip M. Galbo
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Jesper L.V. Maag
- Center for Epigenetics Research, MSK Cancer Center, New York, New York, USA
| | - Richard P. Koche
- Center for Epigenetics Research, MSK Cancer Center, New York, New York, USA
| | - Deyou Zheng
- Department of Genetics, Albert Einstein College of Medicine, Bronx, New York, USA
- Department of Neurology, and
- Department of Neuroscience, Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Liang Deng
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
- Dermatology Service, Department of Medicine, MSK Cancer Center, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
| | - Ming O. Li
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
- Immunology Program, Sloan Kettering Institute
- Louis V. Gerstner Jr. Graduate School of Biomedical Sciences, and
| | - Yu Chen
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
- Department of Medicine, MSK Cancer Center, New York, New York, USA
| | - Ping Chi
- Human Oncology and Pathogenesis Program, Memorial Sloan Kettering (MSK) Cancer Center, New York, New York, USA
- Weill Cornell Graduate School of Medical Sciences, Cornell University, New York, New York, USA
- Weill Cornell Medical College, New York, New York, USA
- Department of Medicine, MSK Cancer Center, New York, New York, USA
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Roick J, Singer S. Soziale Ungleichheiten in der Partizipation nach Kehlkopfkrebs und
Assoziationen mit dem psychischen Befinden. Das Gesundheitswesen 2022. [DOI: 10.1055/s-0042-1753617] [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: 12/12/2022]
Affiliation(s)
- J Roick
- Martin-Luther-Universität Halle-Wittenberg, Institut
für Medizinische Soziologie, Halle (Saale), Deutschland
| | - S Singer
- Universitätsmedizin Mainz, Institut für Medizinische
Biometrie, Epidemiologie und Informatik, Mainz, Deutschland
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Aichmair A, Frank BJ, Simon S, Singer S, Skolek E, Dominkus M, Hofstaetter JG. Postoperative IL-6 levels cannot predict early onset periprosthetic hip/knee infections: an analysis of 7,661 patients at a single institution. Eur Cell Mater 2022; 43:293-298. [PMID: 35762463 DOI: 10.22203/ecm.v043a20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Prior studies have outlined C-reactive protein (CRP) within the first 5 d following total hip arthroplasty (THA) as an inappropriate indicator of an early periprosthetic joint infection (PJI). Recently, interleukin-6 (IL-6), as a potential inflammatory marker following total joint arthroplasty (TJA), has gained increasing interest, particularly due to its considerably shorter half-life. The aim of the present study was to assess IL-6 measured on postoperative day 3 following TJA as a prediction marker of early onset PJI. 7,661 patients, who underwent total hip or knee arthroplasty (THA, TKA) at a single institution between 2016 and 2019, were evaluated. Serum IL-6 values were measured on postoperative day 3 and compared between patients, with and without early onset PJI in the postoperative follow-up, matched for age, gender, Surgical Site Infection Risk Score and Charlson comorbidity index. Overall (n = 7,661), there was no statistically significant difference in serum IL-6 levels comparing patients with and without early onset PJI following THA [38.9 pg/ mL vs. 32.0 pg/mL, p = 0.116] and TKA [30.6 pg/mL vs. 28.2 pg/mL, p = 0.718]. Male gender and high body mass index were associated with an increased risk of early onset PJI following THA (p = 0.027, p = 0.002). Matched cohort analysis (n = 86) showed no statistically significant difference in serum IL-6 levels between patients with and without early onset PJI following THA (p = 0.680) and TKA (p = 0.910). Serum IL-6 values on postoperative day 3 following THA or TKA could not predict early onset PJIs.
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Affiliation(s)
- A Aichmair
- Department of Orthopaedic Surgery, Orthopaedic Hospital Vienna-Speising, Speisingerstrasse 109, AT-1130 Vienna,
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10
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Herbert LS, Wöckel A, Kreienberg R, Kühn T, Flock F, Felberbaum R, Janni W, Curtaz CJ, Kiesel M, Schlaiß T, Diessner J, Salmen J, Schwentner L, Fink V, Bekes I, Leinert E, Lato K, Polasik A, Schochter F, Singer S. Inwieweit fühlen sich die Brustkrebs-Überlebenden 5 Jahre nach der Diagnose gut über die Krankheit und die Behandlung informiert? Geburtshilfe Frauenheilkd 2022. [DOI: 10.1055/s-0042-1749034] [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: 10/18/2022] Open
Affiliation(s)
- L S Herbert
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - A Wöckel
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - R Kreienberg
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - T Kühn
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Esslingen
| | | | - R Felberbaum
- Klinik für Frauenheilkunde und Geburtshilfe, Klinikum Kempten, Klinikverbund Allgäu gGmbH, Kempten
| | - W Janni
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - CJ Curtaz
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - M Kiesel
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - T Schlaiß
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - J Diessner
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - J Salmen
- Frauenklinik und Poliklinik, Universitätsklinikum, Würzburg
| | - L Schwentner
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - V Fink
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - I Bekes
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - E Leinert
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - K Lato
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - A Polasik
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - F Schochter
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm
| | - S Singer
- Institut für Medizinische Biometrie, Epidemiologie und Informatik (UMBEI); Mainz
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11
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Abstract
Solar radiation contains about 6.8% ultraviolet (UV) radiation. UV radiation is still regarded as one of the most important risk factors for both nonmelanoma skin cancer (NMSC; predominantly basal cell carcinoma and squamous cell carcinoma) and malignant melanoma (MM). To avoid induction and persistence of UV-induced mutations, our skin is armed with an arsenal of endogenous protective mechanisms such as induction of cell cycle arrest, repair mechanisms, immunosurveillance and the initiation of various types of cell death. Exogenous sun protection includes a range of behaviors such as avoiding extensive sun exposure, wearing UV-proof clothing and appropriate application of topical sunscreens.
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Affiliation(s)
- B Kurz
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland.
| | - M Berneburg
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
| | - S Singer
- Klinik und Poliklinik für Dermatologie, Universität Regensburg, Franz-Josef-Strauß-Allee 11, 93053, Regensburg, Deutschland
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12
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Klemen N, Hwang S, Bradic M, Rosenbaum E, Dickson M, Gounder M, Kelly C, Keohan M, Movva S, Thornton K, Chi P, Nacev B, Chan J, Bartlett E, Richards A, Singer S, Donoghue M, Tap W, D'Angelo S. 1527MO Biomarkers of response and hyperprogression in patients with sarcoma treated with checkpoint blockade. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Cavnar MJ, Seier K, Gönen M, Curtin C, Balachandran VP, Tap WD, Antonescu CR, Singer S, DeMatteo RP. Prognostic Factors After Neoadjuvant Imatinib for Newly Diagnosed Primary Gastrointestinal Stromal Tumor. J Gastrointest Surg 2021; 25:1828-1836. [PMID: 33169327 PMCID: PMC8386278 DOI: 10.1007/s11605-020-04843-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Accepted: 10/17/2020] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Neoadjuvant imatinib (Neo-IM) therapy may facilitate R0 resection in primary gastrointestinal stromal tumors (GISTs) that are large or in difficult anatomic locations. While response to preoperative tyrosine kinase inhibitors is associated with better outcome in metastatic GIST, little is known about prognostic factors after Neo-IM in primary GIST. STUDY DESIGN Patients with primary GIST with or without synchronous metastases who underwent Neo-IM were retrospectively analyzed from a prospective maintained institutional database for Response Evaluation Criteria in Solid Tumors (RECIST), tumor viability, and mitotic rate. Overall survival (OS) was estimated by Kaplan-Meier and compared by log-rank test. Cox proportionate hazard models were used for univariate and multivariate analysis. RESULTS One hundred and fifty patients were treated for a median of 7.1 months (range 0.2-160). By RECIST, partial response, stable disease, and progressive disease were seen in 40%, 51%, and 9%, respectively. By pathologic analysis, ≤ 50% of the tumor was viable in 72%, and the mitotic rate was ≤ 5/50HPF in 74%. On multivariate analysis, RECIST response and tumor viability were not associated with OS, while post-treatment high mitotic rate (hazard ratio (HR) for death 5.3, CI 2.3-12.4), R2 margins (HR 6.0, CI 2.3-15.5), and adjuvant imatinib (HR 0.4, CI 0.2-0.9) were (p < 0.05). Five-year OS was 81 vs. 38% for low vs. high mitotic rate; 81, 59, and 39% for R0, R1, and R2 margins; and 75 vs 61% for adjuvant vs. no adjuvant imatinib therapy (p < 0.05). CONCLUSIONS In primary GIST undergoing Neo-IM therapy, progression was uncommon, but substantial down-sizing occurred in the minority. High tumor mitotic rate and incomplete resection following Neo-IM were associated with poor outcome, while adjuvant imatinib was associated with prolonged survival.
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Affiliation(s)
- Michael J. Cavnar
- Department of Surgery, Memorial Sloan Kettering Cancer
Center, New York, NY,Department of Surgery, University of Kentucky, Lexington,
KY
| | - Kenneth Seier
- Department of Biostatistics, Memorial Sloan Kettering
Cancer Center, New York, NY
| | - Mithat Gönen
- Department of Biostatistics, Memorial Sloan Kettering
Cancer Center, New York, NY
| | - Christina Curtin
- Department of Surgery, Memorial Sloan Kettering Cancer
Center, New York, NY
| | | | - William D. Tap
- Department of Medicine, Memorial Sloan Kettering Cancer
Center, New York, NY,Department of Medicine, Weill Cornell Medical College, New
York, NY
| | | | - Sam Singer
- Department of Surgery, Memorial Sloan Kettering Cancer
Center, New York, NY
| | - Ronald P. DeMatteo
- Department of Surgery, Memorial Sloan Kettering Cancer
Center, New York, NY
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14
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David KA, Sundaram S, Kim S, Vaca R, Lin Y, Singer S, Malecek M, Carter J, Zayac A, Kim MS, Reddy N, Ney D, Habib A, Strouse C, Graber J, Bachanova V, Salman S, Vendiola JA, Hossain N, Tsang M, Major A, Bond DB, Agrawal P, Mier‐Hicks A, Torka P, Rajakumar P, Venugopal P, Berg S, Glantz M, Goldlust S, Kumar P, Ollila T, Cai J, Spurgeon S, Sieg A, Cleveland J, Epperla N, Karmali R, Naik S, Martin P, Smith SM, Rubenstein J, Kahl B, Evens AM. OLDER PATIENTS WITH PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL): REAL WORLD (RW) OUTCOMES OF POST‐INDUCTION THERAPY IN THE MODERN ERA. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2880] [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: 11/10/2022]
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15
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Donato ML, Park S, Baker M, Korngold R, Morawski A, Geng X, Tan M, Ip A, Goldberg S, Rowley S, Chow K, Brown E, Zenreich J, McKiernan P, Buttner K, Ullrich A, Long L, Feinman R, Ricourt A, Kemp M, Vendivil M, Suh H, Balani B, Cicogna C, Sebti R, Al-Khan A, Sperber S, Desai S, Fanning S, Arad D, Go R, Tam E, Rose K, Sadikot S, Siegel D, Gutierrez M, Feldman T, Goy A, Pecora A, Biran N, Leslie L, Gillio A, Timmapuri S, Boonstra M, Singer S, Kaur S, Richards E, Perlin DS. Clinical and laboratory evaluation of patients with SARS-CoV-2 pneumonia treated with high-titer convalescent plasma. JCI Insight 2021; 6:143196. [PMID: 33571168 PMCID: PMC8026191 DOI: 10.1172/jci.insight.143196] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 02/10/2021] [Indexed: 01/08/2023] Open
Abstract
Here, we report on a phase IIa study to determine the intubation rate, survival, viral clearance, and development of endogenous Abs in patients with COVID-19 pneumonia treated with convalescent plasma (CCP) containing high levels of neutralizing anti-SARS-CoV-2 Abs. Radiographic and laboratory evaluation confirmed all 51 treated patients had COVID-19 pneumonia. Fresh or frozen CCP from donors with high titers of neutralizing Abs was administered. The nonmechanically ventilated patients (n = 36) had an intubation rate of 13.9% and a 30-day survival rate of 88.9%, and the overall survival rate for a comparative group based on network data was 72.5% (1625/2241). Patients had negative nasopharyngeal swab rates of 43.8% and 73.0% on days 10 and 30, respectively. Patients mechanically ventilated had a day-30 mortality rate of 46.7%; the mortality rate for a comparative group based on network data was 71.0% (369/520). All evaluable patients were found to have neutralizing Abs on day 3 (n = 47), and all but 1 patient had Abs on days 30 and 60. The only adverse event was a mild rash. In this study on patients with COVID-19 disease, we show therapeutic use of CCP was safe and conferred transfer of Abs, while preserving endogenous immune response.
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Affiliation(s)
- Michele L Donato
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Steven Park
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Melissa Baker
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Robert Korngold
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Alison Morawski
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Xue Geng
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, USA
| | - Ming Tan
- Department of Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC, USA
| | - Andrew Ip
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Stuart Goldberg
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Scott Rowley
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Kar Chow
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Emily Brown
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Joshua Zenreich
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Phyllis McKiernan
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Kathryn Buttner
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Anna Ullrich
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Laura Long
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Rena Feinman
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Andrea Ricourt
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Marlo Kemp
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Mariefel Vendivil
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Hyung Suh
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Bindu Balani
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Cristina Cicogna
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Rani Sebti
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Abdulla Al-Khan
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Steven Sperber
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Samit Desai
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Stacey Fanning
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
| | - Danit Arad
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Ronaldo Go
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Elizabeth Tam
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Keith Rose
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Sean Sadikot
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - David Siegel
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Martin Gutierrez
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Tatyana Feldman
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Andre Goy
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Andrew Pecora
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Noa Biran
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Lori Leslie
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Alfred Gillio
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Sarah Timmapuri
- Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Michele Boonstra
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Sam Singer
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Sukhdeep Kaur
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - Ernest Richards
- John Theurer Cancer Center, Hackensack University Medical Center, Hackensack, New Jersey, USA
| | - David S Perlin
- Hackensack Meridian Health Center for Discovery and Innovation, Nutley, New Jersey, USA
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16
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Kelly CM, Antonescu CR, Bowler T, Munhoz R, Chi P, Dickson MA, Gounder MM, Keohan ML, Movva S, Dholakia R, Ahmad H, Biniakewitz M, Condy M, Phelan H, Callahan M, Wong P, Singer S, Ariyan C, Bartlett EK, Crago A, Yoon S, Hwang S, Erinjeri JP, Qin LX, Tap WD, D'Angelo SP. Objective Response Rate Among Patients With Locally Advanced or Metastatic Sarcoma Treated With Talimogene Laherparepvec in Combination With Pembrolizumab: A Phase 2 Clinical Trial. JAMA Oncol 2020; 6:402-408. [PMID: 31971541 DOI: 10.1001/jamaoncol.2019.6152] [Citation(s) in RCA: 102] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Importance Patients with advanced sarcoma have limited treatment options. Talimogene laherparepvec (T-VEC) has been shown to increase tumor-specific immune activation via augmenting antigen presentation and T-cell priming. Objective To examine whether T-VEC in combination with pembrolizumab is associated with increased tumor-infiltrating lymphocyte infiltration and programmed death-ligand 1 expression and thus with increased antitumor activity in patients with locally advanced or metastatic sarcoma. Design, Setting, and Participants This open-label, single-institution phase 2 interventional trial of T-VEC plus pembrolizumab enrolled 20 patients with locally advanced or metastatic sarcoma between March 16 and December 4, 2017, for whom at least 1 standard systemic therapy had failed. The median duration of therapy was 16 weeks (range, 7-67 weeks). Reported analyses include data through December 14, 2018. Intervention Patients received pembrolizumab (200-mg flat dose) intravenously and T-VEC (first dose, ≤4 mL × 106 plaque-forming units [PFU]/mL; second and subsequent doses, ≤4 mL × 108 PFU/mL) injected into palpable tumor site(s) on day 1 of each 21-day cycle. Main Outcomes and Measures The primary end point was objective response rate (ORR; complete response and partial response) at 24 weeks determined by Response Evaluation Criteria In Solid Tumors (RECIST), version 1.1, criteria. Secondary end points included best ORR by immune-related RECIST criteria, progression-free survival rate at 24 weeks, overall survival, and safety. Results All 20 patients (12 women [60%]; median age, 63.5 years [range, 24-90 years]) were evaluable for response. The study met its primary end point of evaluating the best ORR at 24 weeks determined by RECIST, version 1.1, criteria; the best ORR was 30% (95% CI, 12%-54%; n = 6). The ORR overall was 35% (95% CI, 15%-59%; n = 7). The incidence of grade 3 treatment-related adverse events was low (4 patients [20%]). There were no grade 4 treatment-related adverse events or treatment-related deaths. Conclusions and Relevance In this phase 2 clinical trial, treatment with T-VEC plus pembrolizumab was associated with antitumor activity in advanced sarcoma across a range of sarcoma histologic subtypes, with a manageable safety profile. This combination therapy met its predefined primary study end point; further evaluation of T-VEC in combination with pembrolizumab for patients with select sarcoma subtypes is planned. Trial Registration ClinicalTrials.gov identifier: NCT03069378.
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Affiliation(s)
- Ciara M Kelly
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Department of Sarcoma Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Timothy Bowler
- Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Rodrigo Munhoz
- Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Ping Chi
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mark A Dickson
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Mrinal M Gounder
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Mary Louise Keohan
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Sujana Movva
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Reena Dholakia
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hamza Ahmad
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Matthew Biniakewitz
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Mercedes Condy
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Haley Phelan
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Margaret Callahan
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Phillip Wong
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York.,Immune Monitoring Facility, Ludwig Center for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sam Singer
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Charlotte Ariyan
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Edmund K Bartlett
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aimee Crago
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sam Yoon
- Weill Cornell Medical College, New York, New York.,Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Sinchun Hwang
- Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Joseph P Erinjeri
- Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Li-Xuan Qin
- Memorial Hospital, Memorial Sloan Kettering Cancer Center, New York, New York
| | - William D Tap
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York
| | - Sandra P D'Angelo
- Evelyn H. Lauder Breast Center, Memorial Sloan Kettering Cancer Center, New York, New York.,Weill Cornell Medical College, New York, New York.,Parker Institute for Cancer Immunotherapy, Memorial Sloan Kettering Cancer Center, New York, New York
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17
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Zhang M, Crago A, Yoon S, Singer S, Alektiar K. Feasibility of Preoperative Dose-Painting Intensity Modulated Radiation Therapy (IMRT) for Borderline Resectable/Unresectable Primary Retroperitoneal Sarcoma. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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18
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Herbert SL, Wöckel A, Kreienberg R, Kühn T, Flock F, Felberbaum R, Janni W, Curtaz C, Kiesel M, Stüber T, Diessner J, Salmen J, Schwentner L, Fink V, Bekes I, Leinert E, Lato K, Polasik A, Schochter F, Singer S. To which extent do breast cancer survivors feel well informed about disease and treatment 5 years after diagnosis? Breast Cancer Res Treat 2020; 185:677-684. [PMID: 33104958 PMCID: PMC7921033 DOI: 10.1007/s10549-020-05974-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 10/08/2020] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In this study, we investigated to which extent patients feel well informed about their disease and treatment, which areas they wish more or less information and which variables are associated with a need for information about the disease, medical tests and treatment. METHODS In a German multi-centre prospective study, we enrolled 759 female breast cancer patients at the time of cancer diagnosis (baseline). Data on information were captured at 5 years after diagnosis with the European Organisation for Research and Treatment of Cancer (EORTC) Information Module (EORTC QLQ-INFO24). Good information predictors were analysed using linear regression models. RESULTS There were 456 patients who participated at the 5-year follow-up. They reported to feel well informed about medical tests (mean score 78.5) and the disease itself (69.3) but relatively poorly about other services (44.3) and about different places of care (31.3). The survivors expressed a need for more information concerning: side effects and long-term consequences of therapy, more information in general, information about aftercare, prognosis, complementary medicine, disease and therapy. Patients with higher incomes were better informed about medical tests (β 0.26, p 0.04) and worse informed with increasing levels of fear of treatment (β - 0.11, p 0.02). Information about treatment was reported to be worse by survivors > 70 years old (β -0.34, p 0.03) and by immigrants (β -0.11, p 0.02). Survivors who had received additional written information felt better informed about disease, medical tests, treatment and other services (β 0.19/0.19/0.20/0.25; each p < 0.01). CONCLUSION Health care providers have to reconsider how and what kind of information they provide. Providing written information, in addition to oral information, may improve meeting those information needs.
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Affiliation(s)
- S L Herbert
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany.
| | - A Wöckel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - R Kreienberg
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - T Kühn
- Department of Gynaecology and Obstetrics, Hospital Esslingen, Esslingen, Germany
| | - F Flock
- Department of Gynaecology and Obstetrics, Hospital Memmingen, Memmingen, Germany
| | - R Felberbaum
- Department of Gynaecology and Obstetrics, Hospital Kempten, Kempten, Germany
| | - W Janni
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - C Curtaz
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - M Kiesel
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - T Stüber
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - J Diessner
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - J Salmen
- Department of Obstetrics and Gynaecology, University Medical Centre Würzburg, Würzburg, Germany
| | - L Schwentner
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - V Fink
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - I Bekes
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - E Leinert
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - K Lato
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - A Polasik
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - F Schochter
- Department of Gynaecology and Obstetrics, University of Ulm, Ulm, Germany
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Centre Mainz, Mainz, Germany
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Morningstar M, Mattson WI, Singer S, Venticinque JS, Nelson EE. Children and adolescents' neural response to emotional faces and voices: Age-related changes in common regions of activation. Soc Neurosci 2020; 15:613-629. [PMID: 33017278 DOI: 10.1080/17470919.2020.1832572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The perception of facial and vocal emotional expressions engages overlapping regions of the brain. However, at a behavioral level, the ability to recognize the intended emotion in both types of nonverbal cues follows a divergent developmental trajectory throughout childhood and adolescence. The current study a) identified regions of common neural activation to facial and vocal stimuli in 8- to 19-year-old typically-developing adolescents, and b) examined age-related changes in blood-oxygen-level dependent (BOLD) response within these areas. Both modalities elicited activation in an overlapping network of subcortical regions (insula, thalamus, dorsal striatum), visual-motor association areas, prefrontal regions (inferior frontal cortex, dorsomedial prefrontal cortex), and the right superior temporal gyrus. Within these regions, increased age was associated with greater frontal activation to voices, but not faces. Results suggest that processing facial and vocal stimuli elicits activation in common areas of the brain in adolescents, but that age-related changes in response within these regions may vary by modality.
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Affiliation(s)
- M Morningstar
- Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus, OH, USA.,Department of Pediatrics, The Ohio State University , Columbus, OH, USA.,Department of Psychology, Queen's University , Kingston, ON, Canada
| | - W I Mattson
- Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus, OH, USA
| | - S Singer
- Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus, OH, USA
| | - J S Venticinque
- Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus, OH, USA
| | - E E Nelson
- Center for Biobehavioral Health, Nationwide Children's Hospital , Columbus, OH, USA.,Department of Pediatrics, The Ohio State University , Columbus, OH, USA
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Hasenburg A, Plett H, Krämer B, Braicu E, Czogalla B, Bossart M, Singer S, Mayr D, Staebler A, du Bois A, Kommoss S, Link T, Burges A, Heitz F, Keul J, Trillsch F, Harter P, Wimberger P, Buderath P, Klar M. 876P The effect of surgical techniques on sexuality and global quality of life (Qol) in women with ovarian germ cell (OGCT) and sex cord stromal tumours (SCST): An analysis of the AGO-CORSETT database. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1015] [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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Hartman R, Xue Y, Singer S, Markossian T, Joyce C, Mostaghimi A. Modelling the value of risk‐stratified skin cancer screening of asymptomatic patients by dermatologists. Br J Dermatol 2020; 183:509-515. [DOI: 10.1111/bjd.18816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2019] [Indexed: 12/11/2022]
Affiliation(s)
- R.I. Hartman
- Department of Dermatology Brigham and Women's Hospital and Harvard Medical School Boston MA USA
| | - Y. Xue
- Harvard Combined Dermatology Residency Training Program Boston MA USA
| | - S. Singer
- Department of Dermatology Brigham and Women's Hospital and Harvard Medical School Boston MA USA
| | - T.W. Markossian
- Department of Public Health Sciences Loyola University Stritch School of Medicine Chicago IL USA
| | - C. Joyce
- Department of Public Health Sciences Loyola University Stritch School of Medicine Chicago IL USA
| | - A. Mostaghimi
- Department of Dermatology Brigham and Women's Hospital and Harvard Medical School Boston MA USA
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Singer S, Mostaghimi A. LB1075 State-level Medicaid coverage of dermatologic procedures for transgender patients in the United States. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.06.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rosenbaum E, Kelly C, D'Angelo SP, Dickson MA, Gounder M, Keohan ML, Movva S, Condy M, Adamson T, Mcfadyen CR, Antonescu CR, Hwang S, Singer S, Qin LX, Tap WD, Chi P. A Phase I Study of Binimetinib (MEK162) Combined with Pexidartinib (PLX3397) in Patients with Advanced Gastrointestinal Stromal Tumor. Oncologist 2019; 24:1309-e983. [PMID: 31213500 PMCID: PMC6795162 DOI: 10.1634/theoncologist.2019-0418] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 05/27/2019] [Indexed: 12/17/2022] Open
Abstract
Lessons Learned. The combination of pexidartinib and binimetinib was safe and tolerable and demonstrated encouraging signs of efficacy in two patients with advanced gastrointestinal stromal tumor (GIST) refractory to tyrosine kinase inhibitors (TKIs). Molecular profiling of GISTs at diagnosis and upon progression may provide insight into the mechanisms of response or resistance to targeted therapies. Additional trials are needed to further explore combined KIT and MEK inhibition in treatment‐naïve and TKI‐refractory patients with advanced GIST.
Background. Nearly all patients with advanced gastrointestinal stromal tumor (GIST) develop resistance to imatinib, and subsequent treatments have limited efficacy. Dual inhibition of KIT and MAPK pathways has synergistic antitumor activity in preclinical GIST models. Methods. This was an investigator‐initiated, phase I, dose escalation study of the MEK inhibitor binimetinib combined with pexidartinib, a potent inhibitor of CSF1R, KIT, and FLT3, in patients with advanced or metastatic GIST who progressed on imatinib. The primary endpoint was phase II dose determination; secondary endpoints included safety, tolerability, and efficacy. An expansion cohort to further evaluate safety and efficacy was planned. Results. Two patients were treated at dose level one (binimetinib 30 mg b.i.d. and pexidartinib 400 mg every morning and 200 mg every evening), after which the study was terminated by the manufacturer. No dose‐limiting toxicities (DLTs) were reported, and treatment was well tolerated. The only grade ≥3 treatment‐emergent adverse event (TEAE) was asymptomatic elevated creatine phosphokinase (CPK). Both patients had a best response of stable disease (SD) by RECIST. Progression‐free survival (PFS) and overall survival (OS) were 6.1 and 14.6 months, respectively, in one patient with five prior lines of therapy. The second patient with NF1‐mutant GIST had a 27% decrease in tumor burden by RECIST and remains on study after 19 months of treatment. Conclusion. Pexidartinib combined with binimetinib was tolerable, and meaningful clinical activity was observed in two imatinib‐refractory patients.
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Affiliation(s)
- Evan Rosenbaum
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | - Ciara Kelly
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Sandra P D'Angelo
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Mark A Dickson
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Mrinal Gounder
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Mary L Keohan
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Sujana Movva
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | - Mercedes Condy
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | - Travis Adamson
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | | | | | - Sinchun Hwang
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | - Sam Singer
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Li-Xuan Qin
- Memorial Sloan Kettering Cancer Center, New York New York, USA
| | - William D Tap
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
| | - Ping Chi
- Memorial Sloan Kettering Cancer Center, New York New York, USA
- Weill Cornell Medical College, New York New York, USA
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Yang J, Folkert M, Crago A, Singer S, Alektiar K. Impact of Tumor Histology on Local Control in Patients with Primary Soft Tissue Sarcoma of the Extremity. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Oosting S, Desideri I, Staelens D, Caballero C, Tribius S, Simon C, Singer S, Gregoire V, Fortpied C, Luciani A. Treatment patterns in elderly patients with locally advanced head and neck squamous cell carcinoma (LA-HNSCC): Results from an EORTC led survey. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy287.062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Renovanz M, Voß H, Scholz-Kreisel P, Ringel F, Singer S, Coburger J. P01.039 Development of signaling questions assessing distress and quality of life in glioma patients - Results of 50 interviews and an expert analysis. Neuro Oncol 2018. [DOI: 10.1093/neuonc/noy139.081] [Citation(s) in RCA: 1] [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: 11/12/2022] Open
Affiliation(s)
- M Renovanz
- University Medical Centre Mainz, Department of Neurosurgery, Mainz, Germany
| | - H Voß
- University Medical Centre Mainz, Department of Neurosurgery, Mainz, Germany
| | - P Scholz-Kreisel
- University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany
| | - F Ringel
- University Medical Centre Mainz, Department of Neurosurgery, Mainz, Germany
| | - S Singer
- University Medical Centre Mainz, Institute of Medical Biostatistics, Epidemiology and Informatics, Mainz, Germany
| | - J Coburger
- University Medical Centre Ulm, Department of Neurosurgery, Ulm, Germany
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Curchoe C, Geka A, Kokjohn S, Julaton V, Collins J, Leimkuhler H, Berkshire S, Gates L, Anderson L, Francisco S, Farinelli M, Quintero P, Fredricks M, Rosi R, Singer S, Venier B, Park S, Friedman B, Danseshmand S, Chuan S, Kettel M. Extended embryo culture and ploidy of morphologically normal embryos assessed by next gen sequencing PGS: a single center retrospective study. Fertil Steril 2018. [DOI: 10.1016/j.fertnstert.2018.07.110] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Guenzel T, Walliczek-Dworschak U, Teymoortash A, Singer S, Eichler M, Wilhelm T, Schimmer M, Franzen A. Health-related quality of life in oropharyngeal cancer survivors - a population-based study. Otolaryngol Pol 2018; 72:30-35. [PMID: 29748448 DOI: 10.5604/01.3001.0011.7249] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE The aim of this study was to compare QoL of oropharyngeal cancer survivors who had received different treatments. SUBJECTS AND METHODS We contacted 954 survivors. Each survivor received the QoL questionnaires EORTC QLQ-C30 and EORTC QLQ-H&N35. RESULTS A total of 263 survivors completed the questionnaires (28% responses). Forty-five of them had undergone surgery, 20 had received definitive radiotherapy or chemo-radiotherapy, 85 surgery plus adjuvant radiotherapy, and 111 surgery plus adjuvant chemo-radiotherapy. Survivors who had received adjuvant radiotherapy and surgery reported significantly more problems with swallowing (B=13.43 [95% Confidence Interval (CI) 1.83-25.03]), senses (B=24,91 [CI 11.86-37.97]), eating (B=16.91 [CI 3.46-30.36]), dry mouth (B=26.42 [CI 12.17-40.67]), sticky saliva (B=22.37 [CI 6.23-38.50]) and nutritional supplements (B=18.59 [CI 0.62-36.56]) than those who had received surgery only. Survivors who had received adjuvant chemo-radiotherapy and surgery reported significantly many more problems with dry mouth (B=34.15 [CI 18.91-49.39]) and sticky saliva (B=22.90 [CI 5.65-40.16]), and fewer problems with physical functioning (B=-12.07 [CI 0.49-23-64]). CONCLUSION Survivors who participated in this survey and who had undergone surgery alone reported in some head- and neck-specific domains a better health-related quality of life than patients who had undergone multi-modal treatment or adjuvant radiotherapy.
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Affiliation(s)
- Thomas Guenzel
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | | | - A Teymoortash
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | - S Singer
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | - M Eichler
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | - T Wilhelm
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | - M Schimmer
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
| | - A Franzen
- Department of Otorhinolaryngology, Head and Neck Surgery, Leer, Germany
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Mandel J, Ziv E, Yarmohammadi H, Boas F, Keohan M, D’Angelo S, Gounder M, Singer S, Crago A, Erinjeri J. 3:54 PM Abstract No. 258 Percutaneous cryoablation of extra-abdominal desmoid tumors as first-line and salvage therapy. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.287] [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: 11/30/2022] Open
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30
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Koff A, Klein M, Dickson M, Antonescu C, Qin LX, Dooley S, Schwartz G, Crago A, Singer S, Tap W. Senescence after growth arrest: A mechanism by which CDK4/6 inhibitors can mediate their activity suppressing tumor progression. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy046.011] [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: 11/14/2022] Open
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Van Brunt E, Davis LS, Terdiman JF, Singer S, Besag E, Collen MF. Current Status of a Medical Information System. Methods Inf Med 2018. [DOI: 10.1055/s-0038-1636005] [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: 10/17/2022]
Abstract
A pilot medical information system is being implemented and currently is providing services for limited categories of patient data. In one year, physicians’ diagnoses for 500,000 office visits, 300,000 drug prescriptions for outpatients, one million clinical laboratory tests, and 60,000 multiphasic screening examinations are being stored in and retrieved from integrated, direct access, patient computer medical records.This medical information system is a part of a long-term research and development program. Its major objective is the development of a multifacility computer-based system which will support eventually the medical data requirements of a population of one million persons and one thousand physicians. The strategy employed provides for modular development. The central system, the computer-stored medical records which are therein maintained, and a satellite pilot medical data system in one medical facility are described.
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Abstract
ZusammenfassungEine psychoonkologische Betreuung hat sich zu einem integrierten Bestandteil der Versorgung von Tumorpatienten entwickelt. Sie umfasst das gesamte Spektrum von psychosozialer Beratung bis hin zu einer spezifischen Psychotherapie. Um den individuellen Bedarf für die psychoonkologischen Interventionen festzustellen, liegen validierte Instrumente der Diagnostik vor. Insbesondere haben sich Screening-Instrumente für den klinischen Alltag bewährt. Die psychoonkologische Behandlung ist dem supportiven Psychotherapiekonzept zuzuordnen und baut auf einer engen interdisziplinären Zusammenarbeit auf. In Deutschland hat sich die psychoonkologische Versorgung innerhalb der letzten beiden Jahrzehnte deutlich verbessert, wobei sie in den drei Sektoren Akutversorgung, Rehabilitation und ambulante Nachsorge unterschiedlich ausgebaut ist. Insbesondere in den letzten Jahren konnten Standards sowie Maßnahmen zur Qualitätssicherung entwickelt werden, die in Form einer evidenzbasierten Leitlinie weiter ausgearbeitet wird.
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Crago AM, Socci ND, Qin LX, Wilder F, O'Connor R, Craig A, Houdt WV, Weinhold N, Kandoth C, Viale A, Antonescu C, Singer S. Abstract PR16: Multiplatform analysis of paired primary and recurrent well- and dedifferentiated liposarcoma samples defines copy number alterations as dominant drivers of initiation and progression. Clin Cancer Res 2018. [DOI: 10.1158/1557-3265.sarcomas17-pr16] [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
Objective: Initiation of well-differentiated (WD) and dedifferentiated (DD) liposarcoma is driven by 12q13-15 amplification and consequent MDM2 and CDK4 overexpression, but mechanisms that regulate the variable biologic behavior of WD/DD tumors remain poorly understood. We used a multiplatform analysis of paired WD and DD samples to identify genomic events with potential to contribute to liposarcomagenesis.
Methods: From serial tumor resections performed on the same patient, we collected paired WD/DD (n=7) or WD/WD (n=2) test samples and normal tissue. Samples were analyzed using whole-exome sequencing, array comparative genomic hybridization (aCGH), Solexa small RNA sequencing, and, in a subset, RNA-seq. Findings were validated in WD/DD cohorts analyzed by custom capture array (n=201), aCGH (n=210), Affymetrix U133A microarrays (n=146), and Solexa (n=118). Lentivirus was used to deliver shRNA to WD cells in vitro; proliferation was assayed by CyQuant, differentiation by immunoblot/oil red O staining, and gene expression by Illumina microarrays.
Results: 12q13-15 amplification was observed in all WD/DD test and validation samples. Among WD samples, 1q21-24 and 6q23-25 amplifications were found in test samples and in 28% and 18% of the validation set, respectively. Of genes upregulated in WD vs. normal fat test samples, 465 were validated in the larger cohort [≥2-fold change (FC), FDR<0.05]. 53% of these genes lie within regions of copy number alteration (CNA); 8% were predicted targets of 12q-encoded miRNAs. shRNA targeting of MDM2 or drug inhibition of CDK4 in vitro negatively regulated 11% of the genes, including AURKA and its regulators TPX2 and KIF11. 6q23-25 amplification was associated with local recurrence (LR) after primary WD resection (HR 10.9, p<0.001) and with overexpression of CCDC28A and TAB2, an AP-1 regulator (1.7- and 1.9-FC, FDRs<0.05). In 6q23-25-amplified WD cells, shRNA-mediated TAB2 inhibition reduced proliferation by >90%. Comparison of matched WD/DD samples showed retained amplification of 12q13-15 and 6q23-25 after progression. In contrast to WD, DD showed strong association of the 6q23-25 CNA with increased expression of 6q genes TCF21 and HBS1L (16- and 4-FC, FDRs<0.001), but not TAB2 or CCDC28A, suggesting that additional progression events alter the oncogenic effects of initiation-associated CNAs in DD vs WD. Direct comparison of paired DD/WD test samples revealed recurrent 13q loss arising during dedifferentiation (n=3). 13q loss was found in 28% of the DD validation set and associated with reduced expression of 13q genes MYCBP2 and IRS2, regulators of insulin signaling. shRNA inhibition of MYCBP2 or IRS2 in vitro had little effect on WD differentiation, but inhibition of both genes decreased levels of PPARG, FABP4, PLIN and oil red O staining (70% reduction). Uncommon mutations in genes regulating steroid-hormone activation (e.g., NCOA6, KMT2C), adaptive immunity (e.g., LILRA1, NFKB1), and RTK signaling (e.g., NRG1, FGFR1) were identified in 11%, 6%, and 11% of WD/DD samples, respectively, but did not associate with differentiation.
Conclusions: Genes upregulated during WD initiation are commonly located in regions of CNA or regulated by 12q23-25 oncogenes MDM2 and CDK4 (e.g., AURKA, a potential therapeutic target). 6q23-26 amplification, observed in subsets of both WD and DD, associates with LR of WD, but expression of 6q23-26 genes with potential to modulate oncogenesis (e.g., TAB2 vs TCF21) differs in WD and DD tumors, suggesting that the CNA may differentially modulate early and late disease. Losses affecting broad chromosome regions such as 13q likely mediate progression by affecting multiple regulators of adipogenesis pathways (e.g., insulin signaling), while mutations have little effect on dedifferentiation.
Citation Format: Aimee M. Crago, Nicholas D. Socci, Li-Xuan Qin, Fatima Wilder, Rachael O'Connor, Amanda Craig, Willem van Houdt, Nils Weinhold, Cyriac Kandoth, Agnes Viale, Cristina Antonescu, Sam Singer. Multiplatform analysis of paired primary and recurrent well- and dedifferentiated liposarcoma samples defines copy number alterations as dominant drivers of initiation and progression [abstract]. In: Proceedings of the AACR Conference on Advances in Sarcomas: From Basic Science to Clinical Translation; May 16-19, 2017; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(2_Suppl):Abstract nr PR16.
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Affiliation(s)
| | | | - Li-Xuan Qin
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Fatima Wilder
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Amanda Craig
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Nils Weinhold
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Agnes Viale
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Sam Singer
- Memorial Sloan Kettering Cancer Center, New York, NY
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Cavnar MJ, Wang L, Balachandran VP, Antonescu CR, Tap WD, Keohan M, Singer S, Temple L, Nash GM, Weiser MR, Guillem JG, Aguilar JG, DeMatteo RP, Paty PB. Rectal Gastrointestinal Stromal Tumor (GIST) in the Era of Imatinib: Organ Preservation and Improved Oncologic Outcome. Ann Surg Oncol 2017; 24:3972-3980. [PMID: 29058144 DOI: 10.1245/s10434-017-6087-9] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Approximately 5% of gastrointestinal stromal tumors (GISTs) originate in the rectum, and historically, radical resection was commonly performed. Little is known about the outcome for rectal GIST in the era of imatinib. METHODS Using a prospectively maintained database, this study retrospectively analyzed 47 localized primary rectal GISTs treated at our center from 1982 to 2016, stratified by when imatinib became available in 2000. Overall survival (OS), disease-specific survival (DSS), and recurrence-free survival (RFS) were analyzed by the Kaplan-Meier method. RESULTS Rectal GISTs represented 7.1% of 663 primary GISTs. The findings showed 17 patients in the pre-imatinib era and 30 patients in the imatinib era. The two groups had similar follow-up evaluation, age, gender, Miettinen risk, and distance to the anal verge. In the imatinib era, tumors were smaller at diagnosis (median 4 vs. 5 cm; p = 0.029), and 24 of the 30 patients received perioperative imatinib. In the high-risk patients, organ preservation and negative margins were more common among the 13 patients treated with neoadjuvant imatinib than among the 21 patients treated directly with surgery. High-risk patients who received perioperative imatinib (n = 15) had greater (or nearly significantly greater) 5-year OS, DSS, local RFS, and distant RFS than those who did not (n = 19) (91, 100, 100, and 71% vs. 47, 65, 74, and 41%; p = 0.049, 0.052, 0.077, 0.051, respectively). In the imatinib era, no patient has had a local recurrence or death due to GIST. CONCLUSIONS The use of imatinib is associated with organ preservation and improved oncologic outcome for patients with rectal GIST.
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Affiliation(s)
- Michael J Cavnar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Surgery, University of Kentucky, Lexington, KY, USA
| | - Lin Wang
- Department of Gastrointestinal Surgery, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Beijing, China
| | - Vinod P Balachandran
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Cristina R Antonescu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - William D Tap
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mary Keohan
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Sam Singer
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Larissa Temple
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Garrett M Nash
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Martin R Weiser
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jose G Guillem
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Julio Garcia Aguilar
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronald P DeMatteo
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Philip B Paty
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Nayak L, Iwamoto F, Ferreri A, Santoro A, Singer S, Batlevi C, Batchelor T, Rubenstein J, Johnston P, Ramchandren R, Soussain C, Drappatz J, Becker K, Witzens-Harig M, Illerhaus G, Herrera A, Masood A, Shipp M. CHECKMATE 647: A PHASE 2, OPEN-LABEL STUDY OF NIVOLUMAB IN RELAPSED/REFRACTORY PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA OR RELAPSED/REFRACTORY PRIMARY TESTICULAR LYMPHOMA. Hematol Oncol 2017. [DOI: 10.1002/hon.2440_2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- L. Nayak
- Center for Neuro-oncology; Dana-Farber Cancer Institute; Boston USA
| | - F.M. Iwamoto
- Division of Neuro-Oncology; Columbia University Medical Center; New York USA
| | - A.J. Ferreri
- Unit of Lymphoid Malignancies, Department of Onco-Hematology; IRCCS San Raffaele Scientific Institute; Milan Italy
| | - A. Santoro
- Department of Medical Oncology and Hematology, Humanitas Cancer Center; Humanitas University; Milan Italy
| | - S. Singer
- Neurological Oncology Division; Hackensack University Medical Center; Hackensack USA
| | - C. Batlevi
- Division of Hematologic Oncology; Memorial Sloan Kettering Cancer Center; New York USA
| | - T. Batchelor
- Department of Neurology; Massachusetts General Hospital; Boston USA
| | - J. Rubenstein
- Hematology and Blood and Marrow Transplant; University of California San Francisco Medical Center; San Francisco USA
| | - P. Johnston
- Hematology and Blood and Marrow Transplant; Mayo Clinic; Rochester USA
| | - R. Ramchandren
- Department of Hematology/Oncology; Barbara Ann Karmanos Cancer Institute; Detroit USA
| | - C. Soussain
- Department of Hematology; Institut Curie, Hôpital René-Huguenin; Saint-Cloud France
| | - J. Drappatz
- Division of Hematology/Oncology, Hillman Cancer Center; University of Pittsburgh Medical Center; Pittsburgh USA
| | - K. Becker
- Cancer Immunology; Yale Cancer Center; New Haven USA
| | - M. Witzens-Harig
- Department of Internal Medicine; University Hospital Heidelberg; Heidelberg Germany
| | - G. Illerhaus
- Department of Haematology/Oncology and Palliative Care; Klinikum Stuttgart; Stuttgart Germany
| | - A. Herrera
- Department of Hematology/Hematopoietic Cell Transplantation; City of Hope, Duarte USA
| | - A. Masood
- Global Clinical Research; Bristol-Myers Squibb; Lawrenceville USA
| | - M. Shipp
- Center for Hematologic Oncology; Dana-Farber Cancer Institute; Boston USA
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Khuu LA, Tayyari F, Sivak JM, Flanagan JG, Singer S, Brent MH, Huang D, Tan O, Hudson C. Aqueous humor endothelin-1 and total retinal blood flow in patients with non-proliferative diabetic retinopathy. Eye (Lond) 2017; 31:1443-1450. [PMID: 28548649 DOI: 10.1038/eye.2017.74] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 03/14/2017] [Indexed: 12/16/2022] Open
Abstract
PurposeThe purpose of this study was to determine the association between aqueous ET-1 levels and total retinal blood flow (TRBF) in patients with non-insulin-dependent type 2 diabetes mellitus (T2DM) and early non-proliferative diabetic retinopathy (NPDR).Patients and methodsA total of 15 age-matched controls and 15 T2DM patients with NPDR were recruited into the study. Aqueous humor (~80-120 μl) was collected before cataract surgery to measure the levels of ET-1 using suspension multiplex array technology. Four weeks post surgery, six images were acquired to assess TRBF using the prototype RTVue Doppler FD-OCT (Optovue, Inc., Fremont, CA, USA) with a double circular scan protocol. At the same visit, forearm blood was collected to determine plasma glycosylated hemoglobin (A1c) levels.ResultsAqueous ET-1 was significantly elevated in the NPDR group compared with the control group (3.5±1.8 vs 2.2±0.8, P=0.02). TRBF was found to be significantly reduced in the NPDR group compared with the control group (34.5±9.1 vs 44.1±4.6 μl/min, P=0.002). TRBF and aqueous ET-1 were not correlated within the NPDR group (r=-0.24, P=0.22). In a multivariate analysis, high A1c was associated with reduced TRBF and aqueous ET-1 levels across control and NPDR groups (P<0.01).ConclusionAqueous ET-1 levels were increased while TRBF was reduced in patients with NPDR compared with the control group. Although not directly associated, the vasoconstrictory effects of ET-1 are consistent with a reduced TRBF observed in early DR. ET-1 dysregulation may contribute to a reduction in retinal blood flow during early DR.
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Affiliation(s)
- L-A Khuu
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Vision Science and Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - F Tayyari
- School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - J M Sivak
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - J G Flanagan
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Vision Science and Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada.,School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
| | - S Singer
- Vision Science and Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - M H Brent
- Vision Science and Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada
| | - D Huang
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - O Tan
- Casey Eye Institute, Oregon Health and Science University, Portland, OR, USA
| | - C Hudson
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada.,Vision Science and Ophthalmology, Toronto Western Hospital, Toronto, ON, Canada.,School of Optometry and Vision Science, University of Waterloo, Waterloo, ON, Canada
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Giesel FL, Hadaschik B, Cardinale J, Radtke J, Vinsensia M, Lehnert W, Kesch C, Tolstov Y, Singer S, Grabe N, Duensing S, Schäfer M, Neels OC, Mier W, Haberkorn U, Kopka K, Kratochwil C. F-18 labelled PSMA-1007: biodistribution, radiation dosimetry and histopathological validation of tumor lesions in prostate cancer patients. Eur J Nucl Med Mol Imaging 2017; 44:678-688. [PMID: 27889802 PMCID: PMC5323462 DOI: 10.1007/s00259-016-3573-4] [Citation(s) in RCA: 366] [Impact Index Per Article: 52.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 11/09/2016] [Indexed: 11/24/2022]
Abstract
PURPOSE The prostate-specific membrane antigen (PSMA) targeted positron-emitting-tomography (PET) tracer 68Ga-PSMA-11 shows great promise in the detection of prostate cancer. However, 68Ga has several shortcomings as a radiolabel including short half-life and non-ideal energies, and this has motivated consideration of 18F-labelled analogs. 18F-PSMA-1007 was selected among several 18F-PSMA-ligand candidate compounds because it demonstrated high labelling yields, outstanding tumor uptake and fast, non-urinary background clearance. Here, we describe the properties of 18F-PSMA-1007 in human volunteers and patients. METHODS Radiation dosimetry of 18F-PSMA-1007 was determined in three healthy volunteers who underwent whole-body PET-scans and concomitant blood and urine sampling. Following this, ten patients with high-risk prostate cancer underwent 18F-PSMA-1007 PET/CT (1 h and 3 h p.i.) and normal organ biodistribution and tumor uptakes were examined. Eight patients underwent prostatectomy with extended pelvic lymphadenectomy. Uptake in intra-prostatic lesions and lymph node metastases were correlated with final histopathology, including PSMA immunostaining. RESULTS With an effective dose of approximately 4.4-5.5 mSv per 200-250 MBq examination, 18F-PSMA-1007 behaves similar to other PSMA-PET agents as well as to other 18F-labelled PET-tracers. In comparison to other PSMA-targeting PET-tracers, 18F-PSMA-1007 has reduced urinary clearance enabling excellent assessment of the prostate. Similar to 18F-DCFPyL and with slightly slower clearance kinetics than PSMA-11, favorable tumor-to-background ratios are observed 2-3 h after injection. In eight patients, diagnostic findings were successfully validated by histopathology. 18F-PSMA-1007 PET/CT detected 18 of 19 lymph node metastases in the pelvis, including nodes as small as 1 mm in diameter. CONCLUSION 18F-PSMA-1007 performs at least comparably to 68Ga-PSMA-11, but its longer half-life combined with its superior energy characteristics and non-urinary excretion overcomes some practical limitations of 68Ga-labelled PSMA-targeted tracers.
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Affiliation(s)
- Frederik L Giesel
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany.
| | - B Hadaschik
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - J Cardinale
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - J Radtke
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - M Vinsensia
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | | | - C Kesch
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
| | - Y Tolstov
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - S Singer
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - N Grabe
- Institute of Pathology, University Hospital Heidelberg, Heidelberg, Germany
- Department of Medical Oncology, National Center for Tumor Diseases (NCT), University Hospital Heidelberg, Heidelberg, Germany
- Hamamatsu Tissue Imaging and Analysis Center, University of Heidelberg, Heidelberg, Germany
| | - S Duensing
- Department of Urology, University Hospital Heidelberg, Heidelberg, Germany
- Section of Molecular Urooncology, Department of Urology, Medical Faculty Heidelberg, University Hospital Heidelberg, Heidelberg, Germany
| | - M Schäfer
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - O C Neels
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - W Mier
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - U Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
| | - K Kopka
- Division of Radiopharmaceutical Chemistry, German Cancer Research Center (dkfz), Heidelberg, Germany
| | - C Kratochwil
- Department of Nuclear Medicine, University Hospital Heidelberg, INF 400, 69120, Heidelberg, Germany
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Hechtner M, Eichler M, Wehler B, Buhl R, Stratmann J, Sebastian M, Schmidberger H, Gohrbandt B, Peuser J, Kortsik C, Nestle U, Wiesemann S, Wirtz H, Wehler T, Bals R, Blettner M, Singer S. Lebensqualität und psychosoziale Rehabilitation bei Lungenkrebsüberlebenden (LARIS) – eine multizentrische Studie. Pneumologie 2017. [DOI: 10.1055/s-0037-1598466] [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: 10/20/2022]
Affiliation(s)
- M Hechtner
- Institut für Medizinische Biometrie Epidemiologie und Informatik, Universitätsmedizin Mainz, Deutsches Konsortium für Translationale Krebsforschung (Dktk), Partnerstandort Mainz, Deutsches Krebsforschungszentrum Heidelberg
| | - M Eichler
- Institut für Medizinische Biometrie Epidemiologie und Informatik, Universitätsmedizin Mainz, Deutsches Konsortium für Translationale Krebsforschung (Dktk), Partnerstandort Mainz, Deutsches Krebsforschungszentrum Heidelberg
| | - B Wehler
- Klinik für Strahlentherapie und Radioonkologie & Innere Medizin V, Universitätsklinikum des Saarlandes; III. Medizinische Klinik und Poliklinik, Universitätsmedizin Mainz
| | - R Buhl
- Schwerpunkt Pneumologie, III. Medizinische Klinik, Universitätsmedizin Mainz
| | - J Stratmann
- Med. Klinik II, Universitätsklinikum Frankfurt
| | - M Sebastian
- Med. Klinik II, Universitätsklinikum Frankfurt
| | - H Schmidberger
- Klinik und Poliklinik für Radioonkologie und Strahlentherapie, Universitätsmedizin Mainz
| | - B Gohrbandt
- Klinik und Poliklinik für Herz-, Thorax- und Gefäßchirurgie, Universitätsmedizin Mainz
| | - J Peuser
- Klinik für Pneumologie, Beatmungs- und Schlafmedizin, Katholisches Klinikum Mainz
| | - C Kortsik
- Klinik für Pneumologie, Beatmungs- und Schlafmedizin, Katholisches Klinikum Mainz
| | - U Nestle
- Klinik für Strahlenheilkunde, Universiätsklinikum Freiburg
| | - S Wiesemann
- Klinik für Thoraxchirurgie, Universiätsklinikum Freiburg
| | - H Wirtz
- Abteilung für Pneumologie, Universitätsklinikum Leipzig AöR
| | - T Wehler
- Innere Medizin V, Universitätsklinikum des Saarlandes
| | - R Bals
- Innere Medizin V, Universitätsklinikum des Saarlandes
| | - M Blettner
- Institut für Medizinische Biometrie Epidemiologie und Informatik, Universitätsmedizin Mainz
| | - S Singer
- Institut für Medizinische Biometrie Epidemiologie und Informatik, Universitätsmedizin Mainz; Klinik und Poliklinik für Psychosomatische Medizin und Psychotherapie, Universitätsklinikum Leipzig
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Roick J, Danker H, Kersting A, Briest S, Dietrich A, Dietz A, Einenkel J, Papsdorf K, Lordick F, Meixensberger J, Mössner J, Niederwieser D, Prietzel T, Schiefke F, Stolzenburg JU, Wirtz H, Singer S. Factors associated with non-participation and dropout among cancer patients in a cluster-randomised controlled trial. Eur J Cancer Care (Engl) 2017; 27. [PMID: 28134477 DOI: 10.1111/ecc.12645] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/05/2016] [Indexed: 12/01/2022]
Abstract
We investigated the impact of demographic and disease related factors on non-participation and dropout in a cluster-randomised behavioural trial in cancer patients with measurements taken between hospitalisation and 6 months thereafter. The percentages of non-participation and dropout were documented at each time point. Factors considered to be potentially related with non-participation and dropout were as follows: age, sex, marital status, education, income, employment status, tumour site and stage of disease. Of 1,338 eligible patients, 24% declined participation at baseline. Non-participation was higher in older patients (Odds Ratio [OR] 2.1, CI: 0.6-0.9) and those with advanced disease (OR 2.0, CI: 0.1-1.3). Dropout by 6 months was 25%. Dropout was more frequent with increased age (OR 2.8, CI: 0.8-1.2), advanced disease (OR 3.0, CI: 1.0-1.2), being married (OR 2.4, CI 0.7-1.1) and less frequent with university education (OR 0.4, CI -1.3 to -0.8) and middle income (OR 0.4, CI -0.9 to -0.7). When planning clinical trials, it is important to be aware of patient groups at high risk of non-participation or dropout, for example older patients or those with advanced disease. Trial designs should consider their special needs to increase their rate of participation.
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Affiliation(s)
- J Roick
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - H Danker
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - A Kersting
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Leipzig, Leipzig, Germany
| | - S Briest
- Department of Obstetrics and Gynecology, University Medical Center Leipzig, Leipzig, Germany
| | - A Dietrich
- Department of Visceral-, Transplantation-, Thoracic-, and Vascular Surgery, University Medical Center Leipzig, Leipzig, Germany
| | - A Dietz
- Department of Otolaryngology, University Medical Center Leipzig, Leipzig, Germany
| | - J Einenkel
- Department of Obstetrics and Gynecology, University Medical Center Leipzig, Leipzig, Germany
| | - K Papsdorf
- Department of Radiation-Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - F Lordick
- University Cancer Center, University Medical Center Leipzig, Leipzig, Germany
| | - J Meixensberger
- Department of Neurosurgery, University Medical Center Leipzig, Leipzig, Germany
| | - J Mössner
- Department of Gastroenterology, University Medical Center Leipzig, Leipzig, Germany
| | - D Niederwieser
- Department of Hematology and Oncology, University Medical Center Leipzig, Leipzig, Germany
| | - T Prietzel
- Department of Orthopedics and Accident Surgery, Helios Clinic Blankenhain, Blankenhain, Germany
| | - F Schiefke
- Department of Maxillofacial Surgery, University Medical Center Leipzig, Leipzig, Germany
| | - J-U Stolzenburg
- Department of Urology, University Medical Center Leipzig, Leipzig, Germany
| | - H Wirtz
- Department of Pneumology, University Medical Center Leipzig, Leipzig, Germany
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology and Informatics (IMBEI), University Medical Centre of Johannes Gutenberg University Mainz, Mainz, Germany
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Hermanns C, Hampl V, Holzer K, Aigner A, Penkava J, Frank N, Martin DE, Maier KC, Waldburger N, Roessler S, Goppelt-Struebe M, Akrap I, Thavamani A, Singer S, Nordheim A, Gudermann T, Muehlich S. The novel MKL target gene myoferlin modulates expansion and senescence of hepatocellular carcinoma. Oncogene 2017; 36:3464-3476. [DOI: 10.1038/onc.2016.496] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 10/23/2016] [Accepted: 11/22/2016] [Indexed: 12/20/2022]
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Trautmann F, Singer S, Schmitt J. Patients with soft tissue sarcoma comprise a higher probability of comorbidities than cancer-free individuals. A secondary data analysis. Eur J Cancer Care (Engl) 2016; 26. [PMID: 27957779 DOI: 10.1111/ecc.12605] [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] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2016] [Indexed: 01/06/2023]
Abstract
Soft tissue sarcoma comprises a heterogeneous group of solid malignant tumours. Comorbidities are important prognostic factors for survival and adversely impact quality of life. We examined the complex relationship between soft tissue sarcoma and comorbidities over time in a large population-based sample. The study uses routine data from the German statutory healthcare system (n = 2,615,865). Case identification of soft tissue sarcoma and comorbid diseases was based on ICD-10 codes and diagnostic modifiers. Uni- and multivariate regression models were used to obtain risk estimates for chronic somatic and mental comorbidities in soft tissue sarcoma patients compared to a cancer-free control group. At diagnosis, patients with soft tissue sarcoma were significantly more likely to be affected with prevalent bronchial asthma, ≥1 cardiovascular risk factor (hypertension, angina pectoris, heart failure, peripheral arterial disease and thrombosis), back pain, depression, anxiety disorder and adjustment disorder than cancer-free controls. During the course of disease, sarcoma patients were at a significantly higher risk to develop incident depression, anxiety disorder and adjustment disorder. Comorbidities need to be considered in clinical decision making regarding the treatment of soft tissue sarcoma patients. Psycho-oncological treatment should be incorporated into medical care of patients with sarcoma.
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Affiliation(s)
- F Trautmann
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT) (partner site) Dresden and German Cancer Research Center (DKFZ), Dresden, Germany
| | - S Singer
- Department of Medical Biostatistics, Epidemiology and Informatics, University of Mainz, Mainz, Germany
| | - J Schmitt
- Center for Evidence-based Healthcare, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany.,National Center for Tumor Diseases (NCT) (partner site) Dresden and German Cancer Research Center (DKFZ), Dresden, Germany.,University Cancer Center, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
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43
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Kellnar S, Singer S, Münsterer O. [Minimally invasive surgery in childhood]. Chirurg 2016; 87:1087-1096. [PMID: 27812811 DOI: 10.1007/s00104-016-0312-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Similar to surgery in adults, minimally invasive techniques have also become established in pediatric surgery for a wide variety of indications and partially replaced the corresponding conventional open surgical procedures. This applies not only to laparoscopy for abdominal surgical interventions but also to thoracoscopic procedures. The therapy spectrum in pediatric surgery includes all congenital and acquired diseases of the growing organism, from neonates to adolescents and for this reason the indications that are suitable for minimally invasive surgical procedures are corresponding versatile. According to the literature almost every operation in pediatric surgery was performed via a minimally invasive access route. Of course, not every generally feasible minimally invasive technique can be considered as being suitable to replace proven and established open conventional procedures in pediatric surgery.
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Affiliation(s)
- S Kellnar
- Klinik für Kinderchirurgie, Klinikum Dritter Orden, Franz-Schrank-Str. 8, München, Deutschland.
| | - S Singer
- Klinik für Kinderchirurgie, Klinikum Dritter Orden, Franz-Schrank-Str. 8, München, Deutschland
| | - O Münsterer
- Klinik und Poliklinik für Kinderchirurgie, Universitätsmedizin der Johannes Gutenberg-Universität Mainz, Langenbeckstr. 1, 55101, Mainz, Deutschland
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Renovanz M, Hickmann AK, Coburger J, Kohlmann K, Janko M, Reuter AK, Keric N, Nadji-Ohl M, König J, Singer S, Giese A, Hechtner M. Assessing psychological and supportive care needs in glioma patients - feasibility study on the use of the Supportive Care Needs Survey Short Form (SCNS-SF34-G) and the Supportive Care Needs Survey Screening Tool (SCNS-ST9) in clinical practice. Eur J Cancer Care (Engl) 2016; 27. [DOI: 10.1111/ecc.12598] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2016] [Indexed: 12/20/2022]
Affiliation(s)
- M. Renovanz
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - A.-K. Hickmann
- Center for Endoscopic and Minimally Invasive Neurosurgery; Hirslanden; Zürich Switzerland
- Department of Neurosurgery Klinikum Stuttgart; Katharinenhospital; Stuttgart Germany
| | - J. Coburger
- Department of Neurosurgery; University Medical Center; Ulm/Günzburg Germany
| | - K. Kohlmann
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Janko
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - A.-K. Reuter
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - N. Keric
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Nadji-Ohl
- Department of Neurosurgery Klinikum Stuttgart; Katharinenhospital; Stuttgart Germany
| | - J. König
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - S. Singer
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
- German Cancer Consortium (DKTK); Mainz Germany
| | - A. Giese
- Department of Neurosurgery; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
| | - M. Hechtner
- Division of Epidemiology and Health Services Research; Institute of Medical Biostatistics, Epidemiology and Informatics; University Medical Center; Johannes-Gutenberg-University; Mainz Germany
- German Cancer Consortium (DKTK); Mainz Germany
- German Cancer Research Center (DKFZ); Heidelberg Germany
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Keszte J, Danker H, Dietz A, Meister E, Pabst F, Guntinas-Lichius O, Oeken J, Singer S, Meyer A. Course of psychiatric comorbidity and utilization of mental health care after laryngeal cancer: a prospective cohort study. Eur Arch Otorhinolaryngol 2016; 274:1591-1599. [PMID: 27744529 DOI: 10.1007/s00405-016-4340-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/05/2016] [Indexed: 10/20/2022]
Abstract
In a German multi-center prospective cohort study, we wanted to assess the course of psychiatric comorbidity, utilization of mental health care and psychosocial care needs in laryngeal cancer patients during the first year after partial laryngectomy (PRL). Structured interviews with patients were conducted before surgery, 1 week (1 w), 3 months (3 m) and 1 year (12 m) after PRL. Psychiatric comorbidity was assessed using the Structured Clinical Interview for DSM-IV (SCID). Psychosocial care needs and utilization of mental health care were evaluated with standardized face-to-face interviews. In 176 patients, psychiatric disorders were prevalent in 11 % (1 w), 15 % (3 m) and 14 % (12 m), respectively, of which 4 % (12 m) underwent psychiatric treatment or psychotherapy. Two percent had acute, 15 % emerging and 6 % chronic psychiatric comorbidity. Chronically mental ill patients were more frequently younger than 65 years (p = 0.026), female (p = 0.045) and experienced more often a need for psychological counseling (p ≤ 0.001). One year after surgery, 27 % of the comorbid psychiatric patients expressed a need for additional psychological counseling. Alcohol-related disorders were diagnosed in 3 % (1 w), 3 % (3 m) and 8 % (12 m), respectively. Only one of these patients received psychological treatment, while 14 % expressed a need for psychological counseling and 7 % for additional medical consultations. The non-treatment of alcohol-related disorders measured in our sample indicates a major problem since continued alcohol consumption in laryngeal cancer patients is associated with reduced global quality of life, increased functional impairments and reduced overall survival. Screening instruments integrated into acute care are necessary to detect harmful drinking behavior.
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Affiliation(s)
- J Keszte
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany.
| | - H Danker
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
| | - A Dietz
- Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center, Leipzig, Germany
| | - E Meister
- Department of Otorhinolaryngology, Clinical Center Sankt Georg, Leipzig, Germany
| | - F Pabst
- Department of Otorhinolaryngology, Clinical Center Dresden-Friedrichstadt, Dresden, Germany
| | - O Guntinas-Lichius
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital, Jena, Germany
| | - J Oeken
- Department of Otorhinolaryngology, Clinical Center Chemnitz, Chemnitz, Germany
| | - S Singer
- Division of Epidemiology and Health Services Research, Institute of Medical Biostatistics, Epidemiology and Informatics, University Medical Center, Mainz, Germany
| | - A Meyer
- Division Psychosocial Oncology, Department of Medical Psychology and Medical Sociology, University Medical Center, Leipzig, Germany
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Schwentner L, Harbeck N, Singer S, Eichler M, Rack B, Forstbauer H, Wischnik A, Scholz C, Fink V, Huober J, Friedl T, Weissenbacher T, Härtl K, Kiechle M, Janni W. Abstract P1-12-03: Short term quality of life with epirubicin-fluorouracil-cyclophosphamid (FEC) and sequential epirubicin/cyclophosphamid-docetaxel (EC-DOC) chemotherapy in patients with primary breast cancer – Results from the prospective multi-center randomized Adebar trial. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-12-03] [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:
The grade of recommendation for adjuvant dose-dense chemotherapy in patients with high risk primary breast cancer is heterogeneous among international guidelines. Understanding the impact on quality of life (QOL) by adjuvant dose dense chemotherapy in comparison to standard adjuvant chemotherapy is thereby a crucial factor, especially if the benefit is potentially low. This study aims to assess the impact on QOL by adjuvant dose dense chemotherapy in the prospective randomized multi-center ADEBAR trial.
Methods:
QOL was assessed at baseline (t1), before cycle 4 FEC (Epirubicin 60mg/m2 i.v. d 1 + 8, 5-Fluoruracil 500mg/m2 i.v. d 1 + 8, Cyclophosphamide 75mg/m2 p.o. d 1–14, q4w x 6) and cycle 5 EC-DOC (Epirubicin 90mg/m2 plus Cyclophosphamide 600mg/m2 q3w x 4, sequentially followed by Docetaxel 100mg/m2 q3w x 4) (t2), 4 weeks after chemotherapy (t3), 6 weeks after radiation (t4) and 1 year after baseline (t5) using the European Organization for Research and Treatment for Cancer (EORTC) Quality of Life Core Questionnaire (QLQ-C30) and the Breast Cancer-Specific Module (QLQ-BR23). A multivariate mixed model was fitted to test for differences between the two treatment arms. Primary endpoint was global QOL, secondary endpoints physical functioning, nausea&vomiting, fatigue and systemic therapy side effects. A minimum clinically meaningful difference was considered to be 10 points.
Results:
1306 patients were recruited between 3/2002 and 5/2005 675 were assigned to the FEC and 688 to the EC-DOC arm. Compliance to QOL assessment was 74% at baseline and 58% four weeks after therapy, but dropped to 11% after one year follow up. After the beginning of treatment global QOL dropped in both arm by 3 to 4 points. In the EC-DOC arm QOL dropped further at t3 by 7 points and stayed stable in the FEC arm. 6 weeks after radiation QOL exceeded baseline in both arms by 6 to 8 points. The differences between treatment arms were strongest at t3 (54.1 vs. 49.7) but did not reach clinical relevance at any point in time. Physical functioning, nausea vomiting, fatigue and systemic therapy side effects followed with some minor exceptions similar patterns, but showed higher amplitudes.
Conclusion:
In conclusion we could not detect a statistically significant difference between the two treatment arms in QOL parameters, indicating that dose dense adjuvant chemotherapy did not impact QOL at a clinically relevant level compared to standard adjuvant chemotherapy.
Citation Format: Schwentner L, Harbeck N, Singer S, Eichler M, Rack B, Forstbauer H, Wischnik A, Scholz C, Fink V, Huober J, Friedl T, Weissenbacher T, Härtl K, Kiechle M, Janni W. Short term quality of life with epirubicin-fluorouracil-cyclophosphamid (FEC) and sequential epirubicin/cyclophosphamid-docetaxel (EC-DOC) chemotherapy in patients with primary breast cancer – Results from the prospective multi-center randomized Adebar trial. [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 P1-12-03.
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Affiliation(s)
- L Schwentner
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - N Harbeck
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - S Singer
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - M Eichler
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - B Rack
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - H Forstbauer
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - A Wischnik
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - C Scholz
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - V Fink
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - J Huober
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - T Friedl
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - T Weissenbacher
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - K Härtl
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - M Kiechle
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
| | - W Janni
- University Ulm, Germany; Breast Cancer Center, University of Munich, Germany; IMBEI, University of Mainz, Germany; University Munich, Germany; Oncology Rhein-Sieg, Germany; Hospital Augsburg, Germany; Fresenius Universitiy of Applied Science, Germany; Technical University Rechts der Isar, Munich, Germany
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Schwentner L, Singer S, Van Ewijk R, Janni W, Kreienberg R, Blettner M, Woeckel A. Leitlinienkonformität in der Primärbehandlung des Mammakarzinoms – prognostische Implikationen und Barieerefaktoren nicht konformer Behandlung. Geburtshilfe Frauenheilkd 2016. [DOI: 10.1055/s-0035-1570059] [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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Schuler M, Hornemann B, Pawandenat C, Kramer M, Hentschel L, Beck H, Kasten P, Singer S, Schaich M, Ehninger G, Platzbecker U, Schetelig J, Bornhäuser M. Feasibility of an exercise programme in elderly patients undergoing allogeneic stem cell transplantation - a pilot study. Eur J Cancer Care (Engl) 2015; 25:839-48. [DOI: 10.1111/ecc.12400] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2015] [Indexed: 11/26/2022]
Affiliation(s)
- M.K. Schuler
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - B. Hornemann
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - C. Pawandenat
- University Physiotherapy Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - M. Kramer
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - L. Hentschel
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - H. Beck
- Department of Sports Medicine; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - P. Kasten
- Department of Sports Medicine; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - S. Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics; Division of Epidemiology and Health Services Research; University Medical Centre of Johannes Gutenberg University; Mainz Germany
| | - M. Schaich
- Department of Hematology/Oncology; Rems-Murr-Klinikum; Waiblingen Germany
| | - G. Ehninger
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- University Cancer Center; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - U. Platzbecker
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
| | - J. Schetelig
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
- DKMS Clinical Trials Unit; Dresden Germany
| | - M. Bornhäuser
- Department of Internal Medicine I; University Hospital Carl Gustav Carus; Technical University Dresden; Dresden Germany
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Keszte J, Danker H, Dietz A, Meister E, Pabst F, Vogel HJ, Meyer A, Singer S. Mental disorders and psychosocial support during the first year after total laryngectomy: a prospective cohort study. Clin Otolaryngol 2015; 38:494-501. [PMID: 24188349 DOI: 10.1111/coa.12194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/29/2022]
Abstract
OBJECTIVES To assess the frequency of mental disorders and the use of psychosocial services in laryngectomised patients during the first year after surgery. DESIGN Multicentre prospective study including six interviews. Data regarding psychiatric comorbidity 3 months (3 m) and 1 year (12 m) after total laryngectomy (TLE) are reported in this study. SETTING Structured interviews were conducted at nine hospitals and three rehabilitation centres in Germany. PARTICIPANTS One hundred and seventy-one patients were interviewed at both time-points. MAIN OUTCOME MEASURES Structured clinical interview for DSM-IV (SCID). RESULTS Mental disorders were diagnosed in 25% of the patients (3 m) and in 22% of the patients (12 m), respectively. Six per cent of the patients developed a mental disorder during the first year after total laryngectomy. In general, male and female patients suffered from mental disorders with equal frequency (3 m: 23% versus 37%; P = 0.26; 12 m: 22% versus 21%; P = 1.00). Women suffered more often than men from post-traumatic stress disorder (3 m) (P = 0.01) and generalised anxiety disorder (12 m) (P = 0.01).Of the patients who had acquired no voice, 20% suffered from alcohol dependence (P = 0.01) [corrected]. There were no differences between men and women in receiving any kind of counselling (P = 0.79) or psychotherapy/psychiatric treatment (P = 0.47). Of those patients diagnosed with any mental disorder 3 months after total laryngectomy, 7% had received psychotherapy 1 year after total laryngectomy. None of the patients diagnosed with alcohol dependence received psychotherapy or psychiatric treatment. CONCLUSIONS Mental disorders occur in laryngectomees as frequently in men as they do in women. Total laryngectomised patients who were mentally ill did not receive enough psychotherapeutic or psychiatric support. As mental health seems to be related to successful voice restoration, future research should develop and evaluate special psychosocial supportive programmes for patients with laryngeal cancer, especially regarding alcohol dependence treatment.
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Affiliation(s)
- J Keszte
- Department of Medical Psychology and Medical Sociology, Section Psychosocial Oncology, University of Leipzig, Leipzig, Germany
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Zebralla V, Pohle N, Singer S, Neumuth T, Dietz A, Stier-Jarmer M, Boehm A. [Introduction of the Screening Tool OncoFunction for Functional Follow-up of Head and Neck Patients]. Laryngorhinootologie 2015; 95:118-24. [PMID: 26190042 DOI: 10.1055/s-0035-1549858] [Citation(s) in RCA: 5] [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: 10/23/2022]
Abstract
INTRODUCTION The follow-up for head and neck cancer (HNC) focussed on therapy control. Accessory long term functionality is important. Impairment of function is observed, but a comparable documentation is not established. Additional we frequently see psychooncological comorbidities, what complicates the assessment. This was the reason why Tschiesner et al. developed on the base of the "ICF Core set for head and neck cancer" a guideline for the Assessment of Function in HNC. In consequence of good results in other tumour entities we developed an electronic version (OncoFunction). METHODS In a proof of concept study all patients of our follow up consultation from 07/13 to 03/14 were included. OncoFunction was given to patients in a digital form using tablet computers. The results were visible to the physician in a concentrated form before consultation and were supplemented by a physician questionnaire. Furthermore we evaluated the usability in 202 patients. RESULTS We had 682 patient contacts. 530 patient contacts (77, 7%) used the questionnaire. The physician questionnaire was answered in 470 times. Finally there are from 69.8% of the patient contacts full datasets available. Between users and non-users of the questionnaire we see no difference. CONCLUSION The use of a computer-based screening and feedback system (OncoFunction) in clinical use is feasible and excellent assessed by patients. The patient data are visible in a compact form for the physician and problems can clear addressed to the patient. One more benefit is the standardized follow up documentation and the use of comparable data in research.
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Affiliation(s)
- V Zebralla
- Klinik und Poliklinik für Hals-, Nasen-, Ohrenheilkunde, Universitätsklinikum Leipzig AöR, Leipzig
| | - N Pohle
- Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig
| | - S Singer
- Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz
| | - T Neumuth
- Scientific Director, BMBF-Innovation Center Computer Assisted Surgery ICCAS, Leipzig
| | - A Dietz
- Klinik und Poliklinik für Hals-Nasen-Ohrenheilkunde, Plastische Operationen, Universität Leipzig, Leipzig
| | - M Stier-Jarmer
- Lehrstuhl für Public Health und Versorgungsforschung - IBE, Ludwig-Maximilians-Universität, München
| | - A Boehm
- Hals-Nasen-Ohrenheilkunde, Universitätsklinikum Leipzig, Leipzig
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