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Simmons A, Sher DJ, Kim N, Leitch M, Haas JA, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Farr D, Wooldridge R, Seiler S, Goudreau S, Bahrami S, Neufeld S, Mendez C, Lieberman M, Timmerman RD, Rahimi AS. Financial Toxicity and Patient Experience Outcomes on a Multi-Institutional Phase I Single Fraction Stereotactic Partial Breast Irradiation Protocol for Early-Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e259-e260. [PMID: 37784994 DOI: 10.1016/j.ijrobp.2023.06.1212] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Given the demonstrated financial toxicity (FT) of radiation treatment on breast cancer patients shown in both conventional and our recent 5 fraction stereotactic APBI (S-PBI) study, we assessed the FT, as well as patient-reported utility, quality-of-life and patient experience measures, on patients treated in our phase I single fraction S-PBI trial. MATERIALS/METHODS A phase I single fraction dose escalation trial of S-PBI for early-stage breast cancer was conducted. Women with in-situ or stage I-II (AJCC 6) invasive breast cancer following breast conserving surgery were treated with S-PBI in 1 fraction to a total dose of 22.5, 26.5 or 30 Gy (Clinical trials.gov ID NCT02685332). At one month follow-up, patients were asked to complete our novel "Patient Perspective Cost and Convenience of Care Questionnaire". Patients also completed the EQ-5D-5L, including the visual analogue scale of overall health (VAS), at enrollment, 6, 12-, 24-, 36-, and 48-month follow-up. RESULTS Of 29 patients enrolled and treated, questionnaire data was available for all patients. Our trial encompassed a wide range of annual household incomes, education, and employment status. Overall, 44.8% (n = 13/29) of patients reported that radiation treatment presented a financial burden. Interestingly, no demographic information, such as patient race, marital status, education, household income, or employment during treatment predicted perceived FT. Patients reporting FT trended towards younger age (median 64 vs 70.5) and having a cancer related co-pay similar to our 5 fraction S-PBI FT trial; however, due to the small size of this study, this did not reach significance (p = 0.24 and 0.10, respectively). VAS and utility scores were calculated per the EQ-5D-5L and remained unchanged from baseline through 4-year follow-up. Likewise, there was no difference in the utility or VAS between patients who reported FT and those who did not. Interestingly, while patient reported cosmesis was similar for all patients at enrollment, patients who reported FT noted significantly worse cosmesis scores (fair/poor vs good/excellent) at 6 month and 2-year follow-ups (p = 0.01 and 0.04, respectively). Finally, patients were surveyed on treatment related disruption to their daily activities and enjoyment of life. The median values were 0 (scale 0-10, with 0 being no disruption) regardless of perceived FT. Patients were also uniformly satisfied with treatment time with a median score of 10 (scale 0-10, 10 being most satisfied). CONCLUSION Here, we show that despite using SPBI in a single fraction, nearly half of the patients treated still reported FT of treatment. Importantly, single fraction S-PBI has no negative impact on patient VAS or utility scores, and all patients were uniformly satisfied with treatment time without significant disruption to their life.
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Affiliation(s)
- A Simmons
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - D J Sher
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - N Kim
- Vanderbilt University Department of Radiation Oncology, Nashville, TN
| | - M Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - J A Haas
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - X Gu
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, CA
| | - C Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Gao
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, TX
| | - A Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | | | - D Farr
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - R Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Bahrami
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - S Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - C Mendez
- Department of Radiation Oncology, Perlmutter Cancer Center at New York University Langone Hospital - Long Island, Mineola, NY
| | - M Lieberman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - R D Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
| | - A S Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX
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Reinisch M, Blohmer JU, Link T, Just M, Untch M, Stötzer O, Fasching P, Schneeweiss A, Wimberger P, Seiler S, Huober J, Thill M, Jackisch C, Rhiem K, Solbach C, Hanusch C, Denkert C, Engels K, Nekljudova V, Loibl S. 94P Patient quality of life (QoL) from the GeparX trial on the addition of denosumab (Dmab) added to two different nab-paclitaxel (nP) regimens as neoadjuvant chemotherapy (NACT) in primary breast cancer (BC). Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.110] [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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Weber WP, Matrai Z, Hayoz S, Tausch C, Henke G, Zwahlen DR, Gruber G, Zimmermann F, Seiler S, Maddox C, Ruhstaller T, Muenst S, Ackerknecht M, Kuemmel S, Bjelic-Radisic V, Kurzeder C, Újhelyi M, Vrieling C, Satler R, Meyer I, Becciolini C, Bucher S, Simonson C, Fehr PM, Gabriel N, Maráz R, Sarlos D, Dedes KJ, Leo C, Berclaz G, Dubsky P, Exner R, Fansa H, Hager C, Reisenberger K, Singer CF, Reitsamer R, Reinisch M, Winkler J, Lam GT, Fehr MK, Naydina T, Kohlik M, Clerc K, Ostapenko V, Fitzal F, Nussbaumer R, Maggi N, Schulz A, Markellou P, Lelièvre L, Egle D, Heil J, Knauer M. Tailored axillary surgery in patients with clinically node-positive breast cancer: Pre-planned feasibility substudy of TAXIS (OPBC-03, SAKK 23/16, IBCSG 57-18, ABCSG-53, GBG 101). Breast 2021; 60:98-110. [PMID: 34555676 PMCID: PMC8463904 DOI: 10.1016/j.breast.2021.09.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [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: 07/30/2021] [Revised: 09/03/2021] [Accepted: 09/04/2021] [Indexed: 11/24/2022] Open
Abstract
Aim We developed tailored axillary surgery (TAS) to reduce the axillary tumor volume in patients with clinically node-positive breast cancer to the point where radiotherapy can control it. The aim of this study was to quantify the extent of tumor load reduction achieved by TAS. Methods International multicenter prospective study embedded in a randomized trial. TAS is a novel pragmatic concept for axillary surgery de-escalation that combines palpation-guided removal of suspicious nodes with the sentinel procedure and, optionally, imaging-guided localization. Pre-specified study endpoints quantified surgical extent and reduction of tumor load. Results A total of 296 patients were included at 28 sites in four European countries, 125 (42.2%) of whom underwent neoadjuvant chemotherapy (NACT) and 71 (24.0%) achieved nodal pathologic complete response. Axillary metastases were detectable only by imaging in 145 (49.0%) patients. They were palpable in 151 (51.0%) patients, of whom 63 underwent NACT and 21 had residual palpable disease after NACT. TAS removed the biopsied and clipped node in 279 (94.3%) patients. In 225 patients with nodal disease at the time of surgery, TAS removed a median of five (IQR 3–7) nodes, two (IQR 1–4) of which were positive. Of these 225 patients, 100 underwent ALND after TAS, which removed a median of 14 (IQR 10–17) additional nodes and revealed additional positive nodes in 70/100 (70%) of patients. False-negative rate of TAS in patients who underwent subsequent ALND was 2.6%. Conclusions TAS selectively reduced the tumor load in the axilla and remained much less radical than ALND. Tailored axillary surgery is a novel concept for clinically node-positive breast cancer Tailored axillary surgery selectively removes positive lymph nodes Tailored axillary surgery is much less radical than axillary dissection Tailored axillary surgery removes the clipped node in the vast majority of patients
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Affiliation(s)
- Walter P Weber
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
| | - Zoltan Matrai
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary; University of Szeged, H-6725 Szeged, Hungary
| | | | | | - Guido Henke
- Department of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland; Breast Center, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | - Daniel R Zwahlen
- Department of Radiation Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Günther Gruber
- Institute of Radiotherapy, Klinik Hirslanden, Zurich, Switzerland
| | - Frank Zimmermann
- University of Basel, Basel, Switzerland; Department of Radiation Oncology, University Hospital Basel, Basel, Switzerland
| | | | | | | | - Simone Muenst
- University of Basel, Basel, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Markus Ackerknecht
- University of Basel, Basel, Switzerland; Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | | | | | - Christian Kurzeder
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Mihály Újhelyi
- Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Conny Vrieling
- Department of Radiation Oncology, Hirslanden Clinique des Grangettes, Geneva, Switzerland
| | - Rok Satler
- Breast Center, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Inna Meyer
- Breast Center, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Charles Becciolini
- Breast Center, Réseau Hospitalier Neuchâtelois, La Chaux-de-Fonds, Switzerland
| | - Susanne Bucher
- Breast Center, Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - Colin Simonson
- Department of Gynecology, Centre Hospitalier du Haut-Valais (SZO), Sion, Switzerland
| | - Peter M Fehr
- Breast Center Graubünden, Cantonal Hospital Graubünden, Chur, Switzerland
| | | | - Robert Maráz
- Department of Oncology, Bacs-Kiskun Country Hospital, Kecskemet, Hungary
| | - Dimitri Sarlos
- Breast Center, Cantonal Hospital Aarau, Aarau, Switzerland
| | - Konstantin J Dedes
- Breast Cancer Center, University Hospital of Zurich, Zurich, Switzerland
| | - Cornelia Leo
- Breast Center, Cantonal Hospital Baden, Baden, Switzerland
| | | | - Peter Dubsky
- Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland; Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Ruth Exner
- Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Hisham Fansa
- Breast Center Zürich, Bethanien & Spital Zollikerberg, Zurich, Switzerland
| | - Christopher Hager
- Department of Gynecology and Obstetrics, City Hospital, Dornbirn, Austria
| | - Klaus Reisenberger
- Department of Gynecology and Obstetrics, Klinikum Wels-Grieskirchen, Wels, Austria
| | - Christian F Singer
- Department of Gynecology and Obstetrics and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Roland Reitsamer
- Breast Center, Paracelsus Medical University of Salzburg, Salzburg, Austria
| | | | - Jelena Winkler
- Breast Center, Basel Bethesda Hospital, Basel, Switzerland
| | - Giang Thanh Lam
- Breast Center, University Hospital of Geneva, Geneva, Switzerland
| | | | | | | | - Karine Clerc
- Brustzentrum Freiburg, Centre du sein Fribourg, Fribourg, Switzerland
| | | | - Florian Fitzal
- Department of Surgery and Breast Health Center, Medical University of Vienna, Vienna, Austria
| | - Rahel Nussbaumer
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Nadia Maggi
- Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Alexandra Schulz
- University of Basel, Basel, Switzerland; Department of Clinical Research, University Hospital Basel, Basel, Switzerland
| | - Pagona Markellou
- Breast Center, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | | | - Daniel Egle
- Breast Cancer Center Tirol, Department of Gynecology, Medical University Innsbruck, Innsbruck, Austria
| | - Jörg Heil
- Breast Center Heidelberg, Heidelberg, Germany
| | - Michael Knauer
- Breast Center Eastern Switzerland, St. Gallen, Switzerland
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Santo SD, Seiler S, Guzman R, Widmer HR. Endothelial Progenitor Cell-Derived Factors Exert Neuroprotection in Cultured Cortical Neuronal Progenitor Cells. Cell Transplant 2021; 29:963689720912689. [PMID: 32193955 PMCID: PMC7444205 DOI: 10.1177/0963689720912689] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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] [Indexed: 12/30/2022] Open
Abstract
There is substantial evidence that stem and progenitor cells secrete
trophic factors that have potential for repairing injured tissues. We
have previously reported that the conditioned medium (CM) obtained
from endothelial progenitor cells (EPC) cultures protects striatal
neurons against 3-nitropropionic acid-induced toxicity. In the present
study we tested the hypothesis that EPC-CM may support cortical
neuronal cell function and/or survival. EPC were isolated from the
peripheral blood of healthy human donors and cultured in hypoxic
conditions (1.5% O2) to stimulate the secretion of growth
factors. The supernatant or conditioned medium (EPC-CM) was then
collected and used for the various experiments. Primary cultures of
cerebral cortex from fetal rat embryonic day 14 were treated with
EPC-CM and challenged by glucose and serum deprivation. We observed
that EPC-CM treatment significantly increased total cell number and
cell viability in the cultures. Similarly, the number of
lba1-expressing cells was significantly upregulated by EPC-CM, while
western blot analyses for the astroglial marker glial fibrillary
acidic protein did not show a marked difference. Importantly, the
number of beta-lll-tubulin-positive neurons in the cultures was
significantly augmented after EPC-CM treatment. Similarly, western
blot analyses for beta-III-tubulin showed significant higher signal
intensities. Furthermore, EPC-CM administration protected neurons
against glucose- and serum deprivation-induced cell loss. In sum, our findings identified EPC-CM as a means to promote viability
and/or differentiation of cortical neurons and suggest that EPC-CM
might be useful for neurorestorative approaches.
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Affiliation(s)
- Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland.,Departments of Neurosurgery and Biomedicine, Basel University Hospital, University of Basel, Basel, Switzerland
| | - Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Guzman
- Departments of Neurosurgery and Biomedicine, Basel University Hospital, University of Basel, Basel, Switzerland.,Both the authors share senior authorship
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland.,Both the authors share senior authorship
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Weber WP, Henke G, Hayoz S, Ribi K, Seiler S, Maddox C, Ruhstaller T, Zwahlen DR, Muenst S, Ackerknecht M, Fitzal F, Újhelyi M, Kurzeder C, Lelièvre L, Tausch C, Egle D, Heil J, Matrai Z, Knauer M. Abstract OT-04-03: Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101 - TAXIS): A multicenter randomized phase III trial. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-ot-04-03] [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 Main weaknesses of neoadjuvant chemotherapy (NACT) to avoid axillary dissection (ALND) in patients with clinically node-positive breast cancer are frequent failure of achieving nodal pathologic complete response (pCR) and administration of chemotherapy even though not indicated otherwise in many cases. Tailored axillary surgery (TAS) was designed to selectively remove positive nodes and omit ALND in patients with clinically node-positive breast cancer either in the upfront surgery setting or in case of residual nodal disease after neoadjuvant therapy, which distinguishes this trial from all others ongoing and published. Trial design In this international, multi-center, phase-III, non-inferiority randomized controlled trial, including 61 study sites from six countries, we plan to randomize 1500 patients to either receive TAS followed by ALND and regional nodal irradiation excluding the dissected axilla, or receive TAS only followed by regional nodal irradiation including the full axilla. TAS consists of selective removal of the sentinel lymph nodes (SLNs) and all palpably suspicious findings, thereby tailoring the extent of axillary surgery to the extent of axillary disease, followed by specimen radiography to document removal of the clip placed in the sampled node. Imaging-guided localization is encouraged to increase the chances of clip removal. All patients undergo adjuvant whole-breast irradiation after breast conserving surgery and chest wall irradiation after mastectomy. Inclusion of internal mammary nodes is recommended irrespective of treatment arm. ClinicalTrials.gov Identifier: NCT03513614. Inclusion criteria - Clinically node-positive breast cancer (all molecular subtypes allowed) - Node-positivity palpable or detectable only by imaging at time of initial diagnosis - Newly diagnosed or isolated in-breast recurrence or second ipsilateral breast cancer after previous breast conserving surgery and sentinel procedure and at least 3 years disease free and no prior axillary dissection or axillary RT. - In case of prior neoadjuvant treatment: residual disease (including residual ITCs) confirmed by pathology at the time of surgery - Clipping of sampled axillary lymph node Exclusion criteria - Absence of clip in the specimen radiography - Palpable disease left behind in the axilla after TAS - No SLN identified in the axilla Specific aims To test the hypothesis that treatment with TAS and axillary radiotherapy is non-inferior to ALND in terms of disease-free survival (DFS) of clinically node-positive breast cancer patients. Secondary objective is to test if quality of life is significantly better with TAS and axillary radiotherapy compared to ALND. Statistical methods With type I error 5% and power 80%, 385 events will be needed to show non-inferiority of TAS and axillary RT in comparison to ALND with a non-inferiority hazard ratio (HR) of 1.289 (corresponding to a DFS at 5 years of 80% in the ALND arm and 75% in the TAS and axillary RT arm), including one interim analysis for efficacy/futility after 20% of the required events have occurred. The sample size needed is 1500 patients (750 per arm). The HR and one-sided 95% confidence interval will be calculated using a Cox regression model based on the per-protocol set. Present accrual and target accrual The trial was activated on 31 July 2018 and the first patient was randomized on 07 August 2018. As of 03 July 2020, 291 patients have been randomized. Accrual is currently running according to protocol and is planned until end of 2023 with the primary endpoint analysis expected in 2029. Contact information Prof. Dr. Walter Paul Weber, University Hospital Basel; Tel: +41 61 328 61 49; Walter.Weber@usb.ch
Citation Format: Walter Paul Weber, Guido Henke, Stefanie Hayoz, Karin Ribi, Stefanie Seiler, Charlotte Maddox, Thomas Ruhstaller, Daniel Rudolf Zwahlen, Simone Muenst, Markus Ackerknecht, Florian Fitzal, Mihály Újhelyi, Christian Kurzeder, Loïc Lelièvre, Christoph Tausch, Daniel Egle, Jörg Heil, Zoltan Matrai, Michael Knauer. Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101 - TAXIS): A multicenter randomized phase III trial [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr OT-04-03.
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Affiliation(s)
| | - Guido Henke
- 2Department of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | | | - Karin Ribi
- 4IBCSG Coordinating Center, Bern, Switzerland
| | | | | | | | - Daniel Rudolf Zwahlen
- 6Department of Radiation Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Simone Muenst
- 7Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Markus Ackerknecht
- 8Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Florian Fitzal
- 9Department of Surgery and Breast Health Center, Medical University of Vienna, Vienna, Austria
| | - Mihály Újhelyi
- 10Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | | | | | | | - Daniel Egle
- 13Medical University Innsbruck, Innsbruck, Austria
| | - Jörg Heil
- 14Breast Center, Heidelberg, Germany
| | - Zoltan Matrai
- 10Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Michael Knauer
- 5Breast Center Eastern Switzerland, St. Gallen, Switzerland
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Weber WP, Henke G, Hayoz S, Ribi K, Seiler S, Maddox C, Ruhstaller T, Zwahlen DR, Muenst S, Ackerknecht M, Fitzal F, Újhelyi M, Kurzeder C, Lelièvre L, Tausch C, Egle D, Heil J, Matrai Z, Knauer M. Abstract PD4-04: Tailored axillary surgery to omit axillary lymph node dissection independently from the use of neoadjuvant chemotherapy in patients with clinically node-positive breast cancer: Pre-specified subproject within TAXIS (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101). Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-pd4-04] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: We developed tailored axillary surgery (TAS) to selectively remove positive nodes and omit axillary lymph node dissection (ALND) in patients with clinically node-positive breast cancer irrespective of the use of neoadjuvant chemotherapy. In this study, we evaluate the performance of this novel surgical concept that tailors the extent of axillary surgery to the extent of axillary disease. Methods: A prospective study was pre-specified to assess the performance of TAS in the international multicenter phase-III TAXIS trial randomizing patients with clinically node-positive breast cancer to undergo ALND or axillary radiation after TAS. TAS consists of selective removal of all palpably suspicious findings and the SLNs followed by specimen radiography to document removal of the clip placed in the sampled node. Imaging-guided localization is encouraged to increase the chances of clip removal. Only patients with confirmed nodal disease at the time of surgery can be randomized in TAXIS; the first 200 randomized patients were analyzed together with the ones achieving nodal pCR in this study. ClinicalTrials.gov Identifier: NCT03513614. Results: A total of 296 patients with a median age of 56.5 years (range: 25-88 years) were included at 28 breast centers from four European countries, 125 (42.3%) of whom underwent NACT and 75 (25.3%) of whom had nodal pCR. Subtype was hormone receptor (HR) positive (+) and human epidermal growth factor receptor 2 (HER2) negative (-) in 194 (65.5%), HR+/HER2+ in 40 (13.5%), HR-/HER2+ in 17 (5.7%) and HR-/HER2- in 39 (13.2%) patients. Breast-conserving surgery was performed in 178 patients (60%) and mastectomy in 117 (40%). Imaging-guided localization was attempted in 258 patients (87.2%) and was successful in 243 (82.1%). TAS removed a median of two (interquartile range [IQR] 0-3) palpably suspicious lesions and two (IQR 1-3) SLNs, thereby successfully removing the clip in 279 (94.3%) patients. There were no significant differences by use of imaging-guided localization (94.6% with vs 92.1% without, p=0.47) or type of clip (p=0.19), but a trend toward lower rate of clip removal after NACT (91.2% with vs 96.5% without NACT, p=0.075). Palpable disease was left behind after TAS in two (2.1%) patients and no SLN was detected in three (3.1%). In the 200 randomized patients with confirmed nodal disease at the time of surgery, lymph node metastases were palpable at the time of initial diagnosis in 102 (51%) patients and detectable only by imaging in 98 (49%). The median number of lymph nodes removed by TAS was four (IQR 2-8), two (IQR 1-4) of which were positive. Completion ALND following TAS removed additional positive nodes in 71 of 100 (71%) patients in the control group (20% with one additional node, 9% with 2, 8% with 3, 6% with 4, and 28% with >4). The median number of additional lymph nodes removed by ALND was 14 (IQR 10-18), two (IQR 0-6) of which were positive. Of the 200 randomized patients, one in the TAS group received a radiotherapy boost and one in the ALND group returned to the operating room for residual suspicious findings on imaging. Discussion: The present results suggest that TAS has the potential to become the new axillary surgery standard in patients with clinically node-positive breast cancer. TAS was successfully performed in the vast majority of patients, with no further improvement by imaging-guided localization, which makes the procedure feasible at most breast centers. TAS selectively removed positive lymph nodes and was much less radical than ALND, but ALND removed additional positive nodes in more than two thirds of patients. Disease-free survival and quality of life will be assessed in the randomized trial.
Citation Format: Walter Paul Weber, Guido Henke, Stefanie Hayoz, Karin Ribi, Stefanie Seiler, Charlotte Maddox, Thomas Ruhstaller, Daniel Rudolf Zwahlen, Simone Muenst, Markus Ackerknecht, Florian Fitzal, Mihály Újhelyi, Christian Kurzeder, Loïc Lelièvre, Christoph Tausch, Daniel Egle, Jörg Heil, Zoltan Matrai, Michael Knauer. Tailored axillary surgery to omit axillary lymph node dissection independently from the use of neoadjuvant chemotherapy in patients with clinically node-positive breast cancer: Pre-specified subproject within TAXIS (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD4-04.
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Affiliation(s)
| | - Guido Henke
- 2Department of Radiation Oncology, St. Gallen Cantonal Hospital, St. Gallen, Switzerland
| | | | - Karin Ribi
- 4IBCSG Coordinating Center, Bern, Switzerland
| | | | | | | | - Daniel Rudolf Zwahlen
- 6Department of Radiation Oncology, Cantonal Hospital Winterthur, Winterthur, Switzerland
| | - Simone Muenst
- 7Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Markus Ackerknecht
- 8Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Florian Fitzal
- 9Department of Surgery and Breast Health Center, Medical University of Vienna, Vienna, Austria
| | - Mihály Újhelyi
- 10Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | | | | | | | - Daniel Egle
- 13Medical University Innsbruck, Innsbruck, Austria
| | - Jörg Heil
- 14Breast Center, Heidelberg, Germany
| | - Zoltan Matrai
- 10Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary
| | - Michael Knauer
- 5Breast Center Eastern Switzerland, St. Gallen, Switzerland
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Riva T, Préel N, Theiler L, Greif R, Bütikofer L, Ulmer F, Seiler S, Nabecker S. Evaluating the ventilatory effect of transnasal humidified rapid insufflation ventilatory exchange in apnoeic small children with two different oxygen flow rates: a randomised controlled trial . Anaesthesia 2020; 76:924-932. [PMID: 33351194 DOI: 10.1111/anae.15335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 12/30/2022]
Abstract
Transnasal humidified rapid insufflation ventilatory exchange prolongs safe apnoeic oxygenation time in children. In adults, transnasal humidified rapid insufflation ventilatory exchange is reported to have a ventilatory effect with PaCO2 levels increasing less rapidly than without it. This ventilatory effect has yet to be reproduced in children. In this non-inferiority study, we tested the hypothesis that children weighing 10-15 kg exhibit no difference in carbon dioxide clearance when comparing two different high-flow nasal therapy flow rates during a 10-min apnoea period. Following standardised induction of anaesthesia including neuromuscular blockade, patients were randomly allocated to high-flow nasal therapy of 100% oxygen at 2 or 4 l.kg-1 .min-1 . Airway patency was ensured by continuous jaw thrust. The study intervention was terminated for safety reasons when SpO2 values dropped < 95%, or transcutaneous carbon dioxide levels rose > 9.3 kPa, or near-infrared spectroscopy values dropped > 20% from their baseline values, or after an apnoeic period of 10 min. Fifteen patients were included in each group. In the 2 l.kg-1 .min-1 group, mean (SD) transcutaneous carbon dioxide increase was 0.46 (0.11) kPa.min-1 , while in the 4 l.kg-1 .min-1 group it was 0.46 (0.12) kPa.min-1 . The upper limit of a one-sided 95%CI for the difference between groups was 0.07 kPa.min-1 , lower than the predefined non-inferiority margin of 0.147 kPa.min-1 (p = 0.001). The lower flow rate of 2 l.kg-1 .min-1 was non-inferior to 4 l.kg-1 .min-1 relative to the transcutaneous carbon dioxide increase. In conclusion, an additional ventilatory effect of either 2 or 4 l.kg-1 .min-1 high-flow nasal therapy in apnoeic children weighing 10-15 kg appears to be absent.
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Affiliation(s)
- T Riva
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - N Préel
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - L Theiler
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Anaesthesia, Kantonsspital Aarau, Aarau, Switzerland
| | - R Greif
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,School of Medicine, Sigmund Freud University Vienna, Vienna, Austria
| | - L Bütikofer
- CTU Bern, University of Bern, Bern, Switzerland
| | - F Ulmer
- Department of Paediatrics, Section of Paediatric Critical Care, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S Seiler
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland
| | - S Nabecker
- Department of Anaesthesiology and Pain Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department of Anaesthesia and Pain Management, Sinai Health System, University of Toronto, Toronto, Canada
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Fasching PA, Link T, Hauke J, Seither F, Jackisch C, Klare P, Schmatloch S, Hanusch C, Huober J, Stefek A, Seiler S, Schmitt WD, Uleer C, Doering G, Rhiem K, Schneeweiss A, Engels K, Denkert C, Schmutzler RK, Hahnen E, Untch M, Burchardi N, Blohmer JU, Loibl S. Neoadjuvant paclitaxel/olaparib in comparison to paclitaxel/carboplatinum in patients with HER2-negative breast cancer and homologous recombination deficiency (GeparOLA study). Ann Oncol 2020; 32:49-57. [PMID: 33098995 DOI: 10.1016/j.annonc.2020.10.471] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 09/30/2020] [Accepted: 10/12/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND The efficacy and toxicity of olaparib as combination therapy in early breast cancer (BC) patients with homologous recombinant deficiency (HRD) [score high and/or germline (g) or tumour (t) BRCA1/2 mutation] is not well described. GeparOLA (ClinicalTrials.gov, NCT02789332) investigated olaparib in combination with paclitaxel in HER2-negative early BC with HRD. PATIENTS AND METHODS Patients with untreated primary HER2-negative cT2-cT4a-d or cT1c with either cN+ or pNSLN+ or cT1c and triple-negative breast cancer (TNBC) or cT1c and Ki-67>20% BC with HRD were randomised either to paclitaxel (P) 80 mg/m2 weekly plus olaparib (O) 100 mg twice daily for 12 weeks or P plus carboplatinum (Cb) area under the curve 2 weekly for 12 weeks, both followed by epirubicin/cyclophosphamide (EC). Stratification factors were hormone receptor (HR) status (HR+ versus HR-) and age (<40 versus ≥40 years). The primary endpoint was pathological complete response (pCR; ypT0/is ypN0). A two-sided one-group χ2-test was planned to exclude a pCR rate of ≤55% in the PO-EC arm. Secondary end points were other pCR definitions, breast conservation rate, clinical/imaging response, tolerability and safety. RESULTS A total of 107 patients were randomised between September 2016 and July 2018; 106 (PO N = 69; PCb N = 37) started treatment. Median age was 47.0 years (range 25.0-71.0); 36.2% had cT1, 61.0% cT2, 2.9% cT3, and 31.8% cN-positive tumours; grade 3 tumours: 86.8%; Ki-67>20%: 89.6%; TNBC: 72.6%; confirmed gBRCA1/2 mutation: 56.2%. The pCR rate with PO was 55.1% [90% confidence interval (CI) 44.5% to 65.3%] versus PCb 48.6% (90% CI 34.3% to 63.2%). Analysis for the stratified subgroups showed higher pCR rates with PO in the cohorts of patients <40 years and HR+ patients. CONCLUSION GeparOLA could not exclude a pCR rate of ≤55% in the PO arm. PO was significantly better tolerated and the combination merits further evaluation.
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Affiliation(s)
- P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Comprehensive Cancer Center Erlangen-Nuremberg, National Center for Tumor Diseases, Erlangen, Germany
| | - T Link
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Carl Gustav Carus Dresden, Germany
| | - J Hauke
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - F Seither
- German Breast Group, Neu-Isenburg, Germany
| | - C Jackisch
- Sana Klinikum Offenbach, Offenbach, Germany
| | - P Klare
- MediOnko-Institut GbR Berlin, Berlin, Germany
| | | | - C Hanusch
- Rotkreuzklinikum Munich, Munich, Germany
| | - J Huober
- University Hospital Ulm, Ulm, Germany
| | - A Stefek
- Johanniter-Krankenhaus Genthin-Stendal, Stendal, Germany
| | - S Seiler
- German Breast Group, Neu-Isenburg, Germany
| | - W D Schmitt
- Institute of Pathology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - C Uleer
- Gemeinschaftspraxis Hildesheim, Hildesheim, Germany
| | - G Doering
- Hämato-Onkologie im Medicum Bremen, Bremen, Germany
| | - K Rhiem
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - A Schneeweiss
- National Center for Tumor Diseases (NCT), Heidelberg University Hospital and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - K Engels
- Center for Pathology, Cytology and Molecular Pathology Neuss, Neuss, Germany
| | - C Denkert
- Institute of Pathology, Philipps-Universität Marburg und University Hospital Marburg (UKGM), Marburg, Germany
| | - R K Schmutzler
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - E Hahnen
- Center for Familial Breast and Ovarian Cancer, University of Cologne, Cologne, Germany
| | - M Untch
- Helios-Klinikum Berlin-Buch, Berlin, Germany
| | | | - J-U Blohmer
- Brustzentrum Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - S Loibl
- German Breast Group, Neu-Isenburg, Germany.
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Loibl S, Rastogi P, Seiler S, Jackisch C, Lucas P, Denkert C, Poklepovic A, Moreno F, Mamounas E, Nekljudova V, Lin Y, Wolmark N, Geyer C. 248TiP A randomized, double-blind, phase III trial of neoadjuvant chemotherapy (NACT) with atezolizumab/placebo in patients (pts) with triple-negative breast cancer (TNBC) followed by adjuvant continuation of atezolizumab/placebo (GeparDouze). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.369] [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: 10/23/2022] Open
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Link T, Blohmer JU, Just M, Untch M, Stötzer O, Fasching P, Schneeweiss A, Wimberger P, Seiler S, Huober J, Schmitt W, Jackisch C, Rhiem K, Hanusch C, Denkert C, Sinn B, Engels K, Nekljudova V, Loibl S. 168MO GeparX: Denosumab (Dmab) as add-on to different regimen of nab-paclitaxel (nP)-anthracycline based neoadjuvant chemotherapy (NACT) in early breast cancer (BC): Subgroup analyses by RANK expression and HR status. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.290] [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: 10/23/2022] Open
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12
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Weber W, Henke G, Ribi K, Hayoz S, Seiler S, Maddox C, Ruhstaller T, Zwahlen D, Muenst S, Ackerknecht M, Fitzal F, Matrai Z, Újhelyi M, Kurzeder C, Lelièvre L, Tausch C, Heil J, Knauer M. 126TiP Tailored axillary surgery with or without axillary lymph node dissection followed by radiotherapy in patients with clinically node-positive breast cancer (SAKK 23/16 / IBCSG 57-18 / ABCSG-53 / GBG 101 - TAXIS): A multicenter randomized phase III trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Reinisch M, Untch M, Reimer T, Mahlberg R, Aydogdu M, Hitschold T, Jackisch C, Marmé F, Lück HJ, Ladda E, Schmatloch S, Schmidt M, Klare P, Sinn B, Stickeler E, Seiler S, Rey J, Klutinus N, Möbus V, Loibl S. 86P Patients (pts) preference for different administration methods of trastuzumab (T) in pts with HER2+ early breast cancer (BC) treated within the GAIN-2 trial. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.03.026] [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: 11/28/2022] Open
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14
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Werutsky G, Untch M, Hanusch C, Fasching P, Blohmer JU, Seiler S, Denkert C, Tesch H, Jackisch C, Gerber B, Schneeweiss A, Link T, Huober J, Rhiem K, Vladimirova V, Nekljudova V, Loibl S. Risk factors for locoregional recurrence (LRR) after neoadjuvant chemotherapy: Pooled analysis of prospective neoadjuvant breast cancer (BC) trials. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Tesch H, Loibl S, Kast K, Jackisch C, Möbus V, Buchen S, Untch M, Hanusch C, Seiler S, Weigel M, Fasching P, Rhiem K, Huober J, Blohmer JU, Solbach C, Denkert C, Nekljudova V, Link T, Schneeweiss A. Chemotherapy (CT)-induced anaemia in patients (pts) treated with dose-dense regimen: Results of the prospectively randomised anaemia substudy from the neoadjuvant GeparOcto study. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz240.020] [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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16
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Di Santo S, Seiler S, Ducray AD, Widmer HR. Conditioned medium from Endothelial Progenitor Cells promotes number of dopaminergic neurons and exerts neuroprotection in cultured ventral mesencephalic neuronal progenitor cells. Brain Res 2019; 1720:146330. [PMID: 31299185 DOI: 10.1016/j.brainres.2019.146330] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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: 05/29/2019] [Revised: 07/04/2019] [Accepted: 07/08/2019] [Indexed: 12/24/2022]
Abstract
Transplantation of stem and progenitor cells offers a promising tool for brain repair in the context of neuropathological disorders including Parkinson's disease. There is growing proof that the capacity of adult stem and progenitor cells for tissue regeneration relies rather on the release of paracrine factors than on their cell replacement properties. In line with this notion, we have previously reported that conditioned medium (CM) collected from cultured Endothelial Progenitor Cells (EPC) stimulated survival of striatal neurons. In the present study we investigated whether EPC-CM promotes survival of cultured midbrain progenitor cells. For that purpose primary cultures from fetal rat embryonic ventral mesencephalon (VM) were prepared and grown for 7 days in vitro (DIV). EPC-CM was administered from DIV5-7. First, we found that EPC-CM treatment resulted in significantly increased cell densities of TH-ir neurons. Interestingly, this effect was no longer seen after proteolytic digestion of the EPC-CM. EPC-CM also significantly increased densities of beta-III-tubulin positive neurons and lba-1-ir microglial cells. The effect on dopaminergic neurons was not due to higher cell proliferation as no incorporation of EdU was observed in TH-ir cells. Importantly, EPC-CM exerted neuroprotection against MPP+ induced toxicity as in vitro model of Parkinson's disease. Taken together, our findings identified EPC-CM as a powerful tool to promote survival of cultured VM neurons and further support the importance of paracrine factors in the actions of stem and progenitor cells for brain repair.
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Affiliation(s)
- Stefano Di Santo
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
| | - Stefanie Seiler
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Angélique D Ducray
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Division of Pharmacology and Toxicology, Vetsuisse Faculty, University of Bern, CH-3012 Bern, Switzerland
| | - Hans Rudolf Widmer
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland.
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Loibl S, Jackisch C, Rastogi P, Seiler S, Lucas P, Denkert C, Costantino J, Nekljudova V, Wolmark N, Geyer C. GeparDouze/NSABP B-59: A randomized double-blind phase III clinical trial of neoadjuvant chemotherapy with atezolizumab or placebo in patients with triple negative breast cancer (TNBC) followed by adjuvant atezolizumab or placebo. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz097.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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18
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Loibl S, Seiler S. Schwangerschaft nach einer Tumorerkrankung. Gynäkologische Endokrinologie 2019. [DOI: 10.1007/s10304-019-0250-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Santo SD, Seiler S, Andres R, Widmer HR. Endothelial Progenitor Cells Conditioned Medium Supports Number of GABAergic Neurons and Exerts Neuroprotection in Cultured Striatal Neuronal Progenitor Cells. Cell Transplant 2019; 28:367-378. [PMID: 31017468 PMCID: PMC6628568 DOI: 10.1177/0963689719835192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 02/04/2023] Open
Abstract
There is growing evidence that stem and progenitor cells exert regenerative actions by means of paracrine factors. In line with these notions, we recently demonstrated that endothelial progenitor cell (EPC)-derived conditioned medium (EPC-CM) substantially increased viability of brain microvascular cells. In the present study, we aimed at investigating whether EPC-CM supports cell survival of cultured striatal progenitor cells. For that purpose, primary cultures from fetal rat embryonic (E14) ganglionic eminence were prepared and grown for 7 days in vitro (DIV). EPC-CM was administered from DIV5–7. Treatment of the striatal cultures with EPC-CM resulted in significantly increased densities of GABA-immunoreactive (-ir) neurons. Inhibition of mitogen-activated protein kinase and phosphatidylinositol-3-kinase, but not of the ROCK pathway, significantly attenuated the EPC-CM induced increase in GABA-ir cell densities. Similar results were observed when EPC-CM was subjected to proteolytic digestion and lipid extraction. Furthermore, inhibition of translation abolished the EPC-CM induced effects. Importantly, EPC-CM displayed neuroprotection against 3-nitropropionic acid induced toxicity. These findings demonstrate that EPC-derived paracrine factors substantially promote survival and/or differentiation of cultured striatal progenitor cells involving both proteinaceous factors and lipidic factors. In sum, EPC-CM constituents might lead to a novel cell-free therapeutic strategy to challenge neuronal degeneration.
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Affiliation(s)
- Stefano Di Santo
- 1 Department of Neurosurgery, Bern University Hospital, Switzerland
| | - Stefanie Seiler
- 1 Department of Neurosurgery, Bern University Hospital, Switzerland
| | - Robert Andres
- 1 Department of Neurosurgery, Bern University Hospital, Switzerland
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20
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Seiler S, Schmatloch S, Reinisch M, Neunhöffer T, Schmidt M, Bechtner C, Marmé F, Wagner M, Möbus V, Reimer T, Kleine-Tebbe A, Sinn B, Stickeler E, Untch M, Janni W, Seither F, Loibl S. Abstract P1-17-07: Cancer management and outcome of very young non-pregnant patients with breast cancer diagnosed at 40 years or younger– GBG 29. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-17-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction
Breast cancer diagnosed in young women who are 40 years (yrs) or younger is a relatively rare disease. However, it represents the most common cause of cancer-related deaths in this age-group. Furthermore, young age at diagnosis is associated with an increased risk of recurrence and worse survival. To date, general concepts concerning oncological cancer management should be driven by clinicopathological tumor characteristics and should adhere to standardized protocols for patients in general, but little is known about the oncological cancer treatment and outcome of this very young women in today's clinical practice.
Patients and Methods
The breast cancer in pregnancy registry study (BCP/GBG29/BIG 03-02) is a multicenter, international, observational study. BCP was established to investigate the oncological management and outcome of breast cancer in pregnancy. Since 2014 non-pregnant patients who are 40 yrs or younger are eligible if diagnosed with histological confirmed invasive breast cancer, independent of the type of treatment as control cohort. All patients received oncological treatment according to local standards. In this study the following endpoints will be analyzed descriptively for the young non-pregnant women cohort: breast cancer staging at diagnosis, biological characteristics of breast cancer at diagnosis, diagnostic procedures, treatment modalities, toxicity, pathological complete response after neoadjuvant chemotherapy, disease-free survival and overall survival.
Results
From February 2014 until June 2018, 969 non-pregnant patients ≤40 yrs have been registered. The median age at diagnosis was 35 yrs (range 19-40). Overall, 90.1% of patients had a stage T1-2 at diagnosis and 67.1% of patients had negative lymph nodes. 86.7% of tumors were invasive ductal carcinomas and 4.1% lobular carcinomas. Grading (G) 3 was reported in 55.5%. 26.6% of tumors were luminal A-like (ER- and/or PgR-positive, HER2-negative, G1-2), 40.0% luminal B-like (ER- and/or PgR-positive, HER2-negative, G3 or ER- and/or PgR-positive, HER2-positive, any G), 7.7% HER2 positive non-luminal-like, and 25.7% triple negative breast cancers. 3.8% of young non-pregnant patients had metastatic disease at primary diagnosis.
Conclusion
This registry comprises a large cohort of young non-pregnant patients with breast cancer diagnosed at the age of 40 yrs or younger and provides important data about a modern breast cancer treatment as well as oncological outcome in this setting of young women. Further results including oncological management, toxicity, and survival will be presented at the meeting.
Citation Format: Seiler S, Schmatloch S, Reinisch M, Neunhöffer T, Schmidt M, Bechtner C, Marmé F, Wagner M, Möbus V, Reimer T, Kleine-Tebbe A, Sinn B, Stickeler E, Untch M, Janni W, Seither F, Loibl S. Cancer management and outcome of very young non-pregnant patients with breast cancer diagnosed at 40 years or younger– GBG 29 [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-17-07.
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Affiliation(s)
- S Seiler
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - S Schmatloch
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - M Reinisch
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - T Neunhöffer
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - M Schmidt
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - C Bechtner
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - F Marmé
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - M Wagner
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - V Möbus
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - T Reimer
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - A Kleine-Tebbe
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - B Sinn
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - E Stickeler
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - M Untch
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - W Janni
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - F Seither
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
| | - S Loibl
- German Breast Group, Neu-Isenburg, Germany; Brustzentrum, Elisabeth Krankenhaus, Kassel, Germany; Brustzentrum, Kliniken Essen-Mitte, Essen, Germany; HELIOS Dr. Horst Schmidt Kliniken, Wiesbaden, Germany; Universitätsmedizin Mainz, Mainz, Germany; Brustzentrum, Klinikum Memmingen, Memmingen, Germany; Nationales Centrum für Tumorerkrankungen, Heidelberg, Germany; Siloah St. Trudpert Klinikum, Pforzheim, Germany; Klinikum für Gynäkologie und Geburtshilfe, Klinikum Frankfurt Höchst, Frankfurt, Germany; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock, Rostock, Germany; Brustzentrum, DRK Kliniken, Berlin, Germany; Institut für Pathologie, Charité-Universitätsmedizin, Berlin, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Freiburg, Germany; HELIOS Klinikum, Berlin-Buch, Germany; Frauenheilkunde und Geburtshilfe, Universitätsklinikum, Ulm, Germany
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Geyer CE, Loibl S, Rastogi P, Seiler S, Costantino JP, Nekljudova VN, Cortazar P, Lucas PC, Denkert C, Mamounas EP, Jackisch C, Wolmark N. Abstract OT3-05-01: A randomized double-blind phase III clinical trial of neoadjuvant chemotherapy (NAC) with atezolizumab or placebo in patients (pts) with triple negative breast cancer (TNBC) followed by adjuvant atezolizumab or placebo: NSABP B-59/GBG 96-GeparDouze. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-ot3-05-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background:
TNBC is associated with higher percentages of pathological complete response (pCR) to neoadjuvant chemotherapy (NAC), and women with a pCR have a favorable prognosis. However, Liedtke (2008) and Loibl (2017) found that women with residual disease have a substantially higher risk of recurrence than women with other subtypes of breast cancer. Additionally, Adams (2017) and Schmid (2017) found that therapeutic blockade of PD-L1 binding by atezolizumab has resulted in relevant anti-tumor efficacy.
Methods:
Design
This is a phase III, double blind, placebo-control trial evaluating neoadjuvant atezolizumab with NAC followed by adjuvant atezolizumab in TNBC. Pts are stratified by region (North America; Europe), tumor size (1.1-3.0cm; >3.0cm), AC/EC schedule (q2w; q3w), and nodal status (positive; negative), then randomized 1:1 to receive atezolizumab/placebo 1200 mg IV every 3 wks concurrently with both sequential regimens of weekly paclitaxel 80 mg/m2 IV for 12 doses with every 3-wk carboplatin AUC of 5 IV for 4 doses followed by AC/EC every 2-3 wks (per investigator discretion) for 4 cycles. Following surgery, pts resume atezolizumab/placebo 1200 mg IV every 3 wks as adjuvant therapy for 6 months. Radiotherapy based on local standards is co-administered with atezolizumab/placebo.
Eligibility criteria
Centrally-confirmed ER-neg, PR-neg, HER2-neg invasive breast cancer by ASCO/CAP guidelines. Primary tumor must be stage T2 or T3 if cN0 or cN1 with negative biopsy or T1c, T2, or T3 if cN1 with positive biopsy or cN2 or cN3. LVEF >55% and no significant cardiac history.
Statistical methods
Co-primary endpoints are event-free survival (EFS) and pCR breast/nodes. Secondary endpoints include pCR breast, overall survival, distant disease-free survival, safety and toxicity. Trial is an academic collaboration between NSABP and GBG with support from Genentech/Roche.
NCT03281954
Support: Genentech/Roche
Citation Format: Geyer, Jr. CE, Loibl S, Rastogi P, Seiler S, Costantino JP, Nekljudova VN, Cortazar P, Lucas PC, Denkert C, Mamounas EP, Jackisch C, Wolmark N. A randomized double-blind phase III clinical trial of neoadjuvant chemotherapy (NAC) with atezolizumab or placebo in patients (pts) with triple negative breast cancer (TNBC) followed by adjuvant atezolizumab or placebo: NSABP B-59/GBG 96-GeparDouze [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr OT3-05-01.
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Affiliation(s)
- CE Geyer
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - S Loibl
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - P Rastogi
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - S Seiler
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - JP Costantino
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - VN Nekljudova
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - P Cortazar
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - PC Lucas
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - C Denkert
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - EP Mamounas
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - C Jackisch
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
| | - N Wolmark
- NSABP/NRG Oncology, Pittsburgh; Virginia Commonwealth University Massey Cancer Ctr., Richmond; German Breast Group (GBG), Neu-Isenburg, Germany; McGee-Women's Hospital of UPMC, Pittsburgh; University of Pitsburgh, Pittsburgh; Genentech, Inc., San Francisco; University of Pittsburgh School of Medicine, Pittsburgh; Institute of Pathology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Orlando Health UF Cancer Center, Orlando; Sana Klinikum Offenbach GmbH, Offenbach, Germany; Allegheny Health Network Cancer Institute, Pittsburgh
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Loibl S, Metzger O, Mandrekar S, Mundhenke C, Seiler S, Valagussa P, DeMichele A, Lim E, Tripathy D, Winer E, Huang C, Carey L, Francis P, Miller K, Goetz M, Prat A, Loi S, Krop I, Gianni L, Ciruelos E. PATINA: A randomized, open label, phase III trial to evaluate the efficacy and safety of palbociclib + Anti-HER2 therapy + endocrine therapy (ET) vs. anti-HER2 therapy + ET after induction treatment for hormone receptor positive (HR+)/HER2-positive metastatic breast cancer (MBC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy272.357] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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Reinisch M, Seiler S, Hauzenberger T, Schmatloch S, Strittmatter HJ, Zahm DM, Thode C, Jackisch C, Strik D, Moebus V, Reimer T, Sinn B, Stickeler E, Marme F, Janni W, Kamischke A, Rudlowski C, Nekljudova V, von Minckwitz G, Loibl S. Final analysis of the Male-GBG54 study: A prospective, randomised multi-centre phase II study evaluating endocrine treatment with either tamoxifen +/- gonadotropin releasing hormone analogue (GnRHa) or an aromatase inhibitor + GnRHa in male breast cancer patients. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy424.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perez-Bouza A, Di Santo S, Seiler S, Meyer M, Andereggen L, Huber A, Guzman R, Widmer HR. Simultaneous Transplantation of Fetal Ventral Mesencephalic Tissue and Encapsulated Genetically Modified Cells Releasing GDNF in a Hemi-Parkinsonian Rat Model of Parkinson's Disease. Cell Transplant 2018; 26:1572-1581. [PMID: 29113462 PMCID: PMC5680950 DOI: 10.1177/0963689717721202] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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] [Indexed: 12/27/2022] Open
Abstract
Transplantation of fetal ventral mesencephalic (VM) neurons for Parkinson’s disease (PD) is limited by poor survival and suboptimal integration of grafted tissue into the host brain. In a 6-hydroxydopamine rat model of PD, we investigated the feasibility of simultaneous transplantation of rat fetal VM tissue and polymer-encapsulated C2C12 myoblasts genetically modified to produce glial cell line–derived neurotrophic factor (GDNF) or mock-transfected myoblasts on graft function. Amphetamine-induced rotations were assessed prior to transplantation and 2, 4, 6 and 9 wk posttransplantation. We found that rats grafted with VM transplants and GDNF capsules showed a significant functional recovery 4 wk after implantation. In contrast, rats from the VM transplant and mock-capsule group did not improve at any time point analyzed. Moreover, we detected a significantly higher number of tyrosine hydroxylase immunoreactive (TH-ir) cells per graft (2-fold), a tendency for a larger graft volume and an overall higher TH-ir fiber outgrowth into the host brain (1.7-fold) in the group with VM transplants and GDNF capsules as compared to the VM transplant and mock-capsule group. Most prominent was the TH-ir fiber outgrowth toward the capsule (9-fold). Grafting of GDNF-pretreated VM transplants in combination with the implantation of GDNF capsules resulted in a tendency for a higher TH-ir fiber outgrowth into the host brain (1.7-fold) as compared to the group transplanted with untreated VM transplants and GDNF capsules. No differences between groups were observed for the number of surviving TH-ir neurons or graft volume. In conclusion, our findings demonstrate that simultaneous transplantation of fetal VM tissue and encapsulated GDNF-releasing cells is feasible and support the graft survival and function. Pretreatment of donor tissue with GDNF may offer a way to further improve cell transplantation approaches for PD.
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Affiliation(s)
- Alberto Perez-Bouza
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Di Santo
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefanie Seiler
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Morten Meyer
- 2 Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lukas Andereggen
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Huber
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Guzman
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland.,3 Present address: Departments of Neurosurgery and Biomedicine, University Hospital of Basel, Basel, Switzerland
| | - Hans R Widmer
- 1 Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Bern University Hospital, University of Bern, Bern, Switzerland
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Riva T, Pedersen T, Seiler S, Kasper N, Theiler L, Greif R, Kleine-Brueggeney M. Transnasal humidified rapid insufflation ventilatory exchange for oxygenation of children during apnoea: a prospective randomised controlled trial. Br J Anaesth 2018; 120:592-599. [DOI: 10.1016/j.bja.2017.12.017] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 11/29/2017] [Accepted: 12/12/2017] [Indexed: 12/22/2022] Open
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Loibl S, Barinoff J, Seiler S, Decker T, Denkert C, Hardy-Bessard AC, Senkus-Konefka E, Cognetti F, Palmieri C, Gelmon K, Luebbe K, Furlanetto J, Mueller V, Mundhenke C, Schmidt M, von Minckwitz G, Uhlig M, Burchardi N, Thill M. Abstract OT3-05-04: A randomized, open-label, multi-center phase IV study evaluating palbociclib plus endocrine treatment versus a chemotherapy-based treatment strategy in patients with hormone receptor-positive, HER2-negative metastatic breast cancer in a real world setting (PADMA). Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-ot3-05-04] [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:
Although endocrine therapy (ET) is recommended as first-line therapy for hormone receptor (HR)-positive, HER2-negative metastatic breast cancer (MBC) up to 50% of patients receive chemotherapy in this setting. Meanwhile new targeted treatment options for combination with ET have been developed and endocrine-based therapy with the CDK4/6 inhibitor Palbociclib (P) improves the progression free survival (PFS) of ET alone by about 50%. So far, there is no data comparing chemotherapy with or without maintenance ET and ET in combination with P as first-line therapy. Patients included in clinical trials are often criticized not to mirror the general breast cancer population and every-day clinical practice due to rigid inclusion and exclusion criteria, limited number of treatment options, strict monitoring intervals and study assessments.
Methods:
PADMA trial is a so called low intervention trial with no rigid inclusion and exclusion criteria, and study assessments.Patients with first-line HR+/HER2- MBC who are candidate for mono-chemotherapy will be eligible to receive either P plus ET per label or mono-chemotherapy per investigator´s choice with or without maintenance ET (1:1 randomization). Primary objective is to compare the time-to-treatment failure (TTF) for patients randomized to receive the mono-chemotherapy treatment strategy versus those randomized to receive P and ET. TTF is defined as time from randomization to discontinuation of treatment due to disease progression, treatment toxicity, patient's preference, or death. Main secondary objectives are progression free survival, overall survival at 36 months, amongst other time to event endpoints as well as toxicity and compliance. All patients receive a specific mobile device (PADMA-Phone) and a validated wearable device (ActiWatch) in order to collect data regarding sleep and activity levels, patient well-being and health care utilization (number and duration of phone calls, and patient visits to investigator site) for assessment of daily monitoring treatment impact (DMTI).
Results:
Overall, 360 patients will be accrued to show an improved TTF for P in combination with ET compared to mono-chemotherapy of investigator´s choice with or without maintenance ET. Recruitment will start in QIII/2017 and is planned for approximately 18 months in 100 sites in Germany, Spain, Poland, Italy, France, UK and Canada.
Conclusions:
The aim of PADMA is to demonstrate that an endocrine-based strategy consisting of ET plus P is superior to a chemotherapy-based strategy as first-line therapy in women with HR+/HER2- MBC in a real world setting. Assessment of patient-reported outcome, health care utilization, and sleep and activity levels will deliver important information on the differences between endocrine-based and chemotherapy-based treatment.
Citation Format: Loibl S, Barinoff J, Seiler S, Decker T, Denkert C, Hardy-Bessard A-C, Senkus-Konefka E, Cognetti F, Palmieri C, Gelmon K, Luebbe K, Furlanetto J, Mueller V, Mundhenke C, Schmidt M, von Minckwitz G, Uhlig M, Burchardi N, Thill M. A randomized, open-label, multi-center phase IV study evaluating palbociclib plus endocrine treatment versus a chemotherapy-based treatment strategy in patients with hormone receptor-positive, HER2-negative metastatic breast cancer in a real world setting (PADMA) [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr OT3-05-04.
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Affiliation(s)
- S Loibl
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - J Barinoff
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - S Seiler
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - T Decker
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Denkert
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - A-C Hardy-Bessard
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - E Senkus-Konefka
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - F Cognetti
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Palmieri
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - K Gelmon
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - K Luebbe
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - J Furlanetto
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - V Mueller
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - C Mundhenke
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Schmidt
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - G von Minckwitz
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Uhlig
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - N Burchardi
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
| | - M Thill
- German Breast Group; Charité Universitätsmedizin Berlin; Onkologie Ravensburg; Centre Armoricaine d'Oncologie; Medical University of Gdańsk; Istituto Nazionale Tumori Regina Elena; University of Liverpool; University of British Columbia; Diakovere Henriettenstiftung; University Hospital Eppendorf Frauenklinik; University of Kiel; Johannes Gutenberg Universität; Agaplesion Markus Hospital
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Möbus V, Mahlberg R, Janni W, Tomé O, Marmé F, Forstbauer H, Reimer T, von der Assen A, Reinisch M, Lorenz R, Schmatloch S, Schmidt M, Sinn B, Klutinus N, Stickeler E, Untch M, Seiler S, Burchardi N, von Minckwitz G, Loibl S. Abstract P5-20-09: Pharmacokinetic results of a subcutaneous injection of trastuzumab into the thigh versus into the abdominal wall in patients with HER2-positive primary breast cancer (BC) treated within the neo-/adjuvant GAIN-2 study. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p5-20-09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
A new subcutaneous (s.c.) formulation of trastuzumab became available in 2013 based on equivalent efficacy, pharmacokinetic (PK) profile and safety with the standard intravenous (i.v.) administration, where the s.c. trastuzumab was administered only into the thigh. As an s.c. injection into the abdominal wall (abdw) might be more convenient for patients (pts) and health care professionals, the PK profile of s.c. trastuzumab injected into the thigh vs the abdw in pts with HER2+ early BC needs to be evaluated.
Methods
GAIN-2 study compared two intense dose-dense (idd) anthracycline/taxane containing regimens. After completion of the anthracycline and i.v. trastuzumab given concurrently with taxanes, HER2+ BC pts were randomized in a 1:1 ratio to continue adjuvant s.c. trastuzumab 600mg fixed dose injected every 3 weeks either into the thigh or the abdw. Randomization was stratified according to CT arm [(iddEnPC) vs tailored dd CT (dtEC-dtD)] and age (≤50 vs >50). Pts in the EnPC arm received 14 and in the dtEC-dtD arm 15 cycles of s.c. trastuzumab.
For the PK profile of s.c. trastuzumab serum samples collected before cycle 7, on days 2, 4, 8, 15 and 21 of cycle 7 are evaluated. With a total sample size of 30 (15 per group), the simulated 90% two-sided CI for the area under the plasma concentration (AUC0-last) will be (0.79-1.27) and for the peak drug concentration (Cmax) will be (0.77-1.30). Allowing for a dropout rate of 15%, 18 pts per group will be included in the PK analysis.
The primary objective was to assess the PK profile of s.c. trastuzumab injected into the thigh vs the abdw. The secondary objectives included safety and tolerability.
Results
The per-protocol (pp) set consists of 30 pts (17 in the thigh group and 13 in the abdw group). Baseline characteristics were well balanced between the groups. The log-transformed Geometric Least Square Means (GLSM) for Cmax were 11.77 and 11.52 in the thigh and the abdw group, respectively. The geo-mean ratio (on the original scale) for Cmax was 1.29 (90% CI 1.05-1.58). The log-transformed GLSM for AUC0-last were 14.54 and 14.28 in the thigh and the abdw group, respectively. The geo-mean ratio for AUC0-last was 1.29 (90% CI 1.02-1.63).
Overall 29 pts (96.7%) reported any grade and 5 pts (16.7%) high grade adverse events (AEs). The incidence of any grade AEs was similar between the two groups. The most common AEs were anemia (70.6% for the thigh vs 61.5% for the abdw group, p=0.705), leukopenia (80.0% for both groups, p=1.000) and fatigue (47.1% for the thigh vs 76.9% for the abdw group, p=0.141). 6 serious AEs were reported (2 in the thigh vs 4 in the abdw group). The final PK results of s.c. trastuzumab will be presented at the meeting.
Conclusions
Bioavailability of s.c. trastuzumab as reflected by peak and total exposure measured in cycle 7 was approx. 30% higher if administered into the thigh than into the abdw in pts with HER2+ primary BC treated after dose-dense CT plus i.v. trastuzumab. However, no increased toxicity was observed. Study limitations were that no cross-over design was used and number of pts satisfying criteria for pp-set were different in the arms.
Citation Format: Möbus V, Mahlberg R, Janni W, Tomé O, Marmé F, Forstbauer H, Reimer T, von der Assen A, Reinisch M, Lorenz R, Schmatloch S, Schmidt M, Sinn B, Klutinus N, Stickeler E, Untch M, Seiler S, Burchardi N, von Minckwitz G, Loibl S. Pharmacokinetic results of a subcutaneous injection of trastuzumab into the thigh versus into the abdominal wall in patients with HER2-positive primary breast cancer (BC) treated within the neo-/adjuvant GAIN-2 study [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P5-20-09.
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Affiliation(s)
- V Möbus
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - R Mahlberg
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - W Janni
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - O Tomé
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - F Marmé
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - H Forstbauer
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - T Reimer
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - A von der Assen
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - M Reinisch
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - R Lorenz
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - S Schmatloch
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - M Schmidt
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - B Sinn
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - N Klutinus
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - E Stickeler
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - M Untch
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - S Seiler
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - N Burchardi
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - G von Minckwitz
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
| | - S Loibl
- Klinikum Frankfurt; Klinikum Mutterhaus Mitte, Trier; Universitätsklinikum Ulm; St. Vincentius-Kliniken gAG, Karlsruhe; Universitätsklinikum Heidelberg; GOSPL - Gesellschaft für Onkologische Studien, Troisdorf; Universitätsfrauenklinik und Poliklinik am Klinikum Südstadt Rostock; Franziskus-Hospital Harderberg; Kliniken Essen-Mitte; Frauenärztl. Gemeinschafts- u. Schwerpunktpraxis Onkologie, Braunschweig; Elisabeth Krankenhaus Kassel; Universitätsmedizin Mainz; Charité - Universitätsmedizin Berlin; HELIOS Klinikum Pforzheim GmbH Brustzentrum; Universitätsklinikum Freiburg; HELIOS Klinikum Berlin Buch; German Breast Group
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Harraghy N, Seiler S, Jacobs K, Hannig M, Menger MD, Herrmann M. Advances in in Vitro and in Vivo Models for Studying the Staphylococcal Factors Involved in Implant Infections. Int J Artif Organs 2018; 29:368-78. [PMID: 16705605 DOI: 10.1177/039139880602900406] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Implant infections due to staphylococci are one of the greatest threats facing patients receiving implant devices. For many years researchers have sought to understand the mechanisms involved in the adherence of the bacterium to the implanted device and the formation of the unique structure, the biofilm, which protects the indwelling bacteria from the host defence and renders them resistant to antibiotic treatment. A major goal has been to develop in vitro and in vivo models that adequately reflect the real-life situation. From the simple microtiter plate assay and scanning electron microscopy, tools for studying adherence and biofilm formation have since evolved to include specialised equipment for studying adherence, flow cell systems, real-time analysis of biofilm formation using reporter gene assays both in vitro and in vivo, and a wide variety of animal models. In this article, we discuss advances in the last few years in selected in vitro and in vivo models as well as future developments in the study of adherence and biofilm formation by the staphylococci.
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Affiliation(s)
- N Harraghy
- Institute of Medical Microbiology and Hygiene, University of Saarland, Homburg/Saar, Germany.
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Müllner R, Riva T, Pedersen T, Kleine-Brueggeney M, Seiler S, Theiler L, Greif R. Oxygenation during apnoea in children – A prospective randomised controlled trial. Trends in Anaesthesia and Critical Care 2017. [DOI: 10.1016/j.tacc.2017.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seiler S, Di Santo S, Andereggen L, Widmer HR. Antagonization of the Nogo-Receptor 1 Enhances Dopaminergic Fiber Outgrowth of Transplants in a Rat Model of Parkinson's Disease. Front Cell Neurosci 2017; 11:151. [PMID: 28603490 PMCID: PMC5445167 DOI: 10.3389/fncel.2017.00151] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 02/15/2017] [Accepted: 05/09/2017] [Indexed: 11/13/2022] Open
Abstract
Intrastriatal transplantation of fetal human ventral mesencephalic dopaminergic neurons is an experimental therapy for patients suffering from Parkinson’s disease. The success of this approach depends on several host brain parameters including neurotrophic factors and growth inhibitors that guide survival and integration of transplanted neurons. While the potential of neurotrophic factors has been extensively investigated, repression of growth inhibitors has been neglected, despite the significant effects reported in various CNS injury models. Recently, we demonstrated that infusion of neutralizing antibodies against Nogo-A into the lateral ventricles of hemi-parkinsonian rats significantly enhanced graft function. Since the Nogo-receptor 1 also interacts with other neurite growth inhibitors, we investigated whether a direct antagonization of the receptor would result in more robust effects. Therefore, rats with unilateral striatal 6-hydroxydopamine lesions were grafted with ventral mesencephalic tissue in combination with intraventricular infusions of the Nogo-receptor 1 antagonist NEP1-40. Transplanted rats receiving saline infusions served as controls. To test whether NEP1-40 treatment alone affects the remaining dopaminergic striatal fibers, rats with unilateral striatal 6-hydroxydopamine lesions were infused with NEP1-40 or saline without receiving a transplant. Motor behavior was assessed prior to the lesion as well as prior and 1, 3, and 5 weeks after the transplantations. At the end of the experimental period the number of graft-derived dopaminergic fibers growing into the host brain, the number of surviving dopaminergic neurons and graft volume were analyzed. In rats without a transplant, the density of dopaminergic fibers in the striatum was analyzed. We detected that NEP1-40 treatment significantly enhanced graft-derived dopaminergic fiber outgrowth as compared to controls while no effects were detected for graft volume and survival of grafted dopaminergic neurons. Notably, the enhanced dopaminergic fiber outgrowth was not sufficient to improve the functional recovery as compared to controls. Moreover, NEP1-40 infusions in hemi-parkinsonian rats without a transplant did not result in enhanced striatal dopaminergic fiber densities and consequently did not improve behavior. In sum, our findings demonstrate that antagonization of the Nogo-receptor 1 has the capacity to support the engraftment of transplanted mesencephalic tissue in an animal model of Parkinson’s disease.
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Affiliation(s)
- Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of BernBern, Switzerland.,Department of Clinical Research, University of BernBern, Switzerland
| | - Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of BernBern, Switzerland.,Department of Clinical Research, University of BernBern, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of BernBern, Switzerland.,Department of Clinical Research, University of BernBern, Switzerland
| | - Hans R Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of BernBern, Switzerland.,Department of Clinical Research, University of BernBern, Switzerland
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Seiler S, Di Santo S, Sahli S, Andereggen L, Widmer HR. Nogo-receptor 1 antagonization in combination with neurotrophin-4/5 is not superior to single factor treatment in promoting survival and morphological complexity of cultured dopaminergic neurons. Brain Res 2017; 1668:56-64. [PMID: 28535980 DOI: 10.1016/j.brainres.2017.05.015] [Citation(s) in RCA: 4] [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: 03/28/2017] [Revised: 05/12/2017] [Accepted: 05/13/2017] [Indexed: 01/25/2023]
Abstract
Cell transplantation using ventral mesencephalic tissue is an experimental approach to treat Parkinson's disease. This approach is limited by poor survival of the transplants and the high number of dopaminergic neurons needed for grafting. Increasing the yield of dopaminergic neurons in donor tissue is of great importance. We have previously shown that antagonization of the Nogo-receptor 1 by NEP1-40 promoted survival of cultured dopaminergic neurons and exposure to neurotrophin-4/5 increased dopaminergic cell densities in organotypic midbrain cultures. We investigated whether a combination of both treatments offers a novel tool to further improve dopaminergic neuron survival. Rat embryonic ventral mesencephalic neurons grown as organotypic free-floating roller tube or primary dissociated cultures were exposed to neurotrophin-4/5 and NEP1-40. The combined and single factor treatment resulted in significantly higher numbers of tyrosine hydroxylase positive neurons compared to controls. Significantly stronger tyrosine hydroxylase signal intensity was detected by Western blotting in the combination-treated cultures compared to controls but not compared to single factor treatments. Neurotrophin-4/5 and the combined treatment showed significantly higher signals for the neuronal marker microtubule-associated protein 2 in Western blots compared to control while no effects were observed for the astroglial marker glial fibrillary acidic protein between groups, suggesting that neurotrophin-4/5 targets mainly neuronal cells. Finally, NEP1-40 and the combined treatment significantly augmented tyrosine hydroxylase positive neurite length. Summarizing, our findings substantiate that antagonization of the Nogo-receptor 1 promotes dopaminergic neurons but does not further increase the yield of dopaminergic neurons and their morphological complexity when combined with neurotrophin-4/5 hinting to the idea that these treatments might exert their effects by activating common downstream pathways.
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Affiliation(s)
- Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Clinical Research, University of Bern, Switzerland
| | - Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Clinical Research, University of Bern, Switzerland
| | - Sebastian Sahli
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland
| | - Lukas Andereggen
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Clinical Research, University of Bern, Switzerland
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, CH-3010 Bern, Switzerland; Department of Clinical Research, University of Bern, Switzerland.
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Seiler S, Pirpamer L, Gesierich B, Hofer E, Duering M, Pinter D, Jouvent E, Fazekas F, Mangin JF, Chabriat H, Ropele S, Schmidt R. Lower Magnetization Transfer Ratio in the Forceps Minor Is Associated with Poorer Gait Velocity in Older Adults. AJNR Am J Neuroradiol 2017; 38:500-506. [PMID: 27979793 DOI: 10.3174/ajnr.a5036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Accepted: 10/12/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Gait disturbances in the elderly are disabling and a major public health issue but are poorly understood. In this multimodal MR imaging study, we used 2 voxel-based analysis methods to assess the voxelwise relationship of magnetization transfer ratio and white matter hyperintensity location with gait velocity in older adults. MATERIALS AND METHODS We assessed 230 community-dwelling participants of the Austrian Stroke Prevention Family Study. Every participant underwent 3T MR imaging, including magnetization transfer imaging. Voxel-based magnetization transfer ratio-symptom mapping correlated the white matter magnetization transfer ratio of each voxel with gait velocity. To assess a possible relationship between white matter hyperintensity location and gait velocity, we applied voxel-based lesion-symptom mapping. RESULTS We found a significant association between the magnetization transfer ratio within the forceps minor and gait velocity (β = 0.134; 95% CI, 0.011-0.258; P = .033), independent of demographics, general physical performance, vascular risk factors, and brain volume. White matter hyperintensities did not significantly change this association. CONCLUSIONS Our study provides new evidence for the importance of magnetization transfer ratio changes in gait disturbances at an older age, particularly in the forceps minor. The histopathologic basis of these findings is yet to be determined.
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Affiliation(s)
- S Seiler
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
| | - L Pirpamer
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
| | - B Gesierich
- Institute for Stroke and Dementia Research (B.G., M.D.), Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany
| | - E Hofer
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
- Institute of Medical Informatics, Statistics and Documentation (E.H.), Medical University of Graz, Graz, Austria
| | - M Duering
- Institute for Stroke and Dementia Research (B.G., M.D.), Klinikum der Universität München, Ludwig-Maximilians-University, Munich, Germany
| | - D Pinter
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
| | - E Jouvent
- Department of Neurology (E.J., H.C.), Institut National de la Santé et de la Recherche Médicale, UMR-740, Centre Hospitalo-Universitaire Lariboisière, Paris, France
| | - F Fazekas
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
| | - J-F Mangin
- Neurospin (J.-F.M.), Commissariat à l'Energie Atomique et aux Energies Alternatives Saclay, Gif/Yvette, France
| | - H Chabriat
- Department of Neurology (E.J., H.C.), Institut National de la Santé et de la Recherche Médicale, UMR-740, Centre Hospitalo-Universitaire Lariboisière, Paris, France
| | - S Ropele
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
| | - R Schmidt
- From the Department of Neurology (S.S., L.P., E.H., D.P., F.F., S.R., R.S.)
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Perez-Bouza A, Di Santo S, Seiler S, Meyer M, Andereggen L, Huber A, Guzman R, Widmer HR. Simultaneous transplantation of fetal ventral mesencephalic tissue and encapsulated genetically modified cells releasing GDNF in a hemi-parkinsonian rat model of Parkinson’s disease. Cell Transplant 2017. [DOI: 10.3727/096368917x694679] [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: 11/24/2022] Open
Affiliation(s)
- Alberto Perez-Bouza
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefano Di Santo
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stefanie Seiler
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Morten Meyer
- Dept. of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Odense, Denmark
| | - Lukas Andereggen
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Alexander Huber
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Raphael Guzman
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Hans R. Widmer
- Dept. of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
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Di Santo S, Seiler S, Ducray AD, Meyer M, Widmer HR. A Subpopulation of Dopaminergic Neurons Coexpresses Serotonin in Ventral Mesencephalic Cultures But Not After Intrastriatal Transplantation in a Rat Model of Parkinson's Disease. Cell Transplant 2016; 26:679-691. [PMID: 27938488 DOI: 10.3727/096368916x693707] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Cell replacement therapy is a promising avenue into the investigation and treatment of Parkinson's disease (PD), and in some cases, significant long-term motor improvements have been demonstrated. The main source of donor tissue is the human fetal ventral mesencephalon (FVM), which consists of a mixed neuronal population, and its heterogeneity likely contributes to the inconsistent outcome observed in clinical trials. Therefore, detailed knowledge about the neuronal subpopulations in the VM seems essential for successful cell transplantation. Interestingly, it has been reported that some tyrosine hydroxylase-positive (TH+) neurons in the VM of adult rats and in cultured midbrain-derived neuroblasts coexpress additional neurotransmitters. Thus, the present study investigated, by means of colocalization analyses, the possible expression of GABA or serotonin in TH+ neurons. For that purpose, both fetal rat and human dissociated, organotypic and neurosphere FVM cultures as well as an animal model of PD were investigated. In dissociated rat FVM cultures, approximately 30% of the TH+ neurons coexpressed serotonin, while no colocalization with GABA was observed. Interestingly, coexpression of TH and serotonin was found to be dependent on the time in culture, the plating density, and the exposure to neurotrophic factors, that is, higher cell densities and treatment with brain-derived neurotrophic factor resulted in a significantly reduced coexpression rate. Notably, even though approximately 30% of the dopaminergic neurons in the donor tissue coexpressed serotonin, no colocalization could be detected in grafts 1 month after intrastriatal transplantation into hemiparkinsonian rats. In conclusion, a significant and susceptible subpopulation of dopaminergic neurons in FVM tissues coexpresses serotonin. This might have potential implications for the future selection and handling of cells prior to transplantation in PD.
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Rahimi A, Thomas K, Spangler A, Leitch M, Rao R, Wooldridge R, Rivers A, Seiler S, Albuquerque K, Stevenson S, Goudreau S, Garwood D, Haley B, Euhus D, Chen D, Heinzerling J, Ding C, Gao A, Ahn C, Timmerman R. Phase 1 Dose Escalation Trial Using 5-Fraction Stereotactic Body Radiation Therapy For Partial Breast Irradiation (S-PBI). Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Seiler S, Di Santo S, Widmer HR. Nogo-A Neutralization Improves Graft Function in a Rat Model of Parkinson's Disease. Front Cell Neurosci 2016; 10:87. [PMID: 27092052 PMCID: PMC4821173 DOI: 10.3389/fncel.2016.00087] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [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: 12/30/2015] [Accepted: 03/21/2016] [Indexed: 11/13/2022] Open
Abstract
Transplantation of fetal human ventral mesencephalic (VM) dopaminergic neurons into the striatum is a promising strategy to compensate for the characteristic dopamine deficit observed in Parkinson’s disease (PD). This therapeutic approach, however, is currently limited by the high number of fetuses needed for transplantation and the poor survival and functional integration of grafted dopaminergic neurons into the host brain. Accumulating evidence indicates that contrasting inhibitory signals endowed in the central nervous system (CNS) might support neuronal regeneration. Hence, in the present study we aimed at improving survival and integration of grafted cells in the host brain by neutralizing Nogo-A, one of the most potent neurite growth inhibitors in the CNS. For that purpose, VM tissue cultures were transplanted into rats with a partial 6-hydroxydopamine (6-OHDA) lesion causing a hemi-PD model and concomitantly treated for 2 weeks with intra-ventricular infusion of neutralizing anti-Nogo-A antibodies. Motor behavior using the cylinder test was assessed prior to and after transplantation as functional outcome. At the end of the experimental period the number of dopaminergic fibers growing into the host brain, the number of surviving dopaminergic neurons in the grafts as well as graft size was examined. We found that anti-Nogo-A antibody infusion significantly improved the asymmetrical forelimb use observed after lesions as compared to controls. Importantly, a significantly three-fold higher dopaminergic fiber outgrowth from the transplants was detected in the Nogo-A antibody treated group as compared to controls. Furthermore, Nogo-A neutralization showed a tendency for increased survival of dopaminergic neurons (by two-fold) in the grafts. No significant differences were observed for graft volume and the number of dopaminergic neurons co-expressing G-protein-coupled inward rectifier potassium channel subunit two between groups. In sum, our findings support the view that neutralization of Nogo-A in the host brain may offer a novel and therapeutically meaningful intervention for cell transplantation approaches in PD.
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Affiliation(s)
- Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital BernSwitzerland; Graduate School for Cellular and Biomedical Sciences, University of BernBern, Switzerland
| | - Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern Switzerland
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern Switzerland
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Di Santo S, Fuchs AL, Periasamy R, Seiler S, Widmer HR. The Cytoprotective Effects of Human Endothelial Progenitor Cell-Conditioned Medium Against an Ischemic Insult Are Not Dependent on VEGF and IL-8. Cell Transplant 2016; 25:735-47. [PMID: 26776768 DOI: 10.3727/096368916x690458] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Endothelial progenitor cells (EPCs) promote revascularization and tissue repair mainly by paracrine actions. In the present study, we investigated whether EPC-secreted factors in the form of conditioned medium (EPC-CM) can protect cultured brain microvascular endothelial cells against an ischemic insult. Furthermore, we addressed the type of factors that are involved in the EPC-CM-mediated functions. For that purpose, rat brain-derived endothelial cells (rBCEC4 cell line) were exposed to EPC-CM pretreated with proteolytic digestion, heat inactivation, and lipid extraction. Moreover, the involvement of VEGF and IL-8, as canonical angiogenic factors, was investigated by means of neutralizing antibodies. We demonstrated that EPC-CM significantly protected the rBCEC4 cells against an ischemic insult mimicked by induced oxygen-glucose deprivation followed by reoxygenation. The cytoprotective effect was displayed by higher viable cell numbers and reduced caspase 3/7 activity. Heat inactivation, proteolytic digestion, and lipid extraction resulted in a significantly reduced EPC-CM-dependent increase in rBCEC4 viability, tube formation, and survival following the ischemic challenge. Notably, VEGF and IL-8 neutralization did not affect the actions of EPC-CM on rBCEC4 under both standard and ischemic conditions. In summary, our findings show that paracrine factors released by EPCs activate an angiogenic and cytoprotective response on brain microvascular cells and that the activity of EPC-CM relies on the concerted action of nonproteinaceous and proteinaceous factors but do not directly involve VEGF and IL-8.
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Affiliation(s)
- Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
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Affiliation(s)
- Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of Bern, Inselspital, Berne, Switzerland ; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Hans R Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern, Switzerland University of Bern, Inselspital, Berne, Switzerland
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Waser M, Garn H, Deistler M, Benke T, Dal-Bianco P, Ransmayr G, Schmidt H, Sanin G, Santer P, Caravias G, Seiler S, Grossegger D, Fruehwirt W, Schmidt R. Using static and dynamic canonical correlation coefficients as quantitative EEG markers for Alzheimer's disease severity. Annu Int Conf IEEE Eng Med Biol Soc 2015; 2014:2801-4. [PMID: 25570573 DOI: 10.1109/embc.2014.6944205] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We analyzed the relation between Alzheimer's disease (AD) severity as measured by Mini-Mental State Examination (MMSE) scores and quantitative electroencephalographic (qEEG) markers that were derived from canonical correlation analysis. This allowed an investigation of EEG synchrony between groups of EEG channels. In this study, we applied the data from 79 participants in the multi-centric cohort study PRODEM-Austria with probable AD. Following a homogeneous protocol, the EEG was recorded both in resting state and during a cognitive task. A quadratic regression model was used to describe the relation between MMSE and the qEEG synchrony markers. This relation was most significant in the δ and θ frequency bands in resting state, and between left-hemispheric central, temporal and parietal channel groups during the cognitive task. Here, the MMSE explained up to 40% of the qEEG marker's variation. QEEG markers showed an ambiguous trend, i.e. an increase of EEG synchrony in the initial stage of AD (MMSE>20) and a decrease in later stages. This effect could be caused by compensatory brain mechanisms. We conclude that the proposed qEEG markers are closely related to AD severity. Despite the ambiguous trend and the resulting diagnostic ambiguity, the qEEG markers could provide aid in the diagnostics of early-stage AD.
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Abstract
Nogo-A is a myelin associated protein and one of the most potent neurite growth inhibitors in the central nervous system. Interference with Nogo-A signaling has thus been investigated as therapeutic target to promote functional recovery in CNS injuries. Still, the finding that Nogo-A presents a fairly ubiquitous expression in many types of neurons in different brain regions, in the eye and even in the inner ear suggests for further functions besides the neurite growth repression. Indeed, a growing number of studies identified a variety of functions including regulation of neuronal stem cells, modulation of microglial activity, inhibition of angiogenesis and interference with memory formation. Aim of the present commentary is to draw attention on these less well-known and sometimes controversial roles of Nogo-A. Furthermore, we are addressing the role of Nogo-A in neuropathological conditions such as ischemic stroke, schizophrenia and neurodegenerative diseases.
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Affiliation(s)
- Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern and University of Bern, CH-3010 Bern, Switzerland; Graduate School for Cellular and Biomedical Sciences, University of Bern, Bern, Switzerland
| | - Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern and University of Bern, CH-3010 Bern, Switzerland
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University Hospital Bern and University of Bern, CH-3010 Bern, Switzerland.
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Jackisch C, Müller V, Dall P, Neumeister R, Park-Simon TW, Ruf-Dördelmann A, Seiler S, Tesch H, Ataseven B. Subcutaneous Trastuzumab for HER2-positive Breast Cancer - Evidence and Practical Experience in 7 German Centers. Geburtshilfe Frauenheilkd 2015; 75:566-573. [PMID: 26166837 DOI: 10.1055/s-0035-1546172] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Revised: 05/18/2015] [Accepted: 05/18/2015] [Indexed: 02/07/2023] Open
Abstract
A subcutaneous formulation of trastuzumab to treat patients with HER2-positive breast cancer is available since August 2013. The subcutaneous formulation is administered as a fixed dose of 600 mg over a period of up to 5 minutes. The HannaH trial compared subcutaneous with intravenous administration and found comparable pharmacokinetics, efficacy and tolerability for both administration forms of trastuzumab in the neoadjuvant setting. The randomized crossover study PrefHer reported a clear preference from the patient's point of view for subcutaneous over intravenous administration of trastuzumab. The accompanying time-and-motion study reported a reduction concerning the total time spent for the institution as well as for the patient receiving trastuzumab s. c.. The experience of 7 German centers largely corresponded with the results of these studies. Patients expressed a clear preference for subcutaneous trastuzumab administration, with the time saved by the subcutaneous administration route cited as the greatest benefit. Although the existing reimbursement terms mean that centers will receive a lower remuneration, the centers' overall evaluation of the subcutaneous administration route for trastuzumab was overwhelmingly positive. The greatest benefit cited by the centers was the flexibility in scheduling patient appointments. This increased flexibility improved conditions in some centers which were experiencing pressures due to a shortage of staff, particularly at peak times. The general consensus, however, was that the remuneration systems for oncological treatments urgently need to be amended to ensure that the real costs of treatment are covered, even if the administration route has changed.
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Affiliation(s)
- C Jackisch
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach
| | - V Müller
- Frauenklinik, Universitätsklinikum Hamburg-Eppendorf, Hamburg
| | - P Dall
- Frauenklinik, Städtisches Klinikum Lüneburg, Lüneburg
| | - R Neumeister
- Frauenklinik, Universitätsklinikum Magdeburg, Magdeburg
| | - T-W Park-Simon
- Klinik für Frauenheilkunde und Geburtshilfe, Medizinische Hochschule Hannover, Hannover
| | | | - S Seiler
- Klinik für Gynäkologie und Geburtshilfe, Sana Klinikum Offenbach, Offenbach
| | - H Tesch
- Onkologische Gemeinschaftspraxis am Bethanien-Krankenhaus, Frankfurt
| | - B Ataseven
- Gynäkologie und Gynäkologische Onkologie, Kliniken Essen-Mitte, Essen
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Liechti R, Ducray AD, Jensen P, Di Santo S, Seiler S, Jensen CH, Meyer M, Widmer HR. Characterization of fetal antigen 1/delta-like 1 homologue expressing cells in the rat nigrostriatal system: effects of a unilateral 6-hydroxydopamine lesion. PLoS One 2015; 10:e0116088. [PMID: 25723595 PMCID: PMC4344227 DOI: 10.1371/journal.pone.0116088] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 12/04/2014] [Indexed: 11/18/2022] Open
Abstract
Fetal antigen 1/delta-like 1 homologue (FA1/dlk1) belongs to the epidermal growth factor superfamily and is considered to be a non-canonical ligand for the Notch receptor. Interactions between Notch and its ligands are crucial for the development of various tissues. Moreover, FA1/dlk1 has been suggested as a potential supplementary marker of dopaminergic neurons. The present study aimed at investigating the distribution of FA1/dlk1-immunoreactive (-ir) cells in the early postnatal and adult midbrain as well as in the nigrostriatal system of 6-hydroxydopamine (6-OHDA)-lesioned hemiparkinsonian adult rats. FA1/dlk1-ir cells were predominantly distributed in the substantia nigra (SN) pars compacta (SNc) and in the ventral tegmental area. Interestingly, the expression of FA1/dlk1 significantly increased in tyrosine hydroxylase (TH)-ir cells during early postnatal development. Co-localization and tracing studies demonstrated that FA1/dlk1-ir cells in the SNc were nigrostriatal dopaminergic neurons, and unilateral 6-OHDA lesions resulted in loss of both FA1/dlk1-ir and TH-ir cells in the SNc. Surprisingly, increased numbers of FA1/dlk1-ir cells (by 70%) were detected in dopamine-depleted striata as compared to unlesioned controls. The higher number of FA1/dlk1-ir cells was likely not due to neurogenesis as colocalization studies for proliferation markers were negative. This suggests that FA1/dlk1 was up-regulated in intrinsic cells in response to the 6-OHDA-mediated loss of FA1/dlk1-expressing SNc dopaminergic neurons and/or due to the stab wound. Our findings hint to a significant role of FA1/dlk1 in the SNc during early postnatal development. The differential expression of FA1/dlk1 in the SNc and the striatum of dopamine-depleted rats could indicate a potential involvement of FA1/dlk1 in the cellular response to the degenerative processes.
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Affiliation(s)
- Rémy Liechti
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster University of Bern, Inselspital, CH-3010 Berne, Switzerland
| | - Angélique D. Ducray
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster University of Bern, Inselspital, CH-3010 Berne, Switzerland
| | - Pia Jensen
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Winsløwparken 21, DK-5000 Odense C, Denmark
| | - Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster University of Bern, Inselspital, CH-3010 Berne, Switzerland
| | - Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster University of Bern, Inselspital, CH-3010 Berne, Switzerland
| | - Charlotte H. Jensen
- Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Sdr. Boulevard 29, DK-5000, Odense C, Denmark
- Department of Cardiovascular and Renal Research, University of Southern Denmark, Winsløwparken 21, DK-5000 Odense C, Denmark
| | - Morten Meyer
- Department of Neurobiology Research, Institute of Molecular Medicine, University of Southern Denmark, Winsløwparken 21, DK-5000 Odense C, Denmark
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster University of Bern, Inselspital, CH-3010 Berne, Switzerland
- * E-mail:
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Schawkat K, Di Santo S, Seiler S, Ducray AD, Widmer HR. Loss of Nogo-A-expressing neurons in a rat model of Parkinson's disease. Neuroscience 2014; 288:59-72. [PMID: 25554426 DOI: 10.1016/j.neuroscience.2014.12.035] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 09/17/2014] [Revised: 12/15/2014] [Accepted: 12/15/2014] [Indexed: 11/15/2022]
Abstract
The myelin-associated protein Nogo-A is among the most potent neurite growth inhibitors in the adult CNS. Recently, Nogo-A expression was demonstrated in a number of neuronal subpopulations of the adult and developing CNS but at present, little is known about the expression of Nogo-A in the nigrostriatal system, a brain structure severely affected in Parkinson's disease (PD). The present study sought to characterize the expression pattern of Nogo-A immunoreactive (ir) cells in the adult ventral mesencephalon of control rats and in the 6-hydroxydopamine (6-OHDA) rat model of PD. Immunohistochemical analyses of normal adult rat brain showed a distinct expression of Nogo-A in the ventral mesencephalon, with the highest level in the substantia nigra pars compacta (SNc) where it co-localized with dopaminergic neurons. Analyses conducted 1week and 1 month after unilateral striatal injections of 6-OHDA disclosed a severe loss of the number of Nogo-A-ir cells in the SNc. Notably, at 1week after treatment, more dopaminergic neurons expressing Nogo-A were affected by the 6-OHDA toxicity than Nogo-A-negative dopaminergic neurons. However, at later time points more of the surviving dopaminergic neurons expressed Nogo-A. In the striatum, both small and large Nogo-A-positive cells were detected. The large cells were identified as cholinergic interneurons. Our results suggest yet unidentified functions of Nogo-A in the CNS beyond the inhibition of axonal regeneration and plasticity, and may indicate a role for Nogo-A in PD.
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Affiliation(s)
- K Schawkat
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
| | - S Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
| | - S Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
| | - A D Ducray
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
| | - H R Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, CH-3010 Bern, Switzerland.
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Seiler S, Colbus SM, Lucisano G, Rogacev KS, Gerhart MK, Ziegler M, Fliser D, Heine GH. Erratum. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Onuigbo M, Agbasi N, Wu MJ, Shu KH, Kugler E, Cohen E, Krause I, Goldberg E, Garty M, Krause I, Jansen J, De Napoli IE, Schophuizen CM, Wilmer MJ, Mutsaers HA, Heuvel LP, Grijpma DW, Stamatialis D, Hoenderop JG, Masereeuw R, Van Craenenbroeck AH, Van Craenenbroeck EM, Van Ackeren K, Vrints CJ, Hoymans VY, Couttenye MM, Erkmen Uyar M, Tutal E, Bal Z, Guliyev O, Sezer S, Liu L, Wang C, Tanaka K, Kushiyama A, Sakai K, Hara S, Ubara Y, Ohashi Y, Kunugi Y, Kawazu S, Untersteller K, Seiler S, Rogacev KS, Emrich IE, Lennartz CS, Fliser D, Heine GH, Hoshino T, Ookawara S, Miyazawa H, Ueda Y, Ito K, Kaku Y, Hirai K, Mori H, Yoshida I, Kakuta S, Hayama N, Amemiya M, Okamoto H, Inoue S, Tabei K, Campos P, Dias C, Baptista J, Papoila AL, Ortiz A, Inchaustegui L, Soto K, Moon KH, Yang S, Lee DY, Kim HW, Kim B, Isnard Bagnis C, Guerraoui A, Zenasni F, Idier L, Chauveau P, Cerqueira A, Quelhas-Santos J, Pestana M, Choi JY, Jin DC, Choi YJ, Kim WY, Nam SA, Cha JH, Cernaro V, Loddo S, Lacquaniti A, Romeo A, Costantino G, Montalto G, Santoro D, Trimboli D, Ricciardi CA, Lacava V, Buemi M, Emrich IE, Zawada AM, Rogacev KS, Seiler S, Obeid R, Geisel J, Fliser D, Heine GH, Meneses GC, Silva Junior G, Costa MFB, Goncalves HS, Daher EF, Liborio AB, Martins AMC, Ekart R, Hojs N, Bevc S, Hojs R, Lim CS, Hwang JH, Chin HJ, Kim S, Kim DK, Kim S, Park JH, Shin SJ, Lee SH, Choi BS, Lemoine S, Panaye M, Juillard L, Dubourg L, Hadj-Aissa A, Guebre-Egziabher F, Silva Junior G, Vieira APF, Couto Bem AX, Alves MP, Meneses GC, Martins AMC, Liborio AB, Daher EF, Ito K, Ookawara S, Miyazawa H, Ueda Y, Kaku Y, Hirai K, Hoshino T, Mori H, Yoshida I, Tabei K, Stefan G, Capusa C, Stancu S, Margarit D, Petrescu L, Nedelcu ED, Mircescu G, Szarejko-Paradowska A, Rysz J, Hung CC, Chen HC, Ristovska V, Grcevska L, Podesta MA, Reggiani F, Cucchiari D, Badalamenti S, Buemi M, Ponticelli C, Graziani G, Nouri-Majalan N, Moghadasimousavi S, Eshaghyeh Z, Greenwood S, Koufaki P, Maclaughlin H, Rush R, Hendry BM, Macdougall IC, Mercer T, Cairns H. CKD LAB METHODS, PROGRESSION & RISK FACTORS 2. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu165] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
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Fusaro M, Giannini S, Miozzo D, Noale M, Tripepi G, Plebani M, Zaninotto M, Piccoli A, Vilei MT, Cristofaro R, Gallieni M, Hamamoto K, Inaba M, Okuno S, Imanishi Y, Ishimura E, Yamakawa T, Shoji S, Rothe HM, Eller P, Mayer G, Ketteler M, Kramar R, Shaheen F, Al Rukhaimi M, Alsahow A, Al-Ali F, Al Salmi I, Al Ghareeb S, Wang M, Bieber B, Robinson BM, Pisoni RL, Waniewski J, Debowska M, Wojcik-Zaluska A, Ksiazek A, Zaluska W, De Broe ME, Wilson RJ, Copley JB, Hiramtasu R, Ubara Y, Hoshino J, Takaichi K, Ghalli FG, Ghalli FG, Ibakkanavar R, Chess J, Roberts G, Riley S, Oliveira ASA, Carvalho CJB, Oliveira CBL, Pessoa CTBC, Leao RAS, Gueiros JEB, Gueiros APS, Okano K, Tsuruta Y, Hibi A, Tsukada M, Miwa N, Kimata N, Tsuchiya K, Akiba T, Nitta K, Mizobuchi M, Ogata H, Hosaka N, Sanada D, Arai N, Koiwa F, Kinugasa E, Shibata T, Akizawa T, Delanaye P, Krzesinski JM, Warling X, Moonen M, Smelten N, Medart L, Pottel H, Cavalier E, Delanaye P, Souberbielle JC, Gadisseur R, Dubois BE, Krzesinski JM, Cavalier E, Matias P, Jorge C, Mendes M, Azevedo A, Navarro D, Ferreira C, Amaral T, Aires I, Gil C, Ferreira A, Kikuchi H, Shimada H, Karasawa R, Suzuki M, An WS, Lee SM, Oh YJ, Son YK, De Paola L, Lombardi G, Panzino MT, Lombardi L, Reichel H, Hahn KM, Kohnle M, Guggenberger C, Delanna F, Sasaki N, Tsunoda M, Ikee R, Hashimoto N, Sola L, Leyun MN, Diaz JC, Sehabiague C, Gonzalez S, Alallon W, Bourbeau K, Lajoie C, Macway F, Fujii T, Suzuki S, Shinozaki M, Tanaka H, Klingele M, Seiler S, Poppleton A, Lepper P, Fliser D, Seidel R, Lun L, Liu D, Li X, Wei X, Miao J, Gao Z, Hu R, De Paola L, Lombardi G, Panzino MT, Lombardi L, Gros B, Galan A, Gonzalez-Parra E, Herrero JA, Echave M, Vegter S, Tolley K, Oyaguez I, Gutzwiller FS, Braunhofer PG, Szucs TD, Schwenkglenks M, Yilmaz VT, Ozdem S, Donmez L, Kocak H, Dinckan A, Cetinkaya R, Suleymanlar G, Ersoy FF. DIALYSIS BONE DISEASE. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Reyes-Bahamonde J, Raimann JG, Canaud B, Etter M, Kooman JP, Levin NW, Marcelli D, Marelli C, Power A, Van Der Sande FM, Thijssen S, Usvyat LA, Wang Y, Kotanko P, Blank PR, Szucs TD, Gibertoni D, Torroni S, Mandreoli M, Rucci P, Fantini MP, Santoro A, Van Der Veer SN, Nistor I, Bernaert P, Bolignano D, Brown EA, Covic A, Farrington K, Kooman J, Macias J, Mooney A, Van Munster BC, Van Den Noortgate N, Topinkova E, Wirnsberger G, Jager KJ, Van Biesen W, Stubnova V, Os I, Grundtvig M, Waldum B, Wu HY, Peng YS, Wu MS, Chu TS, Chien KL, Hung KY, Wu KD, Carrero JJ, Huang X, Sui X, Ruiz JR, Hirth V, Ortega FB, Blair SN, Coppolino G, Bolignano D, Rivoli L, Presta P, Mazza G, Fuiano G, Marx S, Petrilla A, Hengst N, Lee WC, Ruggajo P, Skrunes R, Svarstad E, Skjaerven R, Reisaether AV, Vikse BE, Fujii N, Hamano T, Akagi S, Watanabe T, Imai E, Nitta K, Akizawa T, Matsuo S, Makino H, Scalzotto E, Corradi V, Nalesso F, Zaglia T, Neri M, Martino F, Zanella M, Brendolan A, Mongillo M, Ronco C, Occelli F, Genin M, Deram A, Glowacki F, Cuny D, Mansurova I, Alchinbayev M, Malikh MA, Song S, Shin MJ, Rhee H, Yang BY, Kim I, Seong EY, Lee DW, Lee SB, Kwak IS, Isnard Bagnis C, Speyer E, Beauger D, Caille Y, Baudelot C, Mercier S, Jacquelinet C, Gentile SM, Briancon S, Yu TM, Li CY, Krivoshiev S, Borissova AM, Shinkov A, Svinarov D, Vlachov J, Koteva A, Dakovska L, Mihaylov G, Popov A, Polner K, Mucsi I, Braunitzer H, Kiss A, Nadasdi Z, Haris A, Zdrojewski L, Zdrojewski T, Rutkowski B, Minami S, Hesaka A, Yamaguchi S, Iwahashi E, Sakai S, Fujimoto T, Sasaki K, Fujita Y, Yokoyama K, Dey V, Farrah T, Traynor J, Spalding E, Robertson S, Geddes CC, Mann MC, Hobbs A, Hemmelgarn BR, Roberts D, Ahmed SB, Rabi D, Elewa U, Fernandez B, Alegre ER, Mahillo I, Egido J, Ortiz A, Marx S, Pomerantz D, Vietri J, Zewinger S, Speer T, Kleber ME, Scharnagl H, Woitas R, Pfahler K, Seiler S, Heine GH, Lepper PM, Marz W, Silbernagel G, Fliser D, Caldararu CD, Gliga ML, Tarta ID, Szanto A, Carlan O, Dogaru GA, Battaglia Y, Del Prete MA, De Gregorio MG, Errichiello C, Gisonni P, Russo L, Scognamiglio B, Storari A, Russo D, Kuma A, Serino R, Miyamoto T, Tamura M, Otsuji Y, Kung LF, Naito S, Iimori S, Okado T, Rai T, Uchida S, Sasaki S, Kang YU, Kim HY, Choi JS, Kim CS, Bae EH, Ma SK, Kim SW, Muthuppalaniappan VM, Byrne C, Sheaff M, Rajakariar R, Blunden M, Delmas Y, Loirat C, Muus P, Legendre C, Douglas K, Hourmant M, Herthelius M, Trivelli A, Goodship T, Bedrosian CL, Licht C, Marks A, Black C, Clark L, Prescott G, Robertson L, Simpson W, Simpson W, Fluck N, Wang SL, Hsu YH, Pai HC, Chang YM, Liu WH, Hsu CC, Shvetsov M, Nagaytseva S, Gerasimov A, Shalyagin Y, Ivanova E, Shilov E, Zhang Y, Zuo W, Marx S, Manthena S, Newmark J, Zdrojewski L, Rutkowski M, Zdrojewski T, Bandosz P, Gaciong Z, Solnica B, Rutkowski B, Wyrzykowski B, Ensergueix G, Karras A, Levi C, Chauvet S, Trivin C, Ficheux M, Augusto JF, Boudet R, Chambaraud T, Boudou-Rouquette P, Tubiana-Mathieu N, Aldigier JC, Jacquot C, Essig M, Thervet E, Oh YJ, Lee CS, Malho Guedes A, Silva AP, Goncalves C, Sampaio S, Morgado E, Santos V, Bernardo I, Leao Neves P, Onuigbo M, Agbasi N. CKD GENERAL AND CLINICAL EPIDEMIOLOGY 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
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Poesen R, Viaene L, Bammens B, Claes K, Evenepoel P, Meijers B, Bozic M, De Pablo C, Alvarez A, Sanchez-Nino MD, Ortiz A, Fernandez E, Valdivielso JM, Speer T, Zewinger S, Holy EW, Stahli BE, Triem S, Cvija H, Rohrer L, Seiler S, Heine GH, Jankowski V, Jankowski J, Camici G, Akhmedov A, Luscher TF, Tanner FC, Fliser D, Isoyama N, Leurs P, Qureshi AR, Anderstam B, Heimburger O, Barany P, Stenvinkel P, Lindholm B, Bolasco P, Palleschi S, Rossi B, Atti M, Amore A, Coppo R, Loiacono E, Ghezzi PM, Palladino G, Caiazzo M, Di Napoli A, Tazza L, Franco F, Chicca S, Bossola M, Di Lallo D, Michelozzi P, Davoli M, Lucisano S, Arena A, Lupica R, Cernaro V, Trimboli D, Aloisi C, Montalto G, Santoro D, Buemi M, Burtey S, Poitevin S, Darbousset R, Gondouin B, Dubois C, Erkmen Uyar M, Bal Z, Bayraktar N, Gurlek Demirci B, Sayin B, Sezer S, Rogacev K, Zawada A, Emrich I, Seiler S, Bohm M, Fliser D, Woollard K, Heine G, Gbandjaba NY, Ghalim N, Saile R, Khalil A, Fujii H, Yamashita Y, Yonekura Y, Nakai K, Kono K, Goto S, Sugano M, Goto S, Ito Y, Nishi S, Leurs P, Meuwese C, Carrero JJ, Qureshi AR, Anderstam B, Barany P, Heimburger O, Stenvinkel P, Lindholm B, Riccio E, Sabbatini M, Bellizzi V, Pisani A, Svedberg O, Stenvinkel P, Qureshi AR, Barany P, Heimburger O, Leurs P, Isoyama N, Lindholm B, Anderstam B, Barreto-Silva MI, Lemos C, Costa-Silva F, Mendes R, Bregman R, Barreto - Silva MI, Lemos C, Vargas S, Barja-Fidalgo TC, Bregman R, Sidoti A, Lusini ML, Biagioli M, Sereni L, Ghezzi PM, Caiazzo M, Palladino G, Kara E, Ahbap E, Basturk T, Koc Y, Sakaci T, Sahutoglu T, Sevinc M, Akgol C, Unsal A, Snaedal S, Qureshi AR, Carrero JJ, Heimburger O, Stenvinkel P, Barany P, Paliouras C, Haviatsos T, Lamprianou F, Papagiannis N, Ntetskas G, Roufas K, Karvouniaris N, Anastasakis E, Moschos N, Alivanis P, Santoro D, Ingegneri MT, Vita G, Pisacane A, Bellinghieri G, Savica V, Buemi M, Lucisano S, Kim HK, Kim SC, Kim MG, Jo SK, Cho WY, Altunoglu A, Yavuz D, Canoz MB, Yavuz R, Karakas LA, Bayraktar N, Colak T, Sezer S, Ozdemir FN, Haberal M, Akbasli AC, Keven K, Erbay B, Nebio lu S, Loboda O, Dudar I, Krot V, Alekseeva V, Grabulosa CC, De Carvalho JTG, Manfredi SR, Canziani ME, Quinto BMR, Peres AT, Batista MC, Cendoroglo M, Dalboni MA, Zingerman B, Azoulay O, Gamzo Z, Rozen-Zvi B, Stefan G, Capusa C, Stancu S, Ilyes A, Viasu L, Mircescu G, Yilmaz MI, Solak Y, Saglam M, Cayci T, Acikel C, Unal HU, Eyileten T, Oguz Y, Sari S, Carrero JJ, Stenvinkel P, Covic A, Kanbay M, Kim YN, Park K, Gwoo S, Shin HS, Jung YS, Rim H, Rhew HY, Gok M, Kurt Y, Unal HU, CetInkaya H, Karaman M, EyIeten T, Vural A, Yilmaz MI, Oguz Y, Flisi Ski M, Brymora A, StrozEcki P, Stefa Ska A, Manitius J, Donderski R, Mi Kowiec-Wi Niewska I, Kretowicz M, Johnson R, Kami Ska A, Junik R, Siodmiak J, Stefa Ska A, Odrowaz-Sypniewska G, Manitius J, Tasic D, Radenkovic S, Kocic G, Wyskida K, Spiechowicz-Zato U, Rotkegel S, Ciepal J, Klein D, Bozentowicz-Wikarek M, Brzozowska A, Olszanecka-Glinianowicz M, Chudek J, Dimitrijevic Z, Cvetkovic T, Mitic B, Paunovic K, Paunovic G, Stojanovic M, Velickovic-Radovanovic R, Gliga ML, Gliga PM, Stoica C, Tarta D, Dogaru G. CKD NUTRITION, INFLAMMATION AND OXIDATIVE STRESS. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu168] [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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Di Santo S, Seiler S, Fuchs AL, Staudigl J, Widmer HR. The secretome of endothelial progenitor cells promotes brain endothelial cell activity through PI3-kinase and MAP-kinase. PLoS One 2014; 9:e95731. [PMID: 24755675 PMCID: PMC3995762 DOI: 10.1371/journal.pone.0095731] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 03/31/2014] [Indexed: 11/19/2022] Open
Abstract
Background Angiogenesis and vascular remodelling are crucial events in tissue repair mechanisms promoted by cell transplantation. Current evidence underscores the importance of the soluble factors secreted by stem cells in tissue regeneration. In the present study we investigated the effects of paracrine factors derived from cultured endothelial progenitor cells (EPC) on rat brain endothelial cell properties and addressed the signaling pathways involved. Methods Endothelial cells derived from rat brain (rBCEC4) were incubated with EPC-derived conditioned medium (EPC-CM). The angiogenic response of rBCEC4 to EPC-CM was assessed as effect on cell number, migration and tubular network formation. In addition, we have compared the outcome of the in vitro experiments with the effects on capillary sprouting from rat aortic rings. The specific PI3K/AKT inhibitor LY294002 and the MEK/ERK inhibitor PD98059 were used to study the involvement of these two signaling pathways in the transduction of the angiogenic effects of EPC-CM. Results Viable cell number, migration and tubule network formation were significantly augmented upon incubation with EPC-CM. Similar findings were observed for aortic ring outgrowth with significantly longer sprouts. The EPC-CM-induced activities were significantly reduced by the blockage of the PI3K/AKT and MEK/ERK signaling pathways. Similarly to the outcome of the rBCEC4 experiments, inhibition of the PI3K/AKT and MEK/ERK pathways significantly interfered with capillary sprouting induced by EPC-CM. Conclusion The present study demonstrates that EPC-derived paracrine factors substantially promote the angiogenic response of brain microvascular endothelial cells. In addition, our findings identified the PI3K/AKT and MEK/ERK pathways to play a central role in mediating these effects.
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Affiliation(s)
- Stefano Di Santo
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Stefanie Seiler
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Anna-Lena Fuchs
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Jennifer Staudigl
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
| | - Hans Rudolf Widmer
- Department of Neurosurgery, Neurocenter and Regenerative Neuroscience Cluster, University of Bern, Inselspital, Bern, Switzerland
- * E-mail:
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Abstract
BACKGROUND Impairment of renal function is associated with adverse outcome in various diseases. Patients with pulmonary hypertension (PH) show diminished cardiac function and organ perfusion. The aim of this study was to investigate the associations between renal function and both haemodynamic parameters and long-term survival in patients with PH. METHODS Blood was collected from 64 patients with PH (Dana Point class 1, 3 and 4) during right heart catheterization, and plasma was prepared. Creatinine, blood urea nitrogen (BUN), cystatin C, neutrophil-gelatinase-associated lipocalin (NGAL), fibroblast growth factor 23 (FGF-23) and α-Klotho levels were determined, and glomerular filtration rate (GFR) was estimated (eGFR). Parameters were evaluated using c-statistics and dichotomized for survival analysis based on receiver operating characteristic curves. RESULTS The median follow-up time was 9.92 years with all-cause mortality as the primary end-point. Elevated BUN, cystatin C and creatinine levels were associated with decreased survival, with hazard ratios (HRs) of 3.237, 4.514 and 2.006, respectively, and equivalent performance according to c-statistics. Estimating GFR by CKD-EPI, MDRD and Cockcroft-Gault formulas resulted in HRs of 2.942, 2.694 and 3.306, respectively. Amongst these formulas, eGFR (Cockcroft-Gault) had the highest c-statistics of 0.674. There was a correlation between BUN and both cardiac index (τ = -0.39) and pulmonary vascular resistance index (τ = 0.249), whereas eGFR (CKD-EPI) was correlated with cardiac index (τ = 0.225). No correlations between either BUN or eGFR and right atrial pressure (RAP) were observed. NGAL, FGF-23 and α-Klotho had no prognostic impact or association with haemodynamic parameters. CONCLUSION Comparison of markers of renal function for prognosis in PH demonstrated superiority of creatinine, cystatin C and BUN over NGAL, FGF-23 and α-Klotho. Minor decreases in eGFR influence long-term prognosis, and measurement of cystatin C levels might be useful to detect renal impairment in patients with a normal serum concentration of creatinine. Renal function in patients with PH is linked to cardiac index rather than RAP.
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Affiliation(s)
- R Kaiser
- Department of Pulmonology, Faculty of Medicine , Saarland University, Homburg/Saar, Germany
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