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Knopp M, Appelhans D, Schönfelder M, Seiler S, Wackerhage H. Quantitative Analysis of 92 12-Week Sub-elite Marathon Training Plans. Sports Med Open 2024; 10:50. [PMID: 38695978 DOI: 10.1186/s40798-024-00717-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 04/15/2024] [Indexed: 05/05/2024]
Abstract
BACKGROUND A typical training plan is a mix of many training sessions with different intensities and durations to achieve a specific goal, like running a marathon in a certain time. Scientific publications provide little specific information to aid in writing a comprehensive training plan. This review aims to systematically and quantitatively analyse the last 12 weeks before a marathon as recommended in 92 sub-elite training plans. METHODS We retrieved 92 marathon training plans and linked their running training sessions to five intensity zones. Subsequently, each training plan was grouped based on the total running volume in peak week into high (> 90 km/week), middle (65-90 km/week), and low (< 65 km/week) training volume plan categories. RESULTS In the final 12 weeks before a race, recommended weekly running volume averaged 108 km, 59 km, and 43 km for high, middle, and low distance marathon training plans. The intensity distribution of these plans followed a pyramidal training structure with 15-67-10-5-3%, 14-63-18-2-3%, and 12-67-17-2-2% in zones 1, 2, 3, 4, and 5, for high, middle, and low volume training plans, respectively. CONCLUSIONS By quantitatively analysing 92 recommended marathon training plans, we can specify typical recommendations for the last 12 weeks before a marathon race. Whilst this approach has obvious limitations such as no evidence for the effectiveness of the training plans investigated, it is arguably a useful strategy to narrow the gap between science and practice.
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Affiliation(s)
- Melanie Knopp
- Department of Health and Sport Sciences, Technical University of Munich, Connollystraße 32, 80809, Munich, Germany.
- adidas Innovation, adidas AG, Adi-Dassler-Str. 1, 91074, Herzogenaurach, Germany.
| | - Daniel Appelhans
- Department of Health and Sport Sciences, Technical University of Munich, Connollystraße 32, 80809, Munich, Germany
| | - Martin Schönfelder
- Department of Health and Sport Sciences, Technical University of Munich, Connollystraße 32, 80809, Munich, Germany
| | - Stephen Seiler
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Henning Wackerhage
- Department of Health and Sport Sciences, Technical University of Munich, Connollystraße 32, 80809, Munich, Germany
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2
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Galy O, Washif JA, Wattelez G, Farooq A, Hue O, Sandbakk Ø, Beaven CM, Seiler S, Ding D, Pyne DB, Chamari K. Training strategies of 10,074 athletes from 121 countries based on human development index in early COVID-19 lockdown. Sci Rep 2024; 14:8866. [PMID: 38632327 PMCID: PMC11024144 DOI: 10.1038/s41598-024-59375-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
The aim of this study was to investigate relationships between changes in training practices and human development index (HDI) levels, and identify strategies employed by athletes who consistently maintained their training quantity during the first 100 days of the COVID-19 pandemic. A total of 10,074 athletes (5290 amateur and 4787 professional athletes from 121 countries) completed an online survey between 17 May to 5 July 2020. We explored their training practices, including specific questions on training frequency, duration and quantity before and during lockdown (March-June 2020), stratified according to the human development index (HDI): low-medium, high, or very high HDI. During the COVID-19 lockdown, athletes in low-medium HDI countries focused on innovative training. Nevertheless, women and amateur athletes experienced a substantial reduction in training activity. Performance-driven athletes and athletes from higher HDI indexed countries, were likely to have more opportunities to diversify training activities during lockdowns, facilitated by the flexibility to perform training away from home. Factors such as lockdown rules, socioeconomic environment, and training education limited training diversification and approaches, particularly in low-medium and high HDI countries. Athletes (amateurs and professionals) who maintained the quantity of training during lockdown appeared to prioritize basic cardiovascular and strength training, irrespective of HDI level. Modifying training and fitness programs may help mitigate the decrease in training activities during lockdowns. Customized training prescriptions based on gender, performance, and HDI level will assist individuals to effectively perform and maintain training activities during lockdowns, or other challenging (lockdown-like) situations.
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Affiliation(s)
- Olivier Galy
- Interdisciplinary Laboratory for Research in Education, University of New Caledonia, Nouméa, New Caledonia.
| | - Jad Adrian Washif
- Sports Performance Division, Institut Sukan Negara Malaysia (National Sports Institute of Malaysia), Kuala Lumpur, Malaysia
| | - Guillaume Wattelez
- Interdisciplinary Laboratory for Research in Education, University of New Caledonia, Nouméa, New Caledonia
| | | | - Olivier Hue
- Laboratoire ACTES, Université des Antilles, Pointe-À-Pitre, Guadeloupe, France
| | - Øyvind Sandbakk
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Stephen Seiler
- Department of Sport Science and Physical Education, Faculty of Health and Sports Sciences, University of Agder, Kristiansand, Norway
| | - Ding Ding
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia
- Charles Perkins Centre, The University of Sydney, Camperdown, NSW, Australia
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, Australia
| | - Karim Chamari
- Higher Institute of Sport and Physical Education, ISSEP Ksar Saïd, Manouba University, Manouba, Tunisia
- Naufar Wellness and Recovery Center, Naufar Wellness and Recovery Center, Doha, Qatar
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3
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Dergaa I, Saad HB, El Omri A, Glenn JM, Clark CCT, Washif JA, Guelmami N, Hammouda O, Al-Horani RA, Reynoso-Sánchez LF, Romdhani M, Paineiras-Domingos LL, Vancini RL, Taheri M, Mataruna-Dos-Santos LJ, Trabelsi K, Chtourou H, Zghibi M, Eken Ö, Swed S, Aissa MB, Shawki HH, El-Seedi HR, Mujika I, Seiler S, Zmijewski P, Pyne DB, Knechtle B, Asif IM, Drezner JA, Sandbakk Ø, Chamari K. Using artificial intelligence for exercise prescription in personalised health promotion: A critical evaluation of OpenAI's GPT-4 model. Biol Sport 2024; 41:221-241. [PMID: 38524814 PMCID: PMC10955739 DOI: 10.5114/biolsport.2024.133661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 11/15/2023] [Accepted: 11/28/2023] [Indexed: 03/26/2024] Open
Abstract
The rise of artificial intelligence (AI) applications in healthcare provides new possibilities for personalized health management. AI-based fitness applications are becoming more common, facilitating the opportunity for individualised exercise prescription. However, the use of AI carries the risk of inadequate expert supervision, and the efficacy and validity of such applications have not been thoroughly investigated, particularly in the context of diverse health conditions. The aim of the study was to critically assess the efficacy of exercise prescriptions generated by OpenAI's Generative Pre-Trained Transformer 4 (GPT-4) model for five example patient profiles with diverse health conditions and fitness goals. Our focus was to assess the model's ability to generate exercise prescriptions based on a singular, initial interaction, akin to a typical user experience. The evaluation was conducted by leading experts in the field of exercise prescription. Five distinct scenarios were formulated, each representing a hypothetical individual with a specific health condition and fitness objective. Upon receiving details of each individual, the GPT-4 model was tasked with generating a 30-day exercise program. These AI-derived exercise programs were subsequently subjected to a thorough evaluation by experts in exercise prescription. The evaluation encompassed adherence to established principles of frequency, intensity, time, and exercise type; integration of perceived exertion levels; consideration for medication intake and the respective medical condition; and the extent of program individualization tailored to each hypothetical profile. The AI model could create general safety-conscious exercise programs for various scenarios. However, the AI-generated exercise prescriptions lacked precision in addressing individual health conditions and goals, often prioritizing excessive safety over the effectiveness of training. The AI-based approach aimed to ensure patient improvement through gradual increases in training load and intensity, but the model's potential to fine-tune its recommendations through ongoing interaction was not fully satisfying. AI technologies, in their current state, can serve as supplemental tools in exercise prescription, particularly in enhancing accessibility for individuals unable to access, often costly, professional advice. However, AI technologies are not yet recommended as a substitute for personalized, progressive, and health condition-specific prescriptions provided by healthcare and fitness professionals. Further research is needed to explore more interactive use of AI models and integration of real-time physiological feedback.
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Affiliation(s)
- Ismail Dergaa
- Primary Health Care Corporation (PHCC), Doha, Qatar
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
- High Institute of Sport and Physical Education of Kef, Jendouba, Kef, Tunisia
| | - Helmi Ben Saad
- University of Sousse, Farhat HACHED hospital, Research Laboratory LR12SP09 «Heart Failure», Sousse, Tunisia
- University of Sousse, Faculty of Medicine of Sousse, laboratory of Physiology, Sousse, Tunisia
| | - Abdelfatteh El Omri
- Surgical Research Section, Department of Surgery, Hamad Medical Corporation, Doha 3050, Qatar
| | | | - Cain C. T. Clark
- College of Life Sciences, Birmingham City University, Birmingham, B15 3TN, UK
- Institute for Health and Wellbeing, Coventry University, Coventry, CV1 5FB, UK
| | - Jad Adrian Washif
- Sports Performance Division, National Sports Institute of Malaysia, Kuala Lumpur, Malaysia
| | - Noomen Guelmami
- High Institute of Sport and Physical Education of Kef, Jendouba, Kef, Tunisia
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, LR19ES13, Faculty of Medicine, University of Sfax, Tunisia
| | | | | | - Mohamed Romdhani
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS (Faculty of Sport Sciences), UPL, Paris Nanterre University, Nanterre, France
| | | | - Rodrigo L. Vancini
- Centro de Educação Física e Desportos, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Morteza Taheri
- Department of Motor Behavior, Faculty of Sport Sciences, University of Tehran, Tehran, Iran
| | - Leonardo Jose Mataruna-Dos-Santos
- Department of Creative Industries, Faculty of Communication, Arts and Sciences, Canadian University of Dubai, Dubai, United Arab Emirates
| | - Khaled Trabelsi
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Hamdi Chtourou
- Research Laboratory Education, Motricité, Sport et Santé (EM2S) LR19JS01, High Institute of Sport and Physical Education of Sfax, University of Sfax, Sfax 3000, Tunisia
| | - Makram Zghibi
- High Institute of Sport and Physical Education of Kef, Jendouba, Kef, Tunisia
| | - Özgür Eken
- Department of Physical Education and Sport Teaching, Inonu University, Malatya 44000, Turkey
| | - Sarya Swed
- University of Aleppo Faculty of Medicine: Aleppo, Aleppo Governorate, Syria
| | - Mohamed Ben Aissa
- Postgraduate School of Public Health, Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy
| | - Hossam H. Shawki
- Department of Comparative and Experimental Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya 467-8601, Japan
| | - Hesham R. El-Seedi
- Department of Chemistry, Faculty of Science, Islamic University of Madinah, Madinah, 42351, Saudi Arabia
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
- International Research Center for Food Nutrition and Safety, Jiangsu University, Zhenjiang 212013, China
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country
- Exercise Science Laboratory, School of Kinesiology, Faculty of Medicine, Universidad Finis Terrae, Santiago, Chile
| | - Stephen Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Piotr Zmijewski
- Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - David B. Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Beat Knechtle
- Institute of Primary Care, University of Zurich, Zurich, Switzerland
| | - Irfan M Asif
- Department of Family and Community Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jonathan A Drezner
- Center for Sports Cardiology, University of Washington, Seattle, Washington, USA
| | - Øyvind Sandbakk
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Karim Chamari
- Higher institute of Sport and Physical Education, ISSEP Ksar Saïd, Manouba University, Tunisia
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Rosenblat MA, Arnold J, Nelson H, Watt J, Seiler S. The Additional Effect of Training Above the Maximal Metabolic Steady State on VO2peak, Wpeak and Time-Trial Performance in Endurance-Trained Athletes: A Systematic Review, Meta-analysis, and Reality Check. Sports Med 2024; 54:429-446. [PMID: 37737543 DOI: 10.1007/s40279-023-01924-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND To improve sport performance, athletes use training regimens that include exercise below and above the maximal metabolic steady state (MMSS). OBJECTIVE The objective of this review was to determine the additional effect of training above MMSS on VO2peak, Wpeak and time-trial (TT) performance in endurance-trained athletes. METHODS Studies were included in the review if they (i) were published in academic journals, (ii) were in English, (iii) were prospective, (iv) included trained participants, (v) had an intervention group that contained training above and below MMSS, (vi) had a comparator group that only performed training below MMSS, and (vii) reported results for VO2peak, Wpeak, or TT performance. Medline and SPORTDiscus were searched from inception until February 23, 2023. RESULTS Fourteen studies that ranged from 2 to 12 weeks were included in the review. There were 171 recreational and 128 competitive endurance athletes. The mean age and VO2peak of participants ranged from 15 to 43 years and 38 to 68 mL·kg-1·min-1, respectively. The inclusion of training above MMSS led to a 2.5 mL·kg-1·min-1 (95% CI 1.4-3.6; p < 0.01; I2 = 0%) greater improvement in VO2peak. A minimum of 81 participants per group would be required to obtain sufficient power to determine a significant effect (SMD 0.44) for VO2peak. No intensity-specific effect was observed for Wpeak or TT performance, in part due to a smaller sample size. CONCLUSION A single training meso-cycle that includes training above MMSS can improve VO2peak in endurance-trained athletes more than training only below MMSS. However, we do not have sufficient evidence to conclude that concurrent adaptation occurs for Wpeak or TT performance.
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Affiliation(s)
| | - Jem Arnold
- School of Kinesiology, Faculty of Education, University of British Columbia, Vancouver, BC, Canada
| | - Hannah Nelson
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Jennifer Watt
- Knowledge Translation Program, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, ON, Canada
- Division of Geriatric Medicine, Department of Medicine, University of Toronto, Toronto, ON, Canada
- Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Stephen Seiler
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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5
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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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6
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Sandbakk Ø, Pyne DB, McGawley K, Foster C, Talsnes RK, Solli GS, Millet GP, Seiler S, Laursen PB, Haugen T, Tønnessen E, Wilber R, van Erp T, Stellingwerff T, Holmberg HC, Bucher Sandbakk S. The Evolution of World-Class Endurance Training: The Scientist's View on Current and Future Trends. Int J Sports Physiol Perform 2023:1-5. [PMID: 37369366 DOI: 10.1123/ijspp.2023-0131] [Citation(s) in RCA: 1] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/05/2023] [Accepted: 06/07/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Elite sport is continuously evolving. World records keep falling and athletes from a longer list of countries are involved. PURPOSE This commentary was designed to provide insights into present and future trends associated with world-class endurance training based on the perspectives, experience, and knowledge of an expert panel of 25 applied sport scientists. RESULTS The key drivers of development observed in the past 10-15 years were related to (1) more accessible scientific knowledge for coaches and athletes combined with (2) better integration of practical and scientific exchange across multidisciplinary perspectives within professionalized elite athlete support structures, as well as (3) utilization of new technological advances. Based on these perspectives, we discerned and exemplified the main trends in the practice of endurance sports into the following categories: better understanding of sport-specific demands; improved competition execution; larger, more specific, and more precise training loads; improved training quality; and a more professional and healthier lifestyle. The main areas expected to drive future improvements were associated with more extensive use of advanced technology for monitoring and prescribing training and recovery, more precise use of environmental and nutritional interventions, better understanding of athlete-equipment interactions, and greater emphasis on preventing injuries and illnesses. CONCLUSIONS These expert insights can serve as a platform and inspiration to develop new hypotheses and ideas, encourage future collaboration between researchers and sport practitioners, and, perhaps most important, stimulate curiosity and further collaborative studies about the training, physiology, and performance of endurance athletes.
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Affiliation(s)
- Øyvind Sandbakk
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim,Norway
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT,Australia
| | - Kerry McGawley
- Swedish Winter Sports Research Center, Department of Health Sciences, Mid Sweden University, Östersund,Sweden
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI,USA
| | - Rune Kjøsen Talsnes
- Center for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim,Norway
| | - Guro Strøm Solli
- Department of Sports Science and Physical Education, Nord University, Trondheim,Norway
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Bodø,Switzerland
| | - Stephen Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand,Norway
| | - Paul B Laursen
- Sports Performance and Athlete Development Environments (SPADE), University of Agder, Kristiansand,Norway
- Sports Performance Research Institute New Zealand (SPRINZ), AUT University, Auckland,New Zealand
| | - Thomas Haugen
- School of Health Sciences, Kristiania University College, Oslo,Norway
| | - Espen Tønnessen
- School of Health Sciences, Kristiania University College, Oslo,Norway
| | - Randy Wilber
- United States Olympic Committee, Colorado Springs, CO,USA
| | - Teun van Erp
- Division of Movement Science and Exercise Therapy (MSET), Department of Exercise, Sport and Lifestyle Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg,South Africa
| | | | - Hans-Christer Holmberg
- Department of Health Sciences, Luleå University of Technology, Luleå,Sweden
- School of Kinesiology, University of British Columbia, Vancouver, BC,Canada
| | - Silvana Bucher Sandbakk
- Department of Teacher Education, Norwegian University of Science and Technology, Trondheim,Norway
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7
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Vinogradov E, Keupp J, Dimitrov IE, Seiler S, Pedrosa I. CEST-MRI for body oncologic imaging: are we there yet? NMR Biomed 2023; 36:e4906. [PMID: 36640112 DOI: 10.1002/nbm.4906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 05/23/2023]
Abstract
Chemical exchange saturation transfer (CEST) MRI has gained recognition as a valuable addition to the molecular imaging and quantitative biomarker arsenal, especially for characterization of brain tumors. There is also increasing interest in the use of CEST-MRI for applications beyond the brain. However, its translation to body oncology applications lags behind those in neuro-oncology. The slower migration of CEST-MRI to non-neurologic applications reflects the technical challenges inherent to imaging of the torso. In this review, we discuss the application of CEST-MRI to oncologic conditions of the breast and torso (i.e., body imaging), emphasizing the challenges and potential solutions to address them. While data are still limited, reported studies suggest that CEST signal is associated with important histology markers such as tumor grade, receptor status, and proliferation index, some of which are often associated with prognosis and response to therapy. However, further technical development is still needed to make CEST a reliable clinical application for body imaging and establish its role as a predictive and prognostic biomarker.
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Affiliation(s)
- Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | | | - Ivan E Dimitrov
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Philips Healthcare, Gainesville, FL, USA
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Ivan Pedrosa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
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8
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Simmons A, Sher D, Kim DWN, Leitch M, Wooldridge R, Goudreau S, Seiler S, Neufeld S, Stein M, Albuquerque K, Spangler A, Heinzerling J, Gardwoood D, Stevenson S, Ahn C, Ding C, Timmerman R, Rahimi A. Abstract P6-05-55: Financial Toxicity Outcomes on a Phase I 5-fraction Partial Breast Irradiation Protocol for Early Stage Breast Cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.sabcs22-p6-05-55] [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: 03/06/2023]
Abstract
Abstract
Purpose/Objectives: Accelerated partial breast irradiation (APBI) has been shown to have both acceptable oncologic and cosmetic outcomes for early stage breast cancer following breast-conserving surgery (BCS). Given the demonstrated financial toxicity (FT) of conventional radiation treatments on breast cancer patients, we wanted to quantitatively assess the FT on patients treated with APBI in our phase I five fraction stereotactic APBI (S-PBI) trial, which could be generalized across APBI treatment regimens. Methods: A phase I dose escalation trial of S-PBI for early stage breast cancer following BCS was conducted. Women age > 18 years with in-situ or stage I-II (AJCC 7) invasive breast cancer < 3 cm following BCS with > 2 mm margins were treated with S-PBI in 5 fractions to a total dose of 30 to 40 Gy over 2.5 Gy increments (Clinical trials.gov ID NCT01162200). One month following completion of treatment, patients were asked to complete our novel “Patient Perspective Cost and Convenience of Care Questionnaire” developed at our institution. Results: Of 75 patients enrolled and treated, questionnaire data was available for 66 patients. Our trial encompassed a wide spectrum of annual household incomes, with 25.5% of patients (n=14/55) reporting income of less than $30k and 45.5% (n=25/55) reporting incomes of more than $80k. Educational status was also well represented with 53.1% completing at least some college (n= 34/64), 25% holding post graduate or professional degrees (n=16/64), and 21.9% patients reporting a high school equivalent or less (n=14/64). Overall 48.4% of patients (n=30/62) said that oncologic treatment did not present a financial burden; however, 29.0% (n=20/62) patients reported a somewhat to significant financial burden. Neither household income nor patient education status predicted perceived FT. Of the 6 patients (9.7%) who reported significant FT, 5 reported travelling at least 25 miles one way for treatment with 2 of these patient travelling over 175 miles. Half of the patients reported having private insurance for medication (49.2%, n=32/65), 33.8% had governmental coverage (n=22/65), 6.1% had both private and government coverage, 7.7% had no coverage (n=5/65), and 3.0% were unsure of their coverage (n=2/65). Only 1 of the 6 patients with significant FT had no coverage. Over half of the patients (54.2%, n=34/62) reported a co-pay during their treatment with a median out of pocket cost of $300 for treatment (range $10-10000, n=16). Over half of the patients were working full or part time during treatment (54.2%, n=32/59). All 26 patients that were working full time had to take time off work for treatment (median of 5 days, range 0.25 days – 10 days). Over a third of these patients (34.6%, n=9) had to use vacation time or unpaid time off. There was an additional patient who reported months off without pay. Additionally, 24.2% of patients (n=15/62) reported they had family or friends take time off work due to the patient’s treatment. Finally, patients were surveyed on the treatment related disruption to their daily activities and enjoyment of life rated on a scale 0-10, with 0 being no disruption, median values were 3 and 1, respectively. Patients also reported a median score of 10 (scale 0-10, 10 being most satisfied) on satisfaction with treatment time. Conclusions: In this cohort of patients, interestingly FT was significant primarily in the 10% of patients who traveled a significant distance for these treatments. However, despite this, and the fact that patients were undergoing cytotoxic cancer therapy, impressively, all patients were uniformly satisfied with treatment time (median score of 10), and most did not express significant disruption to their life. We plan to explore the impact of further reducing treatment fractions (with our single fraction S-PBI studies) on FT and quality of life in future studies.
Citation Format: Ambrosia Simmons, David Sher, Dong W. Nathan Kim, Marilyn Leitch, Rachel Wooldridge, Sally Goudreau, Stephen Seiler, Sarah Neufeld, Maggie Stein, Kevin Albuquerque, Ann Spangler, John Heinzerling, Dan Gardwoood, Stella Stevenson, Chul Ahn, Chuxiong Ding, Robert Timmerman, Asal Rahimi. Financial Toxicity Outcomes on a Phase I 5-fraction Partial Breast Irradiation Protocol for Early Stage Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-55.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Chul Ahn
- 15University of Texas Southwestern Medical Center
| | | | | | - Asal Rahimi
- 18University of Texas Southwestern Medical Center
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Haugen T, Sandbakk Ø, Seiler S, Tønnessen E. The Training Characteristics of World-Class Distance Runners: An Integration of Scientific Literature and Results-Proven Practice. Sports Med - Open 2022; 8:46. [PMID: 35362850 PMCID: PMC8975965 DOI: 10.1186/s40798-022-00438-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 03/22/2022] [Indexed: 11/23/2022]
Abstract
In this review we integrate the scientific literature and results-proven practice and outline a novel framework for understanding the training and development of elite long-distance performance. Herein, we describe how fundamental training characteristics and well-known training principles are applied. World-leading track runners (i.e., 5000 and 10,000 m) and marathon specialists participate in 9 ± 3 and 6 ± 2 (mean ± SD) annual competitions, respectively. The weekly running distance in the mid-preparation period is in the range 160–220 km for marathoners and 130–190 km for track runners. These differences are mainly explained by more running kilometers on each session for marathon runners. Both groups perform 11–14 sessions per week, and ≥ 80% of the total running volume is performed at low intensity throughout the training year. The training intensity distribution vary across mesocycles and differ between marathon and track runners, but common for both groups is that volume of race-pace running increases as the main competition approaches. The tapering process starts 7–10 days prior to the main competition. While the African runners live and train at high altitude (2000–2500 m above sea level) most of the year, most lowland athletes apply relatively long altitude camps during the preparation period. Overall, this review offers unique insights into the training characteristics of world-class distance runners by integrating scientific literature and results-proven practice, providing a point of departure for future studies related to the training and development in the Olympic long-distance events.
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Washif JA, Farooq A, Krug I, Pyne DB, Verhagen E, Taylor L, Wong DP, Mujika I, Cortis C, Haddad M, Ahmadian O, Al Jufaili M, Al-Horani RA, Al-Mohannadi AS, Aloui A, Ammar A, Arifi F, Aziz AR, Batuev M, Beaven CM, Beneke R, Bici A, Bishnoi P, Bogwasi L, Bok D, Boukhris O, Boullosa D, Bragazzi N, Brito J, Cartagena RPP, Chaouachi A, Cheung SS, Chtourou H, Cosma G, Debevec T, DeLang MD, Dellal A, Dönmez G, Driss T, Peña Duque JD, Eirale C, Elloumi M, Foster C, Franchini E, Fusco A, Galy O, Gastin PB, Gill N, Girard O, Gregov C, Halson S, Hammouda O, Hanzlíková I, Hassanmirzaei B, Haugen T, Hébert-Losier K, Muñoz Helú H, Herrera-Valenzuela T, Hettinga FJ, Holtzhausen L, Hue O, Dello Iacono A, Ihalainen JK, James C, Janse van Rensburg DC, Joseph S, Kamoun K, Khaled M, Khalladi K, Kim KJ, Kok LY, MacMillan L, Mataruna-Dos-Santos LJ, Matsunaga R, Memishi S, Millet GP, Moussa-Chamari I, Musa DI, Nguyen HMT, Nikolaidis PT, Owen A, Padulo J, Pagaduan JC, Perera NP, Pérez-Gómez J, Pillay L, Popa A, Pudasaini A, Rabbani A, Rahayu T, Romdhani M, Salamh P, Sarkar AS, Schillinger A, Seiler S, Setyawati H, Shrestha N, Suraya F, Tabben M, Trabelsi K, Urhausen A, Valtonen M, Weber J, Whiteley R, Zrane A, Zerguini Y, Zmijewski P, Sandbakk Ø, Ben Saad H, Chamari K. Correction to: Training During the COVID-19 Lockdown: Knowledge, Beliefs, and Practices of 12,526 Athletes from 142 Countries and Six Continents. Sports Med 2022:10.1007/s40279-022-01776-y. [PMID: 36272061 PMCID: PMC9589640 DOI: 10.1007/s40279-022-01776-y] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Jad Adrian Washif
- Sports Performance Division, Institut Sukan Negara Malaysia (National Sports Institute of Malaysia), Kuala Lumpur, Malaysia.
| | - Abdulaziz Farooq
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Isabel Krug
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | - David B Pyne
- Research Institute for Sport and Exercise, University of Canberra, Canberra, ACT, Australia
| | - Evert Verhagen
- Department of Public and Occupational Health, Amsterdam Collaboration on Health & Safety in Sports, Amsterdam Movement Sciences, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lee Taylor
- School of Sport, Exercise and Health Sciences, National Centre for Sport and Exercise Medicine (NCSEM), Loughborough University, Loughborough, UK
- Human Performance Research Centre, University of Technology Sydney, Sydney, Australia
- Sport & Exercise Discipline Group, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Del P Wong
- School of Nursing and Health Studies, The Open University of Hong Kong, Ho Man Tin, Hong Kong
| | - Iñigo Mujika
- Department of Physiology, Faculty of Medicine and Nursing, University of the Basque Country, Leioa, Basque Country, Spain
- Exercise Science Laboratory, Faculty of Medicine, School of Kinesiology, Universidad Finis Terrae, Santiago, Chile
| | - Cristina Cortis
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Monoem Haddad
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Omid Ahmadian
- Medical Committee of Tehran Football Association, Tehran, Iran
| | - Mahmood Al Jufaili
- Emergency Medicine Department, Sultan Qaboos University Hospital, Alkhoudh, Oman
| | | | | | - Asma Aloui
- Physical Activity, Sport & Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
- High Institute of Sport and Physical Education, University of Gafsa, Gafsa, Tunisia
| | - Achraf Ammar
- Institute of Sport Sciences, Otto-Von-Guericke University, 39104, Magdeburg, Germany
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
| | - Fitim Arifi
- Physical Culture, Sports and Recreation, College Universi, Pristina, Kosovo
- Faculty of Physical Education and Sport, University of Tetova, Tetovo, North Macedonia
| | - Abdul Rashid Aziz
- Sport Science and Sport Medicine, Singapore Sport Institute, Sport Singapore, Singapore, Singapore
| | - Mikhail Batuev
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Christopher Martyn Beaven
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Ralph Beneke
- Division of Medicine, Training and Health, Institute of Sport Science and Motology, Philipps University Marburg, Marburg, Germany
| | - Arben Bici
- Applied Motion Department, Institute of Sport Research, Sports University of Tirana, Tirana, Albania
| | - Pallawi Bishnoi
- Physiotherapy Department, Minerva Punjab Academy and Football Club, Mohali, Punjab, India
| | - Lone Bogwasi
- Department of Orthopedics, Nyangabgwe Hospital, Francistown, Botswana
- Botswana Football Association Medical Committee, Gaborone, Botswana
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Daniel Bok
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Omar Boukhris
- Physical Activity, Sport & Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Daniel Boullosa
- INISA, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
- Sport and Exercise Science, James Cook University, Townsville, QLD, Australia
| | - Nicola Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, M3J 1P3, Canada
| | - Joao Brito
- Portugal Football School, Portuguese Football Federation, Oeiras, Portugal
| | | | - Anis Chaouachi
- Tunisian Research Laboratory, Sport Performance Optimisation, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
- Sports Performance Research Institute New Zealand, AUT University, Auckland, New Zealand
| | - Stephen S Cheung
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Hamdi Chtourou
- Physical Activity, Sport & Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
| | - Germina Cosma
- Faculty of Physical Education and Sport, University of Craiova, Craiova, Romania
| | - Tadej Debevec
- Faculty of Sport, University of Ljubljana, Ljubljana, Slovenia
- Department of Automation, Biocybernetics and Robotics, Jozef Stefan Institute, Ljubljana, Slovenia
| | | | - Alexandre Dellal
- Sport Science and Research Department, Centre Orthopédique Santy, FIFA Medical Centre of Excellence, Lyon, France
- Laboratoire Interuniversitaire de Biologie de la Motricité (LIBM EA 7424), Claude Bernard University (Lyon 1), Lyon, France
| | - Gürhan Dönmez
- Department of Sports Medicine, Hacettepe University, Ankara, Turkey
| | - Tarak Driss
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UFR STAPS, UPL, Paris Nanterre University, Nanterre, France
| | | | | | - Mohamed Elloumi
- Health and Physical Education Department, Prince Sultan University, Riyadh, Kingdom of Saudi Arabia
| | - Carl Foster
- Department of Exercise and Sport Science, University of Wisconsin-La Crosse, La Crosse, WI, USA
| | - Emerson Franchini
- Sport Department, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Andrea Fusco
- Department of Human Sciences, Society and Health, University of Cassino and Lazio Meridionale, Cassino, Italy
| | - Olivier Galy
- Interdisciplinary Laboratory for Research in Education, EA 7483, University of New Caledonia, Avenue James Cook, 98800, Nouméa, New Caledonia
| | - Paul B Gastin
- Sport and Exercise Science, School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, VIC, Australia
| | - Nicholas Gill
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
- New Zealand All Blacks, New Zealand Rugby, Wellington, New Zealand
| | - Olivier Girard
- School of Human Science (Exercise and Sport Science), The University of Western Australia, Perth, WA, Australia
| | - Cvita Gregov
- Faculty of Kinesiology, University of Zagreb, Zagreb, Croatia
| | - Shona Halson
- School of Behavioural and Health Sciences, McAuley at Banyo, Australian Catholic University, Brisbane, QLD, Australia
| | - Omar Hammouda
- Interdisciplinary Laboratory in Neurosciences, Physiology and Psychology: Physical Activity, Health and Learning (LINP2), UPL, UFR STAPS, Paris Nanterre University, Nanterre, France
- Research Laboratory, Molecular Bases of Human Pathology, Faculty of Medicine, LR19ES13, University of Sfax, Sfax, Tunisia
| | - Ivana Hanzlíková
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Bahar Hassanmirzaei
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Iran Football Medical Assessments and Rehabilitation Center, IFMARC, Tehran, Iran
| | - Thomas Haugen
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Kim Hébert-Losier
- Division of Health, Engineering, Computing and Science, Te Huataki Waiora School of Health, University of Waikato, Tauranga, New Zealand
| | - Hussein Muñoz Helú
- Department of Economic-Administrative Sciences, Universidad Autónoma de Occidente, Los Mochis, Sinaloa, México
| | - Tomás Herrera-Valenzuela
- Department of Sport Science and Health, Universidad Santo Tomás, Santiago, Chile
- University of Santiago of Chile (USACH), Sciences of Physical Activity, Sports and Health School, Santiago, Chile
| | - Florentina J Hettinga
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - Louis Holtzhausen
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- Weil-Cornell Medical College in Qatar, Doha, Qatar
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Department of Exercise and Sports Science, University of the Free State, Bloemfontein, South Africa
| | - Olivier Hue
- Laboratoire ACTES, UFR-STAPS, Université Des Antilles, Pointe à Pitre, France
| | - Antonio Dello Iacono
- School of Health and Life Sciences, University of the West of Scotland, Hamilton, UK
| | - Johanna K Ihalainen
- Faculty of Sport and Health Sciences, Biology of Physical Activity, University of Jyväskylä, Jyväskylä, Finland
| | - Carl James
- Sports Performance Division, Institut Sukan Negara Malaysia (National Sports Institute of Malaysia), Kuala Lumpur, Malaysia
| | - Dina C Janse van Rensburg
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- Medical Board Member, International Netball Federation, Manchester, UK
| | - Saju Joseph
- High Performance Director, Sports Authority of India, Bangalore, India
| | - Karim Kamoun
- Tunisian Research Laboratory, Sport Performance Optimisation, National Center of Medicine and Science in Sports (CNMSS), Tunis, Tunisia
| | | | - Karim Khalladi
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Kwang Joon Kim
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Lian-Yee Kok
- Department of Sport Science, Tunku Abdul Rahman University College, Kuala Lumpur, Malaysia
| | - Lewis MacMillan
- Sport Science Department, Fulham Football Club, Fulham, London, UK
| | - Leonardo Jose Mataruna-Dos-Santos
- Centre for Trust, Peace and Social Relation, Coventry University, Coventry, UK
- Department of Sport Management, Faculty of Management, Canadian University of Dubai, Dubai, United Arab Emirates
- Programa Avancado de Cultura Contemporanea, Universidade Federal Do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ryo Matsunaga
- Antlers Sports Clinic, Kashima, Ibaraki, Japan
- Department of Orthopedic Surgery, Tokyo Medical University, Tokyo, Japan
| | - Shpresa Memishi
- Faculty of Physical Education, University of Tetovo, Tetovo, North Macedonia
| | - Grégoire P Millet
- Institute of Sport Sciences, University of Lausanne, Lausanne, Switzerland
| | - Imen Moussa-Chamari
- Physical Education Department, College of Education, Qatar University, Doha, Qatar
| | - Danladi Ibrahim Musa
- Department of Human Kinetics and Health Education, Kogi State University, Anyigba, Nigeria
| | | | | | - Adam Owen
- University Claude Bernard Lyon 1, Lyon, France
- Seattle Sounders Football Club, Seattle, WA, USA
| | - Johnny Padulo
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, Milan, Italy
| | - Jeffrey Cayaban Pagaduan
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
| | - Nirmala Panagodage Perera
- Sports Medicine, Australian Institute of Sport, Bruce, ACT, Australia
- University of Canberra Research Institute for Sport and Exercise (UCRISE), University of Canberra, Bruce, ACT, Australia
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Jorge Pérez-Gómez
- Health, Economy, Motricity and Education (HEME) Research Group, Faculty of Sport Sciences, University of Extremadura, Cáceres, Spain
| | - Lervasen Pillay
- Section Sports Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- University of Witwatersrand, Wits Institute for Sports Health, Johannesburg, South Africa
| | - Arporn Popa
- Health and Sport Science Department, Educational Faculty, Mahasarakham University, Mahasarakham, Thailand
| | - Avishkar Pudasaini
- Medical Department, All Nepal Football Association (ANFA), Lalitpur, Nepal
| | - Alireza Rabbani
- Department of Exercise Physiology, College of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Tandiyo Rahayu
- Faculty of Sport Science, Universitas Negeri Semarang, Semarang, Indonesia
| | - Mohamed Romdhani
- Physical Activity, Sport & Health Research Unit (UR18JS01), National Sport Observatory, Tunis, Tunisia
| | - Paul Salamh
- Krannert School of Physical Therapy, University of Indianapolis, Indianapolis, IN, USA
| | | | | | - Stephen Seiler
- Department of Sports Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Heny Setyawati
- Faculty of Sport Science, Universitas Negeri Semarang, Semarang, Indonesia
| | - Navina Shrestha
- Medical Department, All Nepal Football Association (ANFA), Lalitpur, Nepal
- Physiotherapy Department, BP Eyes Foundation CHEERS Hospital, Bhaktapur, Nepal
| | - Fatona Suraya
- Faculty of Sport Science, Universitas Negeri Semarang, Semarang, Indonesia
| | - Montassar Tabben
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
| | - Khaled Trabelsi
- High Institute of Sport and Physical Education, University of Sfax, Sfax, Tunisia
- Research Laboratory: Education, Motricity, Sport and Health, EM2S, LR19JS01, University of Sfax, Sfax, Tunisia
| | - Axel Urhausen
- Sports Clinic, Centre Hospitalier de Luxembourg, Clinique d'Eich, Luxembourg, Luxembourg
- Luxembourg Institute of Research in Orthopedics, Sports Medicine and Science, Luxembourg, Luxembourg
- Human Motion, Orthopedics, Sports Medicine and Digital Methods, Luxembourg Institute of Health, Luxembourg, Luxembourg
| | | | - Johanna Weber
- Institute for Sports Science, CAU of Kiel, Kiel, Germany
- Neurocognition and Action, University of Bielefeld, Bielefeld, Germany
| | - Rodney Whiteley
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
- University of Queensland, Brisbane, QLD, Australia
| | - Adel Zrane
- Department of Physiology and Lung Function Testing, Faculty of Medicine of Sousse, University of Sousse, Sousse, Tunisia
- Faculty of Sciences of Bizerte, University of Carthage, Bizerte, Tunisia
- High Institute of Sports, Ksar Said, Tunis, Tunisia
| | - Yacine Zerguini
- FIFA Medical Centre of Excellence Algiers, Algiers, Algeria
- Medical Committee, Confederation of African Football, Giza, Egypt
| | - Piotr Zmijewski
- Jozef Pilsudski University of Physical Education in Warsaw, Warsaw, Poland
| | - Øyvind Sandbakk
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian, University of Science and Technology, Trondheim, Norway
| | - Helmi Ben Saad
- Laboratoire de Recherche "Insuffisance Cardiaque" (LR12SP09), Hôpital Farhat HACHED, Université de Sousse, Sousse, Tunisie
- Laboratoire de Physiologie, Faculté de Médicine de Sousse, Université de Sousse, Sousse, Tunisie
| | - Karim Chamari
- Aspetar, Orthopaedic and Sports Medicine Hospital, FIFA Medical Centre of Excellence, Doha, Qatar
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Ausland Å, Sandberg EL, Jortveit J, Seiler S. Heart rhythm assessment in elite endurance athletes: A better method? Front Sports Act Living 2022; 4:937525. [PMID: 35958669 PMCID: PMC9357913 DOI: 10.3389/fspor.2022.937525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/06/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Arrhythmias also occur among elite endurance athletes. Conventional diagnostic tools for assessment of arrhythmias suffer from limited availability and usability challenges, particularly under the demanding training conditions of an elite athlete. Among endurance athletes, there is a need for out-of-hospital monitoring to enhance detection of arrhythmias under conditions that are relevant and potentially provocative of underlying pathology. The Norwegian patch ECG247 Smart Heart Sensor has been developed to simplify the assessment of heart rhythm disorders. The current study aimed to evaluate the ECG247 Smart Heart Sensor function and usability in an elite athlete environment. Methods A total of 13 professional cyclists from the UNO-X Pro Cycling Team were examined with the ECG247 Smart Heart Sensor during training camp in Spain, December 2021. All ECG data were analyzed by cardiologists at Sorlandet Hospital Arendal, Norway. The athletes also completed a brief questionnaire registering their training (from on-bike monitoring units) and provided self-assessment of usability parameters after the test. Results In 8 of 13 athletes (69% male, age 23 ± 4 years), two test periods were performed with different ECG patches, resulting in a total of 21 tests with continuous ECG monitoring. Average total ECG test duration per athlete was 144 ± 47 h (89 ± 24 h/patch). Athletes performed an average of 15 ± 5 training h during each test. The ECG quality from all tests was considered satisfactory for rhythm analysis—also during exercise. The reported usability of the ECG247 Smart Heart Sensor was high, and no athletes reported trouble sleeping or training with the sensor. The automatic arrhythmia algorithm reported episodes of possible arrhythmias in 5 (24%) tests; 2 atrial flutter, 2 supraventricular tachycardia and 1 bradycardia (heart rate <30/min). Manual assessment by physicians verified the episode of bradycardia but revealed normal sinus rhythm in all other tests. No false negative events were identified in over 1,800 h of ECG collection. Conclusion The ECG247 Smart Heart Sensor allowed for high quality ECG monitoring with high usability during intensive exercise in athletes.
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Affiliation(s)
- Ådne Ausland
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
- *Correspondence: Ådne Ausland
| | | | - Jarle Jortveit
- Department of Cardiology, Sorlandet Hospital, Arendal, Norway
| | - Stephen Seiler
- Department of Sport Science and Physical Education, Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Foster C, Casado A, Esteve-Lanao J, Haugen T, Seiler S. Polarized Training Is Optimal for Endurance Athletes: Response to Burnley, Bearden, and Jones. Med Sci Sports Exerc 2022; 54:1035-1037. [PMID: 35576138 DOI: 10.1249/mss.0000000000002923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- Carl Foster
- University of Wisconsin-La Crosse, La Crosse, WI
| | - Arturo Casado
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, SPAIN
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Rahimi A, Simmons A, Kim DN, Leitch M, Haas J, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Goudreau S, Seiler S, Farr D, Wooldridge R, Haley B, Bahrami S, Neufeld S, Mendez C, Alluri P, Rao R, Timmerman RD. In Reply to Hannoun-Levi et al. Int J Radiat Oncol Biol Phys 2022; 113:475-477. [PMID: 35569485 DOI: 10.1016/j.ijrobp.2022.02.034] [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] [Received: 02/12/2022] [Accepted: 02/22/2022] [Indexed: 10/18/2022]
Affiliation(s)
- Asal Rahimi
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Ambrosia Simmons
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - D Nathan Kim
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marilyn Leitch
- Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jonathan Haas
- Perlmutter Cancer Center, NYU Langone Hospital, Long Island, New York
| | - Xuejun Gu
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chul Ahn
- Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ang Gao
- Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ann Spangler
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Howard E Morgan
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sally Goudreau
- Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephen Seiler
- Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Deborah Farr
- Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rachel Wooldridge
- Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Barbara Haley
- Medical Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Shohreh Bahrami
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah Neufeld
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | | | - Prasanna Alluri
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Roshni Rao
- Breast Surgery, Columbia University Medical Center, New York City, New York
| | - Robert D Timmerman
- Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
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Affiliation(s)
- Carl Foster
- University of Wisconsin-La Crosse, La Crosse, WI
| | - Arturo Casado
- Centre for Sport Studies, Rey Juan Carlos University, Madrid, SPAIN
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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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16
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Rahimi A, Simmons A, Kim DN, Leitch M, Haas J, Gu X, Ahn C, Gao A, Spangler A, Morgan HE, Goudreau S, Seiler S, Farr D, Wooldridge R, Haley B, Bahrami S, Neufeld S, Mendez C, Alluri P, Rao R, Timmerman RD. Preliminary Results of Multi-Institutional Phase 1 Dose Escalation Trial Using Single-Fraction Stereotactic Partial Breast Irradiation for Early Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2021; 112:663-670. [PMID: 34710523 DOI: 10.1016/j.ijrobp.2021.10.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 07/28/2021] [Revised: 10/05/2021] [Accepted: 10/12/2021] [Indexed: 12/27/2022]
Abstract
PURPOSE We report on our early experience of our prospective multicenter phase 1 dose- escalation study of single-fraction stereotactic partial breast irradiation (S-PBI) for early stage breast cancer after partial mastectomy using a robotic stereotactic radiation system. METHODS AND MATERIALS Thirty women with in situ or invasive breast cancer stage 0, I, or II with tumor size <3 cm treated with lumpectomy were enrolled in this phase 1 single-fraction S-PBI dose-escalation trial. Women received either 22.5, 26.5, or 30 Gy in a single fraction using a robotic stereotactic radiation system. The primary outcome was to reach tumoricidal dose of 30 Gy in a single fraction to the lumpectomy cavity without exceeding the maximum tolerated dose. Secondary outcomes were to determine dose-limiting toxicity and cosmesis. Tertiary goals were ipsilateral breast recurrence rate, distant disease-free interval, recurrence-free survival, and overall survival. RESULTS From June 2016 to January 2021, 11, 8, and 10 patients were treated to doses of 22.5, 26.5, or 30 Gy in a single fraction, respectively, with median follow-up being 47.9, 25.1, and 16.2 months. No patients experienced acute (<90 days) grade 3 or higher treatment-related toxicity, and maximum tolerated dose was not reached. There were 2 delayed grade 3 toxicities. Four patients (13.8%) developed fat necrosis across all 3 cohorts, which compares favorably with results from other PBI trials. No dose cohort had a statistically significant cosmetic detriment from baseline to 12 months or 24 months follow-up by patient- or physician-reported global cosmetic scores. There were no reports of disease recurrence. CONCLUSIONS This phase 1 trial demonstrates that S-PBI can be used to safely escalate dose to 30 Gy in a single fraction with low toxicity and without detriment in cosmesis relative to baseline.
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Affiliation(s)
- Asal Rahimi
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas.
| | - Ambrosia Simmons
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - D Nathan Kim
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Marilyn Leitch
- Departments of Radiation Surgery, University Texas Southwestern Medical Center, Dallas, Texas
| | - Jonathan Haas
- Perlmutter Cancer Center at NYU Langone Hospital, Long Island, New York
| | - Xuejun Gu
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Chul Ahn
- Departments of Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ang Gao
- Departments of Biostatistics, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ann Spangler
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Howard E Morgan
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Sally Goudreau
- Departments of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephen Seiler
- Departments of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Deborah Farr
- Departments of Radiation Surgery, University Texas Southwestern Medical Center, Dallas, Texas
| | - Rachel Wooldridge
- Departments of Radiation Surgery, University Texas Southwestern Medical Center, Dallas, Texas
| | - Barbara Haley
- Departments of Medical Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Shohreh Bahrami
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah Neufeld
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | | | - Prasanna Alluri
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
| | - Roshni Rao
- Columbia University Medical Center, Breast Surgery, New York City, New York
| | - Robert D Timmerman
- Departments of Radiation Oncology, University Texas Southwestern Medical Center, Dallas, Texas
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Millet GP, Seiler S, Millet GY. Opportunities and obstacles of translating elite sport research to public health. Br J Sports Med 2021; 56:64-65. [PMID: 34261664 DOI: 10.1136/bjsports-2021-104374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 11/04/2022]
Affiliation(s)
| | - Stephen Seiler
- Institute of Public Health, Sport, and Nutrition, University of Agder, Kristiansand, Norway
| | - Guillaume Y Millet
- Inter-University Laboratory of Human Movement Biology, Jean Monnet University, Saint-Etienne, France
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Stellingwerff T, Heikura IA, Meeusen R, Bermon S, Seiler S, Mountjoy ML, Burke LM. Overtraining Syndrome (OTS) and Relative Energy Deficiency in Sport (RED-S): Shared Pathways, Symptoms and Complexities. Sports Med 2021; 51:2251-2280. [PMID: 34181189 DOI: 10.1007/s40279-021-01491-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/26/2021] [Indexed: 12/14/2022]
Abstract
The symptom similarities between training-overload (with or without an Overtraining Syndrome (OTS) diagnosis) and Relative Energy Deficiency in Sport (RED-S) are significant, with both initiating from a hypothalamic-pituitary origin, that can be influenced by low carbohydrate (CHO) and energy availability (EA). In this narrative review we wish to showcase that many of the negative outcomes of training-overload (with, or without an OTS diagnosis) may be primarily due to misdiagnosed under-fueling, or RED-S, via low EA and/or low CHO availability. Accordingly, we undertook an analysis of training-overload/OTS type studies that have also collected and analyzed for energy intake (EI), CHO, exercise energy expenditure (EEE) and/or EA. Eighteen of the 21 studies (86%) that met our criteria showed indications of an EA decrease or difference between two cohorts within a given study (n = 14 studies) or CHO availability decrease (n = 4 studies) during the training-overload/OTS period, resulting in both training-overload/OTS and RED-S symptom outcomes compared to control conditions. Furthermore, we demonstrate significantly similar symptom overlaps across much of the OTS (n = 57 studies) and RED-S/Female Athlete Triad (n = 88 studies) literature. It is important to note that the prevention of under-recovery is multi-factorial, but many aspects are based around EA and CHO availability. Herein we have demonstrated that OTS and RED-S have many shared pathways, symptoms, and diagnostic complexities. Substantial attention is required to increase the knowledge and awareness of RED-S, and to enhance the diagnostic accuracy of both OTS and RED-S, to allow clinicians to more accurately exclude LEA/RED-S from OTS diagnoses.
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Affiliation(s)
- Trent Stellingwerff
- Pacific Institute for Sport Excellence, Canadian Sport Institute-Pacific, 4371 Interurban Road, Victoria, BC, V9E 2C5, Canada.
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada.
| | - Ida A Heikura
- Pacific Institute for Sport Excellence, Canadian Sport Institute-Pacific, 4371 Interurban Road, Victoria, BC, V9E 2C5, Canada
- Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
| | - Romain Meeusen
- Human Physiology and Sports Physiotherapy Research Group, Vrije Universiteit Brussel, Brussels, Belgium
| | - Stéphane Bermon
- Université Côte d'Azur, LAMHESS Nice, Nice, France
- World Athletics, Health and Science Department, Monte Carlo, Monaco
| | - Stephen Seiler
- Department of Sport Science and Physical Education, University of Agder, Kristiansand, Norway
| | - Margo L Mountjoy
- Department of Family Medicine, McMaster University, Hamilton, ON, Canada
- IOC Medical Commission Games Group, Lausanne, Switzerland
| | - Louise M Burke
- Australian Institute of Sport, Bruce, ACT, Australia
- Mary Mackillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
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Rahimi A, Morgan HE, Kim DW, Zhang Y, Leitch M, Wooldridge R, Goudreau S, Haley B, Rao R, Rivers A, Spangler AE, Jones RT, Stevenson S, Staley J, Albuquerque K, Ahn C, Neufeld S, Alluri PG, Ding C, Garwood D, Seiler S, Zhao B, Gu X, Timmerman R. Cosmetic Outcomes of a Phase 1 Dose Escalation Study of 5-Fraction Stereotactic Partial Breast Irradiation for Early Stage Breast Cancer. Int J Radiat Oncol Biol Phys 2021; 110:772-782. [PMID: 33476737 DOI: 10.1016/j.ijrobp.2021.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/06/2021] [Accepted: 01/10/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE Our purpose was to evaluate cosmetic changes after 5-fraction adjuvant stereotactic partial breast irradiation (S-PBI). METHODS AND MATERIALS Seventy-five women with in situ or invasive breast cancer stage 0, I, or II, with tumor size ≤3 cm, were enrolled after lumpectomy in a phase 1 dose escalation trial of S-PBI into cohorts receiving 30, 32.5, 35, 37.5, or 40 Gy in 5 fractions. Before S-PBI, 3 to 4 gold fiducial markers were placed in the lumpectomy cavity for tracking with the Synchrony respiratory tracking system. S-PBI was delivered with a CyberKnife robotic radiosurgery system. Patients and physicians evaluated global cosmesis using the Harvard Breast Cosmesis Scale. Eight independent panelists evaluated digital photography for global cosmesis and 10 subdomains at baseline and follow-up. McNemar tests were used to evaluate change in cosmesis, graded as excellent/good or fair/poor, from baseline to year 3. Wilcoxon signed rank tests were used to evaluate change in subdomains. Cohen's kappa (κ) statistic was used to estimate interobserver agreement (IOA) between raters, and Fleiss' κ was used to estimate IOA between panelists. RESULTS Median cosmetic follow-up was 5, 5, 5, 4, and 3 years for the 30, 32.5, 35, 37.5, and 40 Gy cohorts. Most patients reported excellent/good cosmesis at both baseline (86.3%) and year 3 (89.8%). No dose cohort had significantly worsened cosmesis by year 3 on McNemar analysis. No cosmetic subdomain had significant worsening by year 3. IOA was fair for patient-physician (κ = 0.300, P < .001), patient-panel (κ = 0.295, P < .001), physician-panel (κ = 0.256, P < .001), and individual panelists (Fleiss κ = 0.327, P < .001). CONCLUSIONS Dose escalation of S-PBI from 30 to 40 Gy in 5 fractions for early stage breast cancer was not associated with a detectable change in cosmesis by year 3. S-PBI is a promising modality for treatment of early stage breast cancer.
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Affiliation(s)
- Asal Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Howard E Morgan
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dong W Kim
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Yuanyuan Zhang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marilyn Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rachel Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sally Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Barbara Haley
- Department of Medicine, Division of Hematology-Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Roshni Rao
- Department of Surgery, Columbia University, New York, New York
| | - Aeisha Rivers
- Department of Surgery, Memorial Health Care System, Pembroke Pines, Florida
| | - Ann E Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ryan T Jones
- Department of Radiation Oncology, Tennessee Oncology, Nashville, Tennessee
| | - Stella Stevenson
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jason Staley
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kevin Albuquerque
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chul Ahn
- Department of Population and Data Sciences, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sarah Neufeld
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Prasanna G Alluri
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chuxiong Ding
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dan Garwood
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bo Zhao
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, Uniondale, New York
| | - Xuejun Gu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
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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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Sharifi A, Seiler S, Hwang H, Dogan BE. Neoplastic seeding of breast cancer along the core biopsy tract. Breast J 2020; 26:2129-2131. [PMID: 32657504 DOI: 10.1111/tbj.13974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 06/22/2020] [Accepted: 06/23/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Arghavan Sharifi
- School of Medicine, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Stephen Seiler
- Department of Diagnostic Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Helena Hwang
- Department of Pathology, UT Southwestern Medical Center, Dallas, Texas, USA
| | - Basak E Dogan
- Department of Diagnostic Radiology, UT Southwestern Medical Center, Dallas, Texas, USA
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Zhang E, Seiler S, Chen M, Lu W, Gu X. BIRADS features-oriented semi-supervised deep learning for breast ultrasound computer-aided diagnosis. Phys Med Biol 2020; 65:125005. [PMID: 32155605 DOI: 10.1088/1361-6560/ab7e7d] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We propose a novel BIRADS-SSDL network that integrates clinically-approved breast lesion characteristics (BIRADS features) into task-oriented semi-supervised deep learning (SSDL) for accurate diagnosis of ultrasound (US) images with a small training dataset. Breast US images are converted to BIRADS-oriented feature maps (BFMs) using a distance-transformation coupled with a Gaussian filter. Then, the converted BFMs are used as the input of an SSDL network, which performs unsupervised stacked convolutional auto-encoder (SCAE) image reconstruction guided by lesion classification. This integrated multi-task learning allows SCAE to extract image features with the constraints from the lesion classification task, while the lesion classification is achieved by utilizing the SCAE encoder features with a convolutional network. We trained the BIRADS-SSDL network with an alternative learning strategy by balancing the reconstruction error and classification label prediction error. To demonstrate the effectiveness of our approach, we evaluated it using two breast US image datasets. We compared the performance of the BIRADS-SSDL network with conventional SCAE and SSDL methods that use the original images as inputs, as well as with an SCAE that use BFMs as inputs. The experimental results on two breast US datasets show that BIRADS-SSDL ranked the best among the four networks, with a classification accuracy of around 94.23 ± 3.33% and 84.38 ± 3.11% on two datasets. In the case of experiments across two datasets collected from two different institutions/and US devices, the developed BIRADS-SSDL is generalizable across the different US devices and institutions without overfitting to a single dataset and achieved satisfactory results. Furthermore, we investigate the performance of the proposed method by varying the model training strategies, lesion boundary accuracy, and Gaussian filter parameters. The experimental results showed that a pre-training strategy can help to speed up model convergence during training but with no improvement of the classification accuracy on the testing dataset. The classification accuracy decreases as the segmentation accuracy decreases. The proposed BIRADS-SSDL achieves the best results among the compared methods in each case and has the capacity to deal with multiple different datasets under one model. Compared with state-of-the-art methods, BIRADS-SSDL could be promising for effective breast US computer-aided diagnosis using small datasets.
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Affiliation(s)
- Erlei Zhang
- College of Information Science and Technology, Northwest University, Xi' an 710069, People's Republic of China. Medical Artificial Intelligence and Automation Laboratory, Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, TX 75390, United States of America
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Rahimi A, Zhang Y, Kim DW, Morgan H, Hossain F, Leitch M, Wooldridge R, Seiler S, Goudreau S, Haley B, Rao R, Rivers A, Spangler A, Ahn C, Stevenson S, Staley J, Albuquerque K, Ding C, Gu X, Zhao B, Timmerman R. Risk Factors for Fat Necrosis After Stereotactic Partial Breast Irradiation for Early-Stage Breast Cancer in a Phase 1 Clinical Trial. Int J Radiat Oncol Biol Phys 2020; 108:697-706. [PMID: 32464155 DOI: 10.1016/j.ijrobp.2020.05.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/17/2020] [Accepted: 05/18/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE This study reports predictive dosimetric and physiologic factors for fat necrosis after stereotactic-partial breast irradiation (S-PBI). METHODS AND MATERIALS Seventy-five patients with ductal carcinoma-in situ or invasive nonlobular epithelial histologies stage 0, I, or II, with tumor size <3 cm were enrolled in a dose-escalation, phase I S-PBI trial between January 2011 and July 2015. Fat necrosis was evaluated clinically at each follow-up. Treatment data were extracted from the Multiplan Treatment Planning System (Cyberknife, Accuray). Univariate and stepwise logistic regression analyses were conducted to identify factors associated with palpable fat necrosis. RESULTS With a median follow-up of 61 months (range: 4.3-99.5 months), 11 patients experienced palpable fat necrosis, 5 cases of which were painful. The median time to development of fat necrosis was 12.7 months (range, 3-42 months). On univariate analyses, higher V32.5-47.5 Gy (P < .05) and larger breast volume (P < .01) were predictive of any fat necrosis; higher V35-50 Gy (P < .05), receiving 2 treatments on consecutive days (P = .02), and higher Dmax (P = .01) were predictive of painful fat necrosis. On multivariate analyses, breast volume larger than 1063 cm3 remained a predictive factor for any fat necrosis; receiving 2 treatments on consecutive days and higher V45 Gy were predictive of painful fat necrosis. Breast laterality, planning target volume (PTV), race, body mass index, diabetic status, and tobacco or drug use were not significantly associated with fat necrosis on univariate analysis. CONCLUSIONS Early-stage breast cancer patients treated with breast conserving surgery and S-PBI in our study had a fat necrosis rate comparable to other accelerated partial breast irradiation modalities, but S-PBI is less invasive. To reduce risk of painful fat necrosis, we recommend not delivering fractions on consecutive days; limiting V42.5 < 50 cm3, V45 < 20 cm3, V47.5 < 1 cm3, Dmax ≤ 48 Gy and PTV < 100 cm3 when feasible; and counseling patients about the increased risk for fat necrosis when constraints are not met and for those with breast volume >1000 cm3.
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Affiliation(s)
- Asal Rahimi
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas.
| | - Yuanyuan Zhang
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dong W Kim
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Howard Morgan
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Ferzana Hossain
- Medical School, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Marilyn Leitch
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Rachel Wooldridge
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Sally Goudreau
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Barbara Haley
- Department of Surgery, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Roshni Rao
- Department of Surgery, Columbia University, New York, New York
| | - Aeisha Rivers
- Department of Surgery, Memorial Health care System, Miramar, Florida
| | - Ann Spangler
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chul Ahn
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Stella Stevenson
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jason Staley
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kevin Albuquerque
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Chuxiong Ding
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Xuejun Gu
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Bo Zhao
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert Timmerman
- Department of Radiation Oncology, University of Texas Southwestern Medical Center, Dallas, Texas
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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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Haugen TA, Breitschädel F, Seiler S. Sprint mechanical properties in soccer players according to playing standard, position, age and sex. J Sports Sci 2020; 38:1070-1076. [DOI: 10.1080/02640414.2020.1741955] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Thomas A. Haugen
- School of Health Sciences, Kristiania University College, Oslo, Norway
| | - Felix Breitschädel
- Norwegian Olympic Federation, Oslo, Norway
- Department of Civil and Environmental Engineering, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stephen Seiler
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Haugen T, Seiler S, Sandbakk Ø, Tønnessen E. The Training and Development of Elite Sprint Performance: an Integration of Scientific and Best Practice Literature. Sports Med Open 2019; 5:44. [PMID: 31754845 PMCID: PMC6872694 DOI: 10.1186/s40798-019-0221-0] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/23/2019] [Indexed: 12/27/2022]
Abstract
Despite a voluminous body of research devoted to sprint training, our understanding of the training process leading to a world-class sprint performance is limited. The objective of this review is to integrate scientific and best practice literature regarding the training and development of elite sprint performance. Sprint performance is heavily dependent upon genetic traits, and the annual within-athlete performance differences are lower than the typical variation, the smallest worthwhile change, and the influence of external conditions such as wind, monitoring methodologies, etc. Still, key underlying determinants (e.g., power, technique, and sprint-specific endurance) are trainable. In this review, we describe how well-known training principles (progression, specificity, variation/periodization, and individualization) and varying training methods (e.g., sprinting/running, technical training, strength/power, plyometric training) are used in a sprint training context. Indeed, there is a considerable gap between science and best practice in how training principles and methods are applied. While the vast majority of sprint-related studies are performed on young team sport athletes and focus on brief sprints with maximal intensity and short recoveries, elite sprinters perform sprinting/running over a broad range of distances and with varying intensity and recovery periods. Within best practice, there is a stronger link between choice of training component (i.e., modality, duration, intensity, recovery, session rate) and the intended purpose of the training session compared with the “one-size-fits-all” approach in scientific literature. This review provides a point of departure for scientists and practitioners regarding the training and development of elite sprint performance and can serve as a position statement for outlining state-of-the-art sprint training recommendations and for generation of new hypotheses to be tested in future research.
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Affiliation(s)
- Thomas Haugen
- Faculty of Health Sciences, Kristiania University College, PB 1190 Sentrum, 0107, Oslo, Norway.
| | - Stephen Seiler
- Faculty of Health and Sport Sciences, University of Agder, PB 422, 4604, Kristiansand, Norway
| | - Øyvind Sandbakk
- Centre for Elite Sports Research, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, 7491, Trondheim, Norway
| | - Espen Tønnessen
- Faculty of Health Sciences, Kristiania University College, PB 1190 Sentrum, 0107, Oslo, Norway
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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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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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Affiliation(s)
- Daniel Boullosa
- iLOAD Solutions Brasilia, BRAZIL All In Your Mind Training System Mérida, MEXICO Department of Public HealthSports and NutritionKristiansand, NORWAY
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Haugen TA, Breitschädel F, Seiler S. Sprint mechanical variables in elite athletes: Are force-velocity profiles sport specific or individual? PLoS One 2019; 14:e0215551. [PMID: 31339890 PMCID: PMC6655540 DOI: 10.1371/journal.pone.0215551] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [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: 01/03/2019] [Accepted: 04/03/2019] [Indexed: 12/05/2022] Open
Abstract
Purpose The main aim of this investigation was to quantify differences in sprint mechanical variables across sports and within each sport. Secondary aims were to quantify sex differences and relationships among the variables. Methods In this cross-sectional study of elite athletes, 235 women (23 ± 5 y and 65 ± 7 kg) and 431 men (23 ± 4 y and 80 ± 12 kg) from 23 different sports (including 128 medalists from World Championships and/or Olympic Games) were tested in a 40-m sprint at the Norwegian Olympic Training Center between 1995 and 2018. These were pre-existing data from quarterly or semi-annual testing that the athletes performed for training purposes. Anthropometric and speed-time sprint data were used to calculate the theoretical maximal velocity, horizontal force, horizontal power, slope of the force-velocity relationship, maximal ratio of force, and index of force application technique. Results Substantial differences in mechanical profiles were observed across sports. Athletes in sports in which sprinting ability is an important predictor of success (e.g., athletics sprinting, jumping and bobsleigh) produced the highest values for most variables, whereas athletes in sports in which sprinting ability is not as important tended to produce substantially lower values. The sex differences ranged from small to large, depending on variable of interest. Although most of the variables were strongly associated with 10- and 40-m sprint time, considerable individual differences in sprint mechanical variables were observed among equally performing athletes. Conclusions Our data from a large sample of elite athletes tested under identical conditions provides a holistic picture of the force-velocity-power profile continuum in athletes. The data indicate that sprint mechanical variables are more individual than sport specific. The values presented in this study could be used by coaches to develop interventions that optimize the training stimulus to the individual athlete.
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Affiliation(s)
| | - Felix Breitschädel
- Norwegian Olympic Federation, Oslo, Norway
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Stephen Seiler
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
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Zhang E, Seiler S, Chen M, Lu W, Gu X. Boundary-aware Semi-supervised Deep Learning for Breast Ultrasound Computer-Aided Diagnosis. Annu Int Conf IEEE Eng Med Biol Soc 2019; 2019:947-950. [PMID: 31946050 DOI: 10.1109/embc.2019.8856539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Breast ultrasound (US) is an effective imaging modality for breast cancer diagnosis. US computer-aided diagnosis (CAD) systems have been developed for decades and have employed either conventional handcrafted features or modern automatic deep-learned features, the former relying on clinical experience and the latter demanding large datasets. In this paper, we developed a novel BASDL method that integrates clinical-approved breast lesion boundary characteristics (features) into a semi-supervised deep learning (SDL) to achieve accurate diagnosis with a small training dataset. Original breast US images are converted to boundary-oriented feature maps (BFMs) using a distance-transformation coupled with a Gaussian filter. Then, the converted BFMs are used as the input of SDL network, which is characterized as lesion classification guided unsupervised image reconstruction based on stacked convolutional auto-encode (SCAE). We compared the performance of BASDL with conventional SCAE method and SDL method that used the original images as inputs, as well as SCAE method that used BFMs as inputs. Experimental results on two breast US datasets show that BASDL ranked the best among the four networks, with classification accuracy around 92.00±2.38%, which indicated that BASDL could be promising for effective breast US lesion CAD using small datasets.
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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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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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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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Skovereng K, Sylta Ø, Tønnessen E, Hammarström D, Danielsen J, Seiler S, Rønnestad BR, Sandbakk Ø. Effects of Initial Performance, Gross Efficiency and O 2peak Characteristics on Subsequent Adaptations to Endurance Training in Competitive Cyclists. Front Physiol 2018; 9:713. [PMID: 29962959 PMCID: PMC6010573 DOI: 10.3389/fphys.2018.00713] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 05/23/2018] [Indexed: 11/14/2022] Open
Abstract
The present study investigated the effects of initial levels of cycling performance, peak oxygen uptake (O2peak) and gross efficiency (GE) on the subsequent adaptations of these variables and their relationship following high-intensity training (HIT) designed to increase O2peak in competitive cyclists. Sixty cyclists (O2peak = 61 ± 6 mL kg-1 min-1) were assigned a 12-week training program consisting of twenty-four supervised high-intensity interval training sessions and ad libitum low intensity training. GE was calculated at 125, 175, and 225 W and performance was determined by mean power during a 40-min time-trial (Power40 min). In addition to correlation analyses between initial level and pre- to post-intervention changes of the different variables, we compared these changes between four groups where participants were categorized with either low and/or high initial levels of O2peak and GE. Average volume of high- and low-intensity training during the 12-week intervention was 1.5 ± 0.3 and 8.3 ± 2.7 h·week-1, respectively. Following the 12-week training period, there was a significant increase in absolute and body mass normalized O2peak and Power40 min (p < 0.05) and a significant decrease in GE (p < 0.05) for all athletes pooled. There was no change in body mass following the 12-week training period. We found a moderate negative correlation between initial level of O2peak and the change in O2peak following the training period (r = -0.32; p < 0.05). A small negative correlation was also found between initial Power40 min and its change following training both when expressed in absolute power and power normalized for body mass (r = -0.27 and -0.28; both p < 0.05). A moderate negative correlation was also found between initial levels for GE and its change following training (r = -0.44; p < 0.01). There were no differences between the four groups based on initial levels of O2peak and GE in the response to training on O2peak, GE, or Power40 min (all p > 0.12). In conclusion, the present findings suggest that there are statistically significant effects of initial levels of cycling performance and O2peak and on the subsequent adaptations following a 12-week HIT program, but the small and moderate effects indicate limited influence on training practice.
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Affiliation(s)
- Knut Skovereng
- Centre for Elite Sports Research, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Øystein Sylta
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | | | - Daniel Hammarström
- Section for Sport Science, Lillehammer University College, Lillehammer, Norway
| | - Jørgen Danielsen
- Centre for Elite Sports Research, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stephen Seiler
- Faculty of Health and Sport Sciences, University of Agder, Kristiansand, Norway
| | - Bent R Rønnestad
- Section for Sport Science, Lillehammer University College, Lillehammer, Norway
| | - Øyvind Sandbakk
- Centre for Elite Sports Research, Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
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Vassbakk-Brovold K, Berntsen S, Fegran L, Lian H, Mjåland O, Mjåland S, Nordin K, Seiler S, Kersten C. Lifestyle changes in cancer patients undergoing curative or palliative chemotherapy: is it feasible? Acta Oncol 2018; 57:831-838. [PMID: 29239243 DOI: 10.1080/0284186x.2017.1413247] [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: 12/29/2022]
Abstract
INTRODUCTION This study aimed to explore the feasibility of an individualized comprehensive lifestyle intervention in cancer patients undergoing curative or palliative chemotherapy. MATERIAL AND METHODS At one cancer center, serving a population of 180,000, 100 consecutive of 161 eligible newly diagnosed cancer patients starting curative or palliative chemotherapy entered a 12-month comprehensive, individualized lifestyle intervention. Participants received a grouped startup course and monthly counseling, based on self-reported and electronically evaluated lifestyle behaviors. Patients with completed baseline and end of study measurements are included in the final analyses. Patients who did not complete end of study measurements are defined as dropouts. RESULTS More completers (n = 61) vs. dropouts (n = 39) were married or living together (87 vs. 69%, p = .031), and significantly higher baseline physical activity levels (960 vs. 489 min.wk-1, p = .010), more healthy dietary choices (14 vs 11 points, p = .038) and fewer smokers (8 vs. 23%, p = .036) were observed among completers vs. dropouts. Logistic regression revealed younger (odds ratios (OR): 0.95, 95% confidence interval (CI): 0.91, 0.99) and more patients diagnosed with breast cancer vs. more severe cancer types (OR: 0.16, 95% CI: 0.04, 0.56) among completers vs. dropouts. Improvements were observed in completers healthy (37%, p < 0.001) and unhealthy dietary habits (23%, p = .002), and distress (94%, p < .001). No significant reductions were observed in physical activity levels. Patients treated with palliative intent did not reduce their physical activity levels while healthy dietary habits (38%, p = 0.021) and distress (104%, p = 0.012) was improved. DISCUSSION Favorable and possibly clinical relevant lifestyle changes were observed in cancer patients undergoing curative or palliative chemotherapy after a 12-month comprehensive and individualized lifestyle intervention. Palliative patients were able to participate and to improve their lifestyle behaviors.
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Affiliation(s)
- Karianne Vassbakk-Brovold
- Center for Cancer Treatment, Sorlandet Hospital Trust, Kristiansand, Norway
- Department of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Sveinung Berntsen
- Department of Health and Sport Science, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Liv Fegran
- Department of Health and Nursing Science, University of Agder, Kristiansand, Norway
| | - Henrik Lian
- Department for Physical and Preventive Medicine, Sorlandet Hospital Trust, Kristiansand, Norway
| | - Odd Mjåland
- Surgical Department, Sorlandet Hospital Trust, Kristiansand, Norway
| | - Svein Mjåland
- Center for Cancer Treatment, Sorlandet Hospital Trust, Kristiansand, Norway
| | - Karin Nordin
- Department of Health and Sport Science, University of Agder, Kristiansand, Norway
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Stephen Seiler
- Department of Health and Sport Science, University of Agder, Kristiansand, Norway
| | - Christian Kersten
- Center for Cancer Treatment, Sorlandet Hospital Trust, Kristiansand, Norway
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Partain N, Mokdad A, Puzziferri N, Porembka J, Seiler S, Christie A, Farr D, Rivers A, Marilyn Leitch A, Wooldridge R, Huth J, Rao R. Mammographic density changes in surgical weight loss-an indication for personalized screening. BMC Med Imaging 2018; 18:10. [PMID: 29743035 PMCID: PMC5941592 DOI: 10.1186/s12880-017-0242-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 06/13/2017] [Accepted: 12/15/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Obesity and high radiologic breast density independently increase breast cancer risk. We evaluated the effect of surgical weight loss on mammographic density (MD). METHODS Patients undergoing bariatric surgery and screening mammography (MG) were identified, data regarding demographics, comorbidities, calculated and genetic breast cancer risk was collected. Patients had a MG before and after surgery. Fellowship-trained breast radiologists assigned Breast Imaging Reporting and Data System density categories. RESULTS Patients underwent sleeve gastrectomy (n = 56) or gastric bypass (n = 7), 78% had hypertension, 48% had diabetes. Four had deleterious BRCA mutations, four were calculated high risk. Mean weight loss = 28.7 kg. Mean initial BMI = 44.3 kg/m2 (range:33-77), final BMI = 33.6 kg/m2 (range:20-62;p < 0.01). Density was unchanged in 53, decreased in 1, increased in 9. Of these 9(14%), 5 changed from almost entirely fatty to scattered MD, and 4 changed from scattered MD to heterogeneously dense. Mean weight loss of the 9 with increased MD was greater than the cohort (37.7vs.28.7 kg;p < 0.01). CONCLUSIONS Surgical weight loss increased MD in 14%. Increased MD masks malignancies, patients may benefit from additional screening based on calculated risk assessments that include MD.
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Affiliation(s)
- Natalia Partain
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Ali Mokdad
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Nancy Puzziferri
- Department of Surgery, Division of Gastrointestinal and Endocrine Surgery, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Jessica Porembka
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Alana Christie
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Deborah Farr
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Aeisha Rivers
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - A Marilyn Leitch
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Rachel Wooldridge
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - James Huth
- Department of Surgery, Division of Surgical Oncology, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, 75390-8548, USA
| | - Roshni Rao
- Division of Breast Surgery, Columbia University Medical Center/New York Presbyterian, 161 Fort Washington Ave 10th floor, New York, NY, 10032, USA.
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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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50
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Zhang S, Seiler S, Wang X, Madhuranthakam AJ, Keupp J, Knippa EE, Lenkinski RE, Vinogradov E. CEST-Dixon for human breast lesion characterization at 3 T: A preliminary study. Magn Reson Med 2018; 80:895-903. [PMID: 29322559 DOI: 10.1002/mrm.27079] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2017] [Revised: 11/24/2017] [Accepted: 12/17/2017] [Indexed: 12/20/2022]
Affiliation(s)
- Shu Zhang
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Stephen Seiler
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Xinzeng Wang
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Ananth J Madhuranthakam
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | | | - Emily E Knippa
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Robert E Lenkinski
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Elena Vinogradov
- Department of Radiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.,Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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