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Baumann AK, Beck J, Kirchner T, Hartleben B, Schütz E, Oellerich M, Wedemeyer H, Jaeckel E, Taubert R. Elevated fractional donor-derived cell-free DNA during subclinical graft injury after liver transplantation. Liver Transpl 2022; 28:1911-1919. [PMID: 35429207 DOI: 10.1002/lt.26479] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 03/18/2022] [Accepted: 04/05/2022] [Indexed: 02/07/2023]
Abstract
Personalized immunosuppression (IS) promises to improve the balance of necessary control of alloreactivity and dose-dependent adverse effects of long-term IS such as kidney insufficiency, infections, and malignancies. The majority of liver transplantation (LT) recipients exhibit graft injuries (graft inflammation and/or fibrosis) that are not eligible for an IS reduction according to current Banff criteria, even when liver enzymes are normal or only marginally elevated. This cross-sectional study evaluated the noninvasive prediction of such subclinical graft injuries in surveillance liver biopsies via donor-derived cell-free DNA (dd-cfDNA). Absolute and fractional dd-cfDNA increased stepwise from patients without histological signs of rejection (n = 26) over subclinical graft injury (n = 61), including subclinical T cell-mediated rejection to clinical overt T cell-mediated rejection (n = 21). Thus, fractional plasma dd-cfDNA was significantly elevated paired to surveillance biopsies with relevant subclinical graft injury according to 2016 Banff criteria compared with those with minimal or absent histological graft injury. In contrast, the presence of donor-specific anti-human leukocyte antigen antibodies was not associated with the amount of dd-cfDNA. The sensitivity and specificity of fractional dd-cfDNA to noninvasively predict relevant subclinical graft injury was rather limited with 73% and 52% at the cutoff value of 2.1% fractional dd-cfDNA. The positive predictive value of fractional dd-cfDNA above 2.1% was 76% to noninvasively predict subclinical graft injury, calculated on the prevalence of graft injury in our prospective surveillance biopsy program, whereas the negative predictive values was not predictive (47%). In conclusion, dd-cfDNA has a rather limited diagnostic fidelity in addition to other noninvasive markers for the assessment of subclinical graft injury in personalized IS approaches after LT in a cross-sectional setting.
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Affiliation(s)
- Anna K Baumann
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | | | - Theresa Kirchner
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Björn Hartleben
- Institute for Pathology, Hannover Medical School, Hannover, Germany
| | | | - Michael Oellerich
- Department of Clinical Pharmacology, University Medical Center Goettingen, Goettingen, Germany
| | - Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Elmar Jaeckel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Richard Taubert
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
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2
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Codoni G, Kirchner T, Engel B, Villamil AM, Efe C, Stättermayer AF, Weltzsch JP, Sebode M, Bernsmeier C, Lleo A, Gevers TJG, Kupčinskas L, Castiella A, Pinazo J, De Martin E, Bobis I, Sandahl TD, Pedica F, Invernizzi F, Del Poggio P, Bruns T, Kolev M, Semmo N, Bessone F, Giguet B, Poggi G, Ueno M, Jang H, Elpek GÖ, Soylu NK, Cerny A, Wedemeyer H, Vergani D, Mieli-Vergani G, Lucena MI, Andrade RJ, Zen Y, Taubert R, Beretta-Piccoli BT. Histological and serological features of acute liver injury after SARS-CoV-2 vaccination. JHEP Rep 2022; 5:100605. [DOI: 10.1016/j.jhepr.2022.100605] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 09/22/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
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3
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Kirchner T, Jaeckel E, Falk CS, Eiz-Vesper B, Taubert R. SARS-CoV-2-specific immunity in immunosuppressed COVID-19 convalescents with autoimmune hepatitis. J Hepatol 2021; 75:1506-1509. [PMID: 34284030 PMCID: PMC8285931 DOI: 10.1016/j.jhep.2021.07.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 07/12/2021] [Indexed: 12/12/2022]
Affiliation(s)
- Theresa Kirchner
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Elmar Jaeckel
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany
| | - Christine S Falk
- Institute of Transplant Immunology, Hannover Medical School, Hannover, Germany
| | - Britta Eiz-Vesper
- Institute of Transfusion Medicine and Transplant Engineering, Hannover Medical School, Hannover, Germany
| | - Richard Taubert
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany.
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Wedemeyer H, Herzer K, Serfert Y, Taubert R, Trautwein C, Eurich D, P. Strassburg C, Lang M, Heinz Weiss K, Berg T, R. Galle P, Heinzow H, Zeuzem S, Willuweit K, Kirchner T, Sahin C, Plewe J, Spengler U, Welker MW, Sterneck M, Mehrabi A, Herber A, Zimmermann T, Schmidt H. Declining Numbers of Hepatitis C Virus-Associated Liver Transplantations in Germany. Dtsch Arztebl Int 2021; 118:797-798. [PMID: 35129433 PMCID: PMC8864669 DOI: 10.3238/arztebl.m2021.0318] [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] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 05/31/2021] [Accepted: 08/12/2021] [Indexed: 06/14/2023]
Affiliation(s)
- Heiner Wedemeyer
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover
- Leberstiftungs-GmbH Deutschland, Hannover (Wedemeyer, Serfert)
| | - Kerstin Herzer
- Department of Gastroenterology and Hepatology, Essen University Hospital, Duisburg-Essen University, Essen
- Knappschafts-Klinik, Bad Neuenahr, Germany
| | - Yvonne Serfert
- Leberstiftungs-GmbH Deutschland, Hannover (Wedemeyer, Serfert)
| | - Richard Taubert
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover
| | - Christian Trautwein
- Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen
| | - Dennis Eurich
- Department of Surgery Charité-Universitätsmedizin Berlin, Berlin
| | - Christian P. Strassburg
- Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen
- Department of Internal Medicine I, University Hospital Bonn (UKB), Bonn
| | - Melanie Lang
- Department of Medicine I, University Medical Center Hamburg-Eppendorf (UKE)
| | - Karl Heinz Weiss
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg
- Dept. of Internal Medicine, Salem Medical Center Heidelberg, Heidelberg
| | - Thomas Berg
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig
| | - Peter R. Galle
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
| | - Hauke Heinzow
- Department of Medicine B, Münster University Hospital (UKM), Münster
- Medical Department 1, Merciful Brothers Hospital Trier, Trier, Germany
| | - Stefan Zeuzem
- Medical Department 1, Goethe University Hospital, Frankfurt am Main
| | - Katharina Willuweit
- Department of Gastroenterology and Hepatology, Essen University Hospital, Duisburg-Essen University, Essen
| | - Theresa Kirchner
- Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover
| | - Cennet Sahin
- Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen
| | - Julius Plewe
- Department of Surgery Charité-Universitätsmedizin Berlin, Berlin
| | - Ulrich Spengler
- Department of Internal Medicine III, University Hospital RWTH Aachen, Aachen
- Department of Internal Medicine I, University Hospital Bonn (UKB), Bonn
| | - Martin-Walter Welker
- Medical Department 1, Goethe University Hospital, Frankfurt am Main
- Klinik für Innere Medizin I, Kreisklinik Groß-Umstadt, Groß-Umstadt
| | - Martina Sterneck
- Department of Medicine I, University Medical Center Hamburg-Eppendorf (UKE)
| | - Arianeb Mehrabi
- Department for General, Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg
| | - Adam Herber
- Division of Hepatology, Department of Medicine II, Leipzig University Medical Center, Leipzig
| | - Tim Zimmermann
- I. Department of Medicine, University Medical Center of the Johannes Gutenberg University Mainz, Mainz
- Medizinische Klinik II, Klinikum Worms, Worms
| | - Hartmut Schmidt
- Department of Gastroenterology and Hepatology, Essen University Hospital, Duisburg-Essen University, Essen
- Department of Medicine B, Münster University Hospital (UKM), Münster
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5
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Sultova E, Westphalen C, Jung A, Kirchner T, Mayr D, Heinemann V, Metzeler K, Greif P, Trillsch F, Mahner S, Harbeck N, Wuerstlein R. Panel-guided personalized medicine in metastatic breast and gynecological cancer: First experiences at the Comprehensive Cancer Centre Munich and clinical relevant changes over time. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30539-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sultova E, CB W, Jung A, Kirchner T, Mayr D, Rudelius M, Ormanns S, Kumbrink J, Heinemann V, Metzeler K, PA G, Trillsch F, Mahner S, Harbeck N, Würstlein R. Panel-guided personalized medicine in metastatic breast and gynecological cancer: First experiences at the CCC Munich and clinically relevant changes over time. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Sultova
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
| | - Westphalen CB
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - A Jung
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - T Kirchner
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - D Mayr
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - M Rudelius
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - S Ormanns
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - J Kumbrink
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - V Heinemann
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - K Metzeler
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - Greif PA
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - F Trillsch
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
| | - S Mahner
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
| | - N Harbeck
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Brustzentrum und CCC München
| | - R Würstlein
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
- LMU Klinikum der Universität München, Brustzentrum und CCC München
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von Einem J, Heinemann V, Modest D, Stahler A, Miller-Phillips L, Fischer von Weikersthal L, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran SE, Kahl C, Seipelt G, Kullmann F, Scheithauer W, Jung A, Kirchner T, Stintzing S. 441P Evaluation of conversion therapy in patients undergoing secondary resection of metastases in curative intent within the FIRE-3 (AIO KRK-0306) study. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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8
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Sultova E, Westphalen B, Jung A, Kirchner T, Mayr D, Rudelius M, Ormanns S, Kumbrink J, Heinemann V, Metzeler K, Greif PA, Trillsch F, Mahner S, Harbeck N, Wuerstlein R. Personalisierte Medizin bei metastasierten Brust- und gynäkologischen Krebserkrankungen. Erste Ergebnisse in CCC LMU München. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Sultova
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - B Westphalen
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - A Jung
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - T Kirchner
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - D Mayr
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - M Rudelius
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - S Ormanns
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - J Kumbrink
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - V Heinemann
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - K Metzeler
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - P A Greif
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - F Trillsch
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - N Harbeck
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - R Wuerstlein
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
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9
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Stintzing S, Wirapati P, Lenz HJ, Neureiter D, Fischer von Weikersthal L, Decker T, Kiani A, Kaiser F, Al-Batran S, Heintges T, Lerchenmüller C, Kahl C, Seipelt G, Kullmann F, Moehler M, Scheithauer W, Held S, Modest DP, Jung A, Kirchner T, Aderka D, Tejpar S, Heinemann V. Consensus molecular subgroups (CMS) of colorectal cancer (CRC) and first-line efficacy of FOLFIRI plus cetuximab or bevacizumab in the FIRE3 (AIO KRK-0306) trial. Ann Oncol 2019; 30:1796-1803. [PMID: 31868905 PMCID: PMC6927316 DOI: 10.1093/annonc/mdz387] [Citation(s) in RCA: 118] [Impact Index Per Article: 23.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND FIRE-3 compared first-line therapy with FOLFIRI plus either cetuximab or bevacizumab in 592 KRAS exon 2 wild-type metastatic colorectal cancer (mCRC) patients. The consensus molecular subgroups (CMS) are grouping CRC samples according to their gene-signature in four different subtypes. Relevance of CMS for the treatment of mCRC has yet to be defined. PATIENTS AND METHODS In this exploratory analysis, patients were grouped according to the previously published tumor CRC-CMSs. Objective response rates (ORR) were compared using chi-square test. Overall survival (OS) and progression-free survival (PFS) times were compared using Kaplan-Meier estimation, log-rank tests. Hazard ratios (HR) were estimated according to the Cox proportional hazard method. RESULTS CMS classification could be determined in 438 out of 514 specimens available from the intent-to-treat (ITT) population (n = 592). Frequencies for the remaining 438 samples were as follows: CMS1 (14%), CMS2 (37%), CMS3 (15%), CMS4 (34%). For the 315 RAS wild-type tumors, frequencies were as follows: CMS1 (12%), CMS2 (41%), CMS3 (11%), CMS4 (34%). CMS distribution in right- versus (vs) left-sided primary tumors was as follows: CMS1 (27% versus 11%), CMS2 (28% versus 45%), CMS3 (10% versus 12%), CMS4 (35% versus 32%). Independent of the treatment, CMS was a strong prognostic factor for ORR (P = 0.051), PFS (P < 0.001), and OS (P < 0.001). Within the RAS wild-type population, OS observed in CMS4 significantly favored FOLFIRI cetuximab over FOLFIRI bevacizumab. In CMS3, OS showed a trend in favor of the cetuximab arm, while OS was comparable in CMS1 and CMS2, independent of targeted therapy. CONCLUSIONS CMS classification is prognostic for mCRC. Prolonged OS induced by FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab in the FIRE-3 study appears to be driven by CMS3 and CMS4. CMS classification provides deeper insights into the biology to CRC, but at present time has no direct impact on clinical decision-making.The FIRE-3 (AIO KRK-0306) study had been registered at ClinicalTrials.gov: NCT00433927.
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Affiliation(s)
- S Stintzing
- Department of Medicine, Division of Hematology, Oncology, and Tumor Immunology (CCM), Charité Universitaetsmedizin Berlin, Berlin, Germany.
| | - P Wirapati
- SIB Swiss Institute of Bioinformatics, Bioinformatic Core Facility, Lausanne, Switzerland
| | - H-J Lenz
- USC Norris Comprehensive Cancer Center, Los Angeles, USA
| | - D Neureiter
- Institute of Pathology, Paracelsus Medical University/Salzburger Landeskliniken (SALK), Salzburg, Austria
| | | | - T Decker
- Oncological Practice, Ravensburg
| | - A Kiani
- Medizinische Klinik IV, Klinikum Bayreuth, Bayreuth
| | | | - S Al-Batran
- Department of Hematology and Oncology, Krankenhaus Nordwest, Frankfurt/Main
| | - T Heintges
- Department of Medicine II, Städtisches Klinikum Neuss, Neuss
| | | | - C Kahl
- Haematology and Oncology, Staedtisches Klinikum Magdeburg, Magdeburg
| | | | - F Kullmann
- Department of Medicine I, Klinikum Weiden, Weiden
| | - M Moehler
- University Hospital Mainz, Mainz, Germany
| | - W Scheithauer
- Department of Internal Medicine I & Comprehensive Cancer Center, Medical University Vienna, Vienna, Austria
| | - S Held
- ClinAssess GmbH, Leverkusen
| | - D P Modest
- Department of Medicine III, University Hospital, LMU Munich, Munich
| | - A Jung
- Institute of Pathology University of Munich, Munich, Germany
| | - T Kirchner
- Institute of Pathology University of Munich, Munich, Germany
| | - D Aderka
- Department of Gastrointestinal Oncology, Chaim Sheba Medical Center, Ramat Gan, Israel
| | - S Tejpar
- Molecular Digestive Oncology, UZ Leuven, Belgium
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich
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Ortiz-Brüchle N, Muders M, Toma M, Esposito I, Hartmann A, Stöhr R, Reis H, Wild P, Köllermann J, Bremmer F, Leichsenring J, Stenzinger A, Merkelbach-Bruse S, Kirfel S, Perner S, Hartmann N, Roth W, Jung A, Kirchner T, Schwamborn K, Pfarr N, Dahl E, Knüchel R, Gaisa NT. [Status of the availability and use of next generation sequencing (NGS) in bladder cancer-a questionnaire within the uropathology working group]. Urologe A 2019; 59:318-325. [PMID: 31541269 DOI: 10.1007/s00120-019-01046-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Technical advancement and availability of high-throughput analysis has advanced molecular subtyping of most cancers. Thus, new possibilities for precision oncology have emerged. AIM Therefore, we aimed to collect data regarding availability and use of next generation sequencing (NGS) for urothelial cancer within the uropathology working group of the German Society of Pathology. METHODS We collected data by questionnaires and additionally asked for sequencing results of bladder cancers in the participating institutions. RESULTS A total of 13 university-affiliated institutes of pathology took part in the survey. All university institutes offer NGS-based molecular panel diagnostics and provide panels covering between 15 and 170 genes. Altogether, only 20 bladder cancers were sequenced in routine diagnostics and for 10 cancers potential targeted treatment options were available. DISCUSSION So far, despite availability of NGS diagnostics at university institutes of pathology, only few bladder cancer samples have been sequenced. Based on current data from the molecular subtyping of bladder cancers, we recommend a step-by-step protocol with basic immunohistochemistry analysis and subsequent subtype-dependent analyses, e.g., alterations of the fibroblast growth factor receptors (FGFR) or comprehensive gene panel analyses.
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Affiliation(s)
- N Ortiz-Brüchle
- Institut für Pathologie, Uniklinikum, RWTH Aachen, Pauelsstraße 30, 52074, Aachen, Deutschland
| | - M Muders
- Institut für Pathologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - M Toma
- Institut für Pathologie, Universitätsklinikum Bonn, Bonn, Deutschland
| | - I Esposito
- Institut für Pathologie, Universitätsklinikum Düsseldorf, Heinrich-Heine Universität, Düsseldorf, Deutschland
| | - A Hartmann
- Institut für Pathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - R Stöhr
- Institut für Pathologie, Universitätsklinikum Erlangen, Erlangen, Deutschland
| | - H Reis
- Institut für Pathologie, Universitätsklinikum Essen, Essen, Deutschland
| | - P Wild
- Dr. Senckenbergisches Institut für Pathologie, Frankfurt, Deutschland
| | - J Köllermann
- Dr. Senckenbergisches Institut für Pathologie, Frankfurt, Deutschland
| | - F Bremmer
- Institut für Pathologie, Universitätsklinikum Göttingen, Göttingen, Deutschland
| | - J Leichsenring
- Molekularpathologisches Zentrum, Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - A Stenzinger
- Molekularpathologisches Zentrum, Pathologisches Institut, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | | | - S Kirfel
- Institut für Pathologie, Universitätsklinikum Lübeck, Lübeck, Deutschland
| | - S Perner
- Institut für Pathologie, Universitätsklinikum Lübeck, Lübeck, Deutschland
- Pathologie, Forschungszentrum Borstel, Leibniz Lungenzentrum, Borstel, Deutschland
| | - N Hartmann
- Institut für Pathologie, Universitätsklinikum Mainz, Mainz, Deutschland
| | - W Roth
- Institut für Pathologie, Universitätsklinikum Mainz, Mainz, Deutschland
| | - A Jung
- Pathologisches Institut, LMU München, München, Deutschland
| | - T Kirchner
- Pathologisches Institut, LMU München, München, Deutschland
| | - K Schwamborn
- Institut für Pathologie, TU München, München, Deutschland
| | - N Pfarr
- Institut für Pathologie, TU München, München, Deutschland
| | - E Dahl
- Institut für Pathologie, Uniklinikum, RWTH Aachen, Pauelsstraße 30, 52074, Aachen, Deutschland
| | - R Knüchel
- Institut für Pathologie, Uniklinikum, RWTH Aachen, Pauelsstraße 30, 52074, Aachen, Deutschland
| | - N T Gaisa
- Institut für Pathologie, Uniklinikum, RWTH Aachen, Pauelsstraße 30, 52074, Aachen, Deutschland.
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11
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Quevenco FC, Schreiner SJ, Preti MG, van Bergen JMG, Kirchner T, Wyss M, Steininger SC, Gietl A, Leh SE, Buck A, Pruessmann KP, Hock C, Nitsch RM, Henning A, Van De Ville D, Unschuld PG. GABA and glutamate moderate beta-amyloid related functional connectivity in cognitively unimpaired old-aged adults. Neuroimage Clin 2019; 22:101776. [PMID: 30927605 PMCID: PMC6439267 DOI: 10.1016/j.nicl.2019.101776] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/27/2018] [Revised: 02/03/2019] [Accepted: 03/10/2019] [Indexed: 02/08/2023]
Abstract
Background Effects of beta-amyloid accumulation on neuronal function precede the clinical manifestation of Alzheimer's disease (AD) by years and affect distinct cognitive brain networks. As previous studies suggest a link between beta-amyloid and dysregulation of excitatory and inhibitory neurotransmitters, we aimed to investigate the impact of GABA and glutamate on beta-amyloid related functional connectivity. Methods 29 cognitively unimpaired old-aged adults (age = 70.03 ± 5.77 years) were administered 11C-Pittsburgh Compound B (PiB) positron-emission tomography (PET), and MRI at 7 Tesla (7T) including blood oxygen level dependent (BOLD) functional MRI (fMRI) at rest for measuring static and dynamic functional connectivity. An advanced 7T MR spectroscopic imaging (MRSI) sequence based on the free induction decay acquisition localized by outer volume suppression’ (FIDLOVS) technology was used for gray matter specific measures of GABA and glutamate in the posterior cingulate and precuneus (PCP) region. Results GABA and glutamate MR-spectra indicated significantly higher levels in gray matter than in white matter. A global effect of beta-amyloid on functional connectivity in the frontal, occipital and inferior temporal lobes was observable. Interactive effects of beta-amyloid with gray matter GABA displayed positive PCP connectivity to the frontomedial regions, and the interaction of beta-amyloid with gray matter glutamate indicated positive PCP connectivity to frontal and cerebellar regions. Furthermore, decreased whole-brain but increased fronto-occipital and temporo-parietal dynamic connectivity was found, when GABA interacted with regional beta-amyloid deposits in the amygdala, frontal lobe, hippocampus, insula and striatum. Conclusions GABA, and less so glutamate, may moderate beta-amyloid related functional connectivity. Additional research is needed to better characterize their interaction and potential impact on AD. Combined ultra-high fieldstrength FIDLOVS MRSI at 7 Tesla with 11C-PIB PET. Assessment of gray matter specific levels of GABA and glutamate. Identification of interactive effects of GABA, glutamate and beta-Amyloid. GABA may moderate dysfunctional beta-Amyloid effects on pre-clinical brain pathology.
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Affiliation(s)
- F C Quevenco
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - S J Schreiner
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland
| | - M G Preti
- Department of Radiology and Medical Informatics, Université de Genève, Switzerland; Institute of Bioengineering, École polytechnique fédérale de Lausanne, Switzerland
| | - J M G van Bergen
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - T Kirchner
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - M Wyss
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland
| | - S C Steininger
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland
| | - A Gietl
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - S E Leh
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland
| | - A Buck
- Division of Nuclear Medicine, University Hospital Zurich (USZ), Zurich, Switzerland
| | - K P Pruessmann
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
| | - C Hock
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
| | - R M Nitsch
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland
| | - A Henning
- Institute for Biomedical Engineering, University of Zurich and ETH Zurich, Zurich, Switzerland; Max Planck Institute for Biological Cybernetics, Tubingen, Germany
| | - D Van De Ville
- Department of Radiology and Medical Informatics, Université de Genève, Switzerland; Institute of Bioengineering, École polytechnique fédérale de Lausanne, Switzerland
| | - P G Unschuld
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland; Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland; Neuroscience Center Zurich (ZNZ), Zurich, Switzerland.
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12
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Westphalen CB, Preinfalk A, Kruger S, Haas M, Renz BW, Riener MO, Weber A, Kirchner T, Werner J, Heinemann V, von Bergwelt-Baildon M, Baba HA, Siveke JT, Ormanns S, Boeck S. Neurotrophic tropomyosin receptor kinase (NTRK) and nerve growth factor (NGF) are not expressed in Caucasian patients with biliary tract cancers: pooled data from three independent cohorts. Clin Transl Oncol 2019; 21:1108-1111. [DOI: 10.1007/s12094-018-02030-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 12/21/2018] [Indexed: 12/17/2022]
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13
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Kruger S, Heinemann V, Ross C, Diehl F, Nagel D, Ormanns S, Liebmann S, Prinz-Bravin I, Westphalen C, Haas M, Jung A, Kirchner T, von Bergwelt-Baildon M, Boeck S, Holdenrieder S. Repeated mutKRAS ctDNA measurements represent a novel and promising tool for early response prediction and therapy monitoring in advanced pancreatic cancer. Ann Oncol 2018; 29:2348-2355. [DOI: 10.1093/annonc/mdy417] [Citation(s) in RCA: 80] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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14
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Miller-Phillips L, Fischer von Weikersthal L, Kaiser F, Al-Batran SE, Heintges T, Neureiter D, Kahl C, Kullmann F, Moehler M, Scheithauer W, Vazart C, Fontaine K, Held S, Modest D, Neumann J, Jung A, Kirchner T, Heinemann V, Stintzing S. Association of microRNA-21 (miR-21) with efficacy of cetuximab (cet) and bevacizumab (bev) in patients with metastatic colorectal cancer (mCRC) within the FIRE-3 study (AIO KRK-0306). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy269.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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15
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Sams L, Kruger S, Heinemann V, Bararia D, Haebe S, Alig S, Westphalen B, Haas M, Kirchner T, Ormanns S, Endres S, Weigert O, von Bergwelt-Baildon M, Kobold S, Rataj F, Boeck S. Alterations in peripheral T cell subsets, T cell activation markers and immune checkpoint molecules in advanced pancreatic cancer patients receiving FOLFIRINOX or gemcitabine + nab-paclitaxel. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy288.068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Heinzmann D, Mueller K, Klingel K, Kumbrink J, Kirchner T, Gawaz M, Seizer P. 5925Regulation of NADPH oxidases in tachycardia-induced heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Heinzmann
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - K Mueller
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - K Klingel
- Eberhard-Karls University of Tubingen, Cardiopathology, Institute for Pathology and Neuropathology, Tubingen, Germany
| | - J Kumbrink
- Ludwig-Maximilians University, Institute of Pathology, Munich, Germany
| | - T Kirchner
- Ludwig-Maximilians University, Institute of Pathology, Munich, Germany
| | - M Gawaz
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - P Seizer
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
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17
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Modest D, von Weikersthal LF, Decker T, Vehling-Kaiser U, Uhlig J, Schenk M, Freiberg-Richter J, Peuser B, Denzlinger C, Reddemann CPG, Graeven U, Schuch G, Schwaner I, Stahler A, Jung A, Kirchner T, Held S, Stintzing S, Giessen-Jung C, Heinemann V. Age and RAS status to select patients with metastatic colorectal cancer (mCRC) for initial sequential versus combination therapy including fluoropyrimidines (FP), irinotecan (Iri) and bevacizumab (Bev): XELAVIRI- study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy150.019] [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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18
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Sannino G, Aruna M, Zacherl C, Rubio RA, Kiran M, Hardiman G, Kirchner T, Orth M, Ohmura S, Grünewald T. PO-136 SOX2 is a novel biomarker for high-risk ewing sarcoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.177] [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: 11/04/2022] Open
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19
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Magallón-Neri E, Kirchner T, Forns M, Calderón C, Planellas I. Ecological momentary assessment of contextual variables, satisfaction, and emotional and behavioral states of adolescents by level of victimization. Child Abuse Negl 2018; 80:268-276. [PMID: 29654987 DOI: 10.1016/j.chiabu.2018.03.030] [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] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/20/2018] [Accepted: 03/27/2018] [Indexed: 06/08/2023]
Abstract
The harmful effects of victimization on mental health have been demonstrated in several age groups, cultures, and populations, but there is wide variability in the resulting psychopathology. Ecological momentary assessment (EMA) allows the expression of an emotional state to be recorded at any given time and linked to a situation or context. This study aimed to analyze the contextual variables (where, with whom, and what), momentary satisfaction, and perception of momentary emotional and behavioral symptoms in a cohort of adolescents by the level of victimization, using EMA. We explored the everyday symptom profiles and the contexts in which events took place among 100 adolescents over a one-week period. Sociodemographic data were collected and assessment was done using the EMA (as a smartphone application) and the Juvenile Victimization Questionnaire (to assess childhood and adolescent victimization). In this study, regarding contextual variables, the group with the highest level of victimization (top 10%) showed a significant relationship with being away from home and being with friends other than classmates, and not being with parents or relatives. There was also an unexpectedly higher frequency of sporting engagement in this group. A relationship existed between emotional and behavioral problems and higher levels of victimization. In conclusion, the different groups of victimized subjects present a relatively high level of satisfaction in relation to the daily contexts and show low levels of emotional and behavioral symptomatology.
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Affiliation(s)
- E Magallón-Neri
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain; Research Group: GEIMAC (2014SGR1139 - 2017SGR1681), Spain; Institute of Neurosciences: IR3C, Faculty of Psychology, Spain.
| | - T Kirchner
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain; Research Group: GEIMAC (2014SGR1139 - 2017SGR1681), Spain; Institute of Neurosciences: IR3C, Faculty of Psychology, Spain
| | - M Forns
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain; Research Group: GEIMAC (2014SGR1139 - 2017SGR1681), Spain; Institute of Neurosciences: IR3C, Faculty of Psychology, Spain
| | - C Calderón
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain; Research Group: GEIMAC (2014SGR1139 - 2017SGR1681), Spain
| | - I Planellas
- Department of Clinical Psychology and Psychobiology, Faculty of Psychology, University of Barcelona, Spain
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20
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Marchetto A, Ohmura S, Orth M, Li J, Gerke J, Wehweck F, Aranaz FC, Kirchner T, Sannino G, Grünewald T. PO-047 SOX6 is a direct EWSR1-FLI1 target gene contributing to tumour growth of ewing sarcoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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21
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Hirsch B, Endris V, Lassmann S, Weichert W, Pfarr N, Schirmacher P, Kovaleva V, Werner M, Bonzheim I, Fend F, Sperveslage J, Kaulich K, Zacher A, Reifenberger G, Köhrer K, Stepanow S, Lerke S, Mayr T, Aust DE, Baretton G, Weidner S, Jung A, Kirchner T, Hansmann ML, Burbat L, von der Wall E, Dietel M, Hummel M. Multicenter validation of cancer gene panel-based next-generation sequencing for translational research and molecular diagnostics. Virchows Arch 2018; 472:557-565. [PMID: 29374318 PMCID: PMC5924673 DOI: 10.1007/s00428-017-2288-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 12/05/2017] [Accepted: 12/19/2017] [Indexed: 12/12/2022]
Abstract
The simultaneous detection of multiple somatic mutations in the context of molecular diagnostics of cancer is frequently performed by means of amplicon-based targeted next-generation sequencing (NGS). However, only few studies are available comparing multicenter testing of different NGS platforms and gene panels. Therefore, seven partner sites of the German Cancer Consortium (DKTK) performed a multicenter interlaboratory trial for targeted NGS using the same formalin-fixed, paraffin-embedded (FFPE) specimen of molecularly pre-characterized tumors (n = 15; each n = 5 cases of Breast, Lung, and Colon carcinoma) and a colorectal cancer cell line DNA dilution series. Detailed information regarding pre-characterized mutations was not disclosed to the partners. Commercially available and custom-designed cancer gene panels were used for library preparation and subsequent sequencing on several devices of two NGS different platforms. For every case, centrally extracted DNA and FFPE tissue sections for local processing were delivered to each partner site to be sequenced with the commercial gene panel and local bioinformatics. For cancer-specific panel-based sequencing, only centrally extracted DNA was analyzed at seven sequencing sites. Subsequently, local data were compiled and bioinformatics was performed centrally. We were able to demonstrate that all pre-characterized mutations were re-identified correctly, irrespective of NGS platform or gene panel used. However, locally processed FFPE tissue sections disclosed that the DNA extraction method can affect the detection of mutations with a trend in favor of magnetic bead-based DNA extraction methods. In conclusion, targeted NGS is a very robust method for simultaneous detection of various mutations in FFPE tissue specimens if certain pre-analytical conditions are carefully considered.
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Affiliation(s)
- B Hirsch
- Campus Mitte, Institute of Pathology, Charité-University Medicine Berlin, Virchowweg 15, 10117, Berlin, Germany. .,German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.
| | - V Endris
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Medicine Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - S Lassmann
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacherstraße 115A, 79106, Freiburg, Germany
| | - W Weichert
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - N Pfarr
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, Technical University Munich (TUM), Munich, Germany
| | - P Schirmacher
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Medicine Heidelberg, Im Neuenheimer Feld 224, 69120, Heidelberg, Germany
| | - V Kovaleva
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacherstraße 115A, 79106, Freiburg, Germany
| | - M Werner
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute for Surgical Pathology, Medical Center, Faculty of Medicine, University of Freiburg, Breisacherstraße 115A, 79106, Freiburg, Germany
| | - I Bonzheim
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology and Neuropathology, University Hospital Tuebingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076, Tuebingen, Germany
| | - F Fend
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology and Neuropathology, University Hospital Tuebingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076, Tuebingen, Germany
| | - J Sperveslage
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology and Neuropathology, University Hospital Tuebingen, Eberhard-Karls-University, Liebermeisterstraße 8, 72076, Tuebingen, Germany
| | - K Kaulich
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Department of Neuropathology, Heinrich Heine University Duesseldorf and Biological and Medical Research Center (BMFZ), Genomics and Transcriptomics Laboratory, Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany
| | - A Zacher
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Department of Neuropathology, Heinrich Heine University Duesseldorf and Biological and Medical Research Center (BMFZ), Genomics and Transcriptomics Laboratory, Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany
| | - G Reifenberger
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Department of Neuropathology, Heinrich Heine University Duesseldorf and Biological and Medical Research Center (BMFZ), Genomics and Transcriptomics Laboratory, Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany
| | - K Köhrer
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Department of Neuropathology, Heinrich Heine University Duesseldorf and Biological and Medical Research Center (BMFZ), Genomics and Transcriptomics Laboratory, Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany
| | - S Stepanow
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Department of Neuropathology, Heinrich Heine University Duesseldorf and Biological and Medical Research Center (BMFZ), Genomics and Transcriptomics Laboratory, Heinrich Heine University Duesseldorf, 40225, Duesseldorf, Germany
| | - S Lerke
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - T Mayr
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - D E Aust
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - G Baretton
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, University Hospital Carl Gustav Carus, Fetscherstraße 74, 01307, Dresden, Germany
| | - S Weidner
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians University Munich, Thalkirchner Straße 36, 80337, Munich, Germany
| | - A Jung
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians University Munich, Thalkirchner Straße 36, 80337, Munich, Germany
| | - T Kirchner
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Institute of Pathology, Ludwig-Maximilians University Munich, Thalkirchner Straße 36, 80337, Munich, Germany
| | - M L Hansmann
- German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany.,Dr. Senckenberg Institute of Pathology, University Hospital, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt am Main, Germany
| | - L Burbat
- Campus Mitte, Institute of Pathology, Charité-University Medicine Berlin, Virchowweg 15, 10117, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - E von der Wall
- Campus Mitte, Institute of Pathology, Charité-University Medicine Berlin, Virchowweg 15, 10117, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - M Dietel
- Campus Mitte, Institute of Pathology, Charité-University Medicine Berlin, Virchowweg 15, 10117, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
| | - M Hummel
- Campus Mitte, Institute of Pathology, Charité-University Medicine Berlin, Virchowweg 15, 10117, Berlin, Germany.,German Cancer Consortium (DKTK) Partner Site, and German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany
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22
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Stintzing S, Price B, Knight L, McCavigan A, Walker S, Harkin P, Kennedy R, Neureiter D, Held S, Jung A, Kirchner T, Heinemann V. Predictive assay for anti-angiogenic agents (AADx) identifies molecular subgroups of RASwt mCRC with differential efficacy of FOLFIRI plus bevacizumab in the FIRE-3 (AIO KRK-0306) trial. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx363.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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23
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Stintzing S, Miller-Phillips L, Modest DP, Fischer von Weikersthal L, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran SE, Heintges T, Kahl C, Seipelt G, Kullmann F, Stauch M, Scheithauer W, Held S, Moehler M, Jagenburg A, Kirchner T, Jung A, Heinemann V. Impact of BRAF and RAS mutations on first-line efficacy of FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab: analysis of the FIRE-3 (AIO KRK-0306) study. Eur J Cancer 2017; 79:50-60. [PMID: 28463756 DOI: 10.1016/j.ejca.2017.03.023] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [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: 02/27/2017] [Revised: 03/18/2017] [Accepted: 03/20/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND RAS and BRAF mutations have been identified as negative prognostic factors in metastatic colorectal cancer. Efficacy of 5-fluorouracil, leucovorin, irinotecan (FOLFIRI) plus bevacizumab in patients with RAS-mutant tumours needs to be further evaluated. Whether to treat patients with BRAF-mutant tumours with either bevacizumab or anti-epidermal growth factor receptor (EGFR) antibodies remains unclear. METHODS Patients treated within the FIRE-3 trial were retrospectively tested for BRAF and RAS mutations using formalin fixated paraffin embedded (FFPE) tumour material applying pyrosequencing for KRAS and NRAS exon 2, 3 and 4 mutations as far as for BRAF mutations. Survival analysis was done using Kaplan-Meier estimation and differences were expressed using the log-rank test. Overall response rate (ORR) was compared using Fisher's exact test. Data from a central independent radiological response evaluation were used to calculate early tumour shrinkage (ETS) and depth of response (DpR). RESULTS Overall, 188 patients with RAS-mutant tumours and 48 with BRAF-mutant tumours were identified. In BRAF-mutant patients, ORR was numerically higher in the cetuximab versus the bevacizumab arm (52% versus 40%), while comparable results were achieved for progression-free survival (PFS; hazard ratio [HR] = 0.84, p = 0.56) and overall survival (OS; HR 0.79, p = 0.45). RAS mutation was associated with a trend towards lower ORR (37% versus 50.5%, p = 0.11) and shorter PFS (7.4 versus 9.7 months; HR 1.25; p = 0.14) in patients receiving FOLFIRI plus cetuximab versus bevacizumab, but OS was comparable (19.1 versus 20.1 months; HR 1.05; p = 0.73), respectively. ETS identified subgroups sensitive to cetuximab-based treatment in both BRAF- (9/17) and RAS-mutant (18/48) patients and was associated with significantly longer OS. DpR was comparable between both treatment arms in RAS- and BRAF-mutant patients, respectively. CONCLUSIONS In BRAF- and RAS-mutant patients, cetuximab- and bevacizumab-based treatment had comparable survival times. ETS represents an early parameter associated with the benefit from anti-EGFR, while this was not the case with vascular endothelial growth factor A blockade.
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Affiliation(s)
- S Stintzing
- Department of Hematology and Oncology, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | - L Miller-Phillips
- Department of Hematology and Oncology, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany
| | - D P Modest
- Department of Hematology and Oncology, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
| | | | - T Decker
- Studienzentrum Onkologie Ravensburg, Elisabethenstraße 19, 88212, Ravensburg, Germany.
| | - A Kiani
- Klinikum Bayreuth GmbH, Preuschwitzer Straße 101, 95445, Bayreuth, Germany.
| | - U Vehling-Kaiser
- Praxis Hämatologie/Onkologie/Palliativmedizin - Tagesklinik, Ländgasse 132-135, 84028, Landshut, Germany.
| | - S-E Al-Batran
- Krankenhaus Nordwest, Medizinische Klinik II/Onkologie, Steinbacher Hohl 2-26, 60488, Frankfurt, Germany.
| | - T Heintges
- Lukaskrankenhaus Neuss, Medizinische Klinik II, Preussenstr. 84, 41464, Neuss, Germany.
| | - C Kahl
- Städtisches Klinikum Magdeburg, Hämatologie/Onkologie, Birkenallee 34, 39130, Magdeburg, Germany.
| | - G Seipelt
- Onkologische Schwerpunktpraxis und Tagesklinik, Kronbergerstraße 38, 65812, Bad Soden, Germany.
| | - F Kullmann
- Klinikum Weiden, Medizinische Klinik I, Söllnerstr. 16, 92637, Weiden, Germany.
| | - M Stauch
- Praxis für Hämatologie und internistische Onkologie, Niederbronner Str. 2, 96317, Kronach, Germany.
| | - W Scheithauer
- Univ.-Klinik für Innere Medizin I, Klin. Abteilung für Onkologie, Währinger Gürtel 18-20, 1090, Wien, Austria.
| | - S Held
- ClinAssess GmbH, Birkenbergstraße 82, 51379 Leverkusen, Germany.
| | - M Moehler
- Johannes-Gutenberg Universität Mainz, 1. Medizinische Klinik und Poliklinik, 55101, Mainz, Germany.
| | - A Jagenburg
- Radiology Consulting GmbH, Burscheider Str. 398A, 51381, Leverkusen, Germany.
| | - T Kirchner
- Institute of Pathology, University of Munich, Thalkirchner Str. 37, 82036, Munich, Germany.
| | - A Jung
- Institute of Pathology, University of Munich, Thalkirchner Str. 37, 82036, Munich, Germany.
| | - V Heinemann
- Department of Hematology and Oncology, University of Munich, Marchioninistrasse 15, 81377, Munich, Germany.
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Röcken C, Baretton GB, Kreipe HH, Kirchner T. [University Pathology in Germany]. Pathologe 2017; 38:324-330. [PMID: 28432389 DOI: 10.1007/s00292-017-0285-x] [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] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- C Röcken
- Institut für Pathologie, Christian-Albrechts-Universität, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
| | - G B Baretton
- Institut für Pathologie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Deutschland
| | - H H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - T Kirchner
- Pathologisches Institut, Ludwig-Maximilians-Universität, München, Deutschland
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Magallón-Neri E, Vanneste-Morales S, Forns M, Kirchner T. Coping Victimization among Peers in Spain. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BackgroundBullying at school and victimization problems in adolescence have a negative impact in personal identity development specifically in mental health field.ObjectiveTo analyze coping profiles used in a communitarian adolescents sample in relation to victimization among peers and controlling the other victimization subtypes.MethodFrom Barcelona Metropolitan area, 1031 adolescents between 12 and 20 years old participated (37.5% boys; 15.7% foreigners). The different coping strategies were assessed with adolescent coping orientation for problem experiences test and the victimization types with juvenile victimization questionnaire.ResultsA 46.2% of adolescents suffered a victimization event by peers in the last year. As victimization level by peers advance, it presents an increase of unproductive coping strategies (P < .001; d-Cohen = 0.92). Regularly women score higher than men in low and moderate victimization groups (P < .05). However, when it reaches the highest expression (higher risk profile), unproductive strategies use in both genders is very similar and significant differences disappear. The results show that avoidant coping type is associated with a higher rate of victimization by peers. Positive relationship between previous victimization in other areas and peer victimization rate was found.ConclusionsIt is of high importance to develop and strengthen coping psychoeducation programs centered in solving this problem and struggling against victimization consequences by peers in adolescence. Due to that, increase of this victimization type is very related to the use of unproductive strategies use and therefore a coping by avoiding the problem.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Knösel T, Reiter C, Schubert-Fritschle G, Altendorf-Hofmann A, Kirchner T. [Neuroendocrine neoplasia of the stomach : What is new?]. Pathologe 2017; 38:98-104. [PMID: 28188377 DOI: 10.1007/s00292-017-0269-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
INTRODUCTION Neuroendocrine Neoplasms are classified according to the new WHO classification in (1.) well differentiated neuroendocrine tumors G1 (NET G1, Ki67 ≤ 2 or mitosis count <2) and (2.) well differentiated neuroendocrine tumors G2 (NET G2, Ki67 3-20 or mitosis count 2-20) and (3.) poorly differentiated neuroendocrine carcinomas G3 (NEC G3, Ki67 > 20 or mitosis count >20). MATERIAL AND METHODS In this study 310 NENs of the Ludwig-Maximilians-University in Munich were reevaluated according to the new WHO classification. RESULTS 7% of the analyzed NENs were presented as neoplasias of the stomach. In NENs of the stomach three distinct subtypes are recognized: (1) type 1 associated with autoimmune chronic atrophic gastritis (2) type 2, associated with multiple endocrine neoplasia (MEN1) and Zollinger-Ellison Syndrom; and (3) type 3, sporadic tumors. DISCUSSION Precursor lesions (i. e. hyperplasia of the ECL cells) are found in patients with hypergastrinaemia (type 1 and 2). This article should provide insights into the diagnosis of NENs of the stomach with emphasis on the new international standard.
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Affiliation(s)
- T Knösel
- Pathologisches Institut, Ludwig-Maximilians-Universität (LMU), Thalkirchnerstr. 36, 80337, München, Deutschland.
| | - C Reiter
- Pathologisches Institut, Ludwig-Maximilians-Universität (LMU), Thalkirchnerstr. 36, 80337, München, Deutschland
| | - G Schubert-Fritschle
- Tumorregister München (TRM) des Tumorzentrums München (TZM), Institut für Medizinische Informationsverarbeitung, Biometrie und Epidemiologie (IBE), Ludwig-Maximilians-Universität (LMU), München, Deutschland
| | - A Altendorf-Hofmann
- Abteilung für Allgemein-, Viszeral- und Gefäßchirurgie, Friedrich-Schiller-Universität, Jena, Deutschland
| | - T Kirchner
- Pathologisches Institut, Ludwig-Maximilians-Universität (LMU), Thalkirchnerstr. 36, 80337, München, Deutschland
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Boeck S, Mehraein Y, Ormanns S, Kruger S, Westphalen CB, Haas M, Jung A, Kirchner T, Heinemann V. Mismatch-repair-deficient metastatic pancreatic ductal adenocarcinoma with a germline PALB2 mutation: unusual genetics, unusual clinical course. Ann Oncol 2017; 28:438-439. [PMID: 27803004 DOI: 10.1093/annonc/mdw564] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- S Boeck
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Y Mehraein
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - S Ormanns
- DKTK, German Cancer Consortium, German Cancer Research Center,Heidelberg, Germany
| | - S Kruger
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - C Benedikt Westphalen
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - M Haas
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - A Jung
- DKTK, German Cancer Consortium, German Cancer Research Center,Heidelberg, Germany
| | - T Kirchner
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany,DKTK, German Cancer Consortium, German Cancer Research Center,Heidelberg, Germany
| | - V Heinemann
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.,Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
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Stahler A, Stintzing S, Urbischek M, Modest D, von Weikersthal LF, Kumbrink J, Heinemann V, Kirchner T, Jung A. Targeting FGF2 expression against chemoresistance in colorectal cancer (CRC) cell lines - a potential prognostic biomarker in patients with metastatic colorectal cancer (mCRC) treated with FUFIRI or mIrOx (FIRE1). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lordick F, Al-Batran SE, Hofheinz RD, Lorenzen S, Thuss-Patience P, Baretton GB, Dietel M, Gaiser T, Kirchner T, Kreipe HH, Quaas A, Röcken C, Rüschoff J, Tannapfel A. [HER2 testing in gastric cancer - results of a German expert meeting]. Z Gastroenterol 2016; 54:791-6. [PMID: 27529529 DOI: 10.1055/s-0042-110794] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Valid HER2 testing is essential for optimal therapy of patients with HER2 positive gastric cancer and the correct use of first-line treatment. While each breast cancer is routinely being tested for the HER2 status, HER2 testing in gastric cancer has still not become part of the routine and is often only done upon request by the therapist. An interdisciplinary German expert group took the challenges of HER2 testing in gastric cancer as an opportunity to address essential aspects and questions for the practical use of HER2 testing in this indication from the perspective of pathologists and therapists. The recommendations made in this manuscript reflect the consensus of all participants and correspond to their opinions and long-term experience.
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Affiliation(s)
- F Lordick
- Universitätsklinikum Leipzig, Universitäres Krebszentrum (UCCL), Leipzig, Germany
| | | | | | - S Lorenzen
- III. Medizinischen Klinik des Klinikums rechts der Isar, München, Germany
| | - P Thuss-Patience
- Charité - Universitätsmedizin Berlin, CVK: Campus Virchow-Klinikum Charité Centrum Tumormedizin CC14, Berlin, Germany
| | - G B Baretton
- Institut für Pathologie, Universitätsklinikum Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - M Dietel
- Institut für Pathologie, Charité Universitätsmedizin Berlin Campus Mitte, Berlin, Germany
| | - T Gaiser
- Pathologisches Institut Mannheim, Mannheim, Germany
| | - T Kirchner
- Pathologisches Institut der Ludwig-Maximilians-Universität München, München, Germany
| | - H H Kreipe
- Institut für Pathologie, Medizinische Hochschule Hannover, Hannover, Germany
| | - A Quaas
- Uniklinik Köln, Institut für Pathologie, Köln, Germany
| | - C Röcken
- Institut für Pathologie, Christian-Albrechts-Universität, Kiel, Germany
| | - J Rüschoff
- Institut für Pathologie Nordhessen u. Targos GmbH, Kassel, Germany
| | - A Tannapfel
- Georgius Agricola Stiftung Ruhr, Institut für Pathologie der Ruhr-Universität Bochum am Berufsgenossenschaftlichen Universitätsklinikum, Bergmannsheil, Bochum, Germany
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Baretton G, Dietel M, Gaiser T, Kirchner T, Kreipe HH, Quaas A, Röcken C, Rüschoff J, Tannapfel A, Lordick F, Al-Batran S, Hofheinz R, Lorenzen S, Moehler M, Thuss-Patience P. HER2-Testung beim Magenkarzinom. Pathologe 2016; 37:361-6. [DOI: 10.1007/s00292-016-0179-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Blaj C, Bringmann A, Urbischek M, Krebs S, Blum H, Fröhlich T, Arnold G, Jung A, Kirchner T, Horst D. ADNP is a repressor of WNT signaling in colon cancer that can be therapeutically induced. Eur J Cancer 2016. [DOI: 10.1016/s0959-8049(16)61611-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Modest DP, Ricard I, Heinemann V, Hegewisch-Becker S, Schmiegel W, Porschen R, Stintzing S, Graeven U, Arnold D, von Weikersthal LF, Giessen-Jung C, Stahler A, Schmoll HJ, Jung A, Kirchner T, Tannapfel A, Reinacher-Schick A. Outcome according to KRAS-, NRAS- and BRAF-mutation as well as KRAS mutation variants: pooled analysis of five randomized trials in metastatic colorectal cancer by the AIO colorectal cancer study group. Ann Oncol 2016; 27:1746-53. [PMID: 27358379 PMCID: PMC4999563 DOI: 10.1093/annonc/mdw261] [Citation(s) in RCA: 179] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 06/20/2016] [Indexed: 02/06/2023] Open
Abstract
In this pooled analysis of metastatic colorectal cancer patients, mutations in KRAS, and BRAF were associated with inferior progression-free and overall survival compared with patients with non-mutated tumors. KRAS exon 2 mutation variants were associated with heterogeneous outcome compared with unmutated tumors with KRAS G12C and G13D being associated with rather poor survival. Background To explore the impact of KRAS, NRAS and BRAF mutations as well as KRAS mutation variants in patients with metastatic colorectal cancer (mCRC) receiving first-line therapy. Patients and methods A total of 1239 patients from five randomized trials (FIRE-1, FIRE-3, AIOKRK0207, AIOKRK0604, RO91) were included into the analysis. Outcome was evaluated by the Kaplan–Meier method, log-rank tests and Cox models. Results In 664 tumors, no mutation was detected, 462 tumors were diagnosed with KRAS-, 39 patients with NRAS- and 74 patients with BRAF-mutation. Mutations in KRAS were associated with inferior progression-free survival (PFS) and overall survival (OS) [multivariate hazard ratio (HR) for PFS: 1.20 (1.02–1.42), P = 0.03; multivariate HR for OS: 1.41 (1.17–1.70), P < 0.001]. BRAF mutation was also associated with inferior PFS [multivariate HR: 2.19 (1.59–3.02), P < 0.001] and OS [multivariate HR: 2.99 (2.10–4.25), P < 0.001]. Among specific KRAS mutation variants, the KRAS G12C-variant (n = 28) correlated with inferior OS compared with unmutated tumors [multivariate HR 2.26 (1.25–4.1), P = 0.001]. A similar trend for OS was seen in the KRAS G13D-variant [n = 71, multivariate HR 1.46 (0.96–2.22), P = 0.10]. More frequent KRAS exon 2 variants like G12D [n = 152, multivariate HR 1.17 (0.86–1.6), P = 0.81] and G12V [n = 92, multivariate HR 1.27 (0.87–1.86), P = 0.57] did not have significant impact on OS. Conclusion Mutations in KRAS and BRAF were associated with inferior PFS and OS of mCRC patients compared with patients with non-mutated tumors. KRAS exon 2 mutation variants were associated with heterogeneous outcome compared with unmutated tumors with KRAS G12C and G13D (trend) being associated with rather poor survival.
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Affiliation(s)
- D P Modest
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - I Ricard
- Institute of Medical Informatics, Biometry and Epidemiology, University of Munich, Munich
| | - V Heinemann
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | | | - W Schmiegel
- Medizinische Klinik, Knappschaftskrankenhaus Ruhr-Universität Bochum, Bochum
| | - R Porschen
- Klinik für Innere Medizin, Klinikum Bremen-Ost, Bremen
| | - S Stintzing
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - U Graeven
- Kliniken Maria Hilf GmbH, Department of Hematology, Oncology and Gastroenterology, Mönchengladbach, Germany
| | - D Arnold
- Instituto CUF de Oncologia, Lisboa, Portugal
| | | | - C Giessen-Jung
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich
| | - A Stahler
- Department of Medical Oncology and Comprehensive Cancer Center, University Hospital Grosshadern, Ludwig-Maximilians-Universität, Munich Institute of Pathology University of Munich, Munich
| | - H J Schmoll
- Department of Hematology/Oncology, University Hospital Halle, Halle (Saale)
| | - A Jung
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg Institute of Pathology University of Munich, Munich
| | - T Kirchner
- German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg Institute of Pathology University of Munich, Munich
| | - A Tannapfel
- Institute for Pathology, Ruhr-University Bochum, Bochum
| | - A Reinacher-Schick
- Department of Hematology, Oncology and Palliative Care, St Josef-Hospital, Ruhr University Bochum, Bochum, Germany
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Stintzing S, Fischer von Weikersthal L, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran SE, Heintges T, Lerchenmüller C, Kahl C, Seipelt G, Kullmann F, Stauch M, Hielscher J, Lerch M, Scheithauer W, Jagenburg A, Held S, Modest D, Jung A, Kirchner T, Heinemann V. PD-027 BRAF mutant and RAS mutant patients treated with FOLFIRI plus Bevacizumab or FOLFIRI plus Cetuximab. Role of ETS and molecular markers in FIRE-3 (AIO KRK-0306). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw200.27] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Michl M, Stintzing S, Fischer von Weikersthal L, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran SE, Heintges T, Lerchenmueller C, Kahl C, Seipelt G, Kullmann F, Stauch M, Scheithauer W, Hielscher J, Scholz M, Mueller S, Lerch MM, Modest DP, Kirchner T, Jung A, Heinemann V. CEA response is associated with tumor response and survival in patients with KRAS exon 2 wild-type and extended RAS wild-type metastatic colorectal cancer receiving first-line FOLFIRI plus cetuximab or bevacizumab (FIRE-3 trial). Ann Oncol 2016; 27:1565-72. [PMID: 27234640 DOI: 10.1093/annonc/mdw222] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/19/2016] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND To examine the relation of carcinoembryonic antigen (CEA) response with tumor response and survival in patients with (K)RAS wild-type metastatic colorectal cancer receiving first-line chemotherapy in the FIRE-3 trial comparing FOLFIRI plus cetuximab versus FOLFIRI plus bevacizumab. PATIENTS AND METHODS CEA response assessed as the percentage of CEA decrease from baseline to nadir was evaluated for its association with tumor response and survival. Receiver operating characteristic analysis revealed an optimal cut-off value of 75% using the maximum of sensitivity and specificity for CEA response to discriminate CEA responders from non-responders. In addition, the time to CEA nadir was calculated. RESULTS Of 592 patients in the intent-to-treat population, 472 were eligible for analysis of CEA (cetuximab arm: 230 and bevacizumab arm: 242). Maximal relative CEA decrease (%) significantly (P = 0.003) differed between the cetuximab arm (median 83.0%; IQR 40.9%-94.7%) and the bevacizumab arm (median 72.3%; IQR 26.3%-91.0%). In a longitudinal analysis, the CEA decrease occurred faster in the cetuximab arm and was greater than in the bevacizumab arm at all evaluated time points until 56 weeks after treatment start. CEA nadir occurred after 3.3 months (cetuximab arm) and 3.5 months (bevacizumab arm), (P = 0.49). In the cetuximab arm, CEA responders showed a significantly longer progression-free survival [11.8 versus 7.4 months; hazard ratio (HR) 1.53; 95% Cl, 1.15-2.04; P = 0.004] and longer overall survival (36.6 versus 21.3 months; HR 1.73; 95% Cl, 1.24-2.43; P = 0.001) than CEA non-responders. Analysis of extended RAS wild-type patients revealed similar results. CONCLUSION In the FIRE-3 trial, CEA decrease was significantly faster and greater in the cetuximab arm than in the bevacizumab arm and correlated with the prolonged survival observed in patients receiving FOLFIRI plus cetuximab. CLINICAL TRIALS NUMBER NCT00433927 (ClinicalTrials.gov); AIO KRK0306 FIRE-3.
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Affiliation(s)
- M Michl
- Department of Hematology and Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University Munich, Munich
| | - S Stintzing
- Department of Hematology and Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University Munich, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | | | - T Decker
- Practice for Hematology and Medical Oncology, Onkonet-Onkologie Ravensburg, Ravensburg
| | - A Kiani
- Department of Hematology and Medical Oncology, Klinik Herzoghöhe, Bayreuth
| | | | - S-E Al-Batran
- Department of Hematology and Medical Oncology, Krankenhaus Nordwest, University Cancer Center Frankfurt, Frankfurt
| | - T Heintges
- Department of Gastroenterology and Oncology, Medical Department II, Lukaskrankenhaus, Städtisches Klinikum Neuss, Neuss
| | | | - C Kahl
- Department of Hematology and Medical Oncology, Klinikum Magdeburg, Magdeburg
| | - G Seipelt
- Practice for Hematology and Medical Oncology, Bad Soden
| | - F Kullmann
- Department of Gastroenterology, Hematology and Medical Oncology, Klinikum Weiden, Weiden
| | - M Stauch
- Practice for Hematology and Medical Oncology, Kronach, Germany
| | - W Scheithauer
- Department of Hematology and Medical Oncology, Medical University of Vienna, Vienna, Austria
| | - J Hielscher
- Department of Surgery, Klinikum Chemnitz, Chemnitz
| | - M Scholz
- Department of Medicine, Klinikum Stuttgart, Stuttgart
| | - S Mueller
- Practice for Hematology and Medical Oncology, Ansbach
| | - M M Lerch
- Department of Medicine A, University Medicine Greifswald, Greifswald
| | - D P Modest
- Department of Hematology and Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University Munich, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - T Kirchner
- Department of Pathology, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - A Jung
- Department of Pathology, Klinikum Grosshadern, Ludwig-Maximilians-University Munich, Munich, Germany German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
| | - V Heinemann
- Department of Hematology and Medical Oncology, Klinikum Grosshadern and Comprehensive Cancer Center Munich, Ludwig-Maximilians-University Munich, Munich German Cancer Consortium (DKTK), German Cancer Research Centre (DKFZ), Heidelberg
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Abstract
In recent years, several predictive and prognostic biomarkers have been established in colorectal cancer (CRC). The RAS-mutation status is widely applied in the daily routine diagnostic as predictive biomarker for treatment with EGFR-inhibitors. A BRAF- mutation has no predictive value in this context. The detection of high-grade microsatellite instability (MSI-H) is a predictive biomarker for response to 5-Fluoruracil-monotherapy. Prognostic biomarkers in CRC are the MSI-status and the mutational status of BRAF. According to the current WHO classification poorly and undifferentiated CRC and MSI-associated special morphological subtypes are molecular graded depending on their MSI-status. The detection of a BRAF-mutation in the context of microsatellite stability (MSS) is associated with a very poor prognosis and thus represents the most aggressive molecular subtype of CRC. In patients with positive Bethesda criteria a stepwise immunohistochemical and molecular diagnostic scheme is proposed.
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Affiliation(s)
- J H L Neumann
- Pathologisches Institut, Ludwig-Maximilians-Universität München, Thalkirchner Straße 36, 80337, München, Deutschland,
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Waldburger N, Rupp C, Klinke S, Wieczorek K, Gotthardt D, Kirchner T, Sotlar K, Schirmacher P, Straub BK. Aggressive systemic mastocytosis of the liver with cholangitis. Z Gastroenterol 2015. [DOI: 10.1055/s-0035-1568065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Stahler A, Heinemann V, Giessen-Jung C, Crispin A, Schalhorn A, Stintzing S, Fischer von Weikersthal L, Vehling-Kaiser U, Stauch M, Quietzsch D, Held S, von Einem JC, Holch J, Neumann J, Kirchner T, Jung A, Modest DP. Influence of mRNA expression of epiregulin and amphiregulin on outcome of patients with metastatic colorectal cancer treated with 5-FU/LV plus irinotecan or irinotecan plus oxaliplatin as first-line treatment (FIRE 1-trial). Int J Cancer 2015; 138:739-46. [PMID: 26284333 DOI: 10.1002/ijc.29807] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 07/07/2015] [Accepted: 08/03/2015] [Indexed: 12/22/2022]
Abstract
Our aim was to investigate the impact of EREG and AREG mRNA expression (by RT-qPCR) in patients with metastatic colorectal cancer (mCRC). In addition, epidermal growth factor receptor (EGFR) expression (by immunohistochemistry) as well as RAS-and PIK3CA-mutations (by pyrosequencing) were assessed. Tumors of 208 mCRC patients receiving 5-fluorouracil/leucovorin plus irinotecan (FUFIRI) or irinotecan plus oxaliplatin (mIROX) within the FIRE-1 trial were analyzed for mutations. Molecular characteristics were correlated with response, progression-free survival (PFS), overall survival (OS). mRNA expression was evaluated using ROC-analysis in 192 tumors (AREG high n = 31 vs. low n = 161; EREG high n = 89 vs. low n = 103). High versus low AREG expression was associated with PFS of 10.0 versus 8.0 months (HR = 0.62, 95% CI: 0.402-0.940, p = 0.03) and OS of 24.6 versus 18.7 months (HR = 0.72, 95% CI: 0.476-1.078, p = 0.11). High versus low EREG expression correlated with prolonged PFS (9.4 vs. 6.8 months, HR = 0.62, 95% CI: 0.460-0.846, p = 0.002) and OS (25.8 vs. 15.5 months, HR = 0.48, 95% CI: 0.351-0.657, p < 0.001). The positive prognostic effect of high EREG expression was confirmed in a multivariate analysis and was neither affected by EGFR expression nor by mutations of RAS- and PIK3CA-genes. EREG expression appears as an independent prognostic marker in patients with mCRC receiving first-line irinotecan-based chemotherapy.
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Affiliation(s)
- A Stahler
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany.,Institute of Pathology, University of Munich, Germany
| | - V Heinemann
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - C Giessen-Jung
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany
| | - A Crispin
- Institute of Medical Informatics, Biometry, and Epidemiology, University of Munich, Germany
| | - A Schalhorn
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany
| | - S Stintzing
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | | | | | - M Stauch
- Onkologische Schwerpunktpraxis in Kronach, Ambulantes Zentrum Für Hämatologie Und Onkologie, Kronach, Germany
| | | | - S Held
- ClinAssess GmbH, Leverkusen, Germany
| | - J C von Einem
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany
| | - J Holch
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany
| | - J Neumann
- Institute of Pathology, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - T Kirchner
- Institute of Pathology, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - A Jung
- Institute of Pathology, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - D P Modest
- Department of Medicine III And Comprehensive Cancer Centre, University Hospital Grosshadern, University of Munich, Germany.,DKTK, German Cancer Consortium, German Cancer Research Centre (DKFZ), Heidelberg, Germany
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Ivaništšev V, Kirchner K, Kirchner T, Fedorov MV. Restructuring of the electrical double layer in ionic liquids upon charging. J Phys Condens Matter 2015; 27:102101. [PMID: 25680201 DOI: 10.1088/0953-8984/27/10/102101] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
We have investigated the electrical double layer (EDL) structure at an interface between ionic liquid (IL) and charged surface using molecular dynamics simulations. We show that for three different models of ILs the EDL restructuring, driven by surface charging, can be rationalized by the use of two parameters--renormalized surface charge (κ) and charge excess in the interfacial layers (λ). Analysis of the relationship between the λ and κ parameters provides new insights into mechanisms of over-screening and charge-driven structural transitions in the EDL in ionic liquids. We show that the restructuring of the EDL upon charging in all three studied systems has two characteristic regimes: (1) transition from the bulk-like (κ(Ion) = 0) to the multilayer structure (κ(Ion) ≈ 0.5) through the formation of an ionic bilayer of counter- and co-ions; and (2) transition from the multilayer (κ(Ion) ≈ 0.5) to the crowded (κ(Ion) > 1) structure through the formation of a monolayer of counter-ions at κ(Ion) = 1.
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Affiliation(s)
- V Ivaništšev
- Department of Physics, Scottish Universities Physics Alliance (SUPA), Strathclyde University, John Anderson Building, 107 Rottenrow East, Glasgow G4 0NG, UK. Institute of Chemistry, University of Tartu, Ravila 14A, 50114 Tartu, Estonia
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Segura A, Magallón-Neri E, Soler L, Kirchner T, Forns M. Polyvictimization and Its Effects On Mental Health Problems Among Immigrant and Native Adolescents in Catalonia. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)31956-8] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Magallón-Neri E, Kirchner T, Forns M, Calderón C, Canalda G. Mental Health Problems and Victimization in Adolescents. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30338-2] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Pallauf A, Schopohl J, Makeschin M, Kirchner T, Reincke M. Lethal generalized calcinosis and hypercalcemic crisis in primary hyperparathyroidism. J Clin Endocrinol Metab 2015; 100:17-8. [PMID: 25343236 DOI: 10.1210/jc.2014-2813] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Affiliation(s)
- A Pallauf
- Medizinische Klinik und Poliklinik IV (A.P., J.S., M.R.), Klinikum der Universität München, 80336 München, Germany; and Pathologisches Institut (M.M., T.K.), Ludwig-Maximilians-University München, 80337 München, Germany
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Orbach DN, Packard JM, Kirchner T, Würsig B. Evasive behaviours of female dusky dolphins (Lagenorhynchus obscurus) during exploitative scramble competition. BEHAVIOUR 2015. [DOI: 10.1163/1568539x-00003310] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
When males engage in scramble competition, are females non-evasive recipients of male coercion or evasive? Small groups of male dusky dolphins (Lagenorhynchus obscurus) engage in exploitative (non-interference) scramble competition for access to oestrous females near Kaikoura, New Zealand. We conducted behavioural sequence analyses of videos of 48 mating groups with continuous records and focal individual follows of females. We determined (1) the frequency and type of behaviours (non-evasive vs. evasive), (2) the variation in simple transition probabilities of behaviours leading to a copulatory position associated with female resistance and non-resistance and (3) the variation in female responses to male behaviours throughout focal follows. Females exhibited frequent active evasive manoeuvers following male behaviours. Copulation sequences were highly variable and most complex when terminated by females. Females altered responses to male signals, one aspect of mate choice potentially favouring male endurance.
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Affiliation(s)
- Dara N. Orbach
- Department of Marine Biology, Texas A&M University at Galveston, Galveston, TX 77553, USA
| | - Jane M. Packard
- Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, TX 77843, USA
| | - Theresa Kirchner
- Department of Fisheries and Wildlife, Marine Mammal Institute, Hatfield Marine Science Center, Oregon State University, Newport, OR 97365, USA
| | - Bernd Würsig
- Department of Marine Biology, Texas A&M University at Galveston, Galveston, TX 77553, USA
- Department of Wildlife and Fisheries Sciences, Texas A&M University, College Station, TX 77843, USA
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Modest D, Stintzing S, von Weikersthal LF, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran S, Heintges T, Lerchenmüller C, Kahl C, Seipelt G, Kullmann F, Stauch M, Scheithauer W, Held S, Giessen C, Jung A, Kirchner T, Heinemann V. 2Nd-Line Therapies After 1St-Line Therapy with Folfiri in Combination with Cetuximab or Bevacizumab in Patients with Kras Wild-Type Metastatic Colorectal Cancer (Mcrc)-Analysis of the Aio Krk 0306 (Fire 3)- Trial. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu333.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stintzing S, Modest D, Fischer von Weikersthal L, Decker T, Kiani A, Vehling-Kaiser U, Al-Batran S, Heintges T, Lerchenmueller C, Kahl C, Seipelt G, Kullmann F, Scheithauer W, Held S, Giessen C, Moehler M, Jagenburg A, Jung A, Kirchner T, Heinemann V. Independent Radiological Evaluation of Objective Response, Early Tumor Shrinkage, and Depth of Response in Fire-3 (Aio Krk-0306) in the Final Ras Evaluable Population. Ann Oncol 2014. [DOI: 10.1093/annonc/mdu438.9] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [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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Abstract
In the current German S3 guidelines for colorectal carcinoma (CRC), morphologically based tumor grading is extended by molecular grading for poorly differentiated and undifferentiated carcinomas, as well as for special morphological subtypes. These CRC are classified as low-grade when microsatellite instability (MSI) is found. In routine diagnostics, immunohistochemistry for hMLH1 and hMSH2, capturing MSI-CRC with high sensitivity and specificity, can be used as an inexpensive substitute for molecular MSI-testing. In patients with positive Bethesda criteria, a stepwise immunohistochemical and molecular diagnostic scheme is proposed. The detection of a BRAF mutation in tumors with hMLH1 loss allows distinguishing between sporadic and HNPCC-associated MSI-CRC. For rectal cancer the residual tumor classification (R-status) is completed by the circumferential resection margin classification (CRM).
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Affiliation(s)
- J H L Neumann
- Pathologisches Institut, Ludwig-Maximilians-Universität München, Thalkirchner Str. 36, 80337, München, Deutschland,
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von Einem JC, Heinemann V, von Weikersthal LF, Vehling-Kaiser U, Stauch M, Hass HG, Decker T, Klein S, Held S, Jung A, Kirchner T, Haas M, Holch J, Michl M, Aubele P, Boeck S, Schulz C, Giessen C, Stintzing S, Modest DP. Left-sided primary tumors are associated with favorable prognosis in patients with KRAS codon 12/13 wild-type metastatic colorectal cancer treated with cetuximab plus chemotherapy: an analysis of the AIO KRK-0104 trial. J Cancer Res Clin Oncol 2014; 140:1607-14. [PMID: 24816724 PMCID: PMC4131148 DOI: 10.1007/s00432-014-1678-3] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 03/28/2014] [Indexed: 02/06/2023]
Abstract
Purpose AIO KRK-0104 investigated first-line therapy of metastatic colorectal cancer (mCRC) with cetuximab, capecitabine and irinotecan versus cetuximab, capecitabine and oxaliplatin. This analysis investigated the impact of primary tumor location on outcome of patients. Patients and methods Left-sided primary tumors were defined as tumors from rectum to left flexure, while tumors in the remaining colon were regarded right sided. Overall survival (OS), progression-free survival (PFS) and response rate were correlated with primary tumor location. A Cox regression model was used to evaluate interaction between primary tumor location and KRAS mutation. Results Of 146 patients of the AIO KRK-0104 trial, 100 patients presented left-sided (of those 68 KRAS codon 12/13 wild-type) and 46 patients right-sided primary tumors (of those 27 KRAS codon 12/13 wild-type). Left-sided tumors were associated with significantly longer OS (p = 0.016, HR = 0.63) and PFS (p = 0.02, HR = 0.67) as compared to right-sided tumors. These effects were present in the KRAS codon 12/13 wild-type population (HR OS: 0.42; HR PFS: 0.54), while no impact of primary tumor location was evident in patients with KRAS codon 12/13 mutant tumors (HR OS: 1.3; HR PFS: 1.01). A significant interaction of KRAS status and primary tumor location concerning OS and PFS was observed. Conclusion Our findings suggest that primary tumor location and KRAS codon 12/13 mutational status interact on the outcome of patients with mCRC receiving cetuximab-based first-line therapy. Left-sided primary tumor location might be a predictor of cetuximab efficacy.
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Affiliation(s)
- J C von Einem
- Department of Medicine III, University Hospital Grosshadern, University of Munich, Munich, Germany,
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Kirchner T. Pathophysiology of disseminated thyroid autonomy/toxic multinodular goiter (DISA). Exp Clin Endocrinol Diabetes 2014. [DOI: 10.1055/s-0034-1372171] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Kirchner K, Kirchner T, Ivaništšev V, Fedorov M. Electrical double layer in ionic liquids: Structural transitions from multilayer to monolayer structure at the interface. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2013.05.049] [Citation(s) in RCA: 93] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Denkert C, Loibl S, Kronenwett R, Budczies J, von Törne C, Nekljudova V, Darb-Esfahani S, Solbach C, Sinn B, Petry C, Müller B, Hilfrich J, Altmann G, Staebler A, Roth C, Ataseven B, Kirchner T, Dietel M, Untch M, von Minckwitz G. RNA-based determination of ESR1 and HER2 expression and response to neoadjuvant chemotherapy. Ann Oncol 2013; 24:632-9. [DOI: 10.1093/annonc/mds339] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Braun T, Betz CS, Ledderose GJ, Havel M, Stelter K, Kuhnel T, Strauss G, Waschke J, Kirchner T, Briner HR, Simmen D, Caversaccio M, Wormald PJ, Jones N, Leunig A. Endoscopic sinus surgery training courses: benefit and problems - a multicentre evaluation to systematically improve surgical training. Rhinology 2013; 50:246-54. [PMID: 22888480 DOI: 10.4193/rhino11.266] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of this multicentre study was to systematically analyse the strengths and weaknesses in the surgical training for endoscopic sinus surgery (ESS) and identify measures that may improve training. METHODOLOGY Using a structured questionnaire, 133 participants of ESS courses in seven centres in Germany, Switzerland and Australia were asked about their experiences during their dissection courses and how they perceived their course could be improved. RESULTS Gaining confidence in handling of instruments and endoscopes was only a problem for participants with little experience in ESS. The majority of the participants, independent from their level of training, considered infundibulotomy and anterior ethmoidectomy as the easiest dissection steps, whilst surgery of the frontal sinus posed a considerable challenge for many surgeons even those with a higher level of training. Participants with and without ESS experience thought that emphasis on anatomy was the most important improvement that could be made during their surgical training. Virtually all participants stated that the course improved their anatomical knowledge, their surgical skills and their confidence when performing ESS. CONCLUSIONS ESS dissection courses are considered beneficial by surgical trainees. Participants felt that more emphasis on sinus anatomy in conjunction with private study is essential to maximize their skills in surgical dissection. For beginners with ESS, an infundibulotomy and anterior ethmoidectomy were thought to be the best initial procedures to help develop endoscopic surgical skills.
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Affiliation(s)
- T Braun
- Department of Otorhinolaryngology, Ludwig Maximilian University, Munich, Germany.
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